DISINFACTS | Issue 1/2022

Surfaces in focus Surface cleaning and disinfection is an indispensable part of infection prevention. Innovations increase effectiveness. DISINFACTS Issue 01/2022

KNOWLEDGE Hand disinfectant or soap 08 Global increase in the rate of healthcare-associated infections 17 FORUM World Hand Hygiene Day on May 5th 06 Briefly informed: Interesting facts from our world 11 Sterillium® permanently named “Brand of the Century” by ZEIT Publishing Group 12 M: IP® Analysis tool 16 On surfaces: More is better Alcohol pre-soaked disinfecting wipes are playing an increasingly important role in healthcare and community facilities. The better saturated the wipes and the greater their surface coverage, the more efficient their use. POSTER Efficacy of disinfectants 09 COMPETENCE Best cleaning performance with confirmed skin and mucous membrane compatibility 04 STUDIES Range of low-alcohol pre-soaked disinfectant wipes 14

3 Editorial Dear readers, Current research results indicate that the omicron variant of SARS-CoV-2 is significantly more stable on surfaces than the original or delta variant. Surface disinfection could thus become more important again in containing the pandemic than it has been in the past two years. But this news also reminds us of a fundamental fact: disinfecting critical and frequently touched surfaces is – regardless of Coronavirus – an elementary and indispensable part of sustainable infection prevention. With the new Bacillol® 30 Sensitive, which has been available as tissues as well as foam since January, and the new flowpack holder flex for use at the point of care, current product innovations from HARTMANN are helping to improve the effectiveness of surface disinfection. We will present both products in detail to you in this issue of DISINFACTS. For its decades of innovation leadership, our Sterillium® brand has now been permanently named “Brand of the Century” by ZEIT Publishing Group. This award spurs us on to continue working on improvements in all areas. This is also demonstrated by our new, modern website: thanks to its intuitive menu navigation and its user-friendly navigation, you can now quickly and efficiently gain an overview of all important topics with just one click. Take a look! Yours, Dr. Heide Niesalla Head of HARTMANN SCIENCE CENTER Dr. Henning Mallwitz Director Research & Development Dr. Heide Niesalla Dr. Henning Mallwitz

COMPETENCE 4 Best cleaning performance with confirmed skin and mucous membrane compatibility The new Bacillol® 30 Sensitive: Triple award-winner Tested wfk quality of the tissues: Best cleaning performance of the tissues compared to the competition*,** In order to prove the cleaning performance of Bacillol® 30 Sensitive, the wfk - Institut für Angewandte Forschung GmbH, Krefeld tested 14 different ready-to-use disinfectant wipes [1]. For this purpose, white, glazed tiles were soiled in a controlled manner and the dirt was then also baked in the drying cabinet. The tiles were cleaned with the help of an automatic multitrack wiper on which the respective wipes were attached. After rinsing and drying, five referees visually assessed the cleaning performance using a 10-point photo scale. The result: Together with Bacillol® 30 Tissues Bacillol® 30 Sensitive Tissues clearly performed best in comparison with the competition *,** [1]. For almost 100 years, the Bacillol® brand has been successfully represented on the market with various products for surface disinfection. At the same time, we at HARTMANN are constantly improving our products to take account of customer wishes and changes in application. For the new Bacillol® 30 Sensitive, which has been available since January as tissues as well as foam, the desire for a particularly skin-friendly, surface-friendly and at the same time more powerful disinfectant was the main focus. The independent awards from the wfk - Institut für Angewandte Forschung GmbH, Krefeld [1], the SGS Institute Fresenius [2] and the European Centre for Allergy Research Foundation ECARF [3,4] as well as the initial feedback from our customers confirm that we have succeeded in implementing these wishes. Cleaning performance of ready-to-use disinfectant wipes. Cleaning result 0 = 0 %, 10 = 100 % (photo scale). Dotted line is the arithmetic mean of the cleaning performance of all wipes We are particularly impressed with the new Bacillol® 30 Sensitive Tissues because they are really gentle on surfaces and do not form streaks. The surface is objectively clean and streak-free. ” ” Birgit Ehrhardt, Facility Management Diakoniewerk Martinsberg e. V., Pausa-Mühltroff * In the removal of a fat-dust soil, test report WL 2566A/21 of 29.04.2021, „Comparative investigation of the cleaning performance of 14 ready-to-use wet disinfectant wipes“, wfk-Institut für Angewandte Forschung GmbH, Krefeld. ** The tested ready-to-use wet disinfection wipes represent more than 90% of the value share (as of Q1, 2021) of the German market in the segment of pre-soaked disinfection wipes. Use surface disinfectants carefully. Always read the label and product information before use. Please amend in accordance with local requirements (e.g. law of advertising, product status, CLP labelling) Bacillol® 30 Tissues Bacillol® 30 Sensitive Tissues Strongest competitor Strongest competitor 7.0 2.7 5.9 6.5 10 8 6 4 2 0 Cleaning performance (photo scale) Mean cleaning performance wfk - Institut für Angewandte Forschung GmbH

5 COMPETENCE Sources: 1. Ophüls A (2021): WL2566A/21. Unpublished study - data at BODE Chemie GmbH. 2. Segger D. (2021): SGS Study No. 204-01-0029. Unpublished study - data at BODE Chemie GmbH. 3. Zuberbier T (2021): ECARF Studie 033-R-21. Unpublished study - data at BODE Chemie GmbH. 4. Zuberbier T (2021): ECARF Studie 021-S-21. Unpublished study - data at BODE Chemie GmbH Dermatological expertise ensures compatibility during application In addition to its cleaning performance, HARTMANN also had its skin compatibility tested by the leading testing and certification company SGS Institut Fresenius. For this purpose, 30 test subjects, half of whom described their skin as sensitive, were given skin patches made of 2 x 2 cm pieces of Bacillol® 30 Sensitive Tissues on their backs for 24 hours in a randomised, blinded study [2]. The study was controlled with distilled water as a negative control and the skin irritant sodium dodecyl sulphate (0.5 % by weight) as a positive control. The skin of the test subjects was examined for erythema and oedema before and 15 minutes, 24 hours and 48 hours after application. The result: Bacillol® 30 Sensitive Tissues showed very good skin compatibility and were non-irritating under occlusive conditions [2]. They howed the same low irritation potential as distilled water [2] and were therefore awarded the SGS seal “dermatologically tested”. ” ” Denis Olah, Area Sales Manager of Leber Hygiene-Service GmbH, Gutach Allergy and asthma friendly: ECARF seal confirms skin and mucous membrane compatibility In addition, skin and mucous membrane tolerance of Bacillol® 30 Sensitive Tissues and Foam were investigated by the ECARF Institute under medical supervision. 21 volunteers with atopic dermatitis took part in the 7-day skin tolerance study [3], and 22 subjects with asthma bronchiale took part in the 15-20 minute exposure test for mucous membrane tolerance [4]. The use of Bacillol® 30 Sensitive Tissues and Foam did not result in any worsening of the skin conditions. Test subjects rated the products as “very good” with regard to “tolerance“ and “itching“ [3]. The mucous membrane tolerance was also successfully proven: Overall, only minor reactions without clinical relevance occurred in the eyes, nose and bronchial tubes [4]. The ECARF seal thus proves that Bacillol® 30 Sensitive is allergy- and alsthma-friendly and that no worsening of the skin condition or development of new allergies are to be expected when used properly. Evaluation of mucosal tolerance in subjects with asthma bronchiale: comparison of the occurence of lacrimation and coughing before and after exposure to Bacillol® 30 Sensitive Foam. The wipes convince us. The simple and safe handling, even without gloves, combined with short exposure times in the relevant spectrum of action, are a real plus in our daily work. ” ” Doreen Teetzen, Nursing Service Manager, Paracelsus Harzklinik, Bad Suderode With the upgrade to the Bacillol® 30 Sensitive series, our customers receive a product that has been optimised in all areas: highest material compatibility, improved residue behaviour and skin compatibility thanks to dermatological expertise. In short: a successful product improvement! Conclusion: Bacillol® 30 Sensitive Tissues and Foam are not only characterised by a particularly good cleaning performance, but are also suitable for allergy sufferers and asthmatics thanks to their skin and mucous membrane compatibility. Coughing Lacrimation low no significant low no Before the exposure Before the exposure After the exposure After the exposure 2 Number of subjects 4 6 8 10 12 14 16 18 20 22

FORUM World Hand Hygiene Day on 5 May Unite for safety: clean your hands! Every year on 5 May – symbolic of the fingers on our hands – the World Health Organisation (WHO) reminds us of the importance of hand hygiene and calls on all people in the health sector to join in. This year, the motto is “Unite for safety: clean your hands”. An appeal to unite and create a culture where hand hygiene and infection prevention are valued! Germs – #UniteForSafety – #TogetherSt rongAgainstGerms Just 200 years ago, even experts believed that diseases were spread by so-called miasmas (harmful vapours from the soil). The findings of hygienists like Robert Koch and Louis Pasteur initially fell on deaf ears and it was not until the end of the 19th century that they made it credible that germs cause diseases [1]. Today we know that bacteria, viruses and other pathogens can harm us and are also spread through the hands. Hand hygiene – #UniteForSafety – #TogetherSt rongAgainstGerms Our hands treat, care for and promote healing – and come into contact with a wide variety of pathogens. That is why hand hygiene is an indispensable part of infection prevention in healthcare facilities – and one of the most impor tant building blocks of all in the fight against germs! H and hygiene includes hand washing and hand disinfection (removing germs) as well as skin care "Pflichttext" Sterillium® according to the German "Heilmittelwerbegesetz" (HWG) - Sterillium®: Active substances: Propan-2-ol, Propan-1-ol, Mecetronium ethylsulfate. Composition: 100 g solution contains: Active substances: Propan-2-ol 45.0 g, Propan-1-ol 30.0 g, Mecetronium ethylsulfate 0.2 g. Excipients: Glycerol 85 %, Tetradecan-1-ol, Fragrance, Patent Blue V (E 131), Purified water. Indications: Hygienic and surgical hand disinfection. Skin disinfection prior to injections and punctures. Microbiological efficacy: Bactericidal, yeasticidal, virucidal and limited virucidal activity PLUS (incl. Adeno-, Noro- and Rotavirus). Contraindications: Not suitable for disinfection of mucous membranes. Do not use in the immediate proximity of the eyes or open wounds. Hypersensitivity (allergy) to any of the ingredients. This medicine contains fragrance with benzyl alcohol, citral, citronellol, coumarin, eugenol, farnesol, geraniol, hydroxycitronellal, limonene and linalool. Undesirable effects: Occasionally, slight dryness or irritation of the skin may occur. In such a case, it is recommended to intensify general skin care. The frequency of allergic reactions is rare. Special warnings and precautions for use: Sterillium should not be used on newborn and premature infants. Do not use electrical equipment until dry. Do not bring into contact with open flames. Also do not use near sources of ignition. Flash point 23 °C, flammable. Fire and explosion hazards are not to be expected if the preparation is used as intended. After spilling the disinfectant, take the following measures: immediately absorb the liquid, dilute with plenty of water, ventilate the room and eliminate sources of ignition. Do not smoke. In case of fire, extinguish with water, extinguishing powder, foam or CO2. Any decanting may only be carried out under aseptic conditions (e.g. use of sterile containers under laminar airflow cabinet). Marketing authorisation holder and manufacturer: BODE Chemie GmbH, Melanchthonstraße 27, 22525 Hamburg. Date of preparation: December 2020 Acc to german Drug Advertising Act 6 World Hand Hygiene Day 5.5.2022

7 FORUM Take 5 Moments for Hand Disinfection to protect patient health • BEFORE patient contact • BEFORE aseptic tasks • AFTER body fluid exposure risk • AFTER patient contact • AFTER contact with the patient surroundings How to disinfect hands For hygienic hand disinfection, apply the product to your dry, cupped hand (approx. 2-3 strokes) and carefully rub in vigorously up to the wrists for the entire application time. Keep hands moist for the entire application time and make sure that your hands are completely wetted. Don't forget your thumbs and fingertips, either. Self-reliant rub-in method – for a better wetting. Why focussing on the point of care? Placing hand-rub dispensers exactly where needed helps improve hand hygiene compliance and can contribute to reduce infections. Cleverly designed patient rooms take this aspect into account. WHO-Guideline und Kampf für eigenverantwortl. Einreibemethode (Kampf G et al. (2008) Influence of rub-in technique on required application time and hand coverage in hygienic hand disinfection. BMC Infect Dis 8: 149.) Unite for safety Clean your hands 5 World Hand Hygiene Day 5.5.2022 1 2 3 4 5 Sources: 1. Rakatansky H. (2020) Miasmas and Other False Beliefs: The Road to Sickness and Death. R I Med J;103: 9–11. http://rimed.org/rimedicaljournal/2020/06/2020-06-09-commentary-rakantansky.pdf 2. https://www.who.int/campaigns/world-hand-hygiene-day/2021/key-facts-and-figures (abgerufen am 01.03.2022) 3. WHO (2009) WHO Guidelines on Hand Hygiene in Health Care. Use disinfectants carefully. Always read the label and product information before use. Please amend in accordance with local requirements (e.g. law of advertising, product status, CLP labelling). Effective infection prevention within a few seconds: washing and disinfecting your hands in everyday life! Reference: Boyce JM, Kelliher S, Vallande N. Skin irritation and dryness associated with two hand-hygiene regimens: soap-and-water hand washing versus hand antisepsis with an alcoholic hand gel. Infect Control Hosp Epidemiol. 2000 Jul;21(7):442-8. doi: 10.1086/501785. Verfügbar unter: https://pubmed.ncbi.nlm.nih.gov/10926393/ • when someone in the family or household has a communicable disease such as common cold: sick persons disinfect hands BEFORE contact with others; healthy persons disinfect hands AFTER contact with sick person • BEFORE caring for a relative or friend with a weakened immune system or chronic wounds (home care, e.g. after early discharge from hospital) • BEFORE contact with a relative or friend who is at risk of infection (e.g. immunocompromised) • when there is a risk of being in contact with pathogens and no clean water to wash hands is available (e.g. when travelling or on the go, at the supermarket, on public transportation) • AFTER touching a (potentially sick) animal or its body fluids Better use a disinfectant: Please note: hand disinfection is more gentle on the skin than frequent hand washing • AFTER using the toilet • BEFORE having meal • BEFORE preparing food (non-commercial) • AFTER preparing food (non-commercial) • AFTER blowing your nose • BEFORE touching the face • when coming in from outside (without increased risk of pathogen contact) • when disinfection would be useful, but no disinfectant is on hand • AFTER touching a pet In general, hand washing is recommended and sufficient in our private lives. Nevertheless, there are situations in which hand disinfection is indicated or may become necessary instead of hand washing. Soap will be sufficient: Hygienic hand disinfection Apply sufficient amount of hand disinfectant to the cupped hand so that all areas of the hands can be wetted thoroughly and completely. Carefully rub in hand disinfectant for 30 seconds – cover all areas of skin. Particular attention has to be paid to fingertips and thumbs: Fingertips and thumbs are of particular importance in clinical practice as they most frequently come into direct contact with patients and potentially contaminated surfaces. Furthermore, fingertips harbour the highest concentrations of bacteria compared to other areas of the hand. High density of microorganisms Reference: Kampf G et al. (2008) BMC Infect Dis, 8: 149. 30 sec 1.5 min 30 sec 30 sec 15 sec 15 sec 30 sec hygienic hand disinfection (EN 1500) surgical hand disinfection (EN 12791) limited spectrum of virucidal activity (EN 14476) Norovirus (EN 14348) bactericidal (EN 13727) yeasticidal (EN 13624) mycobactericidal (EN 14348) Sterillium® Proven efficacy Sterillium® classic pure Proven efficacy 30 sec 1.5 min 30 sec 30 sec 15 sec 15 sec 30 sec hygienic hand disinfection (EN 1500) surgical hand disinfection (EN 12791) limited spectrum of virucidal activity (EN 14476) Norovirus (EN 14476) bactericidal (EN 13727) yeasticidal (EN 13624) mycobactericidal (EN 14348) 30 sec 1.5 min 1 min 15 sec 15 sec 30 sec 15 sec hygienic hand disinfection (EN 1500) surgical hand disinfection (EN 12791) virucidal (EN 14476) Norovirus (EN 14476) bactericidal (EN 13727) fungicdal (EN 13624) mycobactericidal (EN 14348) Sterillium® Gel Proven efficacy Sterillium® med Proven efficacy 30 sec 1.5 min 30 sec 30 sec 15 sec 30 sec 15 sec hygienic hand disinfection (EN 1500) surgical hand disinfection (EN 12791) virucidal (EN 14476) Norovirus (EN 14476) bactericidal (EN 13727) fungicdal (EN 13624) mycobactericidal (EN 14348) Sterillium® Gel pure Proven efficacy 30 sec 1.5 min 1 min 15 sec 15 sec 30 sec 15 sec hygienic hand disinfection (EN 1500) surgical hand disinfection (EN 12791) virucidal (EN 14476) Norovirus (EN 14476) bactericidal (EN 13727) fungicdal (EN 13624) mycobactericidal (EN 14348) Please amend in accordance with local requirements (e.g. law of advertising, product status, CLP labelling). #MissionInfectionPrevention www.hartmann.info The classic of alcohol-based hand disinfection. Particularly skin friendly. • comprehensively efficacy, including limited spectrum of virucidal activity • inactivates Norovirus with the hygienic hand disinfection • increases skin hydration, preserves skin elasticity and the natural smoothness of the skin • with proven skin care complex Highly effective hand disinfection gel with broad spectrum of activity and tried and tested moisturising complex. • comprehensive antimicrobial activity against bacteria, fungi and viruses • including norovirus activity • increases skin hydration with regular use • excellent skin tolerability • excellent immediate effect The colourant- and fragrance-free version of the classic Sterillium®. • comprehensively efficacy, including limited spectrum of virucidal activity • inactivates Norovirus with the hygienic hand disinfection • increases skin hydration, preserves skin elasticity and the natural smoothness of the skin (skin care complex) • also suitable for sensitive skin Fragrance-free highly effective hand disinfection gel with broad spectrum of activity and tried and tested moisturising complex. • comprehensive antimicrobial activity against bacteria, fungi and viruses • including norovirus activity • increases skin hydration with regular use • excellent skin tolerability • excellent immediate effect The hand disinfectant with virucidal efficacy within hygienic hand disinfection. • comprehensively efficacy, including virucidal activity within application time (30 sec) • increases skin hydration, preserves skin elasticity and the natural smoothness of the skin • high skin tolerability • colourant- and fragrance-free • with proven skin care complex Sterillium® Sterillium® classic pure Sterillium® Gel Sterillium® med Sterillium® Gel pure #MissionInfectionPrevention www.hartmann.info Sterillium® Products at a glance: Find always the best choice for your Hand Hygiene with Sterillium® Products! 5 Moments for Hand Hygiene To protect the patient against harmful germs carried on your hands. To protect the patient against harmful germs, including the patient’s own germs, entering his or her body. To protect yourself and the health-care environment from harmful patient germs. To protect yourself and the health-care environment from harmful patient germs. To protect yourself and the health-care environment from harmful patient germs. When? Why? Before patient contact Before an aseptic task After body fluid exposure risk After patient contact After contact with patient surroundings Disinfect your hands before touching a patient when approaching him or her. Disinfect your hands immediately before any aseptic task. Disinfect your hands immediately after an exposure risk to body fluids (and after glove removal). Disinfect your hands after touching a patient and his or her immediate surroundings when leaving. Disinfect your hands after touching any object or furniture in the patient’s immediate surroundings, when leaving – even without touching the patient AFTER contact with patient surroundings AFTER patient contact BEFORE patient contact AFTER body fluid exposure risk BEFORE an aseptic task on the patient Reference: WHO (2009) WHO Guidelines on Hand Hygiene in Health Care. More information and materials on World Hand Hygiene Day 2022 – find them here! https://www.bode-sciencecenter.com/center/handhygiene/hand-hygiene-day/ detail-hand-hygiene-day/ article/5-may-2022-isworld-hand-hygiene-day. html Practical hand hygiene posters on the occasion of World Hand Hygiene Day (maintaining the skin barrier) and indeed gloves (providing additional protection for hands in certain situations). As good hand hygiene saves lives in healthcare, additional efforts to improve it are needed. The “5 Moments” show when clean hands are essential [3]. The COVID-19 pandemic has made clear how important supplementary hand disinfection is in private life as well. Washing lotion and water are often enough, but sometimes hand disinfectant should also be used. The right hand disinfectant – #UniteForSafety – #TogetherSt rongAgainstGerms Not all hand disinfectants are the same ! The pandemic has also taught us how important the right spectrum of activity is. A good hand disinfectant is BOTH reliably effective AND skin-friendly. World Hand Hygiene Day 2022 – #UniteForSafety – #TogetherSt rongAgainstGerms Good hand hygiene with the right products ensures clean hands and cr eates an organisational climate that values safety and infection prevention.This can only be achieved by working together. That is why this year’s World Hand Hygiene Day motto is: “Unite for safety: clean your hands!”. By practising good hand hygiene ourselves, we are also setting an example for others. Join us and share your commitment under #HandHygiene, #UniteForSafety, #TogetherS trongAgainstGerms and #MissionInfectionPrevention! Find the right product in no time and test your knowledge online via quiz! https://www.who.int/ campaigns/worldhandhygiene-day/2022

Hand disinfectant or soap What better prevents transmission in the outpatient setting? Hand hygiene is considered an effective intervention in the fight against the transmission of viruses and bacteria that cause respiratory infections. But what helps better to prevent their spread - hand disinfectants or washing hands with soap and water? An Australian research team recently investigated this question in a systematic review with meta-analysis [1]. For this purpose, they included 18 randomised controlled trials: four of themcompared hand disinfectants and soap directly with each other, and 14 assessed both in comparison to a control group. In addition, a doseresponse analysis was conducted to determine the risk of respiratory infection in relation to the frequency of the intervention [1]. Properly applied, both methods contribute to fewer respiratory illnesses Overall, the research team concluded that hand hygiene has a moderate but important role in reducing respiratory disease transmission. Provided interventions are carried out appropriately, both hand disinfection and hand washing with soap can reduce the risk of transmission. However, some evidence from the studies suggested that hand sanitizers may be more effective in practice [1]. While the use of hand disinfectants according to the “5 moments of hand hygiene” has a firm place in health care anyway [2], hand washing with soap and water is usually sufficient in the private sphere. If available, however, hand disinfectants should be used if communicable diseases are known in the environment. This also applies to possible contact with pathogens, when dealing with immunocompromised people and when there is no possibility to wash hands. Direct comparison of hand disinfectant and soap does not yield a clear result The four head-to-head studies that directly compared hand sanitizers with hand washing differed greatly in design. Two two-arm studies found an advantage of hand sanitizers over water andsoap, amounting to a 12% lower rate of absenteeism and a 13% lower risk of respiratory infection in daycare children, respectively [1]. In contrast, two three-arm studies (one in primary schools, one in companies) found no or no significant difference between disinfectant vs. water plus soap [1]. Differences cannot be explained by frequency of intervention BIn the meta-analysis, three studies found a non-significant result with soap and water compared to the control, while disinfectants significantly reduced respiratory infections by 20% (pooled) compared to the control in six studies [1]. However, no clear relationship between dose and effect could be derived from the 11 studies with sufficient information on the frequency of hand hygiene events [1]. Different efficacies of hand disinfectant or soap and water cannot be explained by this. You too can help prevent infections by practising proper hand hygiene. For more information on when to wash your hands and when to disinfect, visit: https://www.sterillium.info/en/stories-hub/hand-hygieneday-2021 https://www.bode-science-center.com/fileadmin/user_ upload/download-en/2022-WHHD-Washing-vs-DisinfectionEN.pdf Sources: 1. Hoffmann T et al. (2021) Soap versus sanitiser for preventing the transmission of acute respiratory infections in the community: a systematic review with meta-analysis and dose-response analysis. BMJ Open;11: e046175. https://doi.org/10.1136/bmjopen-2020-046175 2. WHO (2009) WHO Guidelines on Hand Hygiene in Health Care. 10 9 8 7 6 5 4 3 2 1 0 Sources considered in the review [1] Number of studies SSoap vs. control Hand disinfectant vs. control Head-to-head comparisons soap vs. hand disinfectant (vs. control) 5 9 4 KNOWLEDGE 8

Enveloped viruses Non-enveloped viruses After disinfection After disinfection Lipid envelope is no longer functional Capsid is no longer functional Fragile outer envelope, easy for the disinfectant to destroy Robust capsule containing genetic information. More difficult for disinfectants to destroy Lipid membrane Capsid Efficacies of disinfectants: Viruses Level 1 easy to inactivate virucidal activity against enveloped viruses All enveloped viruses spectrum of efficacy Examples of enveloped viruses Examples of non-enveloped viruses SARS CoV-2 Influenza viruses Hepatitis B viruses Level 2 a little more difficult to inactivate limited spectrum virucidal activity All enveloped viruses + these 3 non-enveloped viruses spectrum of efficacy Adenoviruses Noroviruses Rotaviruses Level 3 most difficult to inactivate virucidal All enveloped viruses + all non-enveloped viruses spectrum of efficacy Polioviruses human Papillomaviruses Polyomaviruses HSC EN 02.22 3

Testing of efficacy against viruses according to European standard EN 14476 The practical test (in-vitro test). This examines how the disinfectant acts on the test pathogens with the addition of an organic load (e.g. protein, blood). ... 1 ml of the mixture is used for further analysis. In order to be effective within a certain spectrum of activity, the disinfectant must inactivate a certain number of test viruses. Test methods of disinfectants: Viruses Level 1 virucidal activity against enveloped viruses All enveloped viruses spectrum of efficacy Test pathogens: • Vacciniavirus Level 3 virucidal All enveloped + all non-enveloped viruses spectrum of efficacy Test pathogens: • Poliovirus • murine Norovirus • Adenovirus • murine Parvovirus (only for application >40 °C) After a defined time ... There are specific test pathogens for each spectrum of activity. They are mixed together with an organic load (e.g. blood) and the disinfectant used for testing. Level 2 limited spectrum virucidal activity All enveloped + 3 non-enveloped viruses (Adeno-, Rota- and Noroviruses) spectrum of efficacy Test pathogens: • murine Norovirus • Adenovirus 3 HSC EN 02.22

11 In this issue you will find: A double-sided poster on the topic “Efficacies of disinfectants: Viruses”. The poster is the start of a series of posters that will appear in the future with each new issue of DISINFACTS. With the first poster we explain questions about the efficacy of disinfectants against viruses. On one side we explain the differences between enveloped and non-enveloped viruses and also explain what “limited spectrum of virucidal activity” efficacy means. On the back of the poster you will find the corresponding test methods. New poster series Topic: Efficacies of disinfectants https://www.hartmann-science-center.com/-/media/country/ hsc/pdf/en/infographic-efficacies-of-disinfectants-viruses. pdf?sc_lang=en&rev=ed639f27829b490090aad993855ad9c5 &hash=41DB6D9A149741C76F7E381F571F84A8 The next poster then takes a closer look at the effectiveness of disinfectants against bacteria. Measures such as hand and surface hygiene for the basis for avoiding nosocomial infections. HARTMANN is committed to combating nosocomial infections with the HARTMANN SCIENCE CENTER ( HSC) and Mission: Infection Prevention (M: IP®) and is raising awareness of the importance of basic hygiene with the symposium series “Safety first – Rethinking Infection Prevention”, which was launched virtually on 11 November 2021 in German-speaking countries. In the kick- off event “ Basic hygiene in motion – approaches to infection prevention”, Professor Andreas Widmer (Swissnoso National Centre for Infection Prevention & WHO) provided insight into how the binding Swiss minimum standard came about. In addition , Dr Tobias Kramer (Charité Berlin & Aktion Saubere Hände) and Professor Johannes Knobloch (University Medical Centre Hamburg-Eppendorf) explained common mistakes in hand hygiene and the importance of surface hygiene in health care facilities. The great interest shown in the inaugural event encourages us to further expand this offer in the future as an internationally event. Find out more about MISSION: INFECTION PREVENTION at: https://www.hartmann.info/en-corp/mission-infection-prevention Start of the new symposium series met with great interest Read the full review of the symposium at: https://www.bode-sciencecenter.com/center/hygienemeasures/standard-hygiene/ detail-standard-hygiene/article/ new-hartmann-science-centersymposium-series-successfullylaunched-basic-hygiene-in-motion. html New look, same expertise: Our website New dress! HARTMANN SCIENCE CENTER Better, faster, more efficient : Now, the HSC website not only comes with a modern look, thanks to its new, intuitive menu and user-friendly navigation, you can now quickly and efficiently gain an overview of every thing important about hand and surface hygiene, medical devices or specific hygiene measures with just one click . Learn more and visit our new website at: www.hartmann-science-center.com Briefly informed: Interesting facts from our world FORUM

FORUM 12 “The ‘Brands of the Century’ have a unique history and have earned the trust of their customers, in some cases over decades. We are happy to honour these successful brands and tell their stories,” said Kai Wutte, Managing Director of TEMPUS CORPORATE GmbH, a member of the ZEIT Publishing Group, in a press release. The success stories of almost 200 brands and companies can be found in the illustrated book “Deutsche Standards – Marken des Jahrhunderts 2022” (German Standards – Brands of the Century 2022), which ZEIT Publishing Group presented in midFebruary. The title of the article about Sterillium® underlines the importance of our brand family. It simply reads: “Sterillium. The hand disinfectant”. “Ever since Sterillium® was invented more than 55 years ago, it has always been about protecting people’s health. Whether for medical professionals or in private environments. This is our motivation and we are very pleased to be named ‘Brand of the Century’ again,” says Alexander Schwieger, Division Head Disinfection at HARTMANN GROUP. Premier class of German brands – Award in perpetuity The election to the royal class of German brands was made proactively – without a prior application – by an independent jury. It was free for the selected companies. According to the ZEIT Publishing Group, the jury follows binding rules and relies on selected facts that speak for the success of a brand. For example, factors such as the age of the brand, its internationality or its entry into the German language are taken into account. What is new is that the award of a brand as “Brand of the Century” is no longer made anew every year, but is in principle valid in perpetuity. Always innovating since 1965 “We are very pleased with the choice. And it spurs us on to continue driving innovation in the field of infection prevention,” says Hossein Gouhari, Global Senior Product Manager Hands & Skin, HARTMANN’s Division Disinfection. “Because people all over the world appreciate the blue Sterillium® bottle and trust its effectiveness to prevent infections.” Therefore, the Sterillium® Sterillium ® permanently named “Brand of the Century” by Z An ongoing success sto Sterillium®: Anyone who says the name of our blue classic does not necessarily think of one of our products. Whoever says Sterillium® probably thinks of hand disinfectants in general. This is one of the reasons why Sterillium® was once again awarded the title “Brand of the Century” by the ZEIT Publishing Group this year. Since 2002, the award has been given to German brands that stand out in terms of quality and are exemplary for an entire product category. On the occasion of the 20th anniversary, this time the award has been awarded permanently. The “Brands of the Century” have a unique history and have earned the trust of their customers, in some cases over decades.. ” ” Kai Wutte, ZEIT Publishing Group Use disinfectants carefully. Always read the label and product information before use. Please amend in accordance with local requirements (e.g. law of advertising, product status, CLP labelling).

13 FORUM ZEIT Publishing Group ory Protect & Care disinfection gel, which is available in pharmacies, was recently introduced especially for use at home and on the go. The latest product in the Sterillium® brand family underlines the permanent innovative spirit for which the Sterillium® brand name has stood from the very beginning: Sterillium® revolutionised hand hygiene in 1965 and set standards in terms of effectiveness and compatibility. It was the world’s first marketable alcohol-based hand disinfectant that was both highly effective and gentle on the skin. Since then, the Sterillium® brand family has stood for constant innovation and for many “firsts” in the hand disinfectant category: Sterillium® classic pure, for example, was one of the first dye- and fragrance-free hand disinfectants on the market. In 2005, Sterillium® was the first hand disinfectant to be approved for surgical hand disinfection with a reduced contact time of only 1.5 minutes instead of 3 minutes. Worldwide acceptance – partners of the Allianz Arena The broad efficacy as well as the very good skin compatibility of all Sterillium® products also have a significant effect on their acceptance: Sterillium® is now available in more than 50 countries. And even before the Coronavirus pandemic, more than four billion hand disinfections were performed annually with Sterillium® products. However, Sterillium® – and with it the entire topic of hand hygiene – has now also arrived in public life as a result of the Coronavirus pandemic. “Infection prevention is not only a topic for professional users. Our holistic solutions around the Sterillium® brand are intended to offer concrete benefits today and in the future in the healthcare sector, but also in the private sphere,” says Alexander Schwieger. In order to be able to hold events safely, holistic hygiene concepts are now required. As an innovation leader in the field of hand and surface disinfection, HARTMANN has therefore been the official hygiene partner of the Allianz Arena since the start of the current football season. This means that two world-renowned brands are now working hand in hand when it comes to infection prevention: FC Bayern München and Sterillium®. A visible sign of this alliance, which will also stand for the “new normal” after the end of the pandemic: The record champion’s stadium, which seats more than 75,000 people, was completely equipped with Sterillium® and matching disinfectant dispensers. "Pflichttext" Sterillium® according to the German "Heilmittelwerbegesetz" (HWG) - Sterillium®: Active substances: Propan-2-ol, Propan-1-ol, Mecetronium ethylsulfate. Composition: 100 g solution contains: Active substances: Propan-2-ol 45.0 g, Propan-1-ol 30.0 g, Mecetronium ethylsulfate 0.2 g. Excipients: Glycerol 85 %, Tetradecan-1-ol, Fragrance, Patent Blue V (E 131), Purified water. Indications: Hygienic and surgical hand disinfection. Skin disinfection prior to injections and punctures. Microbiological efficacy: Bactericidal, yeasticidal, virucidal and limited virucidal activity PLUS (incl. Adeno-, Noro- and Rotavirus). Contraindications: Not suitable for disinfection of mucous membranes. Do not use in the immediate proximity of the eyes or open wounds. Hypersensitivity (allergy) to any of the ingredients. This medicine contains fragrance with benzyl alcohol, citral, citronellol, coumarin, eugenol, farnesol, geraniol, hydroxycitronellal, limonene and linalool. Undesirable effects: Occasionally, slight dryness or irritation of the skin may occur. In such a case, it is recommended to intensify general skin care. The frequency of allergic reactions is rare. Special warnings and precautions for use: Sterillium should not be used on newborn and premature infants. Do not use electrical equipment until dry. Do not bring into contact with open flames. Also do not use near sources of ignition. Flash point 23 °C, flammable. Fire and explosion hazards are not to be expected if the preparation is used as intended. After spilling the disinfectant, take the following measures: immediately absorb the liquid, dilute with plenty of water, ventilate the room and eliminate sources of ignition. Do not smoke. In case of fire, extinguish with water, extinguishing powder, foam or CO2. Any decanting may only be carried out under aseptic conditions (e.g. use of sterile containers under laminar airflow cabinet). Sterillium® classic pure: Active substances: Propan-2-ol, Propan-1-ol, Mecetronium ethylsulfate Composition: 100 g solution contains: Active substances: Propan-2-ol 45.0 g, Propan-1-ol 30.0 g, Mecetronium ethylsulfate 0.2 g. Excipients: Glycerol 85 %, Tetradecan-1-ol, Purified water. Indications: Hygienic and surgical hand disinfection. Skin disinfection prior to injections and punctures. Microbiological efficacy: Bactericidal, yeasticidal, virucidal and limited virucidal activity PLUS (incl. Adeno-, Noro- and Rotavirus). Contraindications: Not suitable for disinfection of mucous membranes. Do not use in the immediate proximity of the eyes or open wounds. Hypersensitivity (allergy) to any of the active substances or the other ingredients. Undesirable effects: Occasionally, slight dryness or irritation of the skin may occur. In such cases, it is recommended to intensify general skin care. Allergic reactions are rare. Special warnings and precautions for use: Hand disinfection is used to specifically prevent the transmission of infections, e.g. in nursing care. Sterillium classic pure should not be used on newborns and premature infants. Use on infants and young children should only be carried out after medical consultation. Contact of the solution with the eyes must be avoided. If the eyes have come into contact with the solution, they should be rinsed with running water for several minutes with the eyelids open. Transferring from one container to another should be avoided to prevent contamination of the solution. If decanting is unavoidable, it may only be performed under aseptic conditions (e.g. use of sterile containers under laminar airflow cabinet). Do not use electrical equipment until dry. Do not bring into contact with open flames. Also do not use near sources of ignition. Flash point 23 °C, flammable. Fire and explosion hazards are not to be expected if the preparation is used as intended. After spilling the disinfectant, take the following measures: immediately absorb the liquid, dilute with plenty of water, ventilate the room and eliminate sources of ignition. Do not smoke. In case of fire, extinguish with water, extinguishing powder, foam or CO2. Marketing authorisation holder and manufacturer: BODE Chemie GmbH, Melanchthonstraße 27, 22525 Hamburg. Date of preparation: December 2020 For information on risks and side effects, read the package leaflet and ask your doctor or pharmacist. Acc to German Drug Advertising Act

14 STUDIES The "German Institutes of Textile and Fibre Research" put Bacillol® 30 Sensitive and some competitors under the microscope In a practical study, the German Institute for Textile and Fibre Research (DITF) examined four low alcohol pre-soaked wipes - including Bacillol® 30 Sensitive Tissues – in terms of liquid behaviour and area output [3,4]. They were tested under standardised conditions at 23 °C and 50% relative humidity. For the coverage test, several tables were set up next to each other and divided into equalsized sections. After cleaning with isopropanol, the test surfaces were each wiped with a cloth folded once at a constant speed, first in the centre and then in loops starting from the top left [3,4]. Bacillol® 30 Sensitive Tissues achieve the highest coverage per wipe with an average of 1.52 m2 To determine the coverage, the surface was assessed against the light until it was no longer completely wetted. The result: While the weakest competitor product achieved an average of just over Range of low-alcohol ready-to-use disinfection A comparison of Bacillol® 30 Sensitive Tissues with the highest coverage per wipe The cleaning and disinfection of critical and frequently touched surfaces is an essential aspect in the prevention of transmissible infections in healthcare and community environments [1]. The use of low alcohol pre-soaked disinfectant wipes is playing an increasingly important role due to their practical manageability and low workload and is considered one of the most efficient disinfection methods [2]. As the wipes are disposed of after use, the risk of possible cross-contamination associated with reusable wipes is eliminated [2]. Using wipes with a proven high coverage - such as Bacillol® 30 Sensitive Tissues [3] – also minimises waste. 1 m2 and the strongest 1.33 m2 [4], Bacillol® 30 Sensitive Tissues achieved an impressive average of 1.52 m2 [3]. This means that up to 30 m2 more area can be disinfected than with comparable products. A recent study*,** by the wfk - Institut für Angewandte Forschung GmbH, Krefeld [5] showed that its high coverage is not at the expense of the cleaning performance, but – on the contrary that Bacillol® 30 Sensitive Tissues are far ahead here as well [5] (see also p. 4 in this DISINFACTS "The new Bacillol® 30 Sensitive: triple award-winner"). Bacillol® 30 Sensitive TissuesA Competitor 1B Competitor 2B Competitor 3B 1.52 1.33 1.16 1.05 1.5 1.0 0.5 0 Surface coverage in m2 Average surface coverage of Bacillol® 30 Sensitive Tissues [3] in comparison to the competition [4]. A 80 wipes per pack; B 100 wipes per pack. Conclusion: In a practical comparison with lowalcohol disinfectant wipes, Bacillol® 30 Sensitive Tissues achieved the highest range with 1.52 m2. Their use thus enables effective disinfection of surfaces with a long range, which not only takes into account economic aspects, but also resourcesaving ones. Use disinfectants carefully. Always read the label and product information before use. Please amend in accordance with local requirements (e.g. law of advertising, product status, CLP labelling).

15 Sources: 1. Assadian O et al. (2021) Practical recommendations for routine cleaning and disinfection procedures in healthcare institutions: a narrative review. J Hosp Infect;113: 104-114. 2. Song X et al. (2019) Efficacy of disinfectant-impregnated wipes used for surface disinfection in hospitals: a review. Antimicrob Resist Infect Control;8: 139. 3. Schweins M (2021): DITF Bericht Nr. E-0001-TT-21. Unpublished study - data at BODE Chemie GmbH. 4. Schweins M (2020): DITF Bericht Nr. E-0130-TT-20. Unpublished study - data at BODE Chemie GmbH. 5. Ophüls A (2021): WL2566A/21. Unpublished study - data at BODE Chemie GmbH. Acc to German Drug Advertising Act * In the removal of a fat-dust soil, test report WL 2566A/21 of 29.04.2021, „Comparative investigation of the cleaning performance of 14 ready-to-use wet disinfectant wipes“, wfk-Institut für Angewandte Forschung GmbH, Krefeld. ** The tested ready-to-use wet disinfection wipes represent more than 90% of the value share (as of Q1, 2021) of the German market in the segment of pre-soaked disinfection wipes. STUDIES

Mission: Infection Prevention (M: IP®) has two goals for hospitals: to make opportunity costs associated with healthcare-associated infections transparent, and to optimise the opportunities by reviewing and improving hygiene processes and prevention measures to avoid preventable healthcare-associated infections (HAIs). In Europe, over 3.8 million people contract a healthcare-associated infection each year. Numerous advances in infection prevention have been made in recent years. Nevertheless, in a recent HARTMANN survey of medical professionals and managers in the German hospital environment, more than two-thirds of respondents stated that HAIs are significant risk factors for hospitals now and in the future, even threatening their very existence. The recently published 2021 hospital report from the German healthcare insurance company Barmer showed as well that risks of getting an HAI during a hospital stay have worsened during the Covid-19 pandemic. Reasons for this include a different patient mix (higher co-morbidities), longer hospital stay and less compliance in infection prevention measures often linked to higher staff workload. Through efficient and standardised infection prevention measures, facilities can protect patients and manage their operations more successfully. Infections generate costs that are preventable. Infection prevention measures can help avoid such costs. Creating transparency in infection incidence and costs The most important thing is to create transparency for hospital managers and infection prevention and control teams. That’s why HARTMANN has developed a new tool called M: IP® Analysis that allows hospitals to transparently display incidences and costs of healthcare-associated infections at facility level. This gives indications on where processes can be optimised and opportunity costs controlled in a targeted manner. The infection incidence in hospitals can be localised by the application in any depth of detail (for example, on department level) and economic key figures can be displayed. These include the costs incurred by a diagnosed infection and the corresponding optimisation potential. The digitisation of infection prevention offers the advantage of transparent hospital data, and so solutions for hygiene and process optimisation can be derived directly from the respective institution. In this way, HARTMANN supports the hospital staff in improving patient safety and staff health. Patient safety and educating to avoid risk “HARTMANN offers a holistic programme for infection prevention. The objective of Mission: Infection Prevention is two-fold: to educate healthcare professionals and improve the safety of the patients they work with,” explains Thomas Haeni, vice president of the HAI-Program at HARTMANN. “This ranges from individual consultation in clinics and nursing homes – for example, optimising processes and interrupting risk chains – to public education to help make infection prevention comprehensible. Digital data analysis and standardised evaluation forms can be used to identify potential for improvement. Subsequently, a revision of the protocols – SOPs – takes place in cooperation with the medical staff on site. Such SOPs can also be recorded digitally and adapted to the clinic’s individual processes. This simplifies the implementation in practice and thus also the compliance with the processes. Continuous evaluation ensures that the desired results are achieved.” 16 FORUM Data against infections in hospitals M: IP® Analysis tool Healthcare-associated infections are one of the greatest preventable threats to patient safety. In addition to causing suffering, they can do lasting, economic damage to medical facilities. The annual estimated costs in Europe amount to over €7bn. The HARTMANN GROUP has launched a new initiative to improve the position of hospitals in the important fight against healthcare-associated infections.

Proportion of inpatients with healthcare-associated infections from 2017 to 2020 [1]. 17 Healthcare-associated infections increased overall, but not all types For example, the 2021 BARMER Hospital Report, which is based on approx. 8.8 million insured persons‘ data, reports NI rates of 5.5-5.7% for Germany for 2017 to 2019 – in each case based on annual case numbers around 1.3 million. However, despite approx. 15% fewer cases treated, the NI rate in 2020 was above these values at 6.3% overall [1]. Particularly in the first weeks of the pandemic, the increase was quite significant at 6.8% and then levelled off again in the course of the year. Global increase in the rate of healthcare-associated infections A side effect of the COVID-19 pandemic One of the declared main goals of infection prevention is the continuous reduction of healthcare-associated infections (HAI). In the past, this has been largely successful in German hospitals. However, the COVID-19 pandemic put a spanner in the works of this development. According to the Hospital Report of the BARMER, a German health insurance, the HAI rate rose slightly in the first pandemic year 2020 compared to previous years – even though fewer people were treated in hospital overall [1]. Internationally, increased HAI rates were also reported for the early phase of the pandemic [2-4]. 2017 2018 2019 2020 5.6 5.7 5.5 6.3 week 3-12 week 13-23 week 24-41 week 42-50 5.8 6.8 6.5 6.2 2020: KNOWLEDGE

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