Final Report Summary - CLEANWARD (Safe, Chemical-Free, Cleaning of Hospital Ward Surfaces)
Executive Summary:
Executive Summary
Water used in cleaning systems typically found on wards and hospital corridors usually contains chemical biocides. The use of UMF based technology can reduce the amount and type of effluent coming from contract cleaners’ buckets to an absolute minimum as well as effectively remove microbes/debris from surfaces such as floors. The Cleanward system consists of a module that is retrofitted to existing cleaning modules used by contract cleaners all over the world, whereby a new range of TiO2 coated ultra microfibre (UMF) mops and fabrics can be placed in a chamber as part of the cleaners’ equipment. Research work continued throughout the second period of the project and important advances have been made in designing and developing a system that can disinfect the mop material as well as the cleaning water. The technology utilises UV disinfection, advanced photo-catalytic oxidation and membrane filtration techniques. We have therefore built on the prior art by further developing and optimising these technologies into an integrated, cost-effective, energy saving, non-polluting system for healthcare environments.
The main components of the technology are: (1) UV water disinfection unit, including assembly of filters and low pressure mercury lamps, and (2) LED-UV modules for the disinfection of the ultra-microfiber cloth used as the mopping material. Tests were carried out to optimise the installation of these components and also assess the functionality of the overall system. The UV water disinfection unit and low pressure UV mercury lamps achieved the highest microbial removal of up to 100% within 5 minutes of treatment. And the LED-UV chambers achieved microbial inactivation of over 99.8% after exposure time of 20 minutes or more. Further tests demonstrated that bacteria are actually transferred from the floor by the mop material into the bucket water during the mop washing and rinsing stages. As a result, the major challenge is to kill the bacteria in the bucket and consequently wash and rinse the mop material in disinfected clean water. The washing and rinsing of the mop in disinfected water is necessary to prevent the transference of bacteria back onto the floor. This challenge has been fully solved by the design and installation of the filter/UV water disinfection unit. Because the filter/UV water disinfection can be continuously operated during the course of the cleaning cycle, the results showed that it was possible to remove microbial contamination from water using the developed prototype. The installation of the UV water disinfection unit has been implemented as the major component of the fully functional prototype Cleanward system for use in healthcare environments and for validation trials. The study has also included literature review and testing of prototypes to assess the effectiveness of microfiber mops in removing debris/microorganisms from floors in comparison with conventional cleaning systems. This analysis shows that the microfiber mopping system offers many health and safety benefits, reduces environmental impact, and has tangible cost benefits.
Project Context and Objectives:
In economic and labour terms, industrial cleaning represents one of the most dynamic areas of corporate services. More than 158,000 cleaning contractors employ 3.75 million employees in Europe, generating a turnover of €62 billion. The sector has recorded an almost continuous growth since 1989, irrespective of the general level of economic activity.
In Europe, the Healthcare contract cleaning market represents 7% of the total; therefore it has a turnover of at least €4.3 Billion. The cleaning industry is a highly labour-intensive sector where about 75% of the total employers’ costs are labour costs. The hospital cleaning equipment market is €500 Million.
In addition to this cost it can also be shown that Healthcare Associated Infections (HCAI) is a major cost to the Healthcare sector. The impact of HCAI implies prolonged hospital stay, long-term disability, increased resistance of microorganisms to antimicrobials, a massive additional financial burden for health systems, high costs for patients and their families, and excess deaths. In Europe, HCAIs cause 16 million extra-days of hospital stay, 37 000 attributable deaths, and contribute to an additional 110,000 every year, with a mean HCAI prevalence of 7.1% where the average length of hospital stays is 4 days. Data shows that significant savings, estimated at €1.5 billion, could be achieved through the implementation of good clinical and hygiene practices. Therefore the Cleanward system with 10% penetration of the market would save €150,000,000. The results of the economic evaluation suggest that successful implementation of the Cleanward system might release cash savings of €150 million and save 450 lives per year.
Project Results:
The design of the prototypes and considerations for the design were successfully completed. A number of factors were considered for the design and the main purpose of the prototype is to disinfect the mop microfiber material as well as disinfect the water in the cleaning bucket to prevent growth and transference of microorganisms. Accordingly, the project consortium has developed a prototype to allow the disinfection of microfiber materials and process (bucket) water to occur in separate UV units: (i) UVA-LED modules for the disinfection of TiO2 coated microfiber materials; and (ii) 254nm low pressure UV mercury lamp for the disinfection of process water. In the latter case, no application of TiO2 is required as direct UV inactivation of microbial cells occurs at this wavelength. The design has also taken into account the assembly of the UVA-LED PCBs and integration of the UV chambers with the SYR cleaning bucket.
In this regard, the designed Cleanward cleaning system consists of a module that can be retrofitted to the existing cleaning Scot Young Research (SYR, our SME partner and project co-ordinator) modules. The TiO2 coated UMF materials can be placed in the UV chamber as part of the cleaners’ equipment. In order to achieve the desired functionalities, the following considerations for the design and development of the UV chamber have been taken into account:
• Cleaning in hospital environments
• Application of microfiber for cleaning
• Biocidal effect of titanium dioxide
• Effect of turbidity and particles on UV disinfection
• Mechanism of UV disinfection
Further, amongst the design elements, consideration has been given to the following:
• Introduction of the UMF fabric into the LED UV chamber
• Maximising LED coverage to increase UV intensity and effectiveness
• Integration of the UV disinfection units with the SYR cleaning system
• Prevention of water and UV leakage
• User interface requirements
• Fail safe mechanism
Important advances (including microfiber technology and photo-catalytic techniques) have been achieved for the inhibition of growth of microorganisms. The project consortium has built on the prior art by further developing and optimising these technologies into an integrated, cost-effective, energy saving, non-polluting system for healthcare environments.
The key features of the selected design of the prototype are:
• Rollers for removal of excess water from microfiber materials
• Water bucket for washing/rinsing microfiber materials
• UV chamber – UVA-LED modules for the disinfection of TiO2 coated microfiber materials
• 254 nm low pressure UV mercury lamp for the disinfection of process water. No application of TiO2 is required as direct photo-catalysis of microbial cells will occur at this wavelength
• Water re-circulation between the sump and water bucket (via pump/filter and UV lamp)
• Filters to reduce turbidity and particles in order to enhance UV disinfection of the bucket water
Because the presence of particles and turbidity have negative impact on UV disinfection, therefore in order to enhance UV disinfection of the bucket, the design includes the installation of a water re-circulation pump and filters prior to the UV disinfection stage. A low level sensor is installed at the bottom of the bucket sump – the low level sensor prevents the user from switching on the pump when there is no water in the bucket. The filtration stage includes two polypropylene cartridge membrane filters connected in series. These membrane filters are installed for the filtration of dirty water from the sump of the bucket. Following the filtration stage, the filtered water is then disinfected using two 11W low
pressure UV mercury lamps connected in series.
After UV disinfection, clean water is returned to the bucket for rinsing the mop microfiber material with the help of rollers that scrub the mop, where the nozzles (located within the roller assembly of the bucket) spray clean water onto the microfiber materials inserted between the rollers for scrubbing and rinsing purposes.
Additionally, a control box is installed for electrical connections and switch on/off of the following components pump, UV lamps, electronic flow meter, low level sensor and LED UV chamber. Photo-catalytic oxidation has a great potential for inactivation of
bacteria on TiO2 coated microfiber materials, we have also developed LED-UV chamber that can be integrated with bucket for the disinfection of UMF mop material.
The in-ward trials of the Cleanward system consisted of the use of ultra-microfiber as the mopping material, filtration and UV water disinfection units. The study has included initial trials that were conducted within the hospital laboratories of the NHS Trust (Birmingham, United Kingdom). The study assessed the effectiveness of microfiber mops in removing microorganisms from floors as well as the ergonomic of the system. Although the disinfection protocol was effective in removing the contamination, samples collected from the bucket demonstrated that bacterial contamination was detected after approximately 48 hours so daily disinfection of the system will be required.
The study has also included literature review and testing of prototypes to assess the effectiveness of microfiber mops in removing debris/microorganisms from floors in comparison with conventional cleaning systems. This analysis shows that the microfiber mopping system offers many health and safety benefits, reduces environmental impact, and has tangible cost benefits. The use of the microfiber system has the following benefits: (1) Effective at capturing microbes: Several studies have determined that microfiber is better than cotton at capturing bacteria. The case studies, including the Cleanward project, have demonstrated that the amount of bacteria picked up by a cotton-loop mop and by a microfiber mop. The cotton-loop mop reduced bacteria on the floors by 30%, whereas the microfiber mop reduced bacteria by 99%; (2) Prevents cross-contamination: Microfiber cloths and mops are available in different colours so that a colour-coding system can be implemented for specific uses; (3) Reduces chemical and water use more effectively: The case studies revealed that the microfiber mopping system uses less water and chemicals, it reduced the amount of water and chemicals handled, and it eliminated the need to wring the heavy cotton mops, resulting in less potential for worker injury; (4) As demonstrated by the Cleanward project, because the UV water disinfection can be continuously operated during the course of the cleaning cycle, the results show that it is possible to remove microbial contamination from water using the developed prototype enabling repeated use of the same cleaning water. All these benefits are beneficial to the worker’s health and well-being.
Potential Impact:
Effective cleaning of surfaces is vital to prevent the spread of contamination and disease. It is also vital that the cleaning process does not allow micro-organisms to build resistance to the chemicals used. Prevention of spreading disease is vital in the healthcare sector; it is also a high priority in catering sectors. Optimising cleaning to minimise risk to life is the key objective in healthcare but there are secondary concerns one of which is the environmental sustainability of the sector. Effective cleaning utilises powerful chemicals which once consumed require disposal, for example by rinsing which consumes water. Further, there has been a trend towards use disposable cleaning products which require disposal usually in landfill.
The CLEANWARD Cleaning technology has advanced in terms of materials with ultra- microfiber cloth and with chemical free sterilisation using UV light and photo-catalytic reactions. The innovative combination of materials and chemical free technology provides a product which can deliver effective cleaning and disinfection without consumption of chemicals and with reduced water consumption and disposal in landfill.
Exploitation of the technology in the initial healthcare sector is through Scott Young with a view to subsequent commercialisation in other sectors such as catering and contract cleaning at a later stage. Dissemination has taken place through relevant associations and through European Trade Shows related to cleaning or materials:
• AHCP - Association of Healthcare Cleaning Professionals – 40 project related discussions
• The British Medical Association
• American Journal of Infection Control
• BMC Infectious Diseases
• CleanFest – 12 expressions of interest
• Cleaning Show - 50 expressions of interest
Additionally, exhibition stands and posters presentations have been used at major European and worldwide conferences for the presentation of the project results to potential stakeholders. See below for details:
The total EU market size for cleaning equipment sales is expected to be €0.5b in healthcare and €1.5b in all cleaning sectors. The unit price for the CLEANWARD technology is still to be finalised and expected to be over €1000, therefore sales of 12,000 units in healthcare would give 2% market penetration.
Investment requirement is €1.45m during the research phase and £1m for commercialisation. The business is expected to have an annual turnover €12m in the five years after the project completion with cumulative turnover of €25.8m and generate profits of €6.4m (annual) and €11.4m (cumulative) with a forecast internal rate of return of 34% (including initial development) or 82% (from start of commercialisation). As an investment proposition, CLEANWARD is highly attractive option.
List of Websites:
http://www.Cleanward.eu
Executive Summary
Water used in cleaning systems typically found on wards and hospital corridors usually contains chemical biocides. The use of UMF based technology can reduce the amount and type of effluent coming from contract cleaners’ buckets to an absolute minimum as well as effectively remove microbes/debris from surfaces such as floors. The Cleanward system consists of a module that is retrofitted to existing cleaning modules used by contract cleaners all over the world, whereby a new range of TiO2 coated ultra microfibre (UMF) mops and fabrics can be placed in a chamber as part of the cleaners’ equipment. Research work continued throughout the second period of the project and important advances have been made in designing and developing a system that can disinfect the mop material as well as the cleaning water. The technology utilises UV disinfection, advanced photo-catalytic oxidation and membrane filtration techniques. We have therefore built on the prior art by further developing and optimising these technologies into an integrated, cost-effective, energy saving, non-polluting system for healthcare environments.
The main components of the technology are: (1) UV water disinfection unit, including assembly of filters and low pressure mercury lamps, and (2) LED-UV modules for the disinfection of the ultra-microfiber cloth used as the mopping material. Tests were carried out to optimise the installation of these components and also assess the functionality of the overall system. The UV water disinfection unit and low pressure UV mercury lamps achieved the highest microbial removal of up to 100% within 5 minutes of treatment. And the LED-UV chambers achieved microbial inactivation of over 99.8% after exposure time of 20 minutes or more. Further tests demonstrated that bacteria are actually transferred from the floor by the mop material into the bucket water during the mop washing and rinsing stages. As a result, the major challenge is to kill the bacteria in the bucket and consequently wash and rinse the mop material in disinfected clean water. The washing and rinsing of the mop in disinfected water is necessary to prevent the transference of bacteria back onto the floor. This challenge has been fully solved by the design and installation of the filter/UV water disinfection unit. Because the filter/UV water disinfection can be continuously operated during the course of the cleaning cycle, the results showed that it was possible to remove microbial contamination from water using the developed prototype. The installation of the UV water disinfection unit has been implemented as the major component of the fully functional prototype Cleanward system for use in healthcare environments and for validation trials. The study has also included literature review and testing of prototypes to assess the effectiveness of microfiber mops in removing debris/microorganisms from floors in comparison with conventional cleaning systems. This analysis shows that the microfiber mopping system offers many health and safety benefits, reduces environmental impact, and has tangible cost benefits.
Project Context and Objectives:
In economic and labour terms, industrial cleaning represents one of the most dynamic areas of corporate services. More than 158,000 cleaning contractors employ 3.75 million employees in Europe, generating a turnover of €62 billion. The sector has recorded an almost continuous growth since 1989, irrespective of the general level of economic activity.
In Europe, the Healthcare contract cleaning market represents 7% of the total; therefore it has a turnover of at least €4.3 Billion. The cleaning industry is a highly labour-intensive sector where about 75% of the total employers’ costs are labour costs. The hospital cleaning equipment market is €500 Million.
In addition to this cost it can also be shown that Healthcare Associated Infections (HCAI) is a major cost to the Healthcare sector. The impact of HCAI implies prolonged hospital stay, long-term disability, increased resistance of microorganisms to antimicrobials, a massive additional financial burden for health systems, high costs for patients and their families, and excess deaths. In Europe, HCAIs cause 16 million extra-days of hospital stay, 37 000 attributable deaths, and contribute to an additional 110,000 every year, with a mean HCAI prevalence of 7.1% where the average length of hospital stays is 4 days. Data shows that significant savings, estimated at €1.5 billion, could be achieved through the implementation of good clinical and hygiene practices. Therefore the Cleanward system with 10% penetration of the market would save €150,000,000. The results of the economic evaluation suggest that successful implementation of the Cleanward system might release cash savings of €150 million and save 450 lives per year.
Project Results:
The design of the prototypes and considerations for the design were successfully completed. A number of factors were considered for the design and the main purpose of the prototype is to disinfect the mop microfiber material as well as disinfect the water in the cleaning bucket to prevent growth and transference of microorganisms. Accordingly, the project consortium has developed a prototype to allow the disinfection of microfiber materials and process (bucket) water to occur in separate UV units: (i) UVA-LED modules for the disinfection of TiO2 coated microfiber materials; and (ii) 254nm low pressure UV mercury lamp for the disinfection of process water. In the latter case, no application of TiO2 is required as direct UV inactivation of microbial cells occurs at this wavelength. The design has also taken into account the assembly of the UVA-LED PCBs and integration of the UV chambers with the SYR cleaning bucket.
In this regard, the designed Cleanward cleaning system consists of a module that can be retrofitted to the existing cleaning Scot Young Research (SYR, our SME partner and project co-ordinator) modules. The TiO2 coated UMF materials can be placed in the UV chamber as part of the cleaners’ equipment. In order to achieve the desired functionalities, the following considerations for the design and development of the UV chamber have been taken into account:
• Cleaning in hospital environments
• Application of microfiber for cleaning
• Biocidal effect of titanium dioxide
• Effect of turbidity and particles on UV disinfection
• Mechanism of UV disinfection
Further, amongst the design elements, consideration has been given to the following:
• Introduction of the UMF fabric into the LED UV chamber
• Maximising LED coverage to increase UV intensity and effectiveness
• Integration of the UV disinfection units with the SYR cleaning system
• Prevention of water and UV leakage
• User interface requirements
• Fail safe mechanism
Important advances (including microfiber technology and photo-catalytic techniques) have been achieved for the inhibition of growth of microorganisms. The project consortium has built on the prior art by further developing and optimising these technologies into an integrated, cost-effective, energy saving, non-polluting system for healthcare environments.
The key features of the selected design of the prototype are:
• Rollers for removal of excess water from microfiber materials
• Water bucket for washing/rinsing microfiber materials
• UV chamber – UVA-LED modules for the disinfection of TiO2 coated microfiber materials
• 254 nm low pressure UV mercury lamp for the disinfection of process water. No application of TiO2 is required as direct photo-catalysis of microbial cells will occur at this wavelength
• Water re-circulation between the sump and water bucket (via pump/filter and UV lamp)
• Filters to reduce turbidity and particles in order to enhance UV disinfection of the bucket water
Because the presence of particles and turbidity have negative impact on UV disinfection, therefore in order to enhance UV disinfection of the bucket, the design includes the installation of a water re-circulation pump and filters prior to the UV disinfection stage. A low level sensor is installed at the bottom of the bucket sump – the low level sensor prevents the user from switching on the pump when there is no water in the bucket. The filtration stage includes two polypropylene cartridge membrane filters connected in series. These membrane filters are installed for the filtration of dirty water from the sump of the bucket. Following the filtration stage, the filtered water is then disinfected using two 11W low
pressure UV mercury lamps connected in series.
After UV disinfection, clean water is returned to the bucket for rinsing the mop microfiber material with the help of rollers that scrub the mop, where the nozzles (located within the roller assembly of the bucket) spray clean water onto the microfiber materials inserted between the rollers for scrubbing and rinsing purposes.
Additionally, a control box is installed for electrical connections and switch on/off of the following components pump, UV lamps, electronic flow meter, low level sensor and LED UV chamber. Photo-catalytic oxidation has a great potential for inactivation of
bacteria on TiO2 coated microfiber materials, we have also developed LED-UV chamber that can be integrated with bucket for the disinfection of UMF mop material.
The in-ward trials of the Cleanward system consisted of the use of ultra-microfiber as the mopping material, filtration and UV water disinfection units. The study has included initial trials that were conducted within the hospital laboratories of the NHS Trust (Birmingham, United Kingdom). The study assessed the effectiveness of microfiber mops in removing microorganisms from floors as well as the ergonomic of the system. Although the disinfection protocol was effective in removing the contamination, samples collected from the bucket demonstrated that bacterial contamination was detected after approximately 48 hours so daily disinfection of the system will be required.
The study has also included literature review and testing of prototypes to assess the effectiveness of microfiber mops in removing debris/microorganisms from floors in comparison with conventional cleaning systems. This analysis shows that the microfiber mopping system offers many health and safety benefits, reduces environmental impact, and has tangible cost benefits. The use of the microfiber system has the following benefits: (1) Effective at capturing microbes: Several studies have determined that microfiber is better than cotton at capturing bacteria. The case studies, including the Cleanward project, have demonstrated that the amount of bacteria picked up by a cotton-loop mop and by a microfiber mop. The cotton-loop mop reduced bacteria on the floors by 30%, whereas the microfiber mop reduced bacteria by 99%; (2) Prevents cross-contamination: Microfiber cloths and mops are available in different colours so that a colour-coding system can be implemented for specific uses; (3) Reduces chemical and water use more effectively: The case studies revealed that the microfiber mopping system uses less water and chemicals, it reduced the amount of water and chemicals handled, and it eliminated the need to wring the heavy cotton mops, resulting in less potential for worker injury; (4) As demonstrated by the Cleanward project, because the UV water disinfection can be continuously operated during the course of the cleaning cycle, the results show that it is possible to remove microbial contamination from water using the developed prototype enabling repeated use of the same cleaning water. All these benefits are beneficial to the worker’s health and well-being.
Potential Impact:
Effective cleaning of surfaces is vital to prevent the spread of contamination and disease. It is also vital that the cleaning process does not allow micro-organisms to build resistance to the chemicals used. Prevention of spreading disease is vital in the healthcare sector; it is also a high priority in catering sectors. Optimising cleaning to minimise risk to life is the key objective in healthcare but there are secondary concerns one of which is the environmental sustainability of the sector. Effective cleaning utilises powerful chemicals which once consumed require disposal, for example by rinsing which consumes water. Further, there has been a trend towards use disposable cleaning products which require disposal usually in landfill.
The CLEANWARD Cleaning technology has advanced in terms of materials with ultra- microfiber cloth and with chemical free sterilisation using UV light and photo-catalytic reactions. The innovative combination of materials and chemical free technology provides a product which can deliver effective cleaning and disinfection without consumption of chemicals and with reduced water consumption and disposal in landfill.
Exploitation of the technology in the initial healthcare sector is through Scott Young with a view to subsequent commercialisation in other sectors such as catering and contract cleaning at a later stage. Dissemination has taken place through relevant associations and through European Trade Shows related to cleaning or materials:
• AHCP - Association of Healthcare Cleaning Professionals – 40 project related discussions
• The British Medical Association
• American Journal of Infection Control
• BMC Infectious Diseases
• CleanFest – 12 expressions of interest
• Cleaning Show - 50 expressions of interest
Additionally, exhibition stands and posters presentations have been used at major European and worldwide conferences for the presentation of the project results to potential stakeholders. See below for details:
The total EU market size for cleaning equipment sales is expected to be €0.5b in healthcare and €1.5b in all cleaning sectors. The unit price for the CLEANWARD technology is still to be finalised and expected to be over €1000, therefore sales of 12,000 units in healthcare would give 2% market penetration.
Investment requirement is €1.45m during the research phase and £1m for commercialisation. The business is expected to have an annual turnover €12m in the five years after the project completion with cumulative turnover of €25.8m and generate profits of €6.4m (annual) and €11.4m (cumulative) with a forecast internal rate of return of 34% (including initial development) or 82% (from start of commercialisation). As an investment proposition, CLEANWARD is highly attractive option.
List of Websites:
http://www.Cleanward.eu