Unlike hospitals, people who enter schools, including students, staff and the public, are not screened for infectious agents. Cleaning and maintaining schools involves a careful look at several high-touch areas prone to germs, which could stem from colds, influenza, pneumonia, diarrhea and even leaking wounds. Understanding where these hot spots are and how they contribute to the overall health of a school is key.
Frequently touched surfaces will harbour bacteria and viruses. The number of bacteria present will depend on who touched the surface (sick person, healthy person, someone with good hand hygiene or poor hand hygiene). Door knobs, desk tops, light switches, pens and pencils may all have varying amounts of organisms on them.
Tips: Students should be encouraged to sanitize their hands after coughing, sneezing and using the toilet. Proper etiquette involves coughing or sneezing into one’s elbow fold, which helps limit the spread of organisms. At the end of the day or between classes, desk tops could be disinfected with a disinfectant that does not require rinsing, has a fast-acting contact time and has little potential to aggravate conditions like asthma. A San Francisco Department of Environment report, Safer Products and Practices for Disinfecting Surfaces, provides a list of alternative products, information on environmental and health hazards and surface compatibility.
Place signs at school entrances to remind students, staff and visitors that they should not enter a building if they are unwell. Still, schools may want to consider having a “sick room” where ill children can lie down and be supervised until a parent or caregiver can bring the child to a more appropriate space. Some families may not be able to provide alternate space for their children, so schools should consider a formal sick area, with appropriate tissues, cleaning and disinfectant agents and appropriate equipment for hand hygiene, including a sink with warm running water and soap, along with alcohol-based hand rub.
Areas around toilets, door pushes or pulls, and taps at the sink all harbour bacteria and viruses. If someone has vomited within a washroom, or their diarrhea is linked to a virus like Norovirus (a winter vomiting disease), many surfaces will be contaminated. A spray of a virus can cover areas up to two metres (six feet away) and survive on surfaces for days.
Tips: After using a restroom, hand hygiene is vital, and washing hands may be superior to alcohol-based hand rubs if hands are visible soiled or if vomiting and diarrhea has occurred. Use paper towels to turn off taps or install taps that automatically turn on when hands are placed beneath them. Having a procedure for reporting soiled washrooms may also be beneficial to help janitorial staff quickly clean up visibly soiled surfaces. Signs within the washroom reminding users of the importance of hand hygiene also help with compliance.
Any area of a gym used for contact sports, such as wrestling or sports where athletes share equipment, can lead to bacteria being shared.
Tips: Mats should be disinfected and athletes should shower after playing sports. Students and staff should not share towels and bars of soap. If equipment needs to be shared, it should be wiped with a disinfectant or sprayed with a sanitizing agent. Athletes could either be designated to clean used equipment on a rotational basis or schools could designate this function to janitorial staff.
Shared work spaces
Since most students now depend on computers and use shared work spaces in areas like libraries, there are more and more high-touch surfaces that need to be considered. The keyboard and mouse of shared computers will harbour bacteria and viruses.
Tips: Regular cleaning and disinfection may harm some of these components if they become too wet. Try to find keyboards or mice that tolerate such cleaning. Having a safe, effective disinfectant wipe in common areas allows students to clean and disinfect equipment before and/or after use. Mounting hand sanitizer within these areas will also help students sanitize hands after they use common equipment. Also, students should not eat in computer labs, as keeping keyboards and mice clean is very difficult, and eating with bacteria or viruses on their hands can lead to illnesses. School administration needs to address what products janitorial staff use, and what products are available for students and teachers to use within classrooms and other common areas. Alcohol-based hand rubs should be available and monitored so abuse does not occur. Utilizing disinfectant wipes with a safe chemistry that is not an asthmagen can protect both students and staff.
Students who congregate and sit in hallways may be prone to picking up bacteria and viruses from the floor. Lockers also carry organisms, but especially on the lock—a high-touch area.
Tips: If students do sit on a floor or carpet, hand hygiene must be emphasized. In large schools, while it may not be practical to disinfect locks on a regular basis, providing an abundance of hand sanitizer before a student enters or leaves a classroom can help reduce infections overall.
Jim Gauthier, MLT, CIC, is the senior clinical advisor of infection prevention at Sealed Air Diversey Care. He is a medical laboratory technologist by training and board-certified in Infection Control