Use of ATP Readings to Predict a Successful Hygiene Intervention in Workplace to Reduce Spreading.

Updated: Jun 15

Before and after testing:

Use of ATP Readings to Predict a Successful Hygiene Intervention in the Workplace to Reduce the Spread of Viruses on Fomites


Received: 20 July 2016 / Accepted: 11 August 2016 Ó Springer Science+Business Media New York 2016 Abstract The purpose of this study was to validate the use of adenosine triphosphate (ATP) for evaluating hygiene intervention effectiveness in reducing viral dissemination in an office environment. The bacterial virus MS-2 was used to evaluate two scenarios, one where the hand of an individual was contaminated and another where a fomite was contaminated. MS-2 was selected as a model because its shape and size are similar to many human pathogenic viruses. Two separate experiments were conducted, one in which the entrance door push plate was inoculated and the other in which the hand of one selected employee was inoculated. In both scenarios, 54 selected surfaces in the office were tested to assess the dissemination of the virus within the office. Associated surface contamination was also measured employing an ATP meter. More than half of the tested hands and surfaces in the office were contaminated with MS-2 within 4 h. Next, an intervention was conducted, and each scenario was repeated. Half of the participating employees were provided hand sanitizer, facial tissues, and disinfecting wipes, and were instructed in their use. A significant (p \ 0.05) reduction was observed in the number of surfaces contaminated with the virus. This reduction in the viral spread was evident from the results of both viral culture and the surface ATP measurements, although there was no direct correlation between ATP measurements with respect to viral concentration. Although ATP does not measure viruses, these results demonstrate that ATP measurements could be use- ful for evaluating the effectiveness of hygiene interventions aimed at preventing viral spread in the workplace. Keywords #Hygiene 􏰁 Adenosine triphosphate (ATP) 􏰁 Viral dispersion 􏰁 Workplace 􏰁 Intervention 􏰁 MS-2 virus Introduction.

Enteric and respiratory illnesses are readily spread among persons working together in an office environment and can result in significant economic and productivity losses (Bramley et al. 2002; Birbaum et al. 2003; Callan et al. 2005). Although the implementation of hygiene interventions may reduce the spread of viral illnesses in the workplace, traditional methods for evaluating their effectiveness are costly and time-consuming. Rapid methods for screening of relative biological loads on surfaces could be helpful in evaluating the efficacy of mitigation efforts. In this study, the measurement of ATP was used to determine its value as a rapid screening method for evaluation of workplace hygiene interventions in reducing the potential for viral spread. Common illnesses of viral etiology, such as colds and diarrhea, have a significant impact on health care costs and absenteeism among office employees (Bramley et al. 2002). The increasingly globalized economy creates greater opportunity than ever before for viral transmission, as evidenced by the recent and emerging viral pandemics such as those caused by H1N1 (Swine Flu), H7N9 (avian flu), and norovirus (Cauchemez et al. 2009; Morens et al. 2013; Hall et al. 2013).


Received: 20 July 2016 / Accepted: 11 August 2016 Ó Springer Science+Business Media New York 2016 Abstract The purpose of this study was to validate the use of adenosine triphosphate (ATP) for evaluating hygiene intervention effectiveness in reducing viral dissemination in an office environment. The bacterial virus MS-2 was used to evaluate two scenarios, one where the hand of an individual was contaminated and another where a fomite was contaminated. MS-2 was selected as a model because its shape and size are similar to many human pathogenic viruses. Two separate experiments were conducted, one in which the entrance door push plate was inoculated and the other in which the hand of one selected employee was inoculated. In both scenarios, 54 selected surfaces in the office were tested to assess the dissemination of the virus within the office. Associated surface contamination was also measured employing an ATP meter. More than half of the tested hands and surfaces in the office were contaminated with MS-2 within 4 h. Next, an intervention was conducted, and each scenario was repeated. Half of the participating employees were provided hand sanitizer, facial tissues, and disinfecting wipes, and were instructed in their use. A significant (p \ 0.05) reduction was observed in the number of surfaces contaminated with the virus. This reduction in the viral spread was evident from the results of both viral culture and the surface ATP measurements, although there was no direct correlation between ATP measurements with respect to viral concentration. Although ATP does not measure viruses, these results demonstrate that ATP measurements could be use- ful for evaluating the effectiveness of hygiene interventions aimed at preventing viral spread in the workplace. Keywords ordsion patterns, #bacteriophage models are also useful in the validation of preventive measures (Mamane-Gravetz and Linden 2004). Availability and use of hygiene interventions have been shown effective in the disruption of both direct contact and surface-mediated microbial transmission in school and hospital environments (Liu et al. 2009; Bright et al. 2010; Bloomfield et al. 2016). Preventive measures such as hand washing (Ryan et al. 2001; Curtis and Cairncross 2003) and use of hand sanitizers (Sandora et al. 2005), as well as antimicrobial wipes and cleaners (Kochar et al. 2009), have been demonstrated to reduce gastrointestinal and respiratory infectious disease incidence. In addition, proper uses of disposable surgical masks and facial tissues have been used to reduce transmission of respiratory infections through aerosolization. Although these measures have been shown effective when properly implemented, there is not currently a rapid, cost-effective means to routinely monitor their sustained effectiveness. Adenosine triphosphate (). The increasingly globalized economy creates greater opportunity than ever before for viral transmission, as evidenced by the recent and emerging viral pandemics such as those caused by #H1N1 (Swine Flu), H7N9 (avian flu), and norovirus (Cauchemez et al. have been validated for assessment of relative microbial presence in aquatic environments (Hammes et al. 2010) and intravenous fluids (Anderson et al. 1986), as well as on inanimate surfaces in hospitals (Moore et al. 2010; Aikin et al. 2011) and food preparation areas (Aycicek et al. 2006). ATP is thus used as a general indicator of the cleanliness of a surface. Simple, handheld, ATP meters are now available that allow for testing of fomites with results available in 15 s (Hygienia 2016). This creates an opportunity for rapid screening of fomites with minimum cost and time. This study describes the effectiveness of a workplace hygiene intervention in preventing the spread of a bacterial virus in an office environment as a model for the removal of a pathogenic virus. ATP measurements were then compared to viral load after the implementation of the hygiene intervention to determine if the general cleanliness of a surface could be correlated with the removal of viral pathogens. This could provide an alternative monitoring tool for the simple and rapid confirmation of the effectiveness of a hygiene intervention on reducing the spread of viruses in the workplace. Materials and Methods Study Approach MS-2 was used to evaluate two scenarios, one where the hand of one selected employee was contaminated and another where a fomite, the entrance door push plate, was contaminated. Samples from 54 selected surfaces were sampled in the office setting at the beginning of the day and at 4 and 7 h after inoculation to assess the dissemination of the virus within the office. The samples were subsequently tested using traditional viral culture and ATP detection methods to assess the spread of the virus through the office environment from each of the two starting points. Each experiment was repeated after the employees were instructed on the use of provided hygiene interventions including facial tissues, disinfecting wipes, and hand sanitizer, as well as hand-washing techniques using basic (not labeled as anti-microbial) hand soap. Office Description This study was conducted in an office setting with approximately 80 full-time employees. The office is loed on the second floor of a three-story building, with three stairway accesses and one elevator access to the floor. The main entry door to the floor is located near the elevator, such that persons exiting the elevator enter through the main door. The entire office shares a common kitchen area (break room) equipped with a microwave oven, a sink area, a coffee machine, and a refrigerator. Other features include several individual offices with doors located along the perimeter of the floor, a central area divided into cubicles, and seven locations containing shared photocopy machines.

MS-2 Virus MS-2 (ATCC 15597-B1) was obtained from the American Type Culture Collection (ATCC Manassas, VA). MS-2 virus was prepared as previously described with minor modifications (Rusin et al. 2002). The agar overlay tech- nique was used to isolate and enumerate phage MS-2. Dilutions of sample suspension (1 mL) followed by log- phase host culture (1 mL) were added to melted top agar tubes. The inoculated top agar tubes were mixed and poured over a TSA plate, and then the solidified agar overlay was inverted and incubated at 37 °C for 24 h. Phage plaques were counted, and the concentration of phage isolated per 100 cm2 was calculated for each fomite sampled. ATP Detection ATP bioluminescence was measured in relative light units (RLU) using a SystemSURETM ATP meter (Hygiena, Camarillio, CA) according to the manufacturer’s recommended protocol. An adjacent 100 cm2 to where the phage sample was collected was swabbed with the swabs pro- vided by the manufacturer for use with the device.

Surface Inoculation An area of approximately 50 cm2 on an office entrance door push plate and the hand of one of the employee were inoculated with 6 9 109/cm2 plaque-forming units (PFU) of MS-2 bacte). The agar overlay technique was used to isolate and enumerate phage MS-2. Dilutions of sample suspension (1 mL) followed by log- phase host culture (1 mL) were added to melted top agar tubes. The inoculated top agar tubes were mixed and poured over a TSA plate, and then the solidified agar overlay was inverted and incubated at 37 °C for 24 h. Phage plaques were counted, and the concentration of phage isolated per 100 cm2 was calculated for each fomite sampled. ATP Detection ATP bioluminescence was measured in relative light units (RLU) using a SystemSURETM ATP meter (Hygiena, Camarillo, CA) according to the manufacturer’s recommended protocol. An adjacent 100 cm2 to where the phage sample was collected was swabbed with the swabs provided by the manufacturer for use with the device. Fomites sampled included desktops, table tops, refrigerator door handles, microwave oven door handles, coffee pot handles, and vending machine buttons. (Reynolds et al.2016). Fomite samples for ATP detection were also collected from adjacent surface areas using swabs recommended by the manufacturer for use with the Sys- temSURETM ATP meter (Hygiena, Camarillo, CA). Each swab was aseptically removed from its transport container, swabbed over an area of approximately 100 cm2 for each surface, and carefully returned to its transport container.). This creates an opportunity for rapid screening of fomites with minimum cost and time. This study describes the effectiveness of a workplace hygiene intervention in preventing the spread of a bacterial virus in an office environment as a model for the removal of a pathogenic virus. ATP measurements were then compared to viral load after the implementation of the hygiene intervention to determine if the general cleanliness of a surface could be correlated with the removal of viral pathogens. This could provide an alternative monitoring tool for the simple and rapid confirmation of the effectiveness of a hygiene intervention on reducing the spread of viruses in the workplace. Materials and Methods Study Approach MS-2 was used to evaluate two scenarios, one where the hand of one selected employee was contaminated and another where a fomite, the entrance door push plate, was contaminated. Samples from 54 selected surfaces were sampled in the office setting at the beginning of the day and at 4 and 7 h after inoculation to assess the dissemination of the virus within the office. The samples were subsequently tested using traditional viral culture and ATP detection methods to assess the spread of the virus through the office environment from each of the two starting points. Each exp). The increasingly globalized economy creates greater opportunity than ever before for viral transmission, as evidenced by the recent and emerging viral pandemics such as those caused by H1N1 (Swine Flu), H7N9 (avian flu), and norovirus (Cauchemez et al. ap. Office Description This study was conducted in an office setting with approximately 80 full-time employees. The office is located on the second floor of a three-story building, with three stairway accesses and one elevator access to the floor. The main entry door to the floor is located near the elevator, such that persons exiting the elevator enter through the main door. The entire office shares a common kitchen area (break room) equipped with a microwave oven, a sink area, a coffee machine, and a refrigerator. Other features include several individual offices with doors located along the perimeter of the floor, a central area divided into cubicles, and seven locations containing shared photocopy machines.


Discussion and Conclusions ATP bioluminescence is a general measurement of bio- logical contamination. It does not directly monitor viruses but indicates a mixture of biological forms, such as human cellular materials, bacteria, and plant and fungal cells. Materials like epithelium from the upper respiratory tract mucus membranes, saliva, and associated material from the coughs and sneezes of persons with viral or bacterial infections can also contribute to ATP measurements (Shaughnessy et al. 2013). While there are limits to the use of ATP measurements in assessing the impact of cleaning practices (Green et al. 1999), recent studies have demonstrated its potential usefulness for validating the effectiveness of cleaning practices in schools (Shaughnessy et al. 2013) and hospitals (Boyce et al. 2009a, b). The rapid spread of the virus throughout the office after a high-touch surface (office door bar) or the hand of one employee was inoculated illustrates how a contaminated surface can result in viral transmission in the workplace. Shared facilities (e.g., break room, copy machine), where a transfer of viruses from infected to uninfected persons is most likely to occur, were readily contaminated. The viral culture results show statistically significant reductions in the spread of virus (MS-2) from either a contaminated hand or fomite throughout an office environment after the implementation of hygiene interventions. This was accomplished with only 52 % of the occupants of the building participating in the intervention, demonstrating that a significant reduction in virus spread can occur without everyone in the office following the intervention protocol. In addition, this improvement occurred after the intervention protocol was in place for only 3 days before the virus was seeded onto the hands/push plate. The seeding of the door handle or hand of an employee made no significant difference in the spread of the virus throughout the facility or the success of the intervention (Reynolds et al. 2016). ATP measurements correlated significantly with reduced viral recovery and showed statistically significant differences in measurements taken before and after an intervention. This suggests that although ATP readings do not specifically predict the occurrence or degree of reduction in microbial contamination, the method can be useful for monitoring the success of health interventions in the workplace in terms of the reduction in the spread of a virus. Despite the described limitations of ATP measurement as a method for monitoring microbial contamination, the results of this study clearly demonstrate that workplace hygiene interventions can result in a significant reduction of viral contamination, and ATP can be used to monitor performance rapidly. It also illustrates that a general measure of cleanliness with a quantitative tool can be related to the spread of viruses in indoor environments and can be used as an aid to assessing of potential interventions.



9 views
 
  • LinkedIn

Phone 0273 985 896

Auckland, New Zealand

©2020 by Virus Fog Limited NZ
Thermal Fogging Coronavirus.