Consumer's demand for Disinfectants and Protective Gear from COVID-19 infection in Al-Hofuf, Saudi.

INTRODUCTION: The paper aims to estimate consumers' demand for personal protecting products (PPP) from COVID-19. Thus, the paper collected primary data on consumers' demand for PPP utilizing the timeframe of the COVID-19 pandemic. METHODOLOGY: The paper uses two sample t-test and Anova test to examine mean differences in the quantity consumed of PPP. Also, the paper uses Almost Ideal Demand System (AIDS) to estimate the responsiveness of quantity demanded of PPP for changes in prices and consumers' income. RESULTS: The results show that there is a significant difference in the mean of quantity demanded of facemasks among men and women. Also, the results show that there is a significant difference in the mean of quantity demand for facemasks, gloves, and hand sanitizer based on respondents' level of education. In addition, the paper analyzed the effect of price and income changes on quantity demanded of PPP. The findings indicate that the quantity demanded of facemask and gloves are sensitive to changes in consumers' income. Also, soap, hand sanitizer, and gloves were recognized as complementary products. Furthermore, facemasks were identified as a complementary product with glove use. Lastly, the own-price elasticities of demand revealed that the demand for PPP is price insensitive. CONCLUSIONS: the paper recommends that the consumer protection unit closely monitor the prices of PPP since the sellers have an opportunity to increase those products prices and maximize their revenue by exploiting the COVID-19 pandemic.

Integración de la prevención de riesgos en el proceso de compra de desinfectantes hospitalarios del Instituto Catalán de la Salud entre los años 2008 y 2017 / Integrating risk prevention in the procurement of disinfection products: the evolution of hospital disinfection product composition in the Catalonian health intstitue, 2008-2017

La desinfección de superficies y de material es una tarea imprescindible en los hospitales para evitar la propagación de infecciones asociadas a la estancia hospitalaria de los pacientes. Por eso, en el Instituto Catalán de la Salud (ICS) en el periodo 2008-2017 se han ido sustituyendo los diversos productos desinfectantes que son nocivos para la salud de los trabajadores, como aldehídos y cancerígenos, por otros menos peligrosos, como los productos oxidantes y alcoholes, que dan también un resultado eficiente y seguro en la desinfección del material y de las superficies. Este trabajo recoge esta experiencia como forma de integración de la prevención de riesgos en la empresa

In hospitals, the disinfection of surfaces and medical instruments is essential for preventing the spread of infections associated with hospital admissions. For this reason, between 2008 and now, the Catalonian Institute of Health (ICS, by its Spanish acronym) has been replacing several potentially harmful disinfection products, such as aldehydes and carcinogens, with less hazardous compounds such as oxidizing products and alcohols, that are safe and also efficient for the disinfection of work surfaces and medical instruments. This paper summarizes our experience, as an example of the integration of risk prevention in healthcare institutions

Implementing the Use of Chemical-Free Products in a Perinatal Unit.

OBJECTIVE: To develop a process to identify, adopt, and increase individual awareness of the use of chemical-free products in perinatal hospital units and to develop leadership skills of the fellow/mentor pair through the Sigma Theta Tau International Maternal-Child Health Nurse Leadership Academy (STTI MCHNLA). DESIGN: Pretest/posttest quality improvement project. SETTING: Tertiary care 80-bed perinatal unit. PATIENTS: Mothers and newborns on perinatal unit. INTERVENTIONS/MEASUREMENTS: The chemical hazard ratings of products currently in use and new products were examined and compared. Chemical-free products were selected and introduced to the hospital system, and education programs were provided for staff and patients. We implemented leadership tools taught at the STTI MCHNLA to facilitate project success. Pre- and postproject evaluations were used to determine interest in the use of chemical-free products and satisfaction with use of the new products. Cost savings were measured. RESULTS: Products currently in use contained potentially harmful chemicals. New, chemical-free products were identified and adopted into practice. Participants were interested in using chemical-free products. Once new products were available, 71% of participants were positive about using them. The fellow and mentor experienced valuable leadership growth throughout the project. CONCLUSIONS: The change to chemical-free products has positioned the organization and partner hospitals as community leaders that set a health standard to reduce environmental exposure for patients, families, and staff. The fellow and mentor learned new skills to assist in practice changes in a large organization by using the tools shared in the STTI MCHNLA.

Increase in hospital purchase of hand hygiene products: The importance of focusing on the right product.

Alcohol-based handrub (AHR) consumption is positively correlated with increases in hand hygiene (HH) compliance. In our 2,000-bed hospital in India, multiple awareness drives have been conducted to promote HH. This study aimed to determine the quantitative effect of these campaigns on use of HH products (soap and AHR) in the hospital. Over the last 6 years, bar soap consumption has increased by 389.15%, whereas that of AHR increased by 146.7%. We also evaluated microbial contamination of 99 bar soap and 60 liquid soap samples in our hospital for a year. Of the samples, 61 (61.6%) of the bar soaps and 2 (3.3%) of the liquid soaps were found to be contaminated with various organisms (P < .0002). To conclude, the focus should be to increase the right kind of HH product so that hospitals in developing countries procure liquid soaps instead of bar soaps for handwashing purposes.

Porous ceramic tablet embedded with silver nanopatches for low-cost point-of-use water purification.

This work describes a novel method to embed silver in ceramic porous media in the form of metallic silver nanopatches. This method has been applied to develop a new POU technology, a silver-infused ceramic tablet that provides long-term water disinfection. The tablet is fabricated using clay, water, sawdust, and silver nitrate. When dropped into a household water storage container, the ceramic tablet releases silver ions at a controlled rate that in turn disinfect microbial pathogens. Characterization of the silver-embedded ceramic media was performed using transmission electron microscopy. Spherical-shaped patches of metallic silver were observed at 1­6 nm diameters and confirmed to be silver with energy dispersive spectroscopy. Disinfection experiments in a 10 L water volume demonstrated a 3 log reduction of Escherichia coli within 8 h while silver levels remained below the World Health Organization drinking water standard (0.1 mg/L). Silver release rate varied with clay mineralogy, sawdust particle size, and initial silver mass. Silver release was repeatable for daily 10 L volumes for 154 days. Results suggest the ceramic tablet can be used to treat a range of water volumes. This technology shows great potential to be a low-cost, simple-to-use water treatment method to provide microbiologically safe drinking water at the household level.

Marketing netcoatings for aquaculture.

Unsustainable harvesting of natural fish stocks is driving an ever growing marine aquaculture industry. Part of the aquaculture support industry is net suppliers who provide producers with nets used in confining fish while they are grown to market size. Biofouling must be addressed in marine environments to ensure maximum product growth by maintaining water flow and waste removal through the nets. Biofouling is managed with copper and organic biocide based net coatings. The aquaculture industry provides a case study for business issues related to entry of improved fouling management technology into the marketplace. Several major hurdles hinder entry of improved novel technologies into the market. The first hurdle is due to the structure of business relationships. Net suppliers can actually cut their business profits dramatically by introducing improved technologies. A second major hurdle is financial costs of registration and demonstration of efficacy and quality product with a new technology. Costs of registration are prohibitive if only the net coatings market is involved. Demonstration of quality product requires collaboration and a team approach between formulators, net suppliers and farmers. An alternative solution is a vertically integrated business model in which the support business and product production business are part of the same company.

Understanding the impacts of allocation approaches during process-based life cycle assessment of water treatment chemicals.

Chemicals are an important component of advanced water treatment operations not only in terms of economics but also from an environmental standpoint. Tools such as life cycle assessment (LCA) are useful for estimating the environmental impacts of water treatment operations. At the same time, LCA analysts must manage several fundamental and as yet unresolved methodological challenges, one of which is the question of how best to "allocate" environmental burdens in multifunctional processes. Using water treatment chemicals as a case study example, this article aims to quantify the variability in greenhouse gas emissions estimates stemming from methodological choices made in respect of allocation during LCA. The chemicals investigated and reported here are those most important to coagulation and disinfection processes, and the outcomes are illustrated on the basis of treating 1000 ML of noncoagulated and nondisinfected water. Recent process and economic data for the production of these chemicals is used and methodological alternatives for solving the multifunctionality problem, including system expansion and mass, exergy, and economic allocation, are applied to data from chlor-alkali plants. In addition, Monte Carlo simulation is included to provide a comprehensive picture of the robustness of economic allocation results to changes in the market price of these industrial commodities. For disinfection, results demonstrate that chlorine gas has a lower global warming potential (GWP) than sodium hypochlorite regardless of the technique used to solve allocation issues. For coagulation, when mass or economic allocation is used to solve the multifunctionality problem in the chlor-alkali facility, ferric chloride was found to have a higher GWP than aluminum sulfate and a slightly lower burden where system expansion or exergy allocation are applied instead. Monte Carlo results demonstrate that when economic allocation is used, GWP results were relatively robust and resilient to the changes in commodity prices encountered during the study period, with standard deviations less than 6% for all chlor-alkali-produced chemicals reported here. Overall outcomes from the study demonstrate the potential variability in LCA results according to the allocation approach taken and emphasize the need for a consensus approach to water sector LCAs.

A randomised single-blind comparison of the effectiveness of Tristel Fuse (chlorine dioxide) as an office-based fluid soak, with Cidex OPA (ortho-phthaldehyde) using an automated endoscopic reprocessor (AER) as high-level disinfection for flexible cystoscopes.

OBJECTIVE: To compare the effectiveness, safety and cost of Tristel Fuse (chlorine dioxide) with Cidex OPA (ortho-phthaldehyde; 1,2-benzenedicarboxaldehyde) in an automated endoscopic reprocessor (AER) for high-level disinfection of flexible cystoscopes. PATIENTS AND METHODS: A randomised single-blind study comparing the high-level disinfectants Tristel Fuse as a simple office-based soak and Cidex OPA using an AER was performed. Participants were 'blinded' to the agent used for disinfection of the flexible cystoscopes. All patients had negative mid-stream urine at baseline, (MSU) no symptoms suggestive of urinary tract infection (UTI) on the day of investigation, no recent antibiotic use or current indwelling urinary catheter. Patients who underwent cystoscopic biopsy during the procedure were excluded. A urine analysis was done before and 3-5 days after cystoscopy and multiple equipment cultures were performed. The Urogenital Distress Inventory (UDI-6 + two questions from the 'long-form'), symptom and quality-of-life scores were assessed before and after cystoscopy as were ease-of-use assessments and a full cost analysis. RESULTS: In all, 180 of 465 screened participants were randomised 1:1 and the mean age was 72.1 years, 17% were females and 57% of procedures were performed for bladder tumour surveillance. The urine analysis was positive in 5.4% of patients in each group and 29% (Tristel) vs 20% (Cidex) of patients had urinary leukocyturia (p = ns) after cystoscopy. The turnover (minutes per cycle) was 7.5 (Tristel) vs 26.7 (Cidex). The per-procedure costs were $11.67 (American dollars) for Tristel Fuse and $21.82 for Cidex OPA with fixed costs of $4788 for Tristel Fuse and $60,514 for Cidex OPA. CONCLUSIONS: Tristel Fuse appears to be as effective and more cost-effective than Cidex OPA for high-level disinfection of flexible cystoscopes. This has significant cost implications for the office urologist.

Evaluation of a hydrogen peroxide-based system for high-level disinfection of vaginal ultrasound probes.

OBJECTIVES: Because of the complex process and the risk of errors associated with the glutaraldehyde-based solutions previously used at our institution for disinfection, our department has implemented a new method for high-level disinfection of vaginal ultrasound probes: the hydrogen peroxide-based Trophon system (Nanosonics, Alexandria, New South Wales, Australia). The aim of this study was to compare the time difference, safety, and sonographers' satisfaction between the glutaraldehyde-based Cidex (CIVCO Medical Solutions, Kalona, IA) and the hydrogen peroxide-based Trophon disinfection systems. METHODS: The Institutional Review Board approved a 14-question survey administered to the 13 sonographers in our department. Survey questions addressed a variety of aspects of the disinfection processes with graded responses over a standardized 5-point scale. A process diagram was developed for each disinfection method with segmental timing analysis, and a cost analysis was performed. RESULTS: Nonvariegated analysis of the survey data with the Wilcoxon signed rank test showed a statistical difference in survey responses in favor of the hydrogen peroxide-based system over the glutaraldehyde-based system regarding efficiency (P = .0013), ease of use (P = .0013), ability to maintain work flow (P = .026), safety (P = .0026), fixing problems (P = .0158), time (P = .0011), and overall satisfaction (P = .0018). The glutaraldehyde-based system took 32 minutes versus 14 minutes for the hydrogen peroxide-based system; the hydrogen peroxide-based system saved on average 7.5 hours per week. The cost of the hydrogen peroxide-based system and weekly maintenance pays for itself if 1.5 more ultrasound examinations are performed each week. CONCLUSIONS: The hydrogen peroxide-based disinfection system was proven to be more efficient and viewed to be easier and safer to use than the glutaraldehyde-based system. The adoption of the hydrogen peroxide-based system led to higher satisfaction among sonographers.

Comparative study of disinfectants for use in low-cost gravity driven household water purifiers.

Point-of-use (POU) gravity-driven household water purifiers have been proven to be a simple, low-cost and effective intervention for reducing the impact of waterborne diseases in developing countries. The goal of this study was to compare commonly used water disinfectants for their feasibility of adoption in low-cost POU water purifiers. The potency of each candidate disinfectant was evaluated by conducting a batch disinfection study for estimating the concentration of disinfectant needed to inactivate a given concentration of the bacterial strain Escherichia coli ATCC 11229. Based on the concentration of disinfectant required, the size, weight and cost of a model purifier employing that disinfectant were estimated. Model purifiers based on different disinfectants were compared and disinfectants which resulted in the most safe, compact and inexpensive purifiers were identified. Purifiers based on bromine, tincture iodine, calcium hypochlorite and sodium dichloroisocyanurate were found to be most efficient, cost effective and compact with replacement parts costing US$3.60-6.00 for every 3,000 L of water purified and are thus expected to present the most attractive value proposition to end users.

The green operating room: simple changes to reduce cost and our carbon footprint.

Generating over four billion pounds of waste each year, the healthcare system in the United States is the second largest contributor of trash with one-third produced by operating rooms. Our objective is to assess improvement in waste reduction and recycling after implementation of a Green Operating Room Committee (GORC) at our institution. A surgeon and nurse-initiated GORC was formed with members from corporate leadership, nursing, anesthesia, and OR staff. Initiatives for recycling opportunities, reduction of energy and water use as well as solid waste were implemented and the results were recorded. Since formation of GORC in 2008, our OR has diverted 6.5 tons of medical waste. An effort to recycle all single-use devices was implemented with annual solid waste reduction of approximately 12,860 lbs. Disposable OR foam padding was replaced with reusable gel pads at greater than $50,000 per year savings. Over 500 lbs of previously discarded batteries were salvaged from the OR and donated to charity or redistributed in the hospital ($9,000 annual savings). A "Power Down" initiative to turn off all anesthesia and OR lights and equipment not in use resulted in saving $33,000 and 234.3 metric tons of CO2 emissions reduced per year. Converting from soap to alcohol-based waterless scrub demonstrated a potential saving of 2.7 million liters of water annually. Formation of an OR committee dedicated to ecological initiatives can provide a significant opportunity to improve health care's impact on the environment and save money.

Evaluation of overhead spray-applied sanitizers for the reduction of Salmonella on tomato surfaces.

UNLABELLED: Efficacy of sanitizers in an overhead spray and brush roller system was examined for reducing Salmonella on unwaxed, mature green tomatoes. Surface inoculated tomatoes were treated in the overhead spray system for 5, 15, 30, and 60 s. A sodium hypochlorite (NaOCl) study tested NaOCl (25, 50, and 100 mg/L) against a water control. A sanitizer study examined NaOCl (100 mg/L), chlorine dioxide (ClO2; 5 mg/L), peroxyacetic acid (PAA; 80 mg/L), and water. The overhead spray system was also compared to a scale-model flume. All NaOCl concentrations were significantly more effective at removing Salmonella than water and achieved at least a 3-log10 CFU/mL reduction at different treatment times (P < 0.05). NaOCl (100 mg/L) achieved a 4 ± 1.8 log10 CFU/mL reduction at 15 s. In the sanitizer study, NaOCl, ClO2, and PAA achieved at least a 3-log10 CFU/mL reduction at 15 s and between 3.9 and 5.5 log10 CFU/mL reductions at 30 to 60 s. NaOCl (100 mg/L) in the overhead spray system significantly reduced more Salmonella than in the flume at 15 to 60 s. NaOCl flume treatment only reached a 1.3 ± 1.1 log10 CFU/mL reduction at 15 s. Results of this study demonstrate the ability of sanitizers in the laboratory model overhead spray system to reduce Salmonella on tomato surfaces. An overhead spray system could be implemented instead of flumes to achieve higher pathogen reduction with less water and sanitizer use, thereby lowering packing costs. PRACTICAL APPLICATION: The use of a non-recirculating, overhead spray brush roller system could offer a cost effective and efficacious way of washing tomatoes. The use large communal dump tanks in tomato processing has been suspected as a source of contamination in the tomato processing process. If effective, the brush roller system could augment or possible replace currently used dump tanks.

Certified athletic trainers' knowledge of methicillin-resistant Staphylococcus aureus and common disinfectants.

CONTEXT: Methicillin-resistant Staphylococcus aureus (MRSA) infections are increasingly common in athletic settings. The MRSA knowledge and infection-control practices of certified athletic trainers (ATs) and the cleanliness of the athletic training room are important factors in preventing MRSA infections. OBJECTIVE: To assess knowledge of MRSA and the use of common disinfectants among ATs and to explore their infection-control practices. DESIGN: Cross-sectional study. SETTING: High school and collegiate athletic training rooms. PATIENTS OR OTHER PARTICIPANTS: A total of 163 ATs from National Collegiate Athletic Association Divisions I, II, and III and high schools, representing all 10 National Athletic Trainers' Association districts. MAIN OUTCOME MEASURE(S): Frequencies, analyses of variance, and χ(2) tests were used to assess current practices and opinions and relationships between factors. RESULTS: Methicillin-resistant Staphylococcus aureus was perceived as a national problem by 92% of respondents; 57% perceived MRSA as a problem in their practice setting. Most respondents had treated general infections (88%), staphylococcal infections (75%), and MRSA infections (57%). Male sex was associated with treating all 3 types of infections (χ(2) test, P < .05). Noncurriculum education was associated with a lack of recognition of environmental issues as risk factors and with the use of isopropyl alcohol for disinfection (χ(2) test, P < .05). For example, 10% of respondents did not recognize that contaminated whirlpools can be a source of MRSA infection. Respondents also incorrectly identified effective cleaning solutions. Thirty percent of respondents cleaned their hands frequently or sometimes before treating each athlete and 35% cleaned their hands sometimes, occasionally, or never after seeing each athlete. CONCLUSIONS: The majority of ATs were informed about MRSA and made correct disinfection choices. However, improvements are still needed, and not all ATs were using proper disinfection practices.

A practical guide to alcohol-based hand hygiene infrastructure in a resource-poor pediatric hospital.

BACKGROUND: Resource-poor hospitals have many barriers to proper hand hygiene (HH). Alcohol-based HH can compensate for inadequate infrastructure and supplies. We describe the implementation of alcohol-based HH in five high-risk wards of a pediatric hospital in El Salvador. METHODS: In 5 high-risk wards for nosocomial infections, we evaluated the accessibility, supplies, and cleanliness of the hand-washing sinks at 132 time points. We then installed gel dispensers, identified a local gel supplier, and trained nursing staff to maintain the dispensers. We evaluated user acceptance, costs, and the practice and technique of HH before and after installation. RESULTS: Access and cleanliness were adequate at 18.9% and 11.3% of observation points, and towels and soap were available at 61.3% and 93.18% of points. Placement of 35 gel dispensers increased the ratio of HH stations to beds from 1:6.2 to 1:1.8. Alcohol gel was better tolerated than hand washing among 60 surveyed staff. Installation cost $2558 (US) and the monthly gel supply, $731 (US). HH practice increased from 33.8% to 40.5%; use of correct technique increased from 73.8% to 95.2%. CONCLUSION: Alcohol gel can address some of the barriers to effective HH at resource-poor institutions, and its cost may be offset by reduction of nosocomial infection.

Sporicidal activity of two disinfectants against Clostridium difficile spores.

The sporicidal activity of an odour-free peracetic acid-based disinfectant (Wofasteril) and a widely-used dichloroisocyanurate preparation (Chlor-clean) was assessed against spores of the hyper-virulent strain of Clostridium difficile (ribotype 027), in the presence and absence of organic matter. In environmentally clean conditions, dichloroisocyanurate achieved a >3 log10 reduction in 3 minutes, but a minimum contact time of 9 minutes was required to reduce the viable spore load to below detection levels. Peracetic acid achieved a >3 log10 reduction in 30 minutes and was overall significantly less effective (P<0.05). However, in the presence of organic matter - which reflects the true clinical environment - there was no significant difference between the sporicidal activity of dichloroisocyanurate and peracetic acid over a 60-minute period (P=0.188). Given the greater occupational health hazards generally associated with chlorine-releasing agents, odour-free peracetic acid-based disinfectants may offer a suitable alternative for environmental disinfection.

Cost and financial sustainability of a household-based water treatment and storage intervention in Zambia.

Providing safe water to >1 billion people in need is a major challenge. To address this need, the Safe Water System (SWS) - household water treatment with dilute bleach, safe water storage, and behavior change - has been implemented in >20 countries. To assess the potential sustainability of the SWS, we analyzed costs in Zambia of "Clorin" brand product sold in bottles sufficient for a month of water treatment at a price of $0.09. We analyzed production, marketing, distribution, and overhead costs of Clorin before and after sales reached nationwide scale, and analyzed Clorin sales revenue. The average cost per bottle of Clorin production, marketing and distribution at start-up in 1999 was $1.88 but decreased by 82% to $0.33 in 2003, when >1.7 million bottles were sold. The financial loss per bottle decreased from $1.72 in 1999 to $0.24 in 2003. Net program costs in 2003 were $428,984, or only $0.04 per person-month of protection. A sensitivity analysis showed that if the bottle price increased to $0.18, the project would be self-sustaining at maximum capacity. This analysis demonstrated that efficiencies in the SWS supply chain can be achieved through social marketing. Even with a subsidy, overall program costs per beneficiary are low.

Bringing safe water to remote populations: an evaluation of a portable point-of-use intervention in rural Madagascar.

Rural populations disproportionately lack access to improved water supplies. We evaluated a novel scheme that employed community-based sales agents to disseminate the Safe Water System (SWS)--a household-level water chlorination and safe storage intervention--in rural Madagascar. Respondents from 242 households in 4 villages were interviewed; all used surface water for drinking water. Respondents from 239 households (99%) had heard of Sûr'Eau, the SWS disinfectant; 226 (95%) reported having ever used Sûr'Eau, and 166 (73%) reported current use. Current Sûr'Eau use was confirmed in 54% of households. Community sales agents effectively motivated their neighbors to adopt a new health behavior that prevents diarrhea. Future work should focus on strategies for sustaining SWS use, factors that motivate community-based sales agents to promote SWS, and the feasibility of scaling up this approach.