Adenosine phosphate-based detection of worker exposure to contaminated water during bathroom cleaning.

BACKGROUND: Workers who clean bathrooms at medical facilities may be regularly exposed to contaminated water harboring pathogenic microbes and should wear personal protective equipment (PPE) to prevent such exposure at medical facilities, which has not been quantitatively assessed. This study quantified the exposure risk from contaminated water when cleaning restrooms at medical facilities and clarified the importance of wearing PPE. METHODS: Existing urinals, toilets, and handwashing sinks (16 each) in a hospital environment were coated with a simulated contaminant containing adenosine phosphate and cleaned with a brush or sponge by workers in PPE. Adenosine phosphate on the PPE, shelf near the toilet, and toilet paper cover was tested before and after cleaning to compare exposure status. RESULTS: Adenosine phosphate on the worker's PPE, shelf near the toilet, and toilet paper cover was significantly higher after cleaning the urinal, toilet, and handwashing sink. More adenosine phosphate was disseminated from urinals and toilets when cleaning with a brush compared with a sponge. DISCUSSION: Workers and the surrounding environment are exposed to contaminated water during bathroom cleaning. Wearing PPE while cleaning and wiping down the toilet environment after cleaning deserves further consideration.

Comparison of adenosine triphosphate, microbiological load, and residual protein as indicators for assessing the cleanliness of flexible gastrointestinal endoscopes.

BACKGROUND: This study evaluated 3 potential indicators of gastrointestinal endoscope cleanliness: adenosine triphosphate (ATP), microbiological load, and protein. METHODS: Before and after cleaning, ATP and microbiological load were determined from swabs of exterior surfaces and rinses of interior suction/accessory channels. Similarly, before and after cleaning, residual protein was determined from rinses of interior suction/accessory channels. RESULTS: Before cleaning, ATP values were 10,417 relative light units (RLU) from the exterior endoscope surface and 30,281 RLU from the suction/accessory channel rinsates. After cleaning, these ATP values were decreased to 82 RLUs and 104 RLUs, a statistically significant difference. A similar trend was observed with microbiological load, but the change in residual protein from before cleaning to after cleaning was not significant. ATP values reliably reflected microbiological colony counts. CONCLUSIONS: ATP measurement can provide a reliable, rapid and practical assessment of endoscope cleanliness for routine monitoring in the clinical setting.