UCLA Infection Control Manual

Dr. Andy Wong

California Continuing Education Credits: 6 units

PIC HOMEPAGE

[ CHAPTER 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 ] [ Table of Contents | Appendix | References ]

CHAPTER FIVE
DISINFECTION

INTRODUCTION

No single chemical agent will meet all criteria for total disinfection. Always follow label directions precisely. Give strict attention to the proper use of the product with regard to dilution, method and duration of application, shelf-life, temperature requirements, and, if applicable, re-use life.


I. LEVELS OF DISINFECTION

EPA classifies disinfectants as high,intermediate, or low level based on the contact time of the solution and the biocidal activity of an agent.

  1. High-level Disinfection - kills some, but not necessarily all bacterial spores. This process kills mycobacterium tuberculosis var bovis, a laboratory test organism used to classify the strength of disinfectant chemicals and other bacteria, fungi and viruses.

  2. Intermediate-level Disinfection - kills mycobacterium tuberculosis var bovis that indicates less resistant organisms such as hepatitis B and HIV are also killed.

  3. Low-level Disinfection - is the least effective disinfection process. It does not kill bacterial spores or mycobacterium tuberculosis var bovis.


II. FACTORS INFLUENCING GERMICIDAL PROCEDURES

A. Bioburden.

B. Nature of the Material.

C. Organic Debris Present.

D. Type and Concentration of the Germicide. Generally, higher concentrations of a chemical agent are more effective and require a shorter time to disinfect.


III. GENERAL CATEGORIES OF LIQUID CHEMICAL AGENTS

Identify the label has an EPA registration number on it.

A. Glutaraldehyde-Based Solutions. (High level sterilants or disinfectants). Require proper ventilation since vapors are extremely toxic.

B. Iodophors. Intermediate level disinfectants if the label claims tuber-culocidal activity. Stains pastel or white vinyl with repeated exposure.

C. Chlorine Dioxide-Based Solution. May be used for high level disinfection of semi-critical items not subject to corrosion. Irritating to the skin and eyes.

D. Phenolics. If the label claims tuberculocidal activity, use intermediate level disinfectants. Irritating to the skin and mucous membranes.


IV.EXAMPLES OF "SEMI-CRITICAL ITEMS" REQUIRING CHEMICAL DISINFECTION

A. Dental light handles, plastic impression trays, photographic mirrors and some radiographic positioning devices.

B. Nitrous Oxide Masks and breathing tubes.

NOTE: ALL "SEMI-CRITICAL ITEMS" RECEIVE AT LEAST HIGH LEVEL DISINFECTION.


V. EXAMPLES OF "NON-CRITICAL ITEMS" REQUIRING CHEMICAL DISINFECTION OR BARRIERS

A. Dental Delivery System consisting of counters, chair, unit, and light; portable dental units; surgical table or chair; x-ray apparatus. In between patients, counter tops and dental unit surfaces shall be cleaned with disposable towels followed by an intermediate-level disinfectant.

  1. Use disposable covers, changing after each patient, to reduce the number of surfaces requiring disinfection.

  2. Disinfect hand operated control, switches, and handles after each patient.

  3. Follow manufacturer's instructions when disinfecting the light lamp head and protective shield.

B. Low-level disinfectants shall be used for visibly soiled areas such as floors, walls and other housekeeping surfaces

NOTE: ALL "NON-CRITICAL ITEMS" REQUIRE AT LEAST INTERMEDIATE LEVEL DISINFECTION.

[ CHAPTER 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 ] [ Table of Contents | Appendix | References ]
TOP OF PAGE | PIC HOMEPAGE

PERIODONTICS INFORMATION CENTER