Surface sanitation in health care: How effective is it?

Aug. 8, 2017
Dr. Linda Lee points out that removing infectious particles from the air before reaching the surface enables better sanitation. 

By Dr. Linda D. Lee, MBA

One of the biggest problems in health care is maintaining a high level of sanitation. Horror stories about people checking into a hospital for a routine procedure, only to develop a severe infection or even die, are numerous and with good reason—it happens quite often. In fact, WHO, the World Health Organization, provided statistics to show that one of every 136 patients checking into a hospital in the US ends up with a serious illness caused by an infection from being in the hospital. Changing that statistic to numbers means that there are two million cases of infection each year resulting in 75,000 deaths.(1)

Those numbers can take their toll on a hospital's reputation. When you consider that one person will tell eight people and those eight tell eight more, it can create an ever-growing circle of negativity that casts a dark shadow of negativity toward the facility. This can wind up costing patients more money and reduce the inpatient margins for the hospital.

While numerous studies are being conducted to show the efficacy of surface cleaning to reduce bacteria, viruses, and fungi, a novel approach might be to reduce these particles from the air before they make contact with the surface, while still maintaining best practices in surface disinfection.

Studies have been conducted to show that cleaning the air in high traffic areas such as waiting rooms, employee break rooms, ICUs, and support areas can lower the biological burden.(2) Simply wiping surface areas isn't enough. In fact, the process of disinfecting a room, changing bedsheets, dusting, or emptying the trash disturbs pathogen particles, sending them airborne where they can be transferred to other people or places. A recent study showed that C. diff was found in the air surrounding 70% of symptomatic patients. It was also found on over two thirds of the infrequently touched surface area, showing how easy it travels over air currents.(3)

Maintaining air quality is extremely important in a health-care setting, whether it's a hospital, doctor's office, dental practice, or other office setting. Clean air can help promote a better working environment, boosting staff productivity and even improving the reputation of the facility for its patients. It can help lower the overall cost to the facility in the process.

A novel technology that reduces airborne bacteria is a system that uses an engineering control that requires no human intervention and operates 24/7. It can work continuously to clean the air of bacteria and fungus so they don't have the opportunity to land on surfaces. The system can help reduce the potential for these opportunistic pathogens as part of the overall bioburden of the room. It's especially important for those with a compromised immune system who are often found in hospital and nursing home settings.

Dental offices are particularly plagued with problems of aerosol spray emitting from standard dental procedures. In one study the levels of bacteria in the air increased up to 20 times during treatment and airborne bacteria was found in a closed operatory over 30 feet away where there was no dental activity.(4)

Using an air purification system can help lower the spread of dental aerosols. A system like VidaShield uses a series of fans to draw air in through a MERV 6 filter into a shielded, reflective chamber that houses a UV-C bulb with a wavelength of 253.7 nanometers. The treated air is then pushed back out at a 30-degree angle to promote circulation throughout the room. Using a system like VidaShield can greatly improve the quality of air, reduce the level of bacteria and fungi present in the air, and make the environment more pleasant in the process by reducing odors. Adding an air treatment system to your infection prevention bundle may increase the success of a surface disinfection program.

Dr. Linda D. Lee, MBA, has spent over 30 years in health care having previously worked for CH2M Hill, WM Healthcare Solutions, Inc., the University of Texas MD Anderson Cancer Center, and Stericycle, Inc. She is a speaker and author of numerous peer-reviewed journals/publications and three books published by the American Hospital Association. She has been a recent speaker/presenter at SHEA, AIHce, IPAC-Canada, and the C Diff Foundation. She graduated with a bachelor’s in environmental health science from Indiana State University. She earned a master’s in operations management from the University of Arkansas College of Engineering. She completed a doctorate of public health in occupational and environmental health from the University of Texas Health Science Center. She has an MBA with an emphasis in health-care management. Dr. Lee is a certified indoor air quality manager and currently serves as chief science officer for VidaShield.


  • Centers for Disease Prevention and Control National Healthcare Safety Network (CDC NHSN)
  • Linda D. Lee., PhD, MBA, LV-17-C042, Can using active air UV-C technology reduce the amount of bacteria and/or fungus in the air and improve indoor air quality? ASHRAE Conference (2017)
  • Best EL, Fawley WN, Parnell P, Wilcox MH (2010) The potential for airborne dispersal of clostridium difficile from symptomatic patients, Clin Infect Dis 50(11):1450-7.
  • Szymańska J: Dental bioaerosol as an occupational hazard in a dentist’s workplace. Ann Agric Environ Med 2007, 14, 203-207.