Conventional cleaning products can contain chemicals associated with respiratory irritation, skin and eye injury, ozone depletion, cancer, and indoor air problems. Based on state occupational injury reporting, janitorial staff have some of the highest on-the-job injury rates. A 2007 study in The Lancet identifies nurses as having the highest rates of work-related asthma of any occupation in the study, and two additional studies in 2007 (Am J Resp Crit Care Med and Occup Environ Med) pointed to the use of cleaning chemicals as a probable trigger for work-related asthma in healthcare. Choosing less toxic cleaning products and using them in combination with effective cleaning practices is a key strategy for reducing worker exposures.
Sustainable cleaning products protect staff, patients and the public from potentially hazardous substances. In addition to reducing the use of more toxic chemicals, sustainable cleaning practices reduce the use of water and virgin paper resources by, for example, using post-consumer recycled content towels and tissue, preferably processed chlorine-free (PCF).
Many environmentally friendly cleaning products are now available and have been tested for performance. Practice Greenhealth recommends using cleaning products that are "certified" as having environmental preferability. This means that a third party has reviewed scientific claims and environmental exposure information and verified that it meets certain criteria for environmental preferability. The two most prominent certification programs for cleaning products are GreenSeal and UL ECOLOGO. GreenGuard also has a certification related to indoor air quality impacts of certain cleaning products. By transitioning to certified green cleaning products, the organization can improve worker safety, improve patient and staff satisfaction, reduce resource use and environmental impact and still achieve an equally high level of cleanliness and disinfection.
Selecting disinfectants and hand sanitizers
Because EPA-registered hospital-use disinfectants are regulated under FIFRA as pesticides, the EPA prohibits labeling of these products under a third-party green certification or labeling systems. This presents a challenge to hospitals that wish to select disinfectants that are effective at killing the required pathogens but who are also interested in identifying a product that has the least exposure impact on worker, patient and environmental health. While Practice Greenhealth does not yet have an easy answer to this challenge, there is room to be hopeful. EPA's Antimicrobial Division is re-examining whether to allow registered disinfectants to be subsequently labeled under a separate green certification label. In the meantime, Practice Greenhealth recommends using an EPA-registered product (think effectiveness first) and then exploring which of those products may present the least exposure risk for cleaning and clinical staff, patients and the environment. Ecologo- based in Canada -does allow green labeling of disinfectants under Standard UL 2794 Disinfectants and Disinfectant Cleaners (formerly CCD 166) and Standard UL 2783 Instant Hand Antiseptics (formerly CCD 170). One could cross-reference the EPA-registered list with those products and see if there is overlap. But again, be sure to utilize only those disinfectants that are EPA-registered in the United States.