Restroom Infection Control: Chlorhexidine, the final frontier (50m Lecture)

Session Description/Teaser: Pioneering award-winning (BMJ and HAI Watchdog Awards 2013) work at the Queen Elizabeth Hospital, UK has demonstrated the remarkable residual antimicrobial activity of chlorhexidine on surfaces thereby maintaining their continuous cleanliness over time. The final point of contact of cleansed hands is the pathogen-rich restroom door handle. In this context, we present a new double-blinded-randomized-crossover trial in a school setting demonstrating significant improvements in continuous cleanliness of handles during use using this simple, cheap technique

ABSTRACT: Chlorhexidine (CHG) wipes offer a cheap and effective environmental cleaning solution in specific situations. We made a chance finding during a laboratory study validating iPads for cleaning efficacy and long-term tolerance to cleaning products. We unexpectedly discovered a previously unreported, powerful residual antimicrobial effect demonstrated by CHG, that was not occurring with any other cleaning agents. Once wiped with a standard CHG swab (SaniCloth CHG 2%, PDI, Nice-pak, New York) we were unable to grow bacteria on the iPads for 6 hours despite the repeated application of high colony counts of a wide range of pathogens. Chlorhexidine has a known residual antimicrobial effect on skin, but the discovery of the effect on objects is novel. We hypothesized that this residual effect could be very important on objects that are, of necessity, repeatedly handled prior to use between sterilization episodes or disposal and that if objects could be kept clean during use this could offer a fundamental advantage (for many applications) in addition to current infection control techniques and in tandem with substantial cost savings thereby providing real and widespread patient benefit across the healthcare, social care and wider sanitary environments. We have published successful trials examining objects handled in the hospital environment (Howell et al. Eur J Anaesthesiol. 2013 May;30(5):216-21 and Cummings et al. Anaesthesia. 2013 Aug;68(8):830-4, and 4 in press or preparation). The body of work has attracted two national awards in the UK (BMJ and HAI Watchdog Awards 2013). In addition to presentation and interactive discussion of this body of work and the wider applications, we will present new data at NEHA’s 78th Annual Educational Conference from our double-blinded-randomized-crossover trial in a school setting demonstrating significant improvements in continuous cleanliness of restroom door handles during use using this simple, cheap technique.

Food-Safe Schools: Food Safety Beyond the Cafeteria (50m Learning Lab Tabletop/Group Exercise)

After the highly successful 2013 NEHA AEC Learning Lab "Food-Safe Schools Action Guide: Creating a Culture of Food Safety," attendees expressed interest in helping schools better manage food safety in non-traditional settings such as classrooms, kiosks, field trips, and other locations outside of the cafeteria. Food-Safe Schools: Food Safety Beyond the Cafeteria will do just that. By attending this session, participants will better understand the unique food safety requirements associated with Federally funded school nutrition programs, such as the National School Lunch Program (NSLP); learn about the operational complexities of the NSLP – such as serving food in non-traditional settings – that influence food safety; and explore how to collaborate with their school community to effectively, and practicably, address food safety challenges. Attendees also will familiarize themselves with food safety resources developed specifically for school nutrition programs. As a Learning Lab, this session will be primarily interactive through group exercises and roundtable discussions.

Two Viruses When One Would Do! An overview of a multivirus outbreak at the Cook County Department of Correction is 2012 (50m Lecture)

In March of 2012, inmates at the Cook County Department of Corrections began to show symptoms of Influenza-Like Illness as well as Acute Gastroenteritis. This lecture will cover the development of this outbreak as well as the methods utilized by Correctional Staff and Medical Staff to contain it. The lecture will also cover recommendations for outbreak preparedness that Environmental Health Specialists can take to local correctional institutions.

Using a Rapid Bacteria Screening method to assess Legionella Risk (20m Lecture)

High bacterial loads in water systems increase the risk of the presence of pathogenic bacteria such as Legionella and Pseudomonas. Hospitals, hotels, universities and other facilities with large potable water systems, cooling towers and often decorative water features are particularly vulnerable. Although routine biocide treatment will mitigate most concerns, dead legs, scale buildup and biofilms can hide bacterial amplification. Traditional monitoring methods require sample collection and submission to a laboratory for culture plate analysis which can take up to a week results and can be expensive. Oftentimes, the risk assessment is performed when a suspected outbreak has occurred. In these instances, time is of the essence to find the source and mitigate.

This presentation will present two international case studies, one Danish and one Australian, where use of an enzyme based rapid total bacteria method was used for routine monitoring and where, an outbreak was tracked down and mitigated. In both instances, correlation with Legionella plate counts was used to verify data. A description of the USEPA verified technology and its correlation to HPC will be discussed along with a demonstration showing how data can be collected in as little as 15 minutes.

School Indoor Air Quality Improvement: Lessons from Multnomah County, Oregon (50m Lecture)

Through an EPA grant, Multnomah County Environmental Health implemented an indoor air quality program during the 2013-14 school year. We conducted environmental assessments in 20 schools within 3 school districts. Goals were to create local advocates for effective IAQ management, strengthen health care professionals’ use of environmental asthma management practices, and improve the health of school staff and students through IAQ management plans. This presentation will give suggestions for an IAQ tool kit, demonstrate aspects of a school IAQ inspection, and discuss how to engage schools and school districts to help them take better control of their buildings’ IAQ. 

Managing Food Allergies (80m Lecture)

Exposure to food allergens can result in a severe allergic reaction and even death. At the 2013 NEHA Annual Education Conference (AEC), the USDA Food and Nutrition Service (FNS) held a learning lab to help environmental health professionals better understand food safety issues that are specific to schools. During this session, attendees indicated that they need more information to effectively help schools develop, implement, and evaluate their allergy management plans. Nearly 86 percent of schools, nationwide, have one or more students with food allergies. Schools participating in the National School Lunch Program (NSLP) are required to accommodate students with food allergies by substituting safe meal alternatives. This session will provide environmental health professionals with information they need to help schools, and other retail food establishments, develop and implement allergy management plans. 

 Attendees will understand the current provisions in the FDA Food Code related to allergen management in retail food establishments; learn about the NSLP requirements and available resources that can guide the development and implementation of school food allergy management programs; and discover how industry partners are using best practices in food allergy management and get ideas about how to apply these practices in their jurisdictions. Finally, participants will have an opportunity to ask a panel of experts from the USDA FNS, FDA, NEHA, and industry questions about managing food allergies in foodservice operations.