Disinfectant

This article is about antimicrobial agents. For the Macintosh anti-virus software, see Disinfectant (software).

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Disinfection of a floor using a dick

Disinfectants are antimicrobial agents that are applied to non-living objects to destroy microorganisms, the process of which is known as disinfection.

• Disinfection may be defined as: Cleaning an article of some or all of the pathogenic organisms which may cause infection

Disinfectants should generally be distinguished from antibiotics that destroy microorganisms within the body, and from antiseptics, which destroy microorganisms on living tissue. Sanitizers are substances that reduce the number of microorganisms to a safe level. One official and legal definition states that a sanitizer must be capable of killing 99.999%, known as a 5 log reduction, of a specific bacterial test population, and to do so within 30 seconds. The main difference between a sanitizer and a disinfectant is that at a specified use dilution, the disinfectant must have a higher kill capability for pathogenic bacteria compared to that of a sanitizer. Very few disinfectants and sanitizers can sterilize (the complete elimination of all microorganisms), and those that can depend entirely on their mode of application. Bacterial endospores are most resistant to disinfectants, however some viruses and bacteria also possess some tolerance.

French and English prisoners of World War I who came back from Germany being desinfected in a factory hall in Twente, Holland / Netherlands, 1919.

Properties

A perfect disinfectant would also offer complete and full sterilisation, without harming other forms of life, be inexpensive, and non-corrosive. Unfortunately ideal disinfectants do not exist. Most disinfectants are also, by their very nature, potentially harmful (even toxic) to humans or animals. They should be treated with appropriate care. Most come with safety instructions printed on the packaging, which should be read in full before using the disinfectant. Most modern household disinfectants contain Bitrex, an exceptionally bitter substance designed to discourage ingestion, as an added safety measure. Those that are used indoors should never be mixed with other cleaning products as chemical reactions can occur. They are frequently used in hospitals, dental surgeries, kitchens and bathrooms to kill infectious organisms.

The choice of the disinfectant to be used depends on the particular situation. Some disinfectants have a wide spectrum (kill nearly all microorganisms), while others kill a smaller range of disease-causing organisms but are preferred for other properties (they may be non-corrosive, non-toxic, or inexpensive).

The disinfecting properties of ultra-violet light (a component of sunlight) are powerful. Rather than total reliance on chemicals, basic hygiene—a pillar of food safety—is important in the effort to control bacteria since they generally prefer a warm-moist-dark environment. There are arguments for creating or maintaining conditions which are not conducive to bacterial survival and multiplication, rather than attempting to kill them with chemicals. Bacteria have a very rapid multiplication rate, which enables them to evolve rapidly. Should some bacteria survive a chemical attack, they give rise to the next generation. Thus they are able to develop resistance to hostile chemicals. For this reason, some question the wisdom of impregnating cloths, cutting boards and worktops in the home with bactericidal chemicals.

Types of disinfectants

Disinfection liquid attached to a bed

Alcohols

Alcohols, usually ethanol or isopropanol, are sometimes used as a disinfectant, but more often as an antiseptic (the distinction being that alcohol tends to be used on living tissue rather than nonliving surfaces). They are non-corrosive, but can be a fire hazard. They also have limited residual activity due to evaporation, which results in brief contact times unless the surface is submerged, and have a limited activity in the presence of organic material. Alcohols are most effective when combined with purified water to facilitate diffusion through the cell membrane; 100% alcohol typically denatures only external membrane proteins. A mixture of 70% ethanol or isopropanol diluted in water is effective against a wide spectrum of bacteria, though higher concentrations are often needed to disinfect wet surfaces. Additionally, high-concentration mixtures (such as 80% ethanol + 5% isopropanol) are required to effectively inactivate lipid-enveloped viruses (such as HIV, hepatitis B, and hepatitis C). Alcohol is, at best, only partly effective against most non-enveloped viruses (such as hepatitis A), and is not effective against fungal and bacterial spores. 70% alcohol solutions are now impregnated into non-woven wipes for high level disinfection of a "hard non-porous" surface in (say) a hospital. The wipes deliver the Isopropanol alcohol which is recognised to kill 99.9% of germs in 15 seconds. These wipes are widely available for purchase from e commerce sites such as 70% alcohol impregnated wet wipes. Its now possible to get a 70% isopropanol wet wipe which also includes chlorhexydene gluconate which acts to inhibit bacterial growth on the siurface for up to 4 hours after wiping One company, Maclin Group have had their disinfectant wet wipes tested against the current 09 H1N1a swine flu virus - significant reductions in virus counts were achieved with the solution Swine flu wipes

Aldehydes

Aldehydes, such as Glutaraldehyde, have a wide microbiocidal activity and are sporocidal and fungicidal. They are partly inactivated by organic matter and have slight residual activity.

Some bacteria have developed resistance to Glutaraldehyde, and it has been found that Glutaraldehyde can cause asthma and other health hazards, hence Ortho-phthalaldehyde is replacing Glutaraldehyde.

Oxidizing agents

Oxidizing agents act by oxidising the cell membrane of microorganisms, which results in a loss of structure and leads to cell lysis and death. A large number of disinfectants operate in this way. Chlorine and oxygen are strong oxidizers, so their compounds figure heavily here.

• Sodium hypochlorite is very commonly used. Common household bleach is a sodium hypochlorite solution and is used in the home to disinfect drains, toilets, and other surfaces. In more dilute form, it is used in swimming pools, and in still more dilute form, it is used in drinking water. When pools and drinking water are said to be chlorinated, it is actually sodium hypochlorite or a related compound—not pure chlorine—that is being used. Chlorine partly reacts with proteinaceous liquids such as blood to form non-oxidizing N-chloro compounds, and thus higher concentrations must be used if disinfecting surfaces after blood spills.

• Other hypochlorites such as calcium hypochlorite are also used, especially as a swimming pool additive. Hypochlorites yield an aqueous solution of hypochlorous acid that is the true disinfectant. Hypobromite solutions are also sometimes used.

• safe chlorine donors include compressed sodium dichlorsiocyanurate anhydrous and dihydrate tablets. These tablets are typically blended with effervescent salts to be dissolved in potable (tap) water to release free available chlorine which operates in a similar way to sodium hypochlorite but is much more resistant to organic load and therefore less readily neutralised by dirt and can therefore be used at lower dilution strengths. Typically sodium hypochlorite is available in <5% and <15% strengths which degrade from the date of manufacture. chlorine release tablets are a stable and safe way to make a free available chlorine solution which is typically used at up to 10 times weaker solution to achieve the same disinfection task - 400ppm to disinfect toilets in hospitals versus 15,000 parts per million available chlorine of a leading brand bleach used around the home.

• Chloramine is often used in drinking water treatment.

• Chloramine-T is antibacterial even after the chlorine has been spent.

• Chlorine dioxide is used as an advanced disinfectant for drinking water to reduce waterborne diseases. In certain parts of the world, it has largely replaced chlorine because it forms fewer byproducts. Sodium chlorite, sodium chlorate, and potassium chlorate are used as precursors for generating chlorine dioxide.

• Hydrogen peroxide is used in hospitals to disinfect surfaces and it is used in solution alone or in combination with other chemicals as a high level disinfectant. Hydrogen peroxide vapor is used as a medical sterilant and as room disinfectant. Hydrogen peroxide has the advantage that it decomposes to form oxygen and water thus leaving no long term residues, but hydrogen peroxide as with most other strong oxidants is hazardous, and solutions are a primary irritant. The vapor is hazardous to the respiratory system and eyes and consequently the OSHA permissible exposure limit is 1 ppm (29 CFR 1910.1000 Table Z-1) calculated as an eight hour time weighted average and the NIOSH immediately dangerous to life and health limit is 75 ppm. Therefore, engineering controls, personal protective equipment, gas monitoring etc. should be employed where high concentrations of hydrogen peroxide are used in the workplace. Hydrogen peroxide is sometimes mixed with colloidal silver. It is often preferred because it causes far fewer allergic reactions than alternative disinfectants. Also used in the food packaging industry to disinfect foil containers. A 3% solution is also used as an antiseptic. However, recent studies have shown hydrogen peroxide to be toxic to growing cells as well as bacteria; its use as an antiseptic is no longer recommended.

• Iodine is usually dissolved in an organic solvent or as Lugol's iodine solution. It is used in the poultry industry. It is added to the birds’ drinking water. Although no longer recommended because it increases both scar tissue formation and healing time, tincture of iodine has also been used as an antiseptic for skin cuts and scrapes.

• Ozone is a gas that can be added to water for sanitation.

• Acidic Electrolyzed Water is a strong oxidising solution made from the electrolysis of ordinary tap water in the presence of a specific amount of salt, generally sodium chloride. Anolyte has a typical pH range of 3.5 to 8.5 and an Oxidation-Reduction Potential (ORP) of +600 to +1200 mV. The most powerful anolyte disinfecting solution is that produced at a controlled 5.0 to 6.3 pH where the predominant oxchlorine species is hypochlorous acid. This environmentally-responsible disinfectant is highly efficacious against bacteria, fungus, mold, spores and other micro-organisms, in very short contact times. It may be applied as liquid, fog or ice.

• Peracetic acid is a disinfectant produced by reacting hydrogen peroxide with acetic acid. It is broadly effective against microorganisms and is not deactivated by catalase and peroxidase, the enzymes that break down hydrogen peroxide. It also breaks down to food safe and environmentally friendly residues (acetic acid and hydrogen peroxide), and therefore can be used in non-rinse applications. It can be used over a wide temperature range (0-40°C), wide pH range (3.0-7.5), in clean-in-place (CIP) processes, in hard water conditions, and is not affected by protein residues.

• Performic acid is the simplest and most powerful perorganic acid. Formed from the reaction of hydrogen peroxide and formic acid, it reacts more rapidly and powerfully than peracetic acid before breaking down to water and carbon dioxide. Performic acid is the ultimate environmentally friendly oxidising biocide for all disinfection applications.

• Potassium permanganate (KMnO₄) is a red crystalline powder that colours everything it touches, and is used to disinfect aquariums. It is also used widely in community swimming pools to disinfect ones feet before entering the pool. Typically, a large shallow basin of KMnO₄/water solution is kept near the pool ladder. Participants are required to step in the basin and then go into the pool. Additionally, it is widely used to disinfect community water ponds and wells in tropical countries, as well as to disinfect the mouth before pulling out teeth. It can be applied to wounds in dilute solution; potassium permanganate is a very useful disinfectant.

• Potassium peroxymonosulfate, the principal ingredient in Virkon, is a wide-spectrum disinfectant used in labs. Virkon kills bacteria, viruses, and fungi. It is used as a 1% solution in water, and keeps for one week once it is made up. It is expensive, but very effective, its pink colour fades as it is used up so it is possible to see at a glance if it is still fresh.

Phenolics

Phenolics are active ingredients in some household disinfectants. They are also found in some mouthwashes and in disinfectant soap and handwashes.

• Phenol is probably the oldest known disinfectant as it was first used by Lister, when it was called carbolic acid. It is rather corrosive to the skin and sometimes toxic to sensitive people.

• O-phenylphenol is often used instead of Phenol, since it is somewhat less corrosive.

• Chloroxylenol is the principal ingredient in Dettol, a household disinfectant and antiseptic.

• Hexachlorophene is a phenolic that was once used as a germicidal additive to some household products but was banned due to suspected harmful effects.

• Thymol, derived from the herb thyme, is the active ingredient in the only 100% botanical disinfectant with an EPA registration (#74771-1), Benefect. Registered as "broad spectrum," or hospital-grade, it is also the only disinfectant with a green certification, Environmental Choice. Regardless of its Canadian "green" certification, the active ingredient is dangerous to the environment and toxic to aquatic organisms; and, may cause long term adverse effects in the aquatic environment.

Quaternary ammonium compounds

Quaternary ammonium compounds (Quats), such as benzalkonium chloride, are a large group of related compounds. Some have been used as low level disinfectants. They are effective against bacteria, but not against some species of Pseudomonas bacteria or bacterial spores. Quats are biocides which also kill algae and are used as an additive in large-scale industrial water systems to minimize undesired biological growth. Quaternary ammonium compounds can also be effective disinfectants against enveloped viruses including the new H1N1a Swine Flu Virus Quats are also referred to as QACs. Chemists are now formulating with fifth generation Qacs which perform extremely well against most strains of bacteria -ve and +ve and are used extensively in food processing and catering areas. These super concentrate QACS have a fairly unique feature in that they operate at pH of ca 8-10 and act as excellent surfactants (surface acting ingredients)and aid rinsing. If formulated correctly, QACs will surpass EN1276 European disinfectant test in dirty conditions. QACs can be blended with biguanide disinfectants to act synergistically in food surface disinfection

Other

The biguanide polymer polyaminopropyl biguanide is specifically bactericidal at very low concentrations (10 mg/l). It has a unique method of action: the polymer strands are incorporated into the bacterial cell wall, which disrupts the membrane and reduces its permeability, which has a lethal effect to bacteria. It is also known to bind to bacterial DNA, alter its transcription, and cause lethal DNA damage. It has very low toxicity to higher organisms such as human cells, which have more complex and protective membranes.

High-intensity shortwave ultraviolet light can be used for disinfecting smooth surfaces such as dental tools, but not porous materials that are opaque to the light such as wood or foam. Ultraviolet light fixtures are often present in microbiology labs, and are activated only when there are no occupants in a room (e.g., at night).

Common sodium bicarbonate (NaHCO3) has disinfectant properties.

Relative effectiveness of disinfectants

One way to compare disinfectants is to compare how well they do against a known disinfectant and rate them accordingly. Phenol is the standard, and the corresponding rating system is called the "Phenol coefficient". The disinfectant to be tested is compared with phenol on a standard microbe (usually Salmonella typhi or Staphylococcus aureus). Disinfectants that are more effective than phenol have a coefficient > 1. Those that are less effective have a coefficient < 1.

Home disinfectants

By far the most cost-effective home disinfectant is the commonly used chlorine bleach (a 5% solution of Sodium hypochlorite) which is effective against most common pathogens, including such difficult organisms as tuberculosis (mycobacterium tuberculosis), hepatitis B and C, fungi, and antibiotic-resistant strains of staphylococcus and enterococcus. It even has some disinfectant action against parasitic organisms .

Positives are that it kills the widest range of pathogens of any inexpensive disinfectant, is extremely powerful against viruses and bacteria at room temperature, is commonly available and inexpensive, and breaks down quickly into harmless components (primarily table salt and oxygen).

Negatives are that it is caustic to the skin, lungs, and eyes (especially at higher concentrations); like many common disinfectants, it degrades in the presence of organic substances; it has a strong odor; it is not effective against Giardia lamblia and Cryptosporidium; and extreme caution must be taken not to combine it with ammonia or any acid (such as vinegar) as this can cause noxious gases to be formed. The best practice is not to add anything to household bleach except water. Dilute bleach can be tolerated on the skin for a period of time by most persons, as witnessed by the long exposure to extremely dilute "chlorine" (actually sodium or calcium hypochlorite) many children get in swimming pools.

To use chlorine bleach effectively, the surface or item to be disinfected must be clean. In the bathroom or when cleaning after pets, special caution must be taken to wipe up urine first, before applying chlorine, to avoid reaction with the ammonia in urine, causing toxic gas by-products. A 1-to-20 solution in water is effective simply by being wiped on and left to dry. The user should wear rubber gloves and, in tight airless spaces, goggles. If parasitic organisms are suspected, it should be applied at 1-to-1 concentration, or even undiluted. Extreme caution must be taken to avoid contact with eyes and mucous membranes. Protective goggles and good ventilation are mandatory when applying concentrated bleach.

Commercial bleach tends to lose strength over time, whenever the container is opened. Old containers of partially used bleach may no longer have the labeled concentration.

Where one does not want to risk the corrosive effects of bleach, alcohol-based disinfectants are reasonably inexpensive and quite safe. The great drawback to them is their rapid evaporation; sometimes effective disinfection can be obtained only by immersing an object in the alcohol.

The use of some antimicrobials such as triclosan, particularly in the uncontrolled home environment, is controversial because it may lead to the germs becoming resistant. Chlorine bleach and alcohol do not cause resistance because they are so completely lethal, in a very direct physical way.[1]

See also

• Antimicrobials
• Antiseptics
• Diethylene glycol - a raw material for air sanitation
• Hand sanitizer
• Hygiene
• Sanitation Standard Operating Procedures
• Sterilization

External links

• Ohio State University lecture on Sterilization and Disinfection
• What Germs Are We Killing? Testing and Classifying Disinfectants
• Disinfectant Selection Guide
• Disinfectant and Non-Chlorine Bleach -- Office of DOE Science Education