Due to the nature of manual cleaning of endoscopes, the process can generate significant splashing and dispersal of droplets. These splashes have the potential to spread contamination throughout the reprocessing environment, exposing both staff and previously processed devices to pathogens.
Nearly every step of the manual cleaning process produces splashing, with rinsing of the endoscope generating the most water droplets.1 A study using water detection paper in a reprocessing environment recorded droplets on counters, walls, floors, and carts. Upon completion of manual cleaning, droplets were detected as far as 1.8 meters from the reprocessing sink. While extensive personal protective equipment (PPE) is required when performing manual cleaning, it does not provide failsafe protection. In the same study, moisture detection paper showed that fluid had penetrated through shoe coverings, and some staff reported feeling droplets on the top of their head despite wearing head covers.
Several outbreaks have been linked to contamination originating from hospital sinks. In one outbreak, investigators determined that droplets had travelled at least 1 metre from the sink, contaminating prep areas.2 In another study, high-concern pathogens were detected on the sinks and floors in a reprocessing area, as well as within a fully reprocessed endoscope.3 This highlights how splashing generated during manual cleaning can expose the environment, equipment, and staff to potential contamination. There is a need for new approaches to manual cleaning to reduce the risks of splashing for both staff and patients.
1. Ofstead CL, Hopkins KM, Daniels FE, Smart AG, et al. Am J Infect Control. 2022;50(11):1200-1207.
2. Hota S et al. Infect Control Hosp Epidemiol. 2009; 30:25-33. 3. Okamoto N et al. Infect Control Hosp Epidemiol. 2022; 43(12):1901-1909.
