DISINFACTS 100 Years Hygiene expertise for HARTMANN Anniversary Edition
EDITORIAL 03 100 YEARS BODE CHEMIE The ’brand of the century’ as a benchmark 04 Anniversary event 08 Sterillium®: The „blue classic“ through the ages 14 KNOWLEDGE High-alcohol hand disinfectants 16 Placement of disinfectant dispensers 18 Bacillol® 30 Sensitive Green Tissues: for sustainable surface disinfection 20 How modern disinfectant wipes can help save CO2 emissions 22 Streptococcal infections on the rise in Japan 27 What are the benefits of multimodal interventions for prevention? 28 Fungicidal versus yeasticidal efficacies 29 Draft standard for virucidal testing converted into a valid standard 30 EVENTS Webinar on hand hygiene in the operating room 26 FORUM World Hand Hygiene Day, 5 May 24 Online tool to improve environmental hygiene 30 DESINFACTS magazine and newsletter available as an online package! 32 STUDIES Digital hygiene monitoring 17 Visualisation of skin hydration 23 Content BODE Chemie today: High-Tech production & digital solutions 2
Editorial DISINFACTS 1|2024 Alexander Schwieger BODE Chemie is one hundred years old this year! Our anniversary will therefore take up a large part of this issue of DISINFACTS. But we don‘t just want to look back with you. Our successful past is also an obligation and an incentive for us at BODE to master the current and future challenges in all areas of infection prevention. And we at BODE have played a major role in this progress - not only because we developed Sterillium®, the world‘s first alcohol-based hand disinfectant: Our company founder, Dr Kurt Bode, was a pharmacist, chemist and scientist. The ’Bacillolfabrik Dr. Bode & Co.’ he founded in 1924 focused from the outset on cooperation with researchers and practitioners. This close partnership with scientists and users is still an important part of our company‘s DNA. It is exemplified by our oldest and first product: In 1924, Bacillol® was one of the best disinfectants available. Today, the Bacillol® brand stands for products that set new standards in terms of efficacy, quality, tolerability and sustainability. We reinvented this product category with the launch of Bacillol® Zero Tissues disinfectant wipes last autumn. These wipes represent a new generation of innovative disinfection solutions that are both effective and less harmful to the environment. This passion for developing products and solutions that can make a positive contribution to the health and safety of people around the world is another building block in our DNA. Combined with business acumen and an entrepreneurial spirit, it has helped us overcome the challenges of the last hundred years. And with these qualities, we are well equipped for the next hundred years. We will continue to be your reliable partner, supplying you in times of crisis and providing you with practical expertise in the face of changing conditions - new regulations, new resistance, new pathogens! - with practical expertise. This has been all the more true since BODE Chemie GmbH became part of PAUL HARTMANN AG in 2009. This brought together two partners who, thanks to their culture of innovation, are market leaders in the field of medical and care products. Together, we can offer you modern system solutions for infection prevention from a single source, combining digital elements with impressive material properties. Enjoy reading! Yours Managing Director BODE Chemie GmbH, a company of the HARTMANN GROUP A. Schwieger 3
1OO YEARS BODE CHEMIE The ’brand of the century’ as a benchmark Pathogens don‘t stand a chance here: in a brightly lit hall, square bottles made of whitish plastic stand in a seemingly endless row in holders on a conveyor belt. They move at high speed from station to station. At the front, the bottles are automatically filled with a light blue liquid. Further back, the caps are screwed on. Finally, the bottles are labelled, packed and stored in the warehouse for shipment: it won‘t be long before a new shipment of Sterillium® hand disinfectants is on its way from HamburgStellingen to customers in around 50 countries around the world. ‘We have invested a total of 13 million euros in this new production line in 2022. We now have one of the most modern production facilities for disinfection products in the world,‘ says BODE Managing Director Alexander Schwieger. ’If necessary - as was recently the case during the COVID-19 pandemic - we can increase our production capacity very quickly and significantly In 2024, BODE Chemie GmbH will be 100 years old. Since its foundation, the company has set standards in the field of hand and surface disinfection. Today, as an important part of PAUL HARTMANN AG, it can support its customers more comprehensively than ever before in the prevention of infections with modern products and multimedia training as well as consulting services. without having to compromise on product quality. The ability to continue supplying customers from the company‘s traditional headquarters in Germany also proved to be an advantage during the pandemic’. The first 25 years: start & restart BODE has been producing in the Stellingen district of Hamburg since 1929. However, the company began just a few kilometres from here: On 16 January 1924, pharmacist Dr Kurt Bode founded his ’Bacillolfabrik Dr Bode & Co.’ in a backyard in the district of Winterhude on the Outer Alster. Bacillol® was one of the first commercially available disinfectants at the time. But Kurt Bode was also a chemist and scientist. As such, he was constantly striving to optimise his disinfectants for various applications through practical research. This enabled the young company to expand its product range in the 1930s: Baktol® and Baktolan® disinfectants for use in hospitals were launched. 100 years of innovation –BODE Chemie GmbH 4
1OO YEARS BODE CHEMIE The company was re-established in 1947 after the Second World War. The hall that had been destroyed in 1943 was rebuilt - and production of the well-known disinfectants continued. When the economy of the young Federal Republic of Germany finally experienced its miracle of growth in the following decade, BODE also broke new ground: in the 1950s, the antiperspirant Hidrofugal® was developed. A milestone in the history of hygiene: the Sterillium® product family In retrospect, BODE‘s real breakthrough came in the mid-1960s: Sterillium®, developed in cooperation with the University Medical Centre Hamburg-Eppendorf (UKE), was the world‘s first alcohol-based rub-in hand disinfectant, highly effective and gentle on the skin at the same time. Sterillium® set the standard for efficacy and skin compatibility and redefined an entire product category. Today, the name Sterillium® is used by many as a synonym for hand disinfectants. This is one of the reasons why Sterillium® was named one of the top German brands by the ZEIT publishing group in 2022 and can now call itself ’Brand of the Century’ in perpetuity. The name of the ’Blue Classic’ is also an example of the culture of innovation cultivated at BODE. Today, users can choose from a variety of Sterillium® products that meet a wide range of needs and have repeatedly set new standards: For example, the Sterillium® 2 in 1 wipes are now available for use at home and when travelling. These are practical disinfectant wipes for hand and surface disinfection. Since 2003, Sterillium® classic pure has been one of the first hand disinfectants to offer the proven Sterillium® skin care complex without perfume or colourants. Since 2019, Sterillium® pure has also been available on a propanol basis as the product also suitable for users with allergic or atopic skin. The brand‘s innovation leadership has been confirmed externally over the decades: In 2005, Sterillium® was the first hand disinfectant to be approved for surgical hand disinfection with a reduced exposure time of 1.5 minutes instead of 3 minutes. And in 1995, Sterillium® Virugard was the first alcohol-based hand disinfectant to be listed by the Robert Koch Institute as effective against viruses. Comprehensive infection prevention: BODE at HARTMANN BODE Chemie has been part of PAUL HARTMANN AG since 2009. ’Together with HARTMANN, we can offer comprehensive system solutions for infection prevention from a single source,’ says Alexander Schwieger. In addition to effective products with impressive properties, this also includes expert advice and training for users. ’We want to provide our customers with the information they need.’ For this reason, the BODE SCIENCE CENTER, meanwhile the HARTMANN SCIENCE CENTER, was founded in 2011 as a competence centre for disinfection and infection prevention. Since 2019, 5
Infection Prevention and Control specialists have been able to use the ’Observe’ and ’My Hygiene SOP’ apps developed by HARTMANN, for example, to document and analyse hand hygiene observations and care processes, or to use ’My Hygiene SOP’ to create standard operating procedures (SOPs) that meet all hygiene requirements. Or the digital management tool ’PUSH® Hygiene’: With this tool, healthcare facilities of all kinds, as well as hotels, government agencies, educational institutions or public institutions with hygiene requirements, can easily create their own hygiene and disinfection plans. Since the coronavirus pandemic, we all know how important this is,’ says Schwieger. Health and the environment But the pandemic has also drawn attention to another - fundamental - aspect of preventive healthcare: an intact environment as a prerequisite for human health. ’We take the issue of sustainability very seriously. Aspects such as raw material consumption during production and distribution, as well as recyclability after use, are consistently incorporated into the development of new products,’ says Alexander Schwieger. One example of this are the new Bacillol® Zero Tissues. ’This is a truly sustainable product. These ready-to-use disinfectant tissues are the next generation of surface disinfection and completely free of plastic fibres.’ The flexible packaging film of Bacillol® Zero Tissues is also non-standard: The flowpack monofilm is more than 95% pure polypropylene and is recyclable. What makes Bacillol® Zero Tissues special, however, is the innovative, completely biodegradable complex of active ingredients developed specifically for this product. It is based on two organic acids that ideally complement each other in their efficacy. 1OO YEARS BODE CHEMIE 6
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From Epidemics to Cleanliness Philipp Osten describes the first plague epidemics in Europe as a turning point in history: Transcontinental trade routes made it possible for new pathogens to spread. Within a few years, a third of Europe‘s population died of the ’Black Plague’. As a result, property was redistributed. Because of the social changes that followed, the cultural historian Egon Friedell called 1348 ’the concept year of modern man’. It was only 300 years later that the port city of Venice set up a public health department in response to the plague spread by merchant ships. ’For the first time, doctors were publicly employed to identify, predict and contain disease,’ says the medical historian. The containment measures introduced at the time also gave rise to the common English term: passport. Originally, the health certificate for disease-free cargo and crew issued by northern In his keynote speech, Prof Dr Philipp Osten from the Institute for the History and Ethics of Medicine at the UKE traced the history from the ’Black Plague’ in the 14th century to Hamburg in the 1920s. This was the time when the concepts of hygiene had finally arrived in the general consciousness - and today‘s BODE Chemie was founded. Italian port doctors was called a ’passa porto’, the written permission to leave the port after a medical examination. In the centuries that followed, however, it was not common practice to do much more than isolate those who were actually or possibly ill - and burn their belongings. After all, the real cause of the plague was not known. For example villages in which an epidemic broke out were consistently sealed off. This is clearly illustrated by a drawing from 1682, which shows that the village of Niederzimmern (near Weimar) was surrounded by more than 30 military checkpoints. At that time - and in the centuries before - so-called ’plague saints’ were in demand. According to historian Prof Dr Philipp Osten, the Catholic Church recognizes a total of 29 saints who were invoked to pray for healing or protection from the disease. Fear of bacteria & disinfection The treatment of diseases such as plague, cholera and the like would only change once the idea of tiny, invisible germs as the cause of these diseases The Development of Infection Prevention and Control and Disinfection over the Course of History Our centenary is a good opportunity to look back - and to look forward at the same time. At the anniversary event on 16 January, we asked two experts from the University Medical Centre Hamburg-Eppendorf (UKE) to do just that in their keynote speeches. 1OO YEARS BODE CHEMIE 8
was generally accepted. This was not a matter of course, as the cholera outbreaks in Hamburg in the 19th century show. In general, Hamburg was not a role model in terms of health management at the time: ’The last major cholera epidemic in Europe took place in Hamburg,’ says Prof Dr Philipp Osten. One reason for this was that people in the Hanseatic city still favoured the idea that cholera was caused by vapours from the soil and not by contaminated drinking water. According to Prof Dr Philipp Osten, this only changed in 1894 when the Imperial Health Office published a map of cholera deaths in and around Hamburg - and the result was striking: the number of deaths changed dramatically at the city limits. At that time, drinking water in Hamburg still came directly from the river Elbe. In Altona, people were already drinking water filtered through sand. From then on, the idea of pathogens - the germ theory - was established. With consequences: Fear of bacteria spread. The age of disinfection therefore also began with the ’germ’. ’The fear of epidemics is now turning into an economic advantage,’ said Prof Dr Philipp Osten. It became a competitive advantage for a port city to be able to offer a ’safe harbour’ that was not a gateway for new pathogens. In the 1890s, the first factories for disinfectants were therefore built primarily in port cities. In Hamburg, for example, the Bacillol factory Sanders was founded in 1897 and became the ’Bacillolfabrik Dr. Bode & Co.’ in 1924. The new era of harbour hygiene was illustrated by a photo from that time presented by Prof Dr Philipp Osten: it shows the ’the guarding of a ship‘s cargo suspected of being infected with the plague by dogs as sharp as rats’. 1OO YEARS BODE CHEMIE 9
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Out of the ivory tower! It can, was the premature conclusion of his presentation. But AI is not a panacea. Prof Dr Johannes Knobloch advocated a middle course between generalized prevention measures - i.e. ’one size fits all’ - and measures that are adapted as far as possible to the actual risk situation on site on site in terms of scope and implementation. Cost pressures in the healthcare sector alone make such an approach necessary. ’Standard precaution measures are the standards that should be applied to all patients in the future,’ says Prof Dr Johannes Knobloch. However, measures that go beyond standard precautions should be individualised in the future. According to the IPC specialist, AI can provide valuable assistance in assessing infection risks and selecting appropriate infection prevention measures. For use in the clinical environment, a powerful IPC AI has a decisive advantage over human IPC teams: the AI is available around the clock! More research for better data The key word in the previous sentence is ’powerful’. In order to use AI effectively, IPC algorithms need to be able to learn with meaningful data from hospital practice. According to Prof Dr Johannes Knobloch, this means that infections and all relevant data must be recorded correctly and automatically in hospital information systems! ’The goal is evidence-based risk assessment based on real data,’ says Prof Dr Knobloch. However, many of the measures currently recommended are In his keynote speech, Prof Dr Johannes Knobloch, Head of Hospital Hygiene Department - Institute of Medical Microbiology, Virology and Hygiene at the University Medical Center HamburgEppendorf (UKE), ventured a look into the future - and a creative play with the possibilities of artificial intelligence. The IPC specialist was particularly interested in whether and how artificial intelligence - AI - can actually help to improve infection prevention and patient safety in everyday hospital life. opinion-driven and need to be scrutinised for evidence. ’Based on insufficiently specific publications and data, AI is currently not very suitable as a concrete decision-making tool’. Future tasks for IPC teams will include analysing the effectiveness of interventions and assessing technical and procedural risks. ’The use of AI will massively change IPC teams in the future’. New professional groups such as IT specialists will have to become part of such teams, according to Prof Dr Johannes Knobloch. Finally, the IPC specialist left the audience with a take-home message: ’We now have to think about how AI can be integrated into everyday working life.’ What can happen when an algorithm acts on the basis of a database fed with prejudices was vividly illustrated by an image Prof Dr Johannes Knobloch had created with AI to accompany his presentation: it shows a male nurse with a nurse‘s cap on his head. Challenges and prospects for the future of hospital hygiene in practice Picture credit: Canva Magic Studio 1OO YEARS BODE CHEMIE 11
What do you associate with BODE? Questions and answers from important companions and partners On January 16, 2024, we invited partners, companions, former and current employees to an anniversary event in a historic hall at the University Medical Center Hamburg-Eppendorf (UKE). Here are their thoughts on our milestone birthday. Anniversary interviews: Insights into the company‘s history ’BODE is an innovative company that has made history with a century-old brand. Also HARTMANN is more than 200 years old. So, tradition is a fundamental value of our company. Tradition means thinking long-term and making consistent decisions in the interests of our customers. It is therefore important that we make decisions today that will ensure we can meet our customers‘ growing needs for the next 100 years. Infection prevention is a key issue for us as a company. And disinfection is an essential part of that.’ Britta Fünfstück, CEO PAUL HARTMANN AG ’This is a special evening for me. Together with Mr Eberhard Bode on the Advisory Board, I was able to nurture and care for the company for 24 years from 1987. At that time, we also felt that we needed to back up our product range with scientific evidence. That‘s why we started with DESINFACTS and promoted practical hygiene research. We have always been able to react quickly to new developments thanks to our close contact with the research community. For example, we realised early on that we also needed an effective hand disinfectant against non-enveloped viruses. That’s why Sterillium® Virugard was developed. With Sterillium® as the most important product for hand disinfection, the name BODE today stands for quality.’ Dr. Ulrich Möllers, Former Managing Director of BODE Chemie GmbH ’For me, BODE Chemie means disinfection. I started working in heart surgery in Eppendorf in 1964. At that time we still had a lot of problems with infections. My idea was to develop a product that would not work by washing, but only by rubbing into the skin. Working with BODE gave me the ideal opportunity to develop a product that would simplify hand disinfection and be gentle on the skin. Since then, my professional career has been associated with the name BODE: I always enjoy seeing a bottle of Sterillium® somewhere.’ Prof. Dr. Peter Kalmár, Former heart surgeon at UKE, source of ideas for the development of Sterillium® 1OO YEARS BODE CHEMIE 12
Mr Schwieger, the company you have been managing for two and a half years is celebrating its centenary this year. How do you feel about this? It is a great honor and pleasure for me as Managing Director to be able to celebrate the centenary of our company. Looking back on one hundred years of BODE fills me with awe, respect and gratitude. What is the achievement that commands the most respect? Humanity has lived through a century of light and shadow. A century of wars, crises, and pandemics. But it has also been a century of many positive developments and exciting innovations. This is particularly true in the field of healthcare. For example, the development of hand and surface disinfection over the past hundred years has been remarkable: constant innovations have helped to improve effectiveness and safety for users, materials and the environment. And BODE has made a significant contribution to this progress - not only by developing the world‘s first alcohol-based hand disinfectant Sterillium®. I am proud of that. At the same time, this successful past is also an obligation for the future. The anniversary year 2024 is also a time of upheaval for BODE. What are the particular challenges that you see for the company in your role as Managing Director? The most important thing about our business is that we help save lives. We help healthcare professionals and patients to stay healthy and minimize the risk of infections. More generally, we help improve the quality of life for many people. And that is what we want to continue to do in the future. That is why we want to offer our customers comprehensive and sustainable solutions that optimally combine health and environmental protection and remain a reliable partner even in times of crisis. Alexander Schwieger, Managing Director BODE Chemie GmbH, a company of the HARTMANN GROUP ’BODE has played a major role in shaping this progress’ 1OO YEARS BODE CHEMIE 13
Sterillium®: The ’blue classic’ throug The ’pre-Sterillium® era’: hand eczema and healthcareassociated infections were widespread To protect patients from healthcare-associated infections (HAI), even before the introduction of Sterillium®, hands were disinfected by scrubbing for several minutes followed by rinsing with highpotency alcohol. However, this method was far from optimal: germs were still able to spread more easily than hoped, and the hands of many users were so stressed by the degreasing process that acceptance of hand disinfection continued to decline. This changed abruptly with the introduction of Sterillium®. The reason for its skin compatibility was its unique formulation, which focused on moisturising agents: Once the volatile alcohols had evaporated, the moisturizers remained on the skin to deliver their benefits. The improved skin health significantly increased hand hygiene compliance [1]. Nearly 60 years ago, Sterillium® revolutionised hand hygiene by launching the world‘s first alcohol-based, yet skin-friendly hand disinfectant. Faster, more effective, more skin friendly: the success story of one of the best-known traditional brands began in 1965 - after intensive cooperation between the University Medical Centre Hamburg-Eppendorf (UKE) and the company Dr. BODE & Co. In the years that followed, the innovative product developed into one of the world‘s most successful hand disinfectants, permanently changing everyday clinical, nursing and medical practice. Sterillium® became synonymous with effective and skin-friendly hand disinfection. But that‘s not all: the brand has continued to set new standards for decades. From 1995: brand expansion with numerous innovations As user needs change over time, BODE has continued to develop Sterillium®. With Sterillium® Virugard, the company established the first virucidal alcohol-based hand disinfectant in 1995. This was followed over the years by the launch of Sterillium® Gel (2003), a highly effective ethanolic disinfectant gel that is effective against noroviruses, Sterillium® classic pure (2007) as a colour- and fragrance-free version for particularly sensitive skin, and Sterillium® Protect & Care (2018), which is available in pharmacies for use at home and on the move. What they all have in common is the usual quality, consistent protection and high standards of care. So Sterillium® not only helps to protect vulnerable groups from germs, but also to ensure that people in the medical sector stay healthy and that their skin health does not suffer as a result of their work. Product design of the Sterillium® family over the years 1OO YEARS BODE CHEMIE 2018 1995 2003 1965 14
gh the ages ck SIGN ℮ 100 ml ℮ 100 ml ℮ 50 ml Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) ohne Parfum/ohne Farbstoff ohne Parfum/ohne Farbstoff ohne Parfum/ohne Farbstoff ohne Parfum/ohne Farbstoff 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 classic pure classic pure classic pure classic pure classic pure ℮ 500 ml ℮ 1000 ml Anbruch: Anbruch: ohne Parfum/ohne Farbstoff Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut 100 % 60 % 100 % 75 % SIGN ml 100 ml ml Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) ohne Parfum /ohne Farbstoff ohne Parfum /ohne Farbstoff ohne Parfum /ohne Farbstoff ohne Parfum /ohne Farbstoff 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 classic pure classic pure classic pure classic pure classic pure ml 1000 ml Anbruch: Anbruch: ohne Parfum/ohne Farbstoff Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut 10 0% 60 % 10 0% 7 5% Lorem ipsum Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Bakterizid, levurozid, mykobakterizid, begrenzt viruzid (zusätzlich Adeno-, Noro- und Rotaviren) ohne Parfum /ohne Farbstoff ohne Parfum /ohne Farbstoff 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 Anbruch: Anbruch: ohne Parfum/ohne Farbstoff Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut ml ml Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) ohne Parfum/ohne Farbstoff ohne Parfum/ohne Farbstoff ohne Parfum/ohne Farbstoff ohne Parfum/ohne Farbstoff 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 ml ml Anbruch: Anbruch: 100 % 60 % 2023: Sterillium® foam extra care conquers the market with extra care Sterillium® foam extra care, the latest addition to the Sterillium® product range, once again set new standards in skin care last year. The low-drip foam is not only effective against bacteria, viruses and yeasts in 15 seconds, but also provides hygienic hand disinfection in accordance with EN 1500 in 30 seconds. It is also dermatologically proven to be skin compatible, thanks to its innovative skin care complex with vitamin E and jojoba oil: After two weeks of use (20 x/day), the skin hydration of the 20 test subjects was demonstrably improved, while redness, dryness and scaling were significantly reduced [2]. Sterillium® Surface Spray for the disinfection of sensitive surfaces and Sterillium® 2 in 1 Wipes for hands and surfaces have also been available since 2023. 2024: Time for a modernised look Last but not least, a visual overhaul is planned this year to modernise the brand visually and prepare it for the future. As a result, our ’blue wonder’ will get a little facelift this year. Stay tuned and join us in looking forward to the new labels on ’your’ Sterillium®! 16 Classic pack PACKAGING DESIGN ℮ 100 ml ℮ 100 ml ℮ 50 ml Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut Bakterizid, levurozid, mykobakterizid, begrenzt viruzid sowie begrenzt viruzid PLUS (zusätzlich Adeno-, Noro- und Rotaviren) H Lösun myk so (zusätzli ohne Parfum /ohne Farbstoff ohne Parfum /ohne Farbstoff ohne Parfum /ohne Farbstoff oh 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 0000000 V 06.23.0 classic pure classic pure classic pure classic pure c 500 ml ℮ 10 Anbruch: Anbruch: ohne Parfum/ohne Farbstoff Hände-Desinfektionsmittel Lösung zur Anwendung auf der Haut The standard pack, which sets the standard for all other pack. If possible, all packs should be transparent with a transparent label. 10 0% 60 % 10 0% 7 5% Lorem ipsum References 1. Girard R et al. (2001): J Hosp Infect 47: 131-137. https://doi.org/10.1053/ jhin.2000.0854 2. Brandt M et al. (2023): SGS-Studie 22.0359-39. Unpublished study - data provided by BODE Chemie GmbH. 1OO YEARS BODE CHEMIE 2024 2023 15
High-Alcohol Hand Disinfectants Benefits in terms of safety and cost Alcohols, such as ethanol and propanols, are proven to be among the most important ingredients in hand disinfectants. Many guidelines recommend an alcohol content of 60-95% to adequately protect patients and staff from transmissible germs. While products with a lower alcohol content may appear cheaper at first glance, products with a higher alcohol content offer more benefits on closer inspection. However, alcohol content claims should always be taken with a pinch of salt: since percentage by volume and percentage by mass cannot be directly compared [1]. Reducing consumption saves money A high-alcohol hand disinfectant usually requires a much smaller volume than a low-alcohol product to properly disinfect hands – often only 1 x 3 mL instead of 2 x 3 mL. As a result, more disinfections can be performed per bottle with a high-alcohol product. So there is huge potential for savings, even if the individual bottle of a high-alcohol product is more expensive in direct comparison. Another advantage is that the bottles of high-alcohol products need to be changed less frequently. This frees up staff time for other tasks and is a plus in terms of plastic waste. In addition, high-alcoholic products tend to dry faster than low-alcohol products, which also saves time for healthcare professionals [2] and meets their daily needs [3]. € KNOWLEDGE 16
References 1. https://www.hartmann-science-center.com/de-de/hygienewissen/händehygiene/händedesinfektion/ethanol-content-in-disinfectants (accessed on 06.03.2024) 2. Macinga DR et al. (2014): BMC Infect Dis 14: 511. https://doi.org/10.1186/1471-2334-14-511 3. Schulz-Stübner S. et al. (2019): Infect Control Hosp Epidemiol 40: 609-612. https://doi.org/10.1017/ice.2019.53 4. Verbund für Angewandte Hygiene, Desinfektionsmittel-Liste des VAH: https://vah-liste.mhp-verlag.de (accessed on 06.03.2024) 5. Test report L23/00565.1 (2024): Contact test method to compare two hand disinfectants. Unpublished study - data provided by BODE Chemie GmbH. KNOWLEDGE 0 20 40 60 80 100 3 mL 2 x 3 mL 3 mL Inactivation of microorganisms on hands. The reduction of colony forming units (CFU) by two VAH-listed hand disinfectants was tested in a practical contact test. Means with standard deviations and single results are shown. A high alcohol content ensures reliable inactivation of the microbial flora. More reliable inactivation of microbial flora However, high-alcohol hand disinfectants do not only score over low-alcohol products in terms of cost and time savings. In a practical test of two VAH-listed hand disinfectants [4], the highalcohol product (85% w/w) reduced the colony forming units (CFU) on the hands of the test subjects more reliably than the low-alcohol product (65% w/w), by more than 90% compared to a reduction of between 60 and 70% [5]. Safer, cheaper and more sustainable High-alcohol hand disinfectants are therefore not only more economical than low-alcohol products, but also fit seamlessly into the needs and routines of healthcare staff. In addition, their use helps to improve patient safety and the sustainability of healthcare facilities. Digital hygiene monitoring provides new insights into hand hygiene behaviour Hand hygiene is widely recognised as the most important measure in the prevention of healthcare associated infections. Hand rub dispensers are particularly suitable for collecting information on hand hygiene as a starting point for any disinfection process. This is especially true when sensors are used to record every single disinfection around the clock. Together with an academic partner and GWA Hygiene GmbH (Stralsund, Germany), the HARTMANN SCIENCE CENTER has recently published a paper on digital hygiene monitoring. In this publication, 931,446 disinfections recorded with NosoEx® from 17 wards in nine German hospitals were analysed in terms of frequency, consumption and location [1]. A summary of the study results is available as a 2 page PDF here: https://bit.ly/Study_results STUDY Quelle 1. Senges C et al. (2024) Infection Prevention in Practice 6:2:100364. https://doi.org/10.1016/j.infpip.2024.100364 Reduction CFU [%] 65% ethanol 85% ethanol 17
While improving hand hygiene (HH) could reduce infection rates, HH assessment is time consuming and not always objective. Electronic tools can now be used to generate comprehensive and objective data. Therefore, a recent study investigated the site-specific use of wall-mounted and point-ofcare dispensers using the electronic HH monitoring system NosoEx® on 17 wards in nine German hospitals [5]. Intensive care units lead in number of dispensers and disinfections The study anonymously recorded the rub volume of 931,446 hand disinfections and analysed the number and rub volume of wall-mounted and point-of-care dispensers by ward and room type. It was found that intensive care units (ICUs), intermediate care units (IMCs) and neurological wards had more dispensers than, for example, orthopaedic surgical wards, with wallmounted dispensers dominating overall (see figure). In addition, ICUs and IMCs were well ahead with more than three dispensers per bed and more than 20 disinfections per patient day. Hand rub dispenser use is location-dependent Interestingly, the study also showed that it is not just the number of dispensers that matters, but also where they are located and how they are used. For example, dispensers were more likely to be used in high-traffic areas such as hallways. It was also confirmed that hand Placement of disinfectant dispensers Practical experience: Observe workflows and locations! Recent data show that up to 6.5% of hospitalised patients in Europe and the USA are affected by healthcare-associated infections (HAIs) [1-3], which can lead to prolonged hospitalisation and increased consumption of antibiotics [4]. Figure 1: Mean number of hand rub dispensers (HRDs) per bed by ward type and comparison of POC and WMD numbers on individual wards. Bars show the averages of POCs and WMDs per ward type, while circles (WMD) and triangles (POC) show the individual numbers of HRDs per ward. Vertical lines indicate recommendations of German KRINKO (0.5 HRDs/bed on normal wards and one HRD/bed on ICU) and the number considered optimal (two HRDs/bed) [7]. ICU, intensive care unit; IMC, intermediate care; POC, point-of-care dispenser; WMD, wall-mounted dispenser. ward type orthopaedic/ surgical neurology other ICU IMC 0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 dispenser per bed wall-mounted dispenser (WMD) point-of-care dispenser (POC) KNOWLEDGE 18
References 1. Magill SS et al. (2018): N Engl J Med 379: 1732-1744. https://doi.org/10.1056/NEJMoa1801550 2. BARMER Krankenhausreport 2021. https://www.barmer.de/blob/339106/ff2b0b22a5770236 (accessed on 21.03.2024) 3. Suetens C et al. (2018): Eurosurveillance 23: 1800516. https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800516 4. Haque M et al. (2018):Infect Drug Resist 11: 2321-2333. https://doi.org/10.2147/IDR.S177247 5. Senges C et al. (2024): Infection Prevention in Practice. 6:2:100364. https://doi.org/10.1016/j.infpip.2024.100364 6. Kuster S et al. (2021): Antimicrob Resist Infect Control 10: 93. https://doi.org/10.1186/s13756-021-00949-0 7. Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut. Händehygiene in Einrichtungen des Gesundheitswesens (2016): Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 9: 1189-1220. https://www.rki.de/DE/Content/Infekt/ Krankenhaushygiene/Kommission/Tabelle_Haendehyg_Rili.html (accessed on 21.03.2024) volume per disinfection [ml] B. neurology ward C. orthopaedic/surgical ward D. ICU E. surgical ICU F. surgical ICU >1 - 2 >2 - 3 >3 - 4 room type patient room bathroom hallway counter other A. other ward Figure 2: HRD usage on ward maps. All maps are exemplary, anonymised recreations of ward layouts. (A, B) Dispenser usage when multiple dispensers are available in patient rooms. (C, D) Dispenser usage on hallways and in patient rooms on orthopaedic/surgical wards and non-surgical ICUs and (E, F) on surgical ICUs. Circles represent WMDs and always touch the wall they are mounted to. Larger circles indicate more frequent usage, but circle sizes are not comparable between subfigures. Green/yellow/red circles indicate that on average >3 to 4 mL/>2 to 3 mL/>1 to 2 mL of ABHR were used per disinfection, respectively. ABHR, alcohol-based hand rub; HRD, hand rub dispenser; ICU, intensive care unit; WMD, wall-mounted dispenser. disinfection is most reliable when there is a risk of exposure to infectious agents. Dispensers placed in patients‘ rooms were most commonly used on surgical wards, presumably because contact with open wounds is unavoidable. In addition, the highest volume of rub per disinfection (3.6 mL) was found in treatment rooms. Consider dispenser placement and workflow for optimal use The results suggest that dispenser use is influenced by room type, as well as ward type and workflow. Therefore, neither simply increasing the number of dispensers nor optimising their placement may be the only solutions to improve HH compliance. Digital monitoring systems that provide accurate and location-specific usage data can be used to objectively analyse the overall picture. In the future, this could lead to more specific recommendations for groups of healthcare workers and room configurations. A. other ward B. neurology ward C. orthopaedic/surgical ward D. ICU E. surgical ICU F. surgical ICU patient room bathroom room type volume per disinfection [ml] KNOWLEDGE 19
Since April, health and climate protection have been two sides of the same coin: with the new generation of Bacillol® 30 Sensitive Tissues, users now have surface disinfection wipes at their disposal with which they can effectively disinfect surfaces and at the same time contribute to environmental protection. The material of the new wipes makes all the difference. The Bacillol® 30 Sensitive Green Tissues are made from renewable resources. The new wipes are based on cellulose sourced from sustainably managed forests. Plastics have been completely eliminated from the wipe material. This means that Bacillol® 30 Sensitive Green Tissues disinfecting wipes are 100% plastic-free. Just like our classic Bacillol® 30 Sensitive Tissues, the new Bacillol® 30 Sensitive Green Tissues is powerful and gentle to materials and skin-compatible. CO2 footprint reduced by 50 percent per disinfectant wipe The carbon footprint of the new Bacillol® 30 Sensitive Green Tissues wipes is per disinfectant wipe 50% lower than that of conventional ready-to-use wipes made from PET (polyethylene terephthalate), which is still the market standard. The carbon footprint indicates how much climate-damaging carbon dioxide gas is produced during the life cycle of a product. Bacillol® 30 Sensitive Green Tissues: for sustainable surface disinfection Our bestseller – now sustainable. KNOWLEDGE The proven Bacillol® 30 Sensitive Tissues surface disinfection wipes are now also available as an improved, sustainable version: Bacillol® 30 Sensitive Green Tissues. The new disinfection wipes are made from material sourced from sustainable forests and are completely plastic-free. The carbon footprint of surface disinfection wipes The relative carbon footprint of Bacillol® 30 Sensitive Green Tissues is per wipe 50% lower than the market standard (in brackets: total number of wipes per pack; source: unpublished study based on ISO 14067 - data from BODE Chemie GmbH). low alcohol, PET-wipe (80) Bacillol® 30 Sensitive Green Tissues (120) relative carbon footprint [%] 100 75 50 25 50% wipe material formulation Sothers plasticfree tissues 20
Significantly higher coverage than the market standard The sustainable Bacillol® wipes from HARTMANN also stand up to comparison in terms of coverage: with an average coverage of 1.5 square metres per wipe, both the new Bacillol® 30 Sensitive Green Tissues and the Bacillol® Zero Tissues launched last autumn wiped a significantly larger area in tests than conventional standard PET wipes (market standard: 1.0 and 1.1 square metres respectively). The average coverage of pre-impregnated disinfectant wipes can be determined using standardised procedures by specialist testing and textile laboratories. A tissue is wiped over a standardised surface under controlled conditions until the liquid film breaks. The size of the wetted area is then determined. No compromises: as effective and material-friendly as ever There is no need for users to be concerned that the environmental benefits of the product are at the expense of their effectiveness and material compatibility: The new generation of Bacillol® 30 Sensitive Tissues offers the same proven performance as our classic product. Bacillol® 30 Sensitive Green Tissues is bactericidal and yeasticidal within one minute. The tissues are effective against noroviruses within two minutes. Their great material compatibility makes them suitable for sensitive materials such as displays, keyboards, mobile phones or tablets, as well as for sensitive, non-invasive medical devices. The wipes are also easy and safe to use: the world‘s leading testing, inspection, and certification company, SGS Institut Fresenius, certifies the Bacillol® 30 Sensitive Tissues having excellent skin compatibility. According to ECARF certification, it is a professional allergy- and asthma-friendly surfaces disinfectant. For disinfecting large areas: Bacillol® Zero Tissues will also come in XL The Bacillol® Zero Tissues launched last autumn, will be available in a larger XL format at the end of this year. The new wipes will measure 20 x 30 centimetres. This makes them ideal for disinfecting larger surfaces. In October, HARTMANN launched a new generation of professional disinfectant wipes that set new standards in terms of sustainability on several levels: The disinfectant effect of Bacillol® Zero Tissues is based on a novel, patented active ingredient complex of organic acids that also occur in nature: the organic acid complex. Alcohols, QACs and peroxides are not used. In total, 98.5% of the ingredients in the finished formulation are of organic origin. The environment also benefits from other properties: The disinfectant wipes of the product are made from regenerated and bio-based fibres derived from the natural polymer cellulose. The flexible packaging foil of the Bacillol® Zero Tissues is also made from pure polypropylene (monofoil). This means that the plastic packaging is fully recyclable. KNOWLEDGE 21
How modern disinfectant wipes can help save CO2 emissions Small wipe, big impact Surface disinfection is an important part of basic hygiene and essential for breaking chains of infection. Depending on the requirements and application, different products are used, e.g. concentrates, foams or ready-to-use solutions Pre-soaked disinfectant wipes are most commonly used, as they save time and increase compliance when disinfecting patientnear surfaces. Find out here how the CO2 footprint is made up in this product family and how modern materials can help to reduce CO2 emissions in hygiene. Not all alcohols are the same In everyday language, the term „alcohol“ is often used to sum up certain active ingredients. However, up to three different alcohols are used in surface disinfectants: ethanol, n-propanol (1-propanol) and isopropanol (2-propanol). And although these three alcohols have a similar chemical structure, they have significantly different CO2 footprints, as the starting materials and type of large-scale production have a considerable influence (Figure 1). Compared to n-propanol, ethanol causes only around 20% of CO2 emissions, isopropanol around 32%. The production of bioethanol (ethanol produced by fermentation of maize, wheat, or sugar cane) causes only 50% of the emissions compared to synthetic ethanol and only 10% compared to the production of n-propanol [1]. When considering bio-based substances, however, it is important that these substances originate from sustainable agriculture and that there is no competition for land with food. Regenerate instead of synthesise Until a few years ago, ready-to-use disinfectant wipes were made exclusively from synthetic fibres from fossil resources (usually PET or polypropylene (PP)), the production of which causes high CO2 emissions. Even a switch to bio-based fibres, e.g. made from polylactic acid (PLA), would only be a minor improvement (Figure 2). Only recently have cellulose-based, so-called regenerated fibres been used in disposable wipes for disinfection and the CO2 footprint can be significantly reduced [2]. 100 % 32% 20% 10% n-Propanol Isopropanol Ethanol Bioethanol rel. CO2-emissions (%) Figure 1: Relative CO2 emissions of different alcohols set in relation to n-propanol. KNOWLEDGE 22
130% 100% 205% 140% Cotton PET PP PLA regenerated fibre 3% rel. CO2-emissions (%) Figure 2: Relative CO2 emissions of different fibres used for pre-soaked wipes in kg CO2 per kg fibre, set in relation to the emissions of cotton fibres [2]. References 1. Munoz I et al. (2014): Int J Life cycle Assess. 19:109-119. https://doi. org/10.1007/s11367-013-0613-1 2. Shen L et al. (2010): RCR Advances. 55:260-274. https://doi.org/10.1016/j. resconrec.2010.10.001 3. https://www.bund-berlin.de/fileadmin/berlin/publikationen/Klimaschutz-pdf/ Fact-Sheet_Narkosegase_und_Klimaschutz_Update.pdf 4. McAlister S et al. (2022): Lancet Reg Health West Pac. 24:100459. https://doi. org/10.1016/j.lanwpc.2022.100459 Want to find out more about sustainability in hygiene? Take a look at our special edition DISINFACTS Green! https://www.hartmann.info/en-corp/disinfacts/2023-2/index.html Taking small steps towards more sustainable hygiene The healthcare system is one of the largest emitters of CO2, with the majority of emissions being attributable to anaesthetic gases [3] or imaging procedures [4], for example. Disinfectant wipes only play a subordinate role here. Nevertheless, for example in Germany, switching from PET wipes to cellulose-based wipes could save around 5500 tonnes of CO2 every year. Visualisation of skin hydration after frequent hand disinfection using Capacitive Contact Imaging A recent study by the HARTMANN SCIENCE CENTER, BODE Chemie GmbH, a company of the HARTMANN GROUP, investigated the skin moisturising effect of a hand disinfectant with a comprehensive skin care complex. Capacitive Contact Imaging (CCI) was used as a method to measure and visualise skin hydration in comparison to conventional corneometry. In addition to established parameters such as pH, transepidermal water loss (TEWL) and dermatological assessments, the effects of a two-week application of a hand disinfectant foam on skin condition were investigated. Regular daily use of the product resulted in an improvement in skin hydration without any intolerance. The results obtained by CCI and corneometry were consistently comparable and showed a significant increase in skin hydration after the two-week application period. CCI visualised the increase in skin hydration, demonstrating its potential as an additional method to assess and demonstrate the effect of hand hygiene products on skin health [1]. The poster summarising the results of the study can be found here: https://bit.ly/Poster_Study STUDY Reference 1. Sadowski T et al. (2024): sofwjournal 5: 8-13. DOI tbd 23
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