FORUM based wipe, an organic acid-based active ingredient complex and recyclable mono-foil packaging. ‘The challenge for us was to demonstrate the benefits of the new carboxylic acid-based active ingredient complex and the advantages of a completely new product compared to established products on the market,‘ says Dr Heide Niesalla. How does the active ingredient complex work? What role does the wipe material play in the carbon footprint, and what impact does the packaging have on the environment and waste management? These questions are relevant to the user and have been systematically investigated and analyzed. The results of this work are the white papers ‘Sustainability in surface disinfection‘ and ‘Sustainable fibres put to the test‘, as well as presentations at national and international conferences, and a series of Knowledge Nuggets that were also shared on LinkedIn. Dr Heide Niesalla: ‘Using the example of the innovative Bacillol® Zero Tissues and the Bacillol® 30 Sensitive Green product family, which has been available since last year, we demonstrate in which areas of surface disinfection there is still scope for reducing CO₂ emissions and material usage, and what influence products have on sustainability in the healthcare sector.‘ Bacillol® Zero The Mode of Action Active agents in Bacillol® Zero What are organic acids? Organic acids are carbon-based molecules often exhibiting the chemical group -COOH, which is called carboxyl group. Organic acids lower the pH of a solution by splitting off protons (H+). What remains is called the anion of the acid: Acid Anion Benzoic acid › Benzoate + H+ Tartaric acid › Tartrate + H+ O O OH OH OH HO O O Na - + O O OH OH OH HO O O Na - + O O OH OH OH HO O O Na - + O O OH OH OH HO O O Na - + Sodium benzoate known from cranberries, blueberries, and raspberries known from grapes Tartaric acid Cell membrane Outside the cell Cell inside Benzoate - Benzoate - Benzoate - Tartrate - Tartaric acid H Benzoic acid H Benzoic acid H 1 Benzoate is charged and cannot pass the cell membrane. 2 Tartaric acid splits off protons which lower the pH; tartrate remains in the solution. 3 Benzoate takes an H+ and is then not charged any more. 5 The concentration of protons in the cell is lower, thus, benzoic acid splits off its proton again and becomes benzoate. 4 As uncharged molecule, benzoic acid can now pass the cell membrane. 6 The charged benzoate cannot exit the cell. H + H + H + H + H + H + H + H + H + H + Perforation Pores are formed in the membrane. Energy loss (1) The cells consume energy to repair the damage. (2) Energy generation is disturbed. Internal cell pressure rises Due to osmosis, water streams into the cell. Protein denaturation Proteins lose their structure and aggregate. Benzoate and H+ together inactivate the cell from the inside. Use surface disinfectants safely. 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® Zero More sustainability on all levels Secondary packaging • Fully recyclable. Foil packaging • For classical composite foil, several different plastics are inseparably welded together, thus, recycling is not possible. The new mono foil of Bacillol® Zero flowpacks consists of only one type of plastic and is fully recyclable. 1 CO2 emissions of the liquid formulation in a ready-to-use flowpack with 100 pre-soaked wipes. 2 Compared to a low-alcohol disinfectant. 3 If infection control and occupational safety protocols permit it. 4 Compared to a tissue made from PET of a low-alcohol surface disinfectant. 5 The fibre without the liquid formulation is compostable according to EN 13432. 6 PEFC licences: 06-33-92, 04-31-1610, and 04-31-2295. PEFC, Programme for the Endorsement of Forest Certification Schemes. Use surface disinfectants safely. 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). Tissue material • In Bacillol® Zero flowpacks, a plastic-free, high-qualitiy non-woven cloth consisting of a wood-based regenerated fibre is used. • The tissue does not release microplastics. • The fibre is fully bio-degradable, and on top of that also compostable5. • PEFC certified6: The fibres come from sustainably managed forests. Formulation • No ingredient is classified as harmful, thus, Bacillol® Zero does not bear any hazard symbols or precautionary statements. • Toxicologically less harmful than conventional surface disinfectants according to Biocide Products Regulation (BPR). • Bacillol® Zero can be used without gloves3. That saves gloves and time. less CO2 emissions4 95% >98.5% bio-based only 43 g CO2 emission per flowpack1 92% less CO2 emission2 plastic-free 100% sustainable forest management 100% composite foil mono foil complex organic acid Sterillium® med and Sterillium® pure fulfill EN 1500 in 15 seconds Factsheet Background Procedure Hands are artificially contaminated with E. coli. 1 After drying, the finger tips are sampled (prevalue). 2 After disinfection, the finger tips are sampled again (postvalue). 4 While an increasing number of guidelines recommend 15-second application times, such as the US SHEA, which considers 15 seconds to be the minimum to achieve full coverage of the hands [5], not everyone supports a reduction from 30 seconds to 15 seconds. Reasons range from concerns that healthcare workers will spend even less time on hand disinfection to concerns about inadequate hand coverage, to the fact that EN 1500 currently does not support tests of less than 30 seconds. Either way, in the end everyone agrees that no compromises should be made when it comes to patient safety. The efficacy of alcohol-based hand rubs (ABHRs) is evaluated using test norms such as EN 1500 for hygienic hand disinfection. For an ABHR to pass EN 1500, it must reproducibly inactivate bacteria on the hands of volunteers at least as effective as a reference alcohol. As these norms form the basis of claims, they influence recommendations and use of ABHRs in clinical practice. For example, a minimum 'rub-in' time of 30 seconds is often recommended in practice, as ABHRs are tested for at least 30 seconds in accordance with EN 1500. However, long rub-in times are often seen as a barrier to hand hygiene, resulting in healthcare workers skipping necessary disinfections to save time. In fact, studies where rub-in times have been reduced in practice show an increased frequency of hand disinfection [1]. However, studies investigating efficacy with shortened applications are often based on modified reference procedures, making it difficult to claim sufficient efficacy [2]. It was investigated, whether Sterillium® med and Sterillium® pure can meet the unmodified efficacy requirements of EN 1500 in 15 seconds instead of 30 seconds [3]. Results 4 3 2 1 0 log10 reduction reference (2x 3 mL isopropanol for 2x 30 sec) disinfectant with responsible application (15 sec) disinfectant with application acc. to EN 1500 (15 sec) 3 mL 5 mL Sterillium® med Sterillium® pure 3 mL 5 mL 3.33 3.20 3.17 3.16 3.25 3.33 3.17 3.27 Sterillium® med and Sterillium® pure reduced the microbial load on the fingers of 20 volunteers similarly to the unmodified reference, both with the rub-in technique described in EN 1500 and with the so-called “responsible rub-in technique”. The latter has no specific order or steps. It only requires that the hands should be completely covered, focusing on the fingertips and thumbs [4]. Both ABHRs therefore meet the unmodified efficacy requirements of EN 1500 in 15 seconds. Efficacy in reduction of bacteria on the hands is compared between reference and test product. 5 1 Kramer et al. (2017) Shortening the application time of alcohol-based hand rubs to 15 seconds may improve the frequency of hand antisepsis actions in a neonatal intensive care unit. Infect Control Hosp Epidemiol. 38:1430-1434 2 Eggerstedt et al. (2018) Alcohol-based hand rubs must meet the requirements of EN 1500. Infect Control Hosp Epidemol. 39:1018 3 Mönch et al. (2024) Alcohol-based hand rubs can fulfil efficacy requirements of EN 1500 in 15 seconds. GMS Hyg Infect Control 19:Doc41 4 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 5 Glowicz JB et al. (2023) SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent healthcare-associated infections through hand hygiene: 2022 Update. Infect Control Hosp Epidemiol 44:355–376 Disinfection with 2x 3 mL 60% isopropanol for 2x 30 s using a standardized rub-in technique. 3 2x 3 mL 2x 30 s Reference Sterillium® Disinfection in 15 s with 3 mL using ‘responsible rub-in technique’ or 5 mL using a standardized rub-in technique. 15 s 3 EN 1500 Controversy Conclusion References Both ethanolic Sterillium® med and propanolic Sterillium® pure meet the efficacy requirements for hygienic hand disinfection according to EN 1500 in 15 seconds. 3 mL 5 mL Use hand disinfectants safely. Always read the label and product information before use. 13
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