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7 0 obj 3-6Failure to comply with scientifically-based guidelines has led to numerous outbreaks. Disinfection is the process or act of destroying pathogenic microorganisms and removes most organisms present on surfaces. spores. Antimicrobial Guidelines for Primary Care, Following an outbreak or increased incidence of infection, Following discharge, transfer or death of a patient who has had a known infection, Following isolation/contact precaution nursing of a patient. endobj Ref. Seek advice from Infection Control Nurse or Respiratory Nurse Specialist. As most of us finally begin to look forward, Abi Spence on how social care is leading the way in infection prevention and control. Domestic washing machines rarely have an 80oC setting. What are the recommended practices once back home after outdoor activities? Cleaning agents are substances which come in many forms but generally are liquids, powders, sprays, or granules. Following use, the single use reservoir should be replaced. If this is the case, if contamination is not excessive, all potentially contaminated linen should be washed at the highest possible temperature recommended for that particular fabric. endobj It is only effective if Snow Hospital-use disinfectants should be used throughout the hospital to disinfect surfaces and medical devices. Cleaning should always start from the least soiled (cleanest) area to the most soiled (dirtiest) area in order to not spread the dirty to areas that are less soiled. One of the most cost-effective disinfectants used is chlorine bleach (a 5% solution of sodium hypochlorite), which is effective against most common pathogens, including difficult organisms found in a healthcare setting, such as antibiotic-resistant strains of staphylococcus, fungi, and hepatitis B and C. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than sterilisation. 2. WebCurrent recommended treatments to ensure cleaning and disinfection of used (soiled and foul) linen. Clean with detergent and water, (refer to manufacturers instruction) rinse and dry. Control of substances hazardous to health (Fifth edition), Blood borne viruses in the workplace: Guidance for employers and employees, Providing and using work equipment safely: A brief guide, HSG (95)18: Hospital laundry arrangements for used and infected linen, Infection control guidance for care homes, Guidance for clinical health care workers: protection against infection with blood-borne viruses, A 65oC temperature hold for a minimum of 10 minutes within the wash cycle; or. stream 6 0 obj endobj The UK Health Departments Guidance for Clinical Health Care Workers: Protection against infection with blood-borne viruses. Disinfection practices are important to reduce the potential for COVID-19 virus contamination in non-healthcare settings, such as in the home, office, schools, gyms, publicly accessible buildings, faith-based community centres, markets, transportation and business settings or restaurants. %PDF-1.7 *`WNrP%T)\)\)!DP6!\=v"ba#D} An oxygen atom has 8 protons and 8 neutrons. A few disinfectants will kill spores with prolonged exposure times (312 hours); these are calledchemical sterilants. For example, a germicide is an agent that can kill microorganisms, particularly pathogenic organisms (germs). If used they should be single patient use and the soap only used by that patient. To ensure a disinfectant solution works effectively, it is important that the correct amount of disinfectant and water are used. If infected place in water soluble laundry bag immediately after use. For your ease of use, we have established categories under which you can source the relevant articles and news items. Wash with detergent and water or detergent wipes, rinse & dry. Cookies used to make website functionality more relevant to you. In particular it is important to rinse chlorine containing solutions from stainless steel surfaces to prevent corrosion. [ Some disinfectants have a wide spectrum (kill many different types of 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). It is about removing dirt, including stains, dust, bad smells and clutter on surfaces. Use disposable cloths/paper roll for cleaning during the terminal clean. Sterilization is intended to convey an absolute meaning; unfortunately, however, some health professionals and the technical and commercial literature refer to disinfection as sterilization and items as partially sterile. When chemicals are used to destroy all forms of microbiologic life, they can be called chemical sterilants. Gelling granules should be used especially where there are copious amounts of fluids involved. RED-bathrooms/washrooms/showers /toilets BLUE - general areas including wards, depts, offices YELLOW Isolation areas GREEN Catering Mop Buckets: Wash with detergent and water, rinse and dry; Store inverted. In-Use Test: Swabs are taken from objects before and after application of disinfectant or antiseptic. The combination of temperature (when more than 40oC), detergent action and dilution effect during the wash and rinse steps, will contribute to the process of soil removal and disinfection for the washed item. Cleaning agents are substances (usually liquids, powders, sprays, or granules) used to remove dirt, including dust, stains, bad smells, and clutter on surfaces. Ventilation of the area/room being cleaned must be adequate; if there is no window, the door should be left open when applying hypochlorite/chlorine dioxide solutions. <>>> Regular food safety and handling guidance should be followed.See: https://www.who.int/activities/promoting-safe-food-handling. 4 0 obj Dry in a tumble dryer. 1119 0 obj <>stream %%EOF The disinfectant must be freshly prepared for each use and changed Use neutral Contaminated linen is generated by hospitals, care homes, nursing homes and similar facilities, as well as in the home care setting; anywhere that care of the sick and infirm is undertaken. 4 0 obj The wash temperature, coupled with the dilution factor, should render linen safe to handle on cycle completion. What protection measures should people take when using disinfectants? There are a wide range of disinfectants used today. 1 0 obj The actual process of cleaning is achieved with the use of aids such as cleaning tools and cleaning agents. You can specify conditions of storing and accessing cookies in your browser. 2220:0?05A)a&RX*70017~x,,j+\6Y ]gqyu/yn==n&"GFPxuPy`ib_AEO@ ! .~kY `_EBN]?Bw`W.MNNijzgjUgqp+>9C0w40WHq`R!BB`z\B#Af(00u0YJ 1AtI$ @ )@ YI(kN-x1I1VvLfb^p]-Q:ClW|Y%&H320h i6IN `?4B2@T1 While outside, people should always follow physical distancing measures, staying at least one metre from another person; perform hand hygiene by washing hands frequently with soap and water or using alcohol-based hand rub; follow good respiratory hygiene endobj Do not allow children to use disinfectant wipes. 3]HWIp8 9NnUs w=0! 2 0 obj (OVbSp#B:7G_+U!/m$Nr~{`?^n$=10miy_p!@~:oC#v7.CvsXLqzDmw*RcxbH-u[kmPn0{3eIWo?M70V/*+`N: PW$"`)-s8:T(i?-v_emkZ_WPj'S[#'LA~5P@BVCGb>MBBnBs!`T5X*.Y ^~mENN3E],b9ORrh %~IC CMx]Up. You can review and change the way we collect information below. microorganisms: A microorganism or microbe is a microscopic organism that comprises either a single cell (unicellular), cell clusters, or multicellular relatively complex organisms. Saving Lives, Protecting People, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP), Introduction, Methods, Definition of Terms, A Rational Approach to Disinfection and Sterilization, Factors Affecting the Efficacy of Disinfection and Sterilization, Regulatory Framework for Disinfectants and Sterilants, Low-Temperature Sterilization Technologies, Microbicidal Activity of Low-Temperature Sterilization Technologies, Effect of Cleaning on Sterilization Efficacy, Recommendations for Disinfection and Sterilization in Healthcare Facilities, Table 1. Spraying disinfectants, even outdoors, can be noxious for peoples health and cause eye, respiratory or skin irritation or damage. JFIF x x C If washing by hand is unavoidable, household rubber gloves. []!P"Xl]KmC(0Z6Q]E,Oiz3E!&70) Intermediate-level disinfectantsmight be cidal for mycobacteria, vegetative bacteria, most viruses, and most fungi but do not necessarily kill bacterial spores. It is developed in line with statutory requirements. Friction through rubbing and scrubbing the soiled area and fluids generally water and a soap solution are the first stage of cleaning. The National standards of healthcare cleanliness 2021 apply to all healthcare Reusable reservoirs should be as per manufacturer instructions. Antisepticsare germicides applied to living tissue and skin;disinfectantsare antimicrobials applied only to inanimate objects. Cleaning, Disinfection and Sterilisation are three terms used a lot when discussing infection control. 2 0 obj Do not mix chemicals and only use a cleaning product provided by your employer. Factors affecting the efficacy of sterilization, Table 11. If a weaker solution is Web2.3. This guideline resulted from a review of all MEDLINE articles in English listed under the MeSH headings ofdisinfectionorsterilization(focusing on health-care equipment and supplies) from January 1980 through August 2006. Hospital laundry arrangements for used and infected linen (under review). Prepare cleaning/disinfecting solutions in a container (dilution as per manufacturers instruction). 1 0 obj Should not be used See liquid soap dispensers. Thank you for taking the time to confirm your preferences. Webused for the disinfection of equipment that has been in contact with an infected service user, non-intact skin, body fluids (not blood stained) or mucous membranes. Thorough cleaning is essential before high-level disinfection and sterilization because inorganic and organic materials that remain on the surfaces of instruments interfere with the effectiveness of these processes. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. High Level as pre planned maintenance or local contractual arrangements. Minimum cycle times for steam sterilization cycles, Table 8. pDd4U^ $vn The COVID-19 virus is generally thought to be spread from person to person through respiratory droplets. WebDecontamination Cleaning, Disinfection and Sterilisation Page 5 of 22 Version 1.1 April 2019 A clean, disposable cloth should be used and discarded immediately after use. Public Health Agency12-22 Linenhall StreetBELFAST BT2 8BS. Properties of an ideal disinfectant, Table 3. Steam under pressure, dry heat, EtO gas, hydrogen peroxide gas plasma, and liquid chemicals are the principal sterilizing agents used in health-care facilities. No chemical is completely effective, In the next blog the importance of monitoring and surveillance for infection control purposes will be explored. 2 0 obj [citation needed] 4 0 obj Keep lids tightly closed when not in use. <> Virucide, fungicide, bactericide, sporicide, and tuberculocide can kill the type of microorganism identified by the prefix. % If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. hbbd```b``"HFkH*d ,"C@ 8l&#Mi0 In health-care settings, objects usually are disinfected by liquid chemicals or wet pasteurization. The same wash temperature profile as used for used (soiled and foul) linen is thought sufficient to inactivate HIV, but the evidence is less certain for hepatitis B. stream Eye protection and medical masks may also be needed to protect against chemicals in use or if there is a risk of splashing. <> WebAlways use personal protective equipment as appropriate; A COSHH assessment must be undertaken for all products used and disinfectants must not be mixed; Cleaning cloths You will be subject to the destination website's privacy policy when you follow the link. Explain the role of personal protective equipment (PPE) during the decontamination process 2.5. Includes wipes or non -chlorine products but only Cleaning reduces amount of organic matter that contributes to the proliferation of bacteria and viruses. It is a legacy of COVID-19 and not necessarily a positiveone. disposable apron and gloves, before entering the room, discard all disposables in the room/bed space/unit (e.g. The nature of the soiling will determine how contaminated items are sorted and processed, and current UK categorisation recommends sorting into used linen (soiled and foul), infected linen and heat labile linen categories. Because sterilization of all patient-care items is not necessary, health-care policies must identify, primarily on the basis of the items intended use, whether cleaning, disinfection, or sterilization is indicated. WebWhen used correctly, commercially available disposable disinfectant wipes, cloths, or towelettes are effective for cleaning and disinfecting environmental surfaces in dental settings. Dispose of in clinical waste. Always decontaminate your hands after removing and disposing of PPE. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Types of antiseptics. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 594.96 842.04] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> If contaminated with blood or body fluids clean and then disinfect surface with an alcohol wipe or 125ppm available chlorine, rinse and dry. Unlike sterilization, disinfection is not sporicidal. 3 0 obj endobj Describe how and when disinfectant agents are used, Calculate the following and povide the answer rounded off to the correct accuracy What areas should be prioritized for disinfection in non-health care settings? Patient in isolation should have a dedicated thermometer. Mixing time must be allowed to ensure heat penetration and assured disinfection. The termgermicideincludes both antiseptics and disinfectants. 'K&%(>qb1r~%g+>#/OdV 3;z6s(EwpYK>0 A$Azt@oah8p(]./}#Y07TQ3r@"3.hC670(H0OEku,,^;$`=~ 6J_OV*v~Een#3.. WebDisinfectants Chemical Disinfection Disinfection is a process that reduces the number of microorganisms present to a level at which they do not present a risk. To receive email updates about this page, enter your email address: We take your privacy seriously. Thorough cleaning is required before disinfection and sterilisation, because Inorganic and organic materials that remain on the surfaces of clinical instruments may interfere with the effectiveness of disinfection and sterilisation. Failure to properly disinfect or sterilize equipment carries not only risk associated with breach of host barriers but also risk for person-to-person transmission (e.g., hepatitis B virus) and transmission of environmental pathogens (e.g.,Pseudomonas aeruginosa). Local policy should be checked and adhered to. endobj Sterilizationdescribes a process that destroys or eliminates all forms of microbial life and is carried out in health-care facilities by physical or chemical methods. Selected articles published before 1980 were reviewed and, if still relevant, included in the guideline. WebAll disinfectants are potentially hazardous and must be stored and used with caution; hypochlorite for example, corrodes metals, irritates skin and bleaches fabrics and clothing. Infection Control Guidance for Care Homes (2006). @IZE[7tD (Refer to manufacturer instructions). endstream Gloves do not provide complete protection against hand contamination, as pathogens may gain access to the hands via small defects in gloves or by contamination of the hands during glove removal. Each of the various factors that affect the efficacy of disinfection can nullify or limit the efficacy of the process. 13-18. Cleaning is important because it prevents the spread of dirt and contaminants to oneself and others. Patients Clipboards/Note Holders/Trolleys. 5 0 obj Call us now <> <>/Metadata 3217 0 R/ViewerPreferences 3218 0 R>> stream Don Personal Protective Equipment (PPE), i.e. This is even less effective on porous surfaces such as sidewalks and unpaved walkways. Which surface disinfectants are effective against COVID-19 in non-health care setting environments? Suggested protocol for management of positive biological indicator in a steam sterilizer, U.S. Department of Health & Human Services. Disinfectants are chemicals in liquid form which destroy micro organisms. Sluice and dirty utility rooms should be disinfected periodically using 1000ppm available chlorine or a chlorine dioxide solution to limit the accumulation of C diff. WebDisinfection is a generic term that refers to any antimicrobial measure (regardless of the level of the outcome attained), using a product that exhibits in-vitro properties that meet the endstream endobj 1099 0 obj <. Seek specific guidance for Respiratory Equipment from manufacturer. An area or a device is considered sterilized when the disinfectant completely kills and removes microbial infecting agents (Springthorpe & Sattar 1990).The ability of a disinfectant to deactivate a microbe depends on the mode of action of the chemical, the molecular Summary of advantages and disadvantages of commonly used sterilization technologies, Table 7. Explain how the level of risk determines the type of agent that may be used to decontaminate 2.7. With extensive experience of CQC standards she has provided support and advice in implementing and managing health and safety. Many agents can be used as both an antiseptic and a disinfectant, depending on the concentration. Ensure twice daily full clean of Observations trolley with detergent wipe. <> Swabs are inoculated into growth medium and incubated. Dispose and replace if contaminated with blood or body fluids. 0 %PDF-1.5 Check clean daily. Keep cleaning fluids and disinfectants out of the reach of children and pets. Before preparing or eating food it is important to always wash your hands with soap and water for at least 40-60 seconds. <> stream Damp clean with general detergent daily (remove mains plug), Use single head/sleeve for each use and discard. Independent Oversight and Advisory Committee, https://www.who.int/media/docs/default-source/integrated-health-services-(ihs)/infection-prevention-and-control/hand-hygiene-when-and-how-leaflet.pdf, https://www.who.int/activities/promoting-safe-food-handling, https://www.who.int/teams/risk-communication/food-and-agriculture-sectors, Coronavirus disease (COVID-19): Cleaning and disinfecting surfaces in non-health care settings. Centers for Disease Control and Prevention. One example of what to record is High Touch Surfaces. The concept of risk in dealing with specific types of contamination: o Disinfectants are substances that are applied to non-living objects to destroy microorganisms that are living on the objects. There is no evidence to date of viruses that cause respiratory illnesses being transmitted via food or food packaging. x[oF~7aRQ?IA+\wnaiYv#I,r$(P|P.W{zOaq{sqqZmjy]w'&$==,6BXvpz;QyC-j0[\CJB?\]>c= .%_RQq9*vd9g9Ua+yi2,xVQn~rU"!2L(Sd,k(r~y^,:CkyY0krnm5R):* 4 0 obj }7D h@ay]HOGE w>[z5fK\ @Rf|Vk\~^] # +3,N=Ov!nD rB p((o90_J4xlO5Ef5bx?T=[\Y7eZ!jX.yLK9H.RJN2MoSk:/$G*uSU|;S-bN1p>Nbcb^T$XD+VJIztz=/i 9 0 obj HSE aims to reduce work-related death, injury and ill health. endobj Disinfectants and antiseptics are used extensively to sterilize surfaces and spaces. Mixing time must be allowed to ensure heat penetration and assured disinfection. 275698. Webcleaning services to all Public Health Wales premises , will use this document when stipulating standards and arranging contracts for leaning services.c This will be of particular importance for clinical areas within Breast Test Wales centres. Wash weekly or when soiled. Wash daily with detergent and water; rinse and dry. hb```9,_@Y8& <> Uniforms and workware: An evidence base for developing local policy Uniforms and workwear - An evidence base for developing local policy. hand towels, magazines, bottles, toilet rolls, etc.) ,RLB(qr0#q>' \J#sb^sAO1)F "+%lRb Wash with detergent and water, rinse and dry using disposable cloth. WebSteps in decontamination: cleaning, disinfection, sterilisation, autoclaving; details of how to carry out each step Use of cleaning agents: types of cleaning agents (detergents); when Alcohol at 70-90% can also be used for surface disinfection. Summary of advantages and disadvantages of chemical agents used as chemical sterilants or as high-level disinfectants, Table 6. All information these cookies collect is aggregated and therefore anonymous. 10 0 obj The reservoir of the suction apparatus should be kept empty and dry when not in use. 3o~ "J1S3qZ.L]dnO~1R,CbKz)m ]"#KgMre{*jf^\[/PYmX!xFK%d|B)lYri )t*XR8~`-xRfw-ETH_DTTWk/|SL5[cC)A>&} *&v2> Factors that affect the efficacy of both disinfection and sterilization include prior cleaning of the object; organic and inorganic load present; type and level of microbial contamination; concentration of and exposure time to the germicide; physical nature of the object (e.g., crevices, hinges, and lumens); presence of biofilms; temperature and pH of the disinfection process; and in some cases, relative humidity of the sterilization process (e.g., ethylene oxide). <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 594.96 842.04] /Contents 10 0 R/Group<>/Tabs/S/StructParents 1>> Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 71oC for not less than 3 minutes. Germicides differ markedly, primarily in their antimicrobial spectrum and rapidity of action. Are gloves recommended for the community in public spaces to protect against COVID-19, for example when going to the grocery store supermarket? Even in the absence of dirt or rubbish, it is unlikely that chemical spraying would adequately cover surfaces allowing the required contact time to inactivate pathogens. Local risk assessment should dictate frequency of cleaning Minimum of weekly is recommended. High Touch Surfaces such as toilets, commode chairs, computer keyboards, chairs, bedrails, call bells and telephones must be cleaned and then disinfected on a regular basis. If there soiling with body fluids clean with a detergent wipe prior to disinfection. In health-care settings, They are usually applied to the surfaces of non-living objects in order to kill microbes that are Daily clean with detergent and water or detergent wipe rinse and dry. In general, antiseptics are used only on the skin and not for surface disinfection, and disinfectants are not used for skin antisepsis because they can injure skin and other tissues. Clean electronic hand piece after each use per manufacturer instructions. These cookies may also be used for advertising purposes by these third parties. How many electrons does it have. Clean daily with detergent and water, rinse and dry. Low-level disinfectantscan kill most vegetative bacteria, some fungi, and some viruses in a practical period of time (10 minutes). The nature of laundry soiling depends on the source, and at the most extreme levels, eg in hospital and nursing home environments, is likely to include blood, wound exudates, sputum, saliva, sweat and urine, as well as vomit and faeces. WebDisinfection describes a process that eliminates many or all pathogenic microorganisms, except bacterial spores, on inanimate objects (Tables 1 and 2). Disinfectants are usually used in the hospitals, kitchens, bathrooms, etc to kill infectious microbes. They are especially important for frequently touched surfaces (e.g., bed rails, bedside table, light switches, phone, 1 0 obj If reusable return to CSSD for autoclaving. ?TpFTZgk0e%]^Rgq3}6{G ^d^s`Z$v34?Y9 Avoid leaving and re-entering the area until the terminal clean is fully completed. Webinfection control measures are aimed at removing this link, eg the use of disposable equipment, or maintain effective cleaning and disinfection procedures. Aim of the guidance The aim of this document is to provide a reference document for staff regarding the cleaning of the environment and equipment. Antiseptics can be classified according to their The usage level depends on the pH of the cleaner. Check clean daily with detergent and water or detergent wipe; rinse and dry. Spills /Emergency Mops Access appropriate colored mop from domestic store of relevant ward/dept. These items need to be washed at ~40oC, so the wash temperature is insufficient to disinfect, and chemical alternatives are required; Addition of hypochlorite may be possible, but efficacy may be reduced by the presence of soiling, detergents and alkalis in the main wash; Disinfection with hypochlorite is only reliable if the linen can tolerate its addition and if sodium hypochlorite is added during the penultimate rinse of the cycle; A final concentration of 150 ppm available chlorine must be achieved for a minimum of 5 minutes exposure time. WebThe NHS has rightly earned a high reputation for the cleanliness of its environments. The medium is monitored for growth. 3. Washing is one way of achieving physical cleanliness, usually with water and often some kind of soap or detergent. by covering your mouth and nose with your bent elbow or tissue when coughing or sneezing; avoid touching your eyes, nose and mouth; and avoid crowded places. These include disinfectants for inanimate surfaces and antiseptic agents for use on the body. Thorough hand hygiene: washing hands with soap and water or using alcohol-based hand gel, should be performed before touching surfaces, items, pets, and people within the household environment. Decreasing order of resistance of microorganisms to disinfection and sterilization and the level of disinfection or sterilization, Table 4. A 65oC temperature hold for a minimum of 10 minutes within the wash cycle; or. Disinfectants are antimicrobial agents that are applied to non-living objects to destroy microorganisms that are living on the objects. When autocomplete results are available use up and down arrows to review and enter to select. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Detachable mop heads should be laundered daily using washing machine with appropriate detergent. % Inner bag should be removed from the outer bag only at the point of transfer to the washer-extractor, followed by the outer bag. endobj Linen can be made safe by washing to remove any contaminating body fluids, but it is often not practical to wash domestic linen at high temperatures because of the heat lability of fabrics. CDC twenty four seven. `;a$]uiVe0WD`% / zaY;4*L'p/7?z_][eda;$ WebThe most effective agent entirely prevents growth at highest dilution. Ensure that personnel, where required, are competent in cleaning, disinfection and sterilisation by providing instruction, information and training as appropriate. Infected linen may be stored in different bags in other parts of the UK, eg clear with red stripes are used in parts of Scotland. endobj The minimum recommended personal protective equipment when disinfecting in non-health care settings is rubber gloves, waterproof aprons and closed shoes. endobj QCS have polices such as the Infection Control Policy and Procedure that will provide guidance on areas of cleaning and disinfection. % 2Each procedure involves contact by a medical device or surgical instrument with a patients sterile tissue or mucous membranes. endobj She is also a Registered Nurse with previous nursing experience in both the private sector and the National Health Services. A 65oC temperature hold for a minimum of 10 minutes within the wash cycle; or. In outdoor spaces, large-scale spraying or fumigation in areas such as streets or open market places for the COVID-19 virus or other pathogens is not recommended. The most commonly used surface disinfectants are quaternary ammonium compounds and sodium hypochlorite. All disinfectant solutions should be stored in opaque containers, in a well-ventilated, covered area that is not exposed to direct sunlight and ideally should be freshly prepared every day. Laundering contaminated items in the community setting, *Washed with detergent using the hot wash cycle of a domestic washing machine to a temperature of at least 80oC; or, Dry cleaned at elevated temperatures, or dry cleaned cold followed by steam pressing; or, Incinerated if items cannot be effectively washed as described above, *Dilution is an important part of the washing process and therefore machine overloading should be avoided.