Working to find solutions that are both safe and effective, many hospitals are implementing environmental cleaning programs that use non-toxic products to properly clean and disinfect medical facilities and equipment. But there's a bit of confusion about just how green cleaning for hospitals should be carried out.


Currently, a number of organizations offer guides to green cleaning in hospitals including Practice Greenhealth and Health Care Without Harm. But there are no industry-wide standards that administrators can use to determine the plan that will be beneficial for their particular facilities.


A recent report by the Health Care Research Collaborative notes that more studies are needed to determine the ways in which green cleaning for hospitals affect cleanliness and infection transmission. Entitled 'Green Cleaning in Healthcare: Current Practices and Questions for Future Research', the report was based on a literature review and five case studies in addition to analysis of 150 responses to an online hospital survey on current green cleaning practices.


So why would hospitals choose to go green in the first place? There are a number of benefits associated with choosing more environmentally-friendly cleaning products and practices including cutting waste, reducing water and energy consumption and improving indoor air quality. Cleaning chemicals can exacerbate health problems, particularly in vulnerable populations like newborns, pregnant women and the elderly. But the biggest concern associated with making these changes is cutting the rates of healthcare-associated infections.


"We need to provide more information — for example, what constitutes a green cleaning program for a healthcare facility," states co-author Anjali Joseph, Ph.D., in a press release. "Further, there is no clear evidence indicating whether cleaners that are promoted as 'green cleaners' effectively meet infection prevention needs and standards given the current focus on the environmental contribution to HAIs or whether such cleaners have unknown health risks. There is an urgent need to conduct research around cleaning in healthcare."


The practices collectively known as 'environmental cleaning for hospitals' represent a crucial cleaning protocol that prevents the spread of healthcare-acquired pathogens including methicillin-resistant Staphylococcus aureus (MRSA). Despite the name, this protocol does not include non-toxic green cleaning products as a standard; some hospitals choose to use these products instead of more conventional disinfectants due to concerns about chemicals in cleaners affecting the health of patients and staff.


However, aside from a list of EPA-approved disinfectants that includes some products with lower levels of volatile organic compounds, there are no standard recommendations for administrators who want to choose healthier cleaning products. It can be difficult to tell whether cleaners promoted as 'green' meet infection prevention needs, or whether they have unknown health risks.


In the five case study facilities noted in the report, nine green cleaning practices were noted, all of which fall into three main categories: selection of greener cleaning products that are either less toxic or consume fewer resources, changing methods of application and dispersion for increased effectiveness and less waste, and changing the design of the building in such a way that the need for cleaning is reduced. These facilities generally have to determine on their own the level of cleanliness that is acceptable based on infection risk estimation. With further research, the study authors assert, facility administration can make more informed decisions.


Furthermore, in almost all of these cases, facility administrators rarely monitored or evaluated the performance of the green cleaning products and procedures that had been adopted. If studies confirmed that green cleaning for hospitals resulted in benefits like reduced water usage, healthier indoor air quality and lower levels of infection rates, such practices would become much more popular.


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