Sinks Don’t Stand Alone; They Are Part of a System

When it comes to restroom cleaning protocols, the focus is invariably on cleanliness and appearance of restroom fixtures, floors, walls, counters and mirrors. However, you should know there is one especially critical area that is often overlooked in the maintenance of a safe, clean restroom—drains.

Problems with drains date back to the introduction of commercial and residential plumbing. An article published in the June 1877 issue of London’s Journal of the Society of Art discusses how in 1852, “an alarming outbreak of fever took place in Croydon (a section of London) on the introduction of a [sewage] system…the chief cause of the outbreak was the escape of infected air from the sewers into house[s] and the inhalation by persons susceptible to disease.” The article goes on to say “the house drains and soil pipes are uninterrupted.”

Uninterrupted meant there were no P-traps installed, if there were, they had dried up. Working properly, P-traps would have prevented the escape of sewer odors, likely preventing the fever.

We all know how an infection can spread through the body’s circulatory system; hospitals have a very similar system. Human body waste in the form of liquids and solids flows by gravity out of the building and into the municipal sewer system via the pipes in the walls and floors of a hospital. Also, vent pipes to the building roof vent the gases created by human waste in sewer pipes to the outdoors.

This sewage system carrying body waste from Soiled Utility room hoppers, sinks, floor drains and toilets is also a Superhighway for the pathogenic organisms mentioned above.

We all know instinctively that toilets harbor pathogens. That’s why we take sensible precautions such as thoroughly washing our hands after using the toilet and regularly treating bathroom surfaces with sanitizing or disinfecting products.

Hospital toilets are particularly challenging because of the compromised health of patients who use them. Understanding how hospital superbugs cross-contaminate surfaces in Intensive Care Unit or Neonatal Intensive Care Unit can go a long way toward developing best practices and engineering safeguards to help prevent potentially deadly exposures.

Hospital wastewater plumbing systems are large, complex waterworks with low-flow areas that produce stagnation and biofilm formation. The water in a hospital is designed never to freeze, with average water temperatures in the 70s – and this labyrinth of pipes provides warm, dark, moist areas that are perfect breeding grounds for bacteria.

Sink waste traps and drains are a reservoir for carbapenem-resistant Enterobacteriaceae (CPE) in hospitals. Once established, CPE contamination might not be confined to a single sink and could spread through wastewater plumbing. Outbreaks of carbapenem-resistant organisms were found more commonly in ICUs and immunocompromised patients. However, the acquisition of infection from sink drains may be more widespread in in-patients than previously thought.

There has been more investigation about microbiologic dynamics of infectious viral particles such as those of severe acute respiratory syndrome (SARS) and Ebola viruses through premise plumbing systems. However, the microbiology, sustainability, and dynamics might be very different areas of a hospital, the backflow and inoculation issues could have some parallels when comparing viruses to bacteria. As Enterobacteriaceae can either multiply or remain viable for long periods of time in biofilms coating the interior of P-traps and the connected plumbing, it may not be sustainable to target any intervention limited to a single isolated sink as a source of a particular pathogen.

Do not pour bleach down drains in an effort to kill pathogenic organisms. Bleach is a powerful chemical solution that can react with other chemicals and substances, including sewer gases such as hydrogen sulfide, ammonia, carbon dioxide, methane, and nitrogen releasing even more harmful fumes. While the bleach may kill some bacteria, it can also damage pipes. Further, it is not an environmentally friendly option.

 When it comes to restroom cleaning protocols, the focus is invariably on cleanliness and appearance of restroom fixtures, floors, walls, counters and mirrors. However, you should know there is one especially critical area that is often overlooked in the maintenance of a safe, clean restroom—drains.

Problems with drains date back to the introduction of commercial and residential plumbing. An article published in the June 1877 issue of London’s Journal of the Society of Art discusses how in 1852, “an alarming outbreak of fever took place in Croydon (a section of London) on the introduction of a [sewage] system…the chief cause of the outbreak was the escape of infected air from the sewers into house[s] and the inhalation by persons susceptible to disease.” The article goes on to say “the house drains and soil pipes are uninterrupted.”

Uninterrupted meant there were no P-traps installed, if there were, they had dried up. Working properly, P-traps would have prevented the escape of sewer odors, likely preventing the fever.

We all know how an infection can spread through the body’s circulatory system; hospitals have a very similar system. Human body waste in the form of liquids and solids flows by gravity out of the building and into the municipal sewer system via the pipes in the walls and floors of a hospital. Also, vent pipes to the building roof vent the gases created by human waste in sewer pipes to the outdoors.

This sewage system carrying body waste from Soiled Utility room hoppers, sinks, floor drains and toilets is also a Superhighway for the pathogenic organisms mentioned above.

We all know instinctively that toilets harbor pathogens. That’s why we take sensible precautions such as thoroughly washing our hands after using the toilet and regularly treating bathroom surfaces with sanitizing or disinfecting products.

Hospital toilets are particularly challenging because of the compromised health of patients who use them. Understanding how hospital superbugs cross-contaminate surfaces in Intensive Care Unit or Neonatal Intensive Care Unit can go a long way toward developing best practices and engineering safeguards to help prevent potentially deadly exposures.

Hospital wastewater plumbing systems are large, complex waterworks with low-flow areas that produce stagnation and biofilm formation. The water in a hospital is designed never to freeze, with average water temperatures in the 70s – and this labyrinth of pipes provides warm, dark, moist areas that are perfect breeding grounds for bacteria.

Sink waste traps and drains are a reservoir for carbapenem-resistant Enterobacteriaceae (CPE) in hospitals. Once established, CPE contamination might not be confined to a single sink and could spread through wastewater plumbing. Outbreaks of carbapenem-resistant organisms were found more commonly in ICUs and immunocompromised patients. However, the acquisition of infection from sink drains may be more widespread in in-patients than previously thought.

There has been more investigation about microbiologic dynamics of infectious viral particles such as those of severe acute respiratory syndrome (SARS) and Ebola viruses through premise plumbing systems. However, the microbiology, sustainability, and dynamics might be very different areas of a hospital, the backflow and inoculation issues could have some parallels when comparing viruses to bacteria. As Enterobacteriaceae can either multiply or remain viable for long periods of time in biofilms coating the interior of P-traps and the connected plumbing, it may not be sustainable to target any intervention limited to a single isolated sink as a source of a particular pathogen.

Do not pour bleach down drains in an effort to kill pathogenic organisms. Bleach is a powerful chemical solution that can react with other chemicals and substances, including sewer gases such as hydrogen sulfide, ammonia, carbon dioxide, methane, and nitrogen releasing even more harmful fumes. While the bleach may kill some bacteria, it can also damage pipes. Further, it is not an environmentally friendly option.