Using “health outcomes” as the basis for developing effective and sustainable hygiene interventions – is 2019 the time for a rethink?

This is a guest post by Prof Sally Bloomfield…

For many years, “5 log reduction” (LR) has been the gold standard for disinfectant efficacy despite absence of dose:response data linking it to clinical outcomes.  The family of EN tests now used to support claims for disinfectant products has its origins in the European Suspension Test (5LR, 5 mins, 5 test organisms) where 5 LR was probably chosen because it is the limit of sensitivity in an assay where, traditionally, the initial bioburden is 108 colony forming units.  For soap, detergent or dry wiping procedures, until recently their effectiveness has been assumed – possibly on the basis that they produce visible cleanliness? It is only recently that we have had access to efficacy data based on lab models.  A trial of EN 1699 handwashing test showed a mean 2.76 LR when hands contaminated with E .coli are washed with soap.

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