Last update 12th. February 2005


Dirt by Design

From Jennifer Mason

Tam Dalyell's comments on efforts to deal with the ever-increasing incidence of antibiotic-resistant MRSA infection demonstrate how the government and health authorities have failed to recognise the fundamental problem behind this increase (22 January, p 47, UK and US edition only). This is that hospitals in the UK, for all their technological advances in other areas, are still using the same inefficient cleaning methods first adopted by Florence Nightingale's generation in the mid-19th century.

In the food-processing industry, in which I work, such methods have long since been abandoned. If you handed a worker in a modern food factory a hospital cleaner's normal cleaning equipment -a broom, mop and bucket, for example, or a cloth and squirty-bottle-and told them to go and clean their working area, they would look at you in horror and refuse, recognising that you were asking them to deliberately go and contaminate it. They would expect to be provided with a range of alkaline and acid cleaning foams, a 100-psi pressure gun and a chlorine-dioxide -enhanced water supply to pump through it, plus a range of other more concentrated chemicals for specialised areas.

They would also expect their working area to have been constructed with such cleaning methods in mind, with awkward corners eliminated, small or otherwise portable equipment mounted on wheels, motors and electrical or data sockets fully waterproofed, cables armoured and pipes and conduits mounted clear of supporting surfaces, as well as adequate drainage in the floor, and so on.

What's more, hospitals permit hordes of people without protective clothing to traipse about at will within this supposedly clean environment, without even requiring them to wash their hands on entry and at intervals after that, or to declare any contagious diseases and viruses that they know they are carrying. In a food factory, anyone not wearing protective clothing is segregated from the clean areas in a separate "dirty" environment of ordinary offices, corridors and stairways. No one is allowed to enter the factory carrying a contagious disease or virus.

We can design MRSA out of all the new hospitals we build in the next few years, simply by changing our standard hospital design, and embracing efficient cleaning technologies already long in use in other industries.

Boston, Lincolnshire, UK

New Scientist 12 February 2005