Sneak preview of article on antimicrobials

Hey Brent, this is really helpful - thanks for posting. So my takeaway is tell my clients:

1. Major Health care providers like Kaiser Permanente have banned the use of antimicrobials in interior products.
2. The CDC says there is no evidence that antimicrobials in products prevent disease.
3. Mary Dickinson says "Do NOT do anything this stupid!"

That should cover it.

You forgot,  4. Soap and Water is the best defense

Brent,
I am a novice in this realm, and this is a great and easily digestible overview of this complex issue.   I recently worked on a residential dormitory project in Chicago, and learned that the city of Chicago plumbing code unfortunately requires antimicrobial-treated toilet seats for public use.  I found this upsetting, but even more so because the local medical community and universities have plenty of anti-antimicrobial advocates.  If anyone lives in Chicago, maybe you can help change this piece of the code. § 18-29-420.3 Water closet seats. “Water closets shall be equipped with seats of smooth non-absorbent material. All seats of water closets provided for public use shall be an antimicrobial plastic material…” 18-29-202  General definitions:  “ANTIMICROBIAL. An additive or surface coating that inhibits the growth of bacteria or staphylococci.”   Thanks, Harry Flamm    

Hey Brent, the discussion about copper was useful, and it make me want to ask if the same research has been done about wood surfaces? Any info there? Margaret Montgomery, FAIA, LEED AP BD+C, WELL AP Principal NBBJ 223 Yale Avenue North SEATTLE WA 98109 Direct: 206.223.5230 Mobile: 206.200.4526 nbbj.com | meanstheworld.co

Brent, Thank you for sharing, Brent.  This is really valuable for several conversations I'm having right now.  When is the formal release date?   Maria  

Is anyone willing to share a vetted list of cleaning products that are free of antimicrobials and other chemicals of concern?  I'm seeing a lot of more of these showing up on the O&M side of our buildings and I'd like to recommend better options.

I'd like to add an additional request - so what can we use in place of antimicrobials?  Are there any that might be generally more safe than others?  I think this article is great about what not to do, but with people obsessing about cleanliness right now I think I need to be able to offer alternatives after my "buyer beware" speech.  Copper is clearly cost prohibitive in most applications.  And, I don't think cleaning is a truly effective solution.  Immediately after a surface has been cleaned it can be recontaminated, and cleaning does not necessarily = sanitization. I'm already fending off antimicrobial pushers left and right (primarily from designers which is surprising me), but there must be something I can offer between just give everyone Clorox wipes on one end and install far UV-C lamps with hourly electrostatic spraying on the other.   Is there an acceptable level of antimicrobial risk we are willing to take from temporary products until the pandemic passes, like those that could go on elevator buttons or door handles that are proven effective?  Save me Brent!

Heather and Steven, Great questions. This GreenSeal page might be a good place to start:  https://greenseal.org/about/blog/how-to-safely-disinfect-for-coronavirus  They take the EPA List N of recommended disinfectants and filter for what might be the "less bad" options:  "When considering EPA’s list, Green Seal recommends choosing products with the following active ingredients: 

• hydrogen peroxide**
• citric acid
• lactic acid
• ethyl alcohol (also called ethanol or just alcohol), or
• isopropyl alcohol
• peroxyacetic acid** 
• sodium bisulfate
  **The combination of hydrogen peroxide and peroxyacetic acid is a designated AOEC asthmagen, so avoid products that contain both." 

The list of products: "On EPA's comprehensive list of recommended disinfectants for COVID-19, the agency includes several products with these active ingredients, including: 

• Force of Nature Activator Capsule*** (EPA Registration No. 93040-1) (10-minute contact time)
• EnvirOx Critical Care (Registered under the name Axen(R) 30) (EPA Registration No. 72977-3) (3-minute contact time)
• Clorox Commercial Solutions Hydrogen Peroxide Disinfecting Cleaner and Clorox Healthcare Hydrogen Peroxide Cleaner Disinfectant (EPA Registration No. 67619-24) (1-minute contact time)
• Diversey’s Oxivir Wipes (EPA Registration No. 70627-60) (1-minute contact time)
• GOJO Industries PURELL Multi-Surface Disinfecting Cleaner, PURELL Multi Surface Disinfectant and PURELL Professional Surface Disinfectant (registered under the name URTHPro) (EPA Registration No. 84368-1) (1-minute contact time)
• Ecolab’s Peroxide Multi Surface Cleaner and Disinfectant (EPA Registration No. 1677-238) (2-minute contact time)
• Ecolab’s Peroxide Disinfectant and Glass Cleaner RTU (EPA Registration No. 1677-251) (.75 minute contact time)
• Clorox Pet Solutions Advanced Formula Disinfecting Stain & Odor Remover (EPA Registration No. 5813-110) (5-minute contact time)
• Clorox Commercial Solutions® Hydrogen Peroxide Cleaner Disinfectant Wipes and Clorox Healthcare Hydrogen Peroxide Cleaner Disinfectant Wipes (EPA Registration No. 67619-25) (2-minute contact time)
• Diversey’s Oxivir TB Ready-to-Use Liquid (EPA Registration No. 70627-56) (1-minute contact time) (1-minute contact time)
• Diversey’s Oxivir Five 16 (registered under the name Oxy-Team Disinfectant) (EPA Registration No. 70627-58) (5-minute contact time)
• Diversey’s Alpha HP Multi-Surface Disinfectant Cleaner (registered under the name Phato 1:64 Disinfectant Cleaner) (EPA Registration No. 70627-62) (5-minute contact time)
• Lysol Disinfecting Bathroom Cleaner (EPA Registration No. 675-55) (5-minute contact time)
• GOJO Industries PURELL Professional Surface Disinfecting Wipes (EPA Registration No. 84150-1) (5-minute contact time)" 

This is one of several resources at: https://greenseal.org/coronavirus  

Hi Heather H - This is a list from EWG that I just downloaded today. It is geared towards residential cleaning https://static.ewg.org/pdf/EWG_Tipsheet_COVID-CleaningProducts_PP01.pdf Also, is any one aware of reputable studies that show toilet seat covers don’t help spread of virus, maybe can even do more harm than good? I found this one from Reader’s Digest https://www.rd.com/home/cleaning-organizing/toilet-seat-covers/ but am hoping for a few studies from other sources. Heather DeGrella AIA, LEED AP BD+C, Fitwel Ambassador, EAC-PS, | sustainable design director, senior associate | she / her / hers | opsis architecture LLP | o:503.525.9511 d:503.943.6228 | www.opsisarch.com Opsis remains committed to our clients and projects and will continue working throughout the COVID-19 emergency through remote locations and tools. Due to our office closure, please use cell phones or email as the primary contact and note that we will conduct meetings online wherever possible. Updates to our office status or policies will be posted here. Fro

Toilet flushing can generate a plume with resuspend virus droplets, including COVID-19, through the fecal route.  If the toilet lid is closed during flushing, it is possible those virus may end up on the toilet seat, so toilet seat cover may help isolate a human from direct contact with them, though you may not get sick by sitting on those virus.  Below is a CDC article on resuspend of elements.    https://www.cdc.gov/niosh/nioshtic-2/20043244.html

Heather and All, In case you haven't looked at this analysis yet, it is an interesting compilation on virus transmission, in terms of time versus exposure. It does not discuss transmission via surfaces, but infers that surfaces are much less of a risk than proximity to an infected person's breathing:  https://www.erinbromage.com/post/the-risks-know-them-avoid-them

Simona, thanks for sharing.  I actually sent this to everyone in my family earlier today after reading it this morning.  In my opinion, it is the best, most practical, and easy to understand - and relatively short - article I have seen on the topic.  I think everyone should check it out if they can!  I'll repost the link here again just to make it easier: https://www.erinbromage.com/post/the-risks-know-them-avoid-them I'm still left though with people who are going to push for antimicrobials.  I can point them in the direction of the evolving research about means of transmission and risks of antimicrobials, but my fear is that people are still going to want to use them anyway.  And, they just simply might not care when I tell them that we don't know the long-term effects of the mineral nanocrystals in the temporary elevator button cover they plan to use when the immediate focus is acute and not chronic. At some point it becomes out of my control, I can only offer so much!  But, if there was somethign that was at least mildly acceptable for temporary applications (or potentially the least bad option) for teams that are committed to it no matter what and where copper isn't on the table that would be helpful to know.  I guess we'll see how things play out over the next months and years and the more coordinated and informed our messaging can be the more likely it is we'll get people to listen.

Thanks, everyone.  David's email reminded me to ask about the EPA list N.  That list includes antimicrobials, even though we're reading that the CDC (and EPA?) have acknowledged that they are not effective in this application.  How are antimicrobial products still getting included in this list?

As we start going back to the office, many companies are defining cleaning protocols and products.  Something we will likely see a lot of is foggers, attempting to deactivate viruses on all surfaces by fogging the entire space.  Does anyone know what products are safter/healthier?  One I have heard proposed is "Fiberlock Shockwave Disinfectant" - active ingredient is Quaternary Ammonium Chloride.  https://www.fiberlock.com/wp-content/uploads/ShockWave-83108311-PDS.pdf  The MSDS sheets do not indicate that it is a carcinogen or a mutagen.  Does anyone know if this is a chemical of concern?

When fear rules people's outlook, their reason cannot be appealed to. Some people will remain in "survival - fight and flight" mode of thinking during this pandemic and will seek to control their environment through any means possible to allay their fear. First, we can help our clients by helping them calm down! Then, when they are calmer, and in a better place to make a rational decision, we can remind then that "...there are no documented cases thus far of a COVID-19 infection originating from a fomite" (1) and that by ignoring their HVAC system and instead focusing on anti-microbials that are not effective against viruses could increase human health risks.  https://msystems.asm.org/content/5/2/e00245-20 (1) "2019 Novel Coronavirus Pandemic: Built Environment Considerations to Reduce Transmission" Of course, if someone sneezes on a surface, and then another person touches that surface, then their face, then a transmission could occur. The vehicle of transmission in these cases isn't the fomite, but the respiratory droplet spread. So cleaning of high-touch surfaces is still important.  Alison Nash
DiMella Shaffer

Yes, it's listed under Six Classes' antimicrobials of concern: https://www.sixclasses.org/videos/antimicrobials

Yes, the Six Classes website is an excellent, clear explanation of the concerns about anti-microbials. I have forwarded this to clients, as well as the back to work planners for our own office. Tamar – Tamar Warburg Director of Sustainability +1 617 923 5343 sasaki.com @SasakiDesign Check out our blog On

Jacob- The WELL Building Standard is a good place to start for Cleaning Protocols. A danger with fogging entire areas is that both harmful and beneficial microbes are eliminated. "Nuking" everything in a space isn't good practice for human health. The WELL standard recommends disintecting only high-touch surfaces. Also, the air-borne nature of COVID-19 poses a particular risk to interiors that rely heavily on re-circulated air. I'm concerned that building operators may rely on "fogging," increase re-circulation without filtration or additional outside air, and inadvertenly create a prime environment for increased transmission.  Alison Nash, DiMella Shaffer

Hi Alison and all, Going a bit farther with WELL, I have begun seeing some people suggest WELL (or perhaps Fitwel) certification as a direct response to COVID-19. In my cursory understanding of the programs I don't see much that would directly impact spread of airborne infectious disease, although presumably in healthier spaces one would be more resistant to any disease generally. Great to hear, Alison, that the Cleaning Protocols are worth looking at. Does anyone know if there is a significant overlap between wellness rating systems and COVID, or is this mostly a marketing approach that I’m hearing? The question is about the current versions, as IWBI is convening experts to provide recommended updates based on COVID-19..https://www.wellcertified.com/placesmatter/task-force -Kjell F

I have several WELL and Fitwel projects. What I've seen so far is that WELL is much more stringent in requirements, but as many know, also more expensive, which may be a deterrent for many clients. They're both tracking the COVID aspects; WELL is additionally paired with Delos, which helped launch the rating system, so from what I know of both historically, and what I've seen so far, WELL will have much more specific guidance going forward if you're looking for thoroughly researched details and requirements. There was a webinar yesterday from Delos/Cushman & Wakefield that I felt gave a good overview of concerns, progress, and perspectives that many of us will likely want to know. They didn't send out the invites until 3 hours before it; regardless, you can still "sign up" for it and watch it on demand. I did this last night and found it to be interesting enough to recommend to others. I'll post the info below. The Delos page where they're tracking info is here: https://delos.com/covid19 As-is, no, WELL does not specifically address enough to alleviate concerns about surface contamination, air system filtering/treatment, etc., but it does have many elements that I feel will become more of a focus longer-term (things they mention in the webinar that I hadn't though of in terms of transformation of buildings and amenities within beyond the need for distancing, cleaning, no-touch movement, etc.). This is where WELL and Fitwel may be a little ahead; essentially, the office may become something needed to attract and retain staff on-site rather than everyone operating in isolation, so features within the building will need to create a draw rather than just perform a remote, required function. They do have an element for Legionnaire's, soap/towel dispensers use, UV treatment, and so on, so I'm sure they'll likely have addenda and/or approved equivalent paths specific to COVID once it's determined what's really appropriate. I know others in this group are also users and will be able to more intelligently/eloquently respond, but hopefully this is a good start for some. Here's the webinar info:
Join Cushman & Wakefield California COVID-19
Client Webinar featuring Delos Founder & CEO,
Paul Scialla Wednesday, May 13
9:00 A.M. PDT / 12:00 P.M. EDT Join for a discussion on COVID-19, recovery readiness protocols, the evolution of work and the built environment. Paul Scialla  Founder & CEO Speakers:

• Lisa Picard, EQ Office, President & CEO
• Paul Scialla, Delos, Founder & CEO
• Despina Katsikakis, Cushman & Wakefield, Head of Workplace Business Performance
• Bill Knightly, Cushman & Wakefield, Chief Operating Officer, GOS
• Andrew McDonald, Cushman & Wakefield, West Region President

REGISTER FOR WEBINAR

WELL just released a guide that directly relates specific Strategies to COVID concerns: Strategies from the WELL Building Standard to Support in the Fight Against COVID-19  Also attached for easy reference.