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The Environmental Protection Agency (EPA) estimates that the various antimicrobial agents now on the market contain various mixes of some 275 active ingredients. Some 5,000 of these products are registered with the EPA, and many others are in different stages of the agency's registration process. Almost 60 percent are targeted at hospitals and other healthcare facilities.

The growing number of formulations coming to the market add to the complexities of deciding on what cleaners and methods will work best for any given facility.

The panic attacks that often follow reported disease clusters can lead to possibly unnecessary, costly and potentially counter-productive measures. These can - and have - ranged from closing schools to disinfecting floors and other surfaces not likely to come into contact with bare skin in some recent MRSA outbreaks.

Extra measures make sense on exercise machines in a health club and door knobs almost anywhere. But it's not practical, or useful, to disinfect surfaces that are unlikely to contact bare skin. Overuse of disinfectants can also affect air quality, add to materials leaching into waterways, and leave residue behind on floors and other surfaces.

Facility considerations, specific microbes and a host of other factors should go into selecting cleaners and antimicrobial agents. Commercial spaces and schools don't require the stringent measures needed in hospitals - or for that matter in many research facilities and manufacturing plants.

Attention to detail

Context helps, along with reading the labels and choosing the germicidal formula that works for the facility and for current conditions within it. You might use one product for routine, everyday cleaning and another if there's been, say, an e.coli outbreak linked to a cafeteria.

MRSA, e-coli, salmonella, norovirus, HIV - the list goes on. In the real world of custodial or janitorial requirements, "How do you tell if a surface is clean?" asks Taylor Stewart, president of EnvirOx.

The answer is that you can't tell by looking at a surface which critters are there, where they are, or how many there are. And after cleaning, you can't tell by visual examination whether you've wiped them out.

A disinfectant or other antimicrobial agent alone isn't always enough. Cleaning before disinfecting helps remove soil that can impede the action of the antimicrobial agent, says Stewart. EnvirOx products include the EPA-registered Critical CareTM Disinfectant-Fungicide-Virucide and H2Orange2® Cleaner-Sanitizer.

Distributors and manufacturers are a key information source for their maintenance and custodial customers about this complex product category.

Taking out the guesswork

The key is to design a cleaning and disinfecting regimen that janitorial staff can carry out on a routine basis.

"You have to take the guesswork out of cleaning and disinfecting," says Steve Olhausen, president of Unelko Corp. Unelko makes the recently patented Sani-Shield® and patent-pending Sani-Scrub® cleaners and cleansers. They offer a one-step approach to cleaning and disinfecting, laying down a barrier that helps prevent recontamination. Both come under the EPA's treated article exemption, which covers articles or substances treated with or containing a registered pesticide to protect the integrity of the article or substance itself.

It's essential to evaluate real needs

"Cleaning isn't about making sure the surface is sterile," says Stewart. "It's about reducing the microbial and fungal load to levels our bodies can handle. It's the overload of bacteria that's harmful, not a few of them."