Keeping a clean and sanitary workplace is your top priority before all else.

How well do you know the differences between Cleaning, Sanitizing, Disinfecting, and Sterilizing? And how well do you know the products and procedures used for each?

As of this writing, Coronavirus is in full force, so it’s very important to be sure that you are keeping your workspace to high levels of cleanliness.


CLEANING
Cleaning is done using detergent, but it doesn’t *kill* bacteria or other microorganisms, it simply removes them. To kill bacteria you must follow cleaning with sanitizing and disinfecting.

Cleaning physically removes soil from a surface with the aid of a detergent or other cleaning agent. Cleaners are simple and straightforward in contrast with sanitizers and disinfectants.

Cleaning agents include soap, detergents, solvents, abrasive cleaners, acid cleaners or some combination of these.

Cleaning-vinegar is a popular cleaner, but it isn’t a registered disinfectant or sanitizer and can’t necessarily kill dangerous bacteria.

The EPA does not test or regulate cleaners for effectiveness.

There are five main types of cleaning agents:

• 1. Soaps - Soap is a cleaning agent created by the chemical reaction of a fatty acid with an alkali. Soaps are made from natural ingredients, such as plant oils or animal fats which chemically react to lye (the alkali). Soap is generally in solid bar form. Chemically, soap contains molecules called surfactants. One end of soap molecules are hydrophilic (love water), the other end of soap molecules are hydrophobic (hate water). The hydrophobic end attaches to oils. This is how soap cleans - it causes drops of grease and dirt to be pulled off and suspended in water. With the Coronavirus outbreak, we have been told repeatedly to wash our hands, repeatedly, with soap and water. Why does soap work so well on the new coronavirus? Because the Covid-19 virus is a lipid enveloped virus. Soap dissolves the fat membrane, and the virus falls apart and becomes inactivated. All soaps are detergents, but not all detergents are soaps.
• 2. Detergents - Detergents are synthetic, man-made cleaning agents. They are generally in liquid form. They work much like soap, using surfactant molecules to break up dirt or soil, making it easy to wash away. A non-surfactant form of detergent is a proteolytic enzyme cleaner, which is used to dissolve proteins, such as blood or skin cells, which are attached to a surface. Proteolytic enzyme cleaners work really well when used in an ultrasonic tub similar to a jewelry cleaner.
• 3. Degreasers - Degreasers are sometimes known as solvent cleaners and are used to remove grease from surfaces. Many degreasers contain chemicals or solvents designed to cause a chemical reaction to change the state of a substance to make it easier to remove. Natural degreasers are distilled vinegar, baking soda, and orange peel oil.
• 4. Abrasives - Abrasives are mechanical cleaners. They can be substances with particles for grit such as salt or baking soda, or they can be physical objects such as brushes or scrubbing pads that depend on scrubbing action to clean dirt from hard surfaces.
• 5. Acids – Acid cleaners are the most powerful type of cleaning agent and should be used with care. If they are not diluted correctly, acid cleaners can be very poisonous and corrosive. Acid cleaning agents are used to remove corrosion, scaling and other inorganic mineral deposits. Normally, the active ingredients in such solutions include chelants and mineral acids along with corrosion inhibitors and surfactants.

Cleaning and sanitation are different because the cleaning steps address physical soils that are loose or adhering to a surface, and sanitation addresses bacteria.

Effective cleaning:

• 1. Remove loose dirt and particulate.
• 2. Wash with hot water (140 °F) and cleaning agent of choice.
• 3. Rinse well with water.
• 4. Air dry.

SANITIZING
Sanitizing is not a substitute for cleaning, but takes cleaning a step further by reducing the number of bacteria and other microorganisms on the surface of the object. Sanitizing can help prevent disease transmission and contamination.

However, a sanitized surface is NOT sterile or completely free of bacteria.

Sanitizing is the act or process of making something sanitary (clean) in relation to the conditions that affect cleanliness, hygiene and favor health.

Sanitizing is a chemical process that lessens and even kills germs on surfaces to make them safe for contact. Usually you sanitize dishes and utensils after using them. You also sanitize bed linens, gowns, and towels.

In the United States, sanitizers are agents that destroy 99.999% of BACTERIA in 30 seconds during the Official Detergent Sanitizer Test (a public health test).

Sanitizers and disinfectants are regulated by the Environmental Protection Agency (EPA) and therefore, must be certified through a process that tests them to meet certain pre-defined criteria. By law, a chemical product cannot be labeled as a sanitizer or a disinfectant unless, and until, it is EPA certified.

Chemical sanitizing generally involves either immersing the object in a sanitizing solution for a specific amount of time or spraying/wiping the object with the solution and allowing it to air-dry. Chemical sanitizers differ in their effectiveness on certain organisms and in the concentration, temperature, and contact time required to kill bacteria. Sanitizers are used at much lower concentrations than the concentrations used for disinfectants.

Both sanitizers and disinfectants must be tested against specific germs. Chemical labels must list out each of these germs individually. One sanitizer or disinfectant could kill germs X and Y while another sanitizer or disinfectant might kill germs Y and Z. It’s important to understand that a single sanitizer or disinfectant will not kill all microorganisms, and to know which germs your products work against.

Sanitizers are certified for bacteria only, while disinfectants can also be certified to kill viruses, mold, mildew, and fungi.

Sanitizing solutions must be correctly prepared to be effective. Follow the manufacturer’s instructions when preparing sanitizing solutions.

Water and bleach solutions can be both a sanitizer (in a lower concentration) and a disinfectant (in a higher concentration) and a pretty reliable, and powerful one at that, as long as you follow contact time recommendations.

Splash-less, scented, or color-safe bleaches are NOT recommended as sanitizers.

Common chemical sanitizers include chlorine, iodine, and quaternary ammonium compounds or “quats.”

• Chlorine (Bleach) - 1 teaspoon of liquid chlorine bleach to one gallon of warm water (at least 75°F) (200 ppm [parts per million] solution). Never add any other ingredient to the bleach solution. Immerse in solution for at least one minute (60 seconds). Air dry. Chlorine based sanitizers are the most commonly used sanitizers. They are effective against all bacteria.
• Iodine - Iodine compounds are used both as sanitizers and disinfectants, they are fast acting and effective against all bacteria. They are relatively nontoxic, non-irritating to skin, and stable. When used at 25 ppm, it is considered to act as a sanitizer. When applied at 75 ppm, it falls into the disinfectant category. Concentration range: 12.5 to 25 ppm.
• Quaternary Ammonia (QUAT, QAC) - Quaternary ammonium compounds in diluted form are odorless, colorless, and nontoxic. Advantages of QAC’s are that they leave a residual antimicrobial film, are stable at high temperatures, and are more effective in the presence of organic materials than chlorine (they are less affected by a light amount of soil than are other sanitizers). Quaternary ammonium compounds are used at 200 ppm as sanitizers. Longer contact time is needed with this sanitizer, since it is slow-acting against some common bacteria. They are generally ineffective against viruses, spores and Mycobacterium tuberculosis. Concentration: Per manufacturer's instruction.

Heat Sanitizing - There are three methods of using heat to sanitize surfaces:

• 1. Steam - kills 99.9% of germs at a temperature between 175 °F and 212 °F. To kill the most germs, keep them in contact with steam for at least 3 minutes. Often the process is effective enough to disinfect or even sterilize the surfaces. (we are not talking about your facial steamer, but try taking the temp of emitted steam to see where it’s at).
• 2. Hot water - at least 171ºF, soaked for 30 seconds.
• 3. Hot Air - must be at least 165ºF, cleaned items must be exposed to these temperatures for at least 30 seconds.

Allowing a surface to be exposed to high heat for a designated period of time will sanitize the surface. Using a higher temperature generally shortens the time required to kill bacteria.

UV Sanitizers (they are NOT sterilizers!) - An ultraviolet (UV) sanitizer is a tool used to get rid of the germs and microbes from an area or surface where the light is being applied. Studies published in several dental journals do indicate that UV sanitizers are effective at killing microorganisms and bacteria. Killing bacteria with UV light requires the use of germicidal wavelengths of 185-254 nanometers (nm). The average bacterium will be killed in ten seconds at a distance of six inches from the lamp. UV sanitizers are used to sanitize and store facial brushes, make-up brushes, and other reusable tools that cannot be sterilized. You must clean and disinfect the tools before storing in a UV sanitizer.
  

DISINFECTING
Disinfection is the destruction of viruses, bacteria, and fungi on *surfaces* that have come in contact with a client's skin, such as brushes and spatulas. Proper disinfection leaves a surface highly unlikely to transmit infection or cause disease. Disinfection is only for non-living surfaces because disinfectants are damaging to living skin and may lead to irritation or allergic reactions. Disinfectants kill 100% of CERTAIN microorganisms, but because disinfectants do not kill ALL microorganisms, especially bacterial spores, they are different from sterillants (something that kills 100% of all microorganisms = sterilizes). Disinfectants are NEVER used on people, only inanimate surfaces.

Disinfectants kill a wider range of microorganisms than sanitizers. They destroy all organisms in 10 minutes during the AOAC Use Dilution Test, a test regulated by the EPA to determine the efficiency of disinfectants.

In a hospital situation it's more important to kill ALL germs even if it takes longer, rather than to kill most of them quickly. Disinfecting is for the big messes, particularly those involving bodily fluids, blood, and the like. Hospitals disinfect areas that have come into contact with blood or other body fluids.

Disinfecting requires a stronger solution to destroy germs rather than simply reduce them. For example, you might disinfect areas where you change a baby's diaper.

- Bleach is a strong and effective disinfectant. Its active ingredient, sodium hypochlorite, denatures protein in micro-organisms and is therefore effective in killing bacteria, fungus and viruses. Household bleach works quickly and is widely available at a low cost. The Centers for Disease Control (CDC) recommends using a 1:10 solution for disinfecting surfaces and objects. 1 part bleach for every 9 parts water. A good amount to start with is 1/4 cup bleach and 2¼ cups of water. Never add any other ingredient to the bleach solution.

- Quaternary ammonium compounds (Quats) diluted anywhere from 600 to 2100 ppm is used as a disinfectant. Quats disinfectant cleaners should not be diluted down to 200 ppm and used as sanitizers. Not only does this violate the label instructions, it is dangerous because of the other chemicals present in the formulation.

- Phenol may have been the first surgical antiseptic. In 1865 the British surgeon Joseph Lister used phenol as an antiseptic to sterilize his operating field. With phenol used in this manner, the mortality rate from surgical amputations fell from 45 to 15 percent in Lister’s ward. Later, in 1879, Lister would go on to invent Listerine mouthwash.

Phenolics are phenol (carbolic acid) derivatives. These biocides act through membrane damage and are effective against enveloped viruses (such as coronavirus), rickettsia (a type of bacteria), fungi and vegetative bacteria. They require a 10 minute contact time. Phenol is quite toxic and concentrated solutions cause severe but painless burns of the skin and mucous membranes. High concentrations can irritate the skin, eyes, and lungs.

Carbolic acid is a poison that can be identified by its smell, which is commonly referred to as a phenolic odor or hospital odor. Pure phenol has a colorless, short, prismatic, needle-shaped, crystalline form. On exposure to air, it turns pink and liquefies. It is fat-soluble; therefore, it can attack the nervous system. It is also soluble in glycerin, ether, and alcohol, and it is slightly soluble in water. It is known specifically for its antiseptic or disinfectant property.

- Accelerated Hydrogen Peroxide (AHP) is a patented formula containing hydrogen peroxide that has been accelerated to dramatically increase its germicidal potency and enhance cleaning performance. AHP disinfectants have validated efficacy with short contact times. Unlike chlorine-based alternatives, AHP is highly efficient as both a cleaner and disinfectant in the presence of soil, inorganic, and organic matter, and body fluids. AHP is safe, it is sustainable, and it is environmentally friendly. There is no residue with AHP and it biodegrades to just oxygen and water.
  

STERILIZING
Sterilization is the complete destruction of all microscopic life on a surface. Hospitals use sterilization on surgical tools. Chemical sterilization is too hazardous for salons; however, pressurized steam sterilization (autoclaving) of nippers, files, and other tools is required in some areas and is preferred by some salons. Surfaces such as table tops and foot spas can’t fit into an autoclave and must be disinfected instead.

Chemical sterilants are specialized chemicals, such as glutaraldehyde or formaldehyde, which are capable of eliminating all forms of microbial life, including spores. The term sterilant conveys an absolute meaning; a substance can not be partially sterile.

Autoclaving at a temperature of 121⁰C (250⁰F), at 15 to 20 psi is one of the most convenient and effective means of sterilization available. The time is measured after the temperature of the material being sterilized reaches 121ºC (250ºF). Care must be taken to ensure that the steam can circulate around articles in order to provide even heat distribution.

Dry heat sterilizers are specialized ovens operating at 160° (320°F) or 170°C (340°F) for periods of 1-2 hours respectively. They are efficient for sterilizing glassware, metals, or other non-porous heat conductive materials. It is unsatisfactory for organic and inorganic materials that can act as insulation and is also unsuitable for heat labile materials.


CORONAVIRUS
Human coronaviruses were first identified in the mid-1960s. Coronavirus is a classification of a particular type of virus. They are a family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). The common coronaviruses are estimated to cause about a third of all cases of the common cold.

Coronaviruses are zoonotic, meaning they are transmitted between animals and people.

Coronaviruses are named for the crown-like spikes on their surface. Our current “disease” is named CoViD-19 which means CO-rona VI-rus Disease 2019. The scientific classification of the virus is called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).

There are 7 Coronaviruses that can infect people. They are:

The Common Coronaviruses that cause colds - people around the world commonly get infected with these:

1. 229E (alpha coronavirus) – you will see many disinfectants cover this one as it is responsible for the common cold, it infects humans and bats
2. NL63 (alpha coronavirus) - causes mostly upper, and at times, lower respiratory tract infection, community-acquired pneumonia, and also croup in children
3. OC43 (beta coronavirus) – responsible for the common cold, it infects humans and cattle
4. HKU1 (beta coronavirus) - originated from infected mice and is associated with community-acquired pneumonia

The Cornaviruses that cause outbreaks – these come from animals:

5. MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS) (from camels)
6. SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS) (from civet cats)
7. SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19) (from bats??)


Coronavirus and Soap
Soap is the best way to destroy the lipid envelope of the coronavirus and deactivate it. Soap is a detergent and detergents have surfactant molecules which attach one end to the lipids and the other end to water molecules. This is how soap and water literally rip apart the lipid envelope and wash the virus away.

Coronavirus and Hand Sanitizer
It takes alcohol 15 to 20 seconds to break down the lipid envelope that surrounds the virus proteins. Luckily, enveloped viruses are the easiest to destroy with alcohol. For personal care settings like your clinics, optimum alcohol concentration to kill viruses is 70% for isopropyl alcohol, and 80% for grain alcohol which is also known as ethanol or ethyl alcohol.

To make a hand sanitizer you should use a 2:1 ratio of alcohol to water or aloe vera, or even a cheap hyaluronic acid could probably work.


Coronavirus and Bleach
The CDC recommends a diluted bleach solution (⅓ cup bleach per 1 gallon of water or 4 teaspoons bleach per 1 quart of water) for virus disinfection.
To make a 10% bleach solution, you'll need 1 part bleach and 9 parts water.
A good amount to start with is 1/4 cup bleach and 2¼ cups of water. Carefully pour the bleach into the spray bottle or jar first, then add the water. Mixing the solution in this order will prevent the bleach from splashing up on you.

HOW TO PROCEED AT WORK

• Supply hand sanitizer and tissues at all workstations
• Stock plenty of disinfectant solution 
• Consider if additional disinfection of common use surfaces is needed during high risk times
• Encourage staff to stay home when sick
• Cross train employees to step in when needed
• Allow customers to cancel without penalty when sick

I hope this helps to clarify the different levels of hygiene that we need to take at work and how those different levels relate to the present conditions we are dealing with.

Good luck to you all and stay safe.  


XO Cassandra Lanning
The Renegade Esthetician
https://www.therenegadeesthetician.com/
https://renegade-esthetics.teachable.com/
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