By Sophia Daukus / Special to Healthcare Facilities Today

Few industries are as sensitive to indoor contamination as the healthcare industry, where preventing hospital-acquired infections (HAIs) is a fundamental priority. The challenge of maintaining a sanitary environment for a dense population of patients with weakened immune systems in the face of an ever-changing assemblage of staff and visitors entering and exiting the building makes maintaining a sanitary environment a challenge.

Should an outbreak occur within a given facility, epidemiologists and forensic microbiologists seek to uncover the source and path of pathogenic microorganisms. Hidden environments, such as floor and sink drains, are often the initial suspects. However, science is discovering that the airborne particles we consider to be “common household dust” are in fact home to an incredibly diverse population of dust-residing microbes, including not only bacteria and viruses, but also fungi, algae and protozoa, many of which can be pathogenic. 

The importance of low-dust environments in healthcare

HAIs can develop in different ways and from many different sources. However, it’s clear that contaminated dust can play a role, posing a serious risk to patients, visitors and staff alike. Consequently, any surface with the potential to collect dust in a healthcare environment warrants attention. And flooring, as a large surface found throughout the facility, can help make or break the success of pathogen-control efforts.

The majority of medical facilities experience high levels of foot and cart traffic, with visitors and staff introducing contaminants from outside the building into the healthcare environment. However, the initial contamination is not the only problem. When there is any type of movement—whether from pedestrians, gurneys, wheelchairs, hand trucks or even maintenance equipment—undesirable microbes and particles can get suspended and re-suspended in the dust released from floor surfaces, thus amplifying the problem. Reducing the presence of dust in the environment can help to significantly reduce the risk of cross-contamination in the facility.  

Carpeting in low-dust locations

It can be unusual to see carpeting utilized in sensitive areas of healthcare facilities, its usage being typically kept to certain foyers, offices and public seating areas. The use of carpet in low dust environments remains highly controversial due to the ability of carpet fibers to entrap particulate. Additionally, the list of volatile organic compounds (VOCs) most carpets and underlayment pads can emit into the environment for weeks or months after installation continues to be of great concern. Such compromised Indoor Air Quality (IAQ) can be especially harmful to immunosuppressed patients and those with respiratory illnesses.

Although institutional carpeting can sometimes be relatively inexpensive to purchase and install, its life cycle cost – the initial financial outlay plus all care and maintenance costs, divided by the number of years the material is in use – can be surprisingly high. The typical replacement cycle for carpeting in high traffic areas is five to seven years. In addition, the material can stain relatively easily, can attract and capture dirt and pathogens, and is generally not considered an appropriate choice for many areas of healthcare facilities.

Vinyl tile and sheet flooring in healthcare

While vinyl tile, sheeting and vinyl plank flooring is frequently utilized in healthcare, these products can pose a range of challenges for low-dust environments. The seams between standard tiles can tend to collect dust and particulate. Similarly, the heat-welded seams of vinyl sheets or planks can have a tendency to crack with heavy use, transforming them into a similar catch-all for germs and dust. In both cases, the microbe-laden dust can get released into the air with footfall or cart movement.

Additionally, water and other liquids have the opportunity to enter the dark crevices, become captured under the surface, creating a moist, germ-gestating situation that often never dries out. And like carpeting, the life cycle cost of vinyl flooring products can be surprisingly high. The chemical stripping, waxing and polishing needed to maintain the appearance of vinyl as it ages consumes materials, equipment, man hours and utilities. These extensive custodial expenses can be generally avoided with the installation of epoxy or other resinous floor systems, which characteristically maintain their finish over the long term.

Epoxy coatings as a flooring solution for low-dust environments

Well-selected epoxy and other resinous floor coatings are capable of withstanding high levels of foot traffic, as well as heavy-duty forklift and wheeled cart traffic, and depending on the finishes selected, are resistant to many solvents, extreme pH substances, harsh cleaning chemicals, and abrasion. These systems have a proven record of success in tough environments, thanks to their innate durability and impressive lifespan.

Additionally, resinous flooring is available in a wide variety of colors and textures, offering many aesthetic options.

For healthcare facilities, the benefits of resinous floors are far-reaching:

• The seamless, fluid-applied floor surface eliminates many of the nooks and crannies that can become depositories for dust and contaminants. This then also helps avoid the secondary issue of entrapped dust getting stirred up and re-suspended by the movement and vibration of traffic across the surface.

• Furthering hygiene initiatives, the unique, integral cove base options of resinous systems can provide water- and chemical-resistant intersections between the wall and the floor. These radial, monolithic surfaces can be more efficiently and thoroughly cleaned than typical ninety degree angles, where dust and pathogens tend to hide.

• High performance, industrial-grade resinous coatings are easy to care for and require no waxing, reducing the time and cost of maintenance.

• Optional features include:

                      • Augmented support for facility pathogen-control efforts with the use of floor coatings containing EPA-registered antimicrobial additives

                      • Betadine® stain resistant topcoats for better long-term aesthetics

                      • Mitigation of Moisture Vapor Transmission (MVTs) from within or underneath the concrete, a condition which can:

                               • Damage nearly any type of floor covering, manifesting itself in bubbling, blistering, disbondment, etc.

                                • Potentially enable more moisture vapor to enter the room, increasing the relative humidity and subsequent   risk to sensitive patients and equipment

                      • Customizable slip-resistance, with facility manager’s desired level of traction on ramps, walkways and frequently wet locations for added safety

                      • Choice of gloss level, ranging from a lower sheen, satin luster to very high levels of light reflectivity, enabling facilities to greatly improve room illumination without additional overhead fixtures or energy consumption

Epoxy and urethane systems for refurbishing existing floor slabs

During facility renovation, epoxy and urethane resurfacing systems can enable managers to economically refurbish surface-damaged concrete slabs, rather than have to destroy and replace them. Additionally, the heavy duty coatings can be used to correct floor slope, facilitating proper flow of wash water toward floor drains to eliminate dangerous puddling. During the substrate preparation and floor installation process, professional crews can use equipment outfitted with HEPA filter attachments and practice good air management, including negative airflow as required. In support of good Indoor Air Quality, all high quality resinous flooring is now low emissions and low to zero V.O.C. during installation, as well as completely inert after full cure, with no outgassing. And today’s formulations cure faster than ever before, allowing manufacturer-approved contractors to install in record time, with minimal facility downtime.

Summary

A nearly unlimited selection of custom aesthetic options allows resinous seamless flooring to contribute to almost any healthcare facility design vision, and can easily incorporate embedded organizational floor logos, wayfinding color delineation and the like. Highly functional, easy to maintain and extremely durable, they are an excellent, low life cycle cost flooring choice for nearly all areas within healthcare facilities. When considering furnishings that support good pathogen-control in low dust environments, fluid-applied seamless flooring deserves to be high on the list,

Sophia Daukus is marketing communications manager for Florock Polymer Flooring, manufactured in Chicago, Ill.