By Sophia Daukus / Special to Healthcare Facilities Today

While hospitals maintain strict protocols for minimizing infections and the spread of microbes, facility managers may be overlooking a prime area of concern. Indentations in flooring and hard-to-clean places are areas where bacteria, viruses, and fungi can grow. Because cross-infections are one of the greatest threats to hospital patients, pathogens cannot be allowed to travel and multiply. Fortunately, there are ways to help mitigate the risks of microbial spread.

Healthcare flooring hygiene – areas of concern

Microbes tend to proliferate on the floor surface in hard-to-clean seams, sharp angles or corners, depressions in the floor, divots, punctures, or anywhere the finish has been breached. Microbes can infiltrate the actual floor covering itself, should it become compromised or susceptible to damage. 

Unwanted microorganisms can also collect in dark, damp pockets underneath the flooring, such as the underside of carpet, vinyl, rubber sheeting, planking, or tile.

It’s easiest to remove pathogens in wide open, visible areas. Facility managers should ensure the flooring can withstand the cleaning chemicals being used, in the concentrations applied, as well as the frequency and duration of exposure. Stain resistance to disinfecting agents may also be a concern with some types of floor coverings.

Pathogen growth in hard-to-clean places

When it comes to reducing pathogen growth in hard-to-clean places on and around the floor, the best and easiest strategy is to reduce the number of locations that are hard to access during the floor covering design and selection stage, especially in hospitals where sanitation is a top concern.

Indentations

One of the biggest issues with sheet vinyl flooring in hospitals is indentations from wheels on heavy beds and equipment. Some medical equipment is so heavy that it can even pulverize the cementitious patch and leveling materials typically used to prep the concrete under vinyl, rubber, or carpeted floors. Beds and machines with wider wheels can help disperse the weight, but the problem remains significant due to the low bearing capacity of these conventional materials. Any depression in the floor can create a perfect environment for moisture to gather and microbes to proliferate.

In contrast, resinous, fluid-applied healthcare flooring has its roots in heavy-duty industrial environments. As a result, the resinous patching materials as well as the highly decorative toppings can demonstrate impressive compressive strength readings of 8,000 to 12,000 psi or even greater, as measured with ASTM International’s C579 test. On high capacity resinous surfaces, heavy hospital equipment is far less likely to create floor divots and depressions that can hold moisture, harbor pathogens and compromise hygiene.

Surface gaps

Breaches in solid floor surfaces are another major concern in healthcare facilities. Any flooring that has seams or gaps that need to be sealed in some way, such as the heat-welding of seams in vinyl and rubber flooring, can later develop weak points that fail. Harsh cleaners, the repeated agitation of mopping and scrubbing, and daily exposure to moisture all take their toll on heat-welded seams. 

In the same way, tile floors, whether grouted or abutting, provide copious opportunities for undesirable microbes to set up shop – whether in porous cementitious grout, depressions created by eventually shrinking elastomeric grout or in the seam where two ungrouted tiles adjoin. Floor finishes that are easily scratched or punctured present similar risks.

Once water or other fluids enter a breach in the floor, the result can be a hidden hygiene disaster. 

Resinous epoxy, urethane mortar, methyl methacrylate, and polyaspartic floors – in other words, flooring that be poured onto the surface are the only true seamless flooring options. Their use helps eliminate the majority of those hard-to-clean places, offering healthcare facilities optimal monolithic germ-fighting advantages.

Cove base concerns

A floor-to-wall cove base removes the sharp angle where the floor meets the wall, allowing for easier cleaning and reduced pathogen growth. However, using a vinyl or rubber cove base that gets glued onto the wall or heat welded to the adjoining floor provides a perfect dark, moist environment for microorganisms to grow – either along the seams or underneath the affixed materials.

To avoid this danger, select resinous, fluid-applied flooring. Seamless floor-to-wall cove bases are a standard option and an optimal choice in hospitals and clinics.

Pathogens within the floor material itself

Many materials used in healthcare settings today boast of their anti-microbial properties, meaning the materials that make up the flooring are said to inhibit the growth of bacteria. 

In general, the inorganic polymers that make up the great majority of today’s healthcare floor surfaces furnish a less-than-ideal food source for bacteria, viruses, and fungi. Yet given the right conditions, even these inhospitable surfaces can host an astounding array of dangerous microorganisms. Concerned flooring manufacturers offer products with additional protection in products formulated with anti-microbial additives. With the right monolithic surface structure and material, anti-microbial flooring can offer protection throughout the depth of the floor, regardless of wear patterns or cleaning regimes.

Pathogen proliferation underneath healthcare flooring

Knowing they have enemies, germs have evolved to thrive in places where light is limited and moisture or moisture vapor is available. What more perfect setting than between an impervious floor surface and a slab of concrete?

Doesn’t the grout bed or floor adhesive prevent this from happening? Isn’t the flooring completely adhered to the concrete? More often than not, the answer to both question is no. Concrete slabs, as well as cementitious tile grout beds, are porous. Moisture can enter from the top or from underneath the slab. Today’s water-based floor adhesives are weaker and often less chemical resistant than the glues used in the past. Chemical cleaning solutions seeping through gaps in the floor surface, as well as moisture and moisture vapor from any source, can break the adhesives down, allowing for microbe-attracting “pockets” to develop between the floor covering and concrete slab.  Anyone doubting this need only observe as flooring gets replaced in a healthcare facility. The underside of the old tile, sheet, or carpeting is often visibly rampant with mold growth and colonies of microbes. 

A better option is resinous flooring, which is fluid-applied directly to a prepared concrete slab, essentially bonding completely with the concrete substrate, eliminating the danger of pockets forming under the floor topping. Additionally, quality manufacturers offer moisture vapor mitigation as well as anti-microbial protection. To avoid the hidden hazards of unseen microbe proliferation in healthcare facilities, seamless resinous flooring offers an ideal solution.

Reducing infection risk with flooring systems

Virtually seamless fluid-applied flooring systems minimize the number of places where microbes can multiply. These floors are also more resistant to indentations, which helps eliminate places where germs can gather. Along with an appropriate cleaning regime, resinous flooring systems help maintain a more sanitary environment overall. By supporting efforts to prevent the spread of microbes, well-selected floor coverings can help reduce the risk of hospital-contracted secondary infections, one of the biggest threats to patients -- especially the elderly and those with compromised immune systems. High performance, antimicrobial resinous flooring is an ideal foundation for a successful healthcare facility sanitation strategy.

Sophia Daukus is a business development manager for Florock Polymer Flooring.