Drainage systems, an occluded source of sanitation related outbreaks

Blom, Kristina

Regulations have been spawn from risk impact assessments (RIA) and cost-benefit analysis [37] . The production is run applying two different systems, hazard analysis critical control points (HACCP) and Good Manufacturing Practice (GMP) intended to assure the safety of food. A major focus is on the reduction of microbes. Noteworthy, is the architectural demands of GMP. GMP focus on e.g. that the facilities must be built and the work must be done so that the risk of contamination is minimized and the quality of the product can be assured. In practice, sinks must be placed strategically to ease the drainage of water during cleaning, and in clean rooms or sterile rooms with the highest clean air requirements, sinks or floor drains are not allowed. Pipes must be made of certain materials and their dimensions must differ from those drainage design requirements in ordinary buildings. Floor drains should be kept to a minimum and must be free from debris, giving off no offensive odors. In addition, all building drains must be cleaned and sanitized on a regular basis. Their design must prevent the possibility of backflow. Open channels should be easy to clean and disinfect. These drains must always be filled with water as a physical barrier and their covers must remain intact. Maintenance must be recorded and continuously monitored. Furthermore, it is essential and mandatory to continuously monitor and include environmental sampling. In the food industry, it has been suggested that if one organism is found in the preparation environment, then there is a 70% chance of it getting into the food (Chris Griffith at IAFP Rome 2007). If this principle holds, then the risk of cross-contamination from the building's drainage systems to other surfaces and/or individuals at hospitals is indeed high. However, GMP systems are not applied in healthcare. Although, HACCP has been evaluated for its applicability to reduce infections but only a handful studies have been found [38] . Thus, practices or maintenance programs considering the sanitation are pretty much up to each hospital.