This Web Exclusive comes from Peter M. Leahy, segment manager, Office Building & Lodging, Kimberly-Clark Professional.
It happens around this time every year. The sore throats, runny noses, and coughs herald the start of flu season.
Up to 20% of the U.S. population gets the seasonal flu annually. More than 200,000 are hospitalized with flu-related complications, and 36,000 people in this country die from flu-related causes.
This year, the emergence of the H1N1 influenza virus—which has caused the first influenza pandemic (global outbreak of disease) in more than 40 years—may cause this flu season to be worse than a regular flu season. It is thought that a lot more people will get sick, be hospitalized, and die than during a typical flu season. As of October 25, there have been more than 440,000 confirmed cases of H1N1 and 5,700+ deaths worldwide, according to the World Health Organization, which cautions that the actual number of cases (ie, milder, unreported cases) is likely significantly higher.
While flu outbreaks can happen before the winter months set in, most of the time influenza activity peaks in January or later. This year, the 2009 H1N1 virus caused illnesses, hospitalizations, and deaths in the U.S. even during the summer months, when influenza is very uncommon.
The uncertain severity and timing of this year’s seasonal-plus-H1N1 flu activity means that schools, businesses, and workplaces need to prepare for higher absenteeism rates, along with cases of presenteeism—when someone goes to work or school while sick—leading to productivity declines and the possibility of spreading illness to others.
Fortunately, there are several things facility managers can do to help prepare their employers and occupants of their buildings for the upcoming flu season and to respond if an outbreak occurs in their facilities. Even seemingly simple strategies like facility sanitation and giving occupants the tools they need for proper personal hygiene can help reduce the spread of germs during flu season and other times of the year.
Influenza 101
Some people may confuse the symptoms of the common cold with those of the flu. Both viruses enter the body through the mucous membranes of the nose, eyes or mouth. Cold symptoms are less severe than flu symptoms and typically begin with a sore throat, which usually goes away after a day or two. Nasal symptoms, runny nose, and congestion follow, along with a cough by the fourth and fifth days. Fever is uncommon in adults. Cold symptoms usually last for about a week with the contagious period being the first three days.
The flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times it can lead to death. Some people—including older people, young children, pregnant women, and people with certain health problems such as asthma, diabetes, or heart disease—are at increased risk for serious complications from the flu. These may include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions.
Someone infected with the flu may be able to infect others beginning one day before symptoms develop and up to seven or more days after becoming sick. Symptoms of seasonal flu include:
- Fever (often high)
- Headache
- Extreme tiredness
- Dry cough
- Sore throat
- Runny or stuffy nose
- Muscle aches
- Stomach symptoms such as nausea, vomiting, diarrhea (particularly associated with H1N1 flu)
Flu viruses spread mainly from person to person through coughing or sneezing. Sometimes, people may become infected by touching something with flu viruses on it and then touching their mouth or nose. In fact, some germs can live for two hours or more on surfaces like doorknobs, desks, and tables.
Preventing the Spread of Flu: Education
There are several steps facility managers can take to help prevent the spread of influenza and other germs in their buildings. Education is critical; people not only need to know how to spot the signs of flu (as outlined above) so they can care for themselves appropriately, they also need to know how to avoid getting sick in the first place and how to avoid spreading germs to others.
Consider instituting a Healthy Tips campaign with letters to building occupants and posters in prominent locations detailing recommendations from health experts like the Centers for Disease Control and Prevention, which advocates the following tips to help stop the spread of germs:
- Cover your mouth and nose when you sneeze or cough. It’s best to cough or sneeze into a tissue, which should be thrown away after it is used, or into one’s sleeve. If you sneeze or cough into your hands, be sure to clean your hands afterward—every time you cough or sneeze.
- Clean your hands often. When possible, use soap and warm water and rub hands vigorously together for 15 to 20 seconds, scrubbing all surfaces of the hands to help dislodge and remove germs. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. If using a gel, rub the gel in your hands until they are dry.
- Avoid touching your eyes, nose, or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
- Stay home when you are sick (and for at least 24 hours after fever is gone) and check with a health care provider when needed. Keeping your distance from others may protect them from getting sick.
The CDC offers free, downloadable posters and other materials to help you get started at these links: www.cdc.gov/germstopper/work.htm and www.cdc.gov/flu. In addition, the World Health Organization posts a visual, step-by-step guide for proper handwashing here. Consider posting this guide in every restroom in the building as well as by hand sinks in break areas.
Preventing the Spread of Flu: Facility Issues
Educating yourself and building occupants about how to prevent the spread of flu is only one step. You’ll also need to make sure you have the right infection control tools for the job. That means stocking workstations and public areas with plenty of facial tissue. Anti-viral facial tissue is now available for this purpose. In addition, you should install wall-mounted dispensers for alcohol gel hand sanitizers throughout your facility. It’s also important to make sure restrooms don’t run out of hand soap and paper towels, and that sufficient numbers of no-touch disposal receptacles are provided for used hand towels and used facial tissue. Keeping surfaces spot-sanitized throughout the day is another good idea.
When stockpiling items like hand soaps and cleaning supplies, the Occupational Safety & Health Administration recommends being aware of each product’s shelf life and storage conditions (e.g., avoid areas that are damp or have temperature extremes) and incorporating product rotation (e.g., consume oldest supplies first) into your stockpile management program.
One area of particular concern when stepping up facility sanitation efforts is the restroom—an area where microorganisms can flourish. Lavatory surfaces that are touched frequently may serve as reservoirs of microbial contamination. In fact, research from Dr. Charles Gerba of the University of Arizona discovered high amounts of bacteria on restroom surfaces:
- The average toilet paper dispenser has more than 150 times the amount of bacteria than the average toilet seat.
- Paper towel dispensers were found to have more than 50 times more bacteria on average than a typical public restroom toilet seat.
Facility managers looking to minimize the potential spread of germs can install touchless restroom dispensing systems. The electronic revolution that has taken place in the washroom in recent years has greatly enhanced restroom hygiene by eliminating the need to touch dispensers, faucets and toilet handles during use. These systems can help make the task of using as well as maintaining the restroom easier, more efficient and more cost-effective.
Not all touchless systems are electronic, however. There are also mechanical no-touch towel dispensers, for example, with no levers to pull, that provide the same hygienic benefits as sensor-activated dispensers. Continue the no-touch theme by providing no-touch disposal receptacles for used towels and installing doorless entryways so that freshly washed hands don’t have to grab a dirty door handle on the way out of the restroom.
Remember that nothing says unhygienic more than a restroom without an adequate supply of toilet paper, hand soap, and paper towels. Highcapacity systems help ensure adequate supply as well as ease maintenance headaches and reduce costs and waste.
Not All Disinfection Methods Are Equal
While germs are common on certain surfaces in the restroom, they can also flourish throughout a building. To prevent the spread of flu, the CDC recommends that routine cleaning of commonly touched surfaces be performed regularly. Use the cleaning agents that are usually used in these areas, and follow directions on the label.
In the case of a flu outbreak, facility managers may choose to increase their surface sanitation efforts. If that happens, it is important for janitorial staff to minimize contamination of the cleaning solution and cleaning tools used for these efforts. Keep in mind that bucket solutions become contaminated almost immediately during cleaning, and continued use of the solution transfers increasing numbers of microorganisms to each subsequent surface to be cleaned. Another source of contamination in the cleaning process is the cleaning cloth, especially if left soaking in dirty cleaning solution. This is why the choice of wiping materials is important.
Indeed, it may be surprising to learn that common systems, such as using a cotton rag or cellulose-based wiper to apply common disinfectants such as bleach to surfaces, deliver less-than-ideal concentrations of disinfectants to the surface. However, a non-woven wiper designed specifically to be compatible with bleach (and used in a closed-bucket system) can keep the active bleach ingredients stable for 72 hours, allowing a much higher concentration of active ingredients to reach the surface being cleaned, according to recent studies.
An enclosed system, with pre-saturated wipes dispensed from a port in the top of the closed bucket, helps avoid contamination of the wipes and cleaning solution while reducing exposure to chemical vapors and splashes, an advantage for janitorial staff.
According to the CDC, businesses and employers, in general, can play a key role in protecting employees’ health and safety, as well as in limiting the negative impact of influenza outbreaks on the individual, the community, and the nation’s economy. Facility managers should be on the front lines in the war against the flu and other germs in their facility. A combination of education and effective flu-prevention tools and practices will put facilities and their occupants in a good position to avoid the brunt of the flu this season.
Additional Resources
The CDC has published a number of Guidance documents to help different groups and facilities decrease the spread of flu:
For the protection of frontline healthcare and emergency medical workers at high risk of infection, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) issued a compliance directive to ensure uniform procedures when conducting inspections to identify and minimize or eliminate high to very high risk occupational exposures to the 2009 H1N1 influenza A virus.
The directive closely follows the Centers for Disease Control’s guidance.
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