< 1 min reading time

As originally asked by Debra Pollock.

Several studies are reporting a reduction in HIA’s with the use of copper alloy objects in the hospital setting.

SHEA Study Reveals Copper Surfaces Reduced the Rate of Healthcare Acquired Infections. (SHEA) Society for Healthcare Epidemiology of America released a year long study funded through a contract from the U.S. Department of Defense. A separate study was conducted at the University of California provided through a $2.5 million federal grant to study the germ fighting effectiveness of copper in hospitals.

Questions remain just how much copper is needed and cost factors for same. The research addresses anti-microbial properties of copper against MRSA and VRE.

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Debra Pollock
🌎 MedCepts Independent Network↔★Top Linked ★ | ✔ 30+ Yrs Healthcare | Medical | Sales & Marketing ★ Recruiter Network
Nice addition, Jamie. There is absolutely no doubt in my mind that products made from EPA registered antimicrobial copper alloys are a viable added solution to addressing HAI’s in the hospital setting. It may take a bit of an investment in “education” for sales team members for the proper presentation to end users. Notwithstanding, as a registered licensed professional, and recognizing the value from my past clinical tenure, this immediately presented a “WOW” factor 27 days ago when first introduced to me. There are endless supporting documents/tools/research, etc. for same – it’s now about getting the products into the proper sales channels that WILL succeed with getting the products into our healthcare facilities. (Yes, well beyond the ICU focus – all patient care facilities.)

Jamie Gregg
CEO, Colonial Bronze Company
I want to disclose upfront a personal bias: my company makes products from EPA registered antimicrobial copper alloys.

If I didn’t think I had a sound basis for committing my company to this course, I would not have done so. Part of my reason for doing so is from experience as a member of my local acute care hospital’s board of directors for the past seven years. I have seen firsthand the financial difficulties facing smaller hospitals and how they struggle to maintain the delivery of quality healthcare.

Under the new Medicare rules, my hospital – which is heavily utilized by Medicare/Medicaid patients – stands to lose funding that is vital to its existence due to the impact of such quality indicators as readmission rates which certainly are influenced by HAI incidence. When I learned about copper’s effectiveness at killing bacteria, it made perfect sense to me to commit to the technology to help.

If the Medicare were to impose 0.10% reduction penalty on my local hospital (one of the lowest available penalties this year), it would lose over $420,000 in reimbursements. When you consider the cost of replacement copper surfaces to numbers like this, the added expense of copper is put into proper perspective.

As has been so truthfully said here, there is no magic solution to HAI’s – but that doesn’t mean we should do every practical thing we can to give the healthcare setting the best tools available to assist them in the fight. If copper works 24 x 7 killing bacteria (and for an exhaustive list of the microbes against which copper is effective, follow the work of Professor Bill Keevil of the University of Southampton, Southampton, England), then does it not make sense to install it in critical, frequent touched surfaces?

I know that the research to date centers on the ICU setting, but the numbers coming out of the study published in ICHE in April of this year are very impressive.

All that said, it still important to focus the replacement effort on those surfaces that are frequently touched and represent the most serious potential for touch transfer contamination. More copper is not better – judicious placement of copper is.

Bob Nolan
President at OIT (Operator Interface Technology)
Lucy is correct in her statement “ Although copper may reduce occurrence of HAI’s, cleaning and disinfection will still need to take place”. If copper objects are not cleaned dead bacteria will accumulate on the surface and new bacteria could survive since it may not be contacting the copper surface. Chlorine based cleaners will corrode stainless steel and aluminum so alternate disinfectants are already being used so there should be no increase in maintenance costs.

Lucy Morris
Managing Director at Tristel Asia Ltd
Although copper may reduce occurrence of HAI’s, cleaning and disinfection will still need to take place. The problem will then be finding products which are compatible with the copper surfaces, i.e. don’t cause corrosion. Common hospital surface disinfectants contain chlorine at high concentrations which will corrode copper. Costs of ongoing maintenance will also need to be factored in.

Michael Sobrepera
Graduate Student
There is a neat looking company called Sharklet [https://www.sharklet.com/|leo://plh/https%3A*3*3www%2Esharklet%2Ecom*3/UHMb?_t=tracking_disc] that is working on this problem using a totally different approach. Rather than inhibiting bacteria growth by disrupting their DNA or rupturing their cell walls, the Sharklet technology works by making a surface that the bacteria don’t seem to attach or grow well on.

Jerrold Shapiro
President and CEO, Fem-Medical LLC
John, would you please share the hyperlinks to the clinical data/trials that support the antimicrobial properties of these catheters? What did you have to prove to secure the CE mark? Are these catheters in a blood or urine environment? Thanks.

Jeffrey Trogolo
Chief Technology Officer at Sciessent LLC
Hi Tina. I have had conversations with hospital executives in which we’ve discussed that they need make evidence-based decisions regarding where to put their resources. They’ve asked about the connection between antimicrobial environmental surfaces and HAI’s. These are good and fair questions that I would ask if I were in their position. The challenge is that it has been hard to make a direct causal connection between a given surface and the rate of infection. I believe, logically, that there is a connection and have heard anecdotal stories of situations such as a particular room in an ICU that seems to be associated with a higher incidence of infection – even after intensive cleaning and disinfection. Were organisms hiding in the sink faucet or drain? The light switch? The bed? The Perhaps with newer advances in genotyping we’ll get a clearer picture of where a given infection causing pathogen may be harbored on environmental surfaces. It seem reasonable to think that if enough cross-contamination sites can be “neutralized” using any efficacious antimicrobial surface, some critical mass of surfaces close to the patient, then fomitic transmission to a susceptible patient might be curbed.

Tina Foster
Clinical Consultant & Entrepreneur
Jeffrey, would you be so kind as to clarify the statement where you mention you have spoken with hospital executives about this topic.

Debra Pollock
🌎 MedCepts Independent Network↔★Top Linked ★ | ✔ 30+ Yrs Healthcare | Medical | Sales & Marketing ★ Recruiter Network
On target, Jeffrey! –> “there is no single solution – no silver or copper bullet – will alone eliminate HAI’s” –

Nicely said – recognize also, as a healthcare provider maintaining the present aggressive “shotgun” (multi-step) approach, I would certainly be receptive to ensure my staff had “copper in their arsenal.”

Jeffrey Trogolo
Chief Technology Officer at Sciessent LLC
This is an interesting discussion about a topic of growing importance, and one I’ve been close to for several years.
To those commenting on kill rate and that it can take minutes to hours for antimicrobial surfaces to have a strong impact on bacteria populations: Yes, it’s true that AM surfaces do not kill bacteria as quickly as a disinfectant like alcohol or H2O2. But that’s not the objective. AM surfaces are a complement to spray disinfectants, which rapidly reduce bacteria populations, but are absent minutes later when a touch-based contamination mechanism can reinoculate that surface. The scientific goal is to reduce cross contamination. Studies in the literature have shown that hand-based cross contamination is a function of the concentration of bacteria on the source surface. So it would be expected that if fewer bacteria are on a surface, the likelihood of an infectious dose of a given bacteria being transferred is lower. The hypothesis is that a contaminated hand on an antimicrobial door handle may transfer an infectious dose to a few people instead of a few dozen from an untreated door handle that harbors a greater number of organisms for a longer time.
Economics will play a role in whether copper, or any other antimicrobial environmental surface, is widely used. It’s hard to compare the overall cost of HAI’s to the cost of copper bedrails because the origin of an HAI is rarely known. Carts with equipment move from room to room, patients move from room to room, healthcare workers move from room to room. And not all objects that contact a patient can be made out of copper (though most plastic surfaces can be rendered antimicrobial using other technologies). I’ve spoken with hospital executives about this topic and they want to see a correlation between this HAI and that surface to even consider justifying the cost of making a surface antimicrobial – it’s a cost/benefit calculation.
On the scientific side, copper has no unique magic. As others have noted, silver and zinc are antimicrobial ions as well. In fact, silver is an order of magnitude more potent than copper. My company uses all three ions and different level across several grades of our product, which is an additive to plastics and coatings. We have been successful in producing antimicrobial plastic surfaces, coatings, textiles and other materials under EPA jurisdiction, several medical devices under FDA jurisdiction showing clinical benefits ([http://www.ncbi.nlm.nih.gov/pubmed/22841551|leo://plh/http%3A*3*3www%2Encbi%2Enlm%2Enih%2Egov*3pubmed*322841551/AwrH?_t=tracking_disc]), and water filters and food contact applications under the jurisdiction of both agencies (an area in which the copper alloys cannot be used).
In general, any studies that show that antimicrobial environmental surfaces in a healthcare context reduce infection should prompt further investigation. It seems only logical that if the healthcare community has determined that it is worthwhile to actively spend time and money using surface disinfectants to reduce the population of bacteria on environmental surfaces, then a passive means to the same end can only be an improvement. But most importantly, an antimicrobial surface is not a substitute for aggressively maintaining high standards of hygienic practice, it is a complement. Given the diverse origins and complex mechanisms that result in HAI’s, no single solution – no silver or copper bullet – will alone eliminate HAI’s. It will take the commitment of manufacturers, hospital executives, infection control practitioners and healthcare workers to solve this problem.

Luther M. S.
Field Technician at Musco Lighting
Thanks for sharing. It would be great to help start cutting down infections in hospitals, clinics, etc. This would be a good start.
Another thing to consider is how the hospital rooms are cleaned during the patient stay and afterward the patient leaves. Do the cleaning people use the same cleaning rags, mops, water, gloves, etc. for each room or do they change them? I don’t know the specific protocols on that…but each hospital may vary.

Robin Becker
Top 1099 Recruiter, Top 10% placements W2 & Contract Consultants at MedCepts
We’re not talking about bed linens or dressings made of copper or other continuous contact items for the patient which would then have an impact for considering allergies. I think there should be additional allergy considerations about aerosols and plates or cups as previously mentioned for the use of copper around allergenic patients. We are mostly talking about the touch areas for staff and eliminating the spread via a passive way. Is that correct?

Robin Becker
Top 1099 Recruiter, Top 10% placements W2 & Contract Consultants at MedCepts
Great video, Mr. Nolan!

Ernst Bergmann
part-time consultant & writer, ski-bum, climber, SAR volunteer, Mountain Rescue Team Leader
Thanks Bob for that reference.

I had been under the assumption that copper allergies were a much bigger problem.
Partly based on anecdotal recollections from studying Chemistry a long time ago.

Also, some people have issues, even with silver jewelry, depending on the purity of the silver. Sterling is 8% Cu if memory serves me correctly.

Helen K
HRK Enterprises, Inc.
Very interesting. About 3-4 years ago there was an article in American Journal of Nursing about hospital beds with I believe a copper coating on the rails. In reference to Bob Nolan’s comment about “scrap copper” that theft should not be an issue, here in South Florida Air Conditioning Units have been pulled apart for the copper tubing then sold as scrap. If copper can inhibit growth of bacteria, then that’s a good thing.
Helen K.

Bob Nolan
President at OIT (Operator Interface Technology)
Interesting facts

“Considering the widespread use of copper in dentistry, medicine, industrial use, coinage and personal adornment, copper sensitivities are rare. According to a 1998 report in the British Medical Journal, from 1960 to 1976, St John’s Institute of Dermatology treated only one case of copper contact allergy, which occurred in a woman whose hobby was copper beating.”

Read more: [http://www.livestrong.com/article/276340-copper-allergies/#ixzz2UcYsOjYc|leo://plh/http%3A*3*3www%2Elivestrong%2Ecom*3article*3276340-copper-allergies*3%23ixzz2UcYsOjYc/5mkv?_t=tracking_disc]

Here is a link that has a video shows the efficacy of copper in a study done at South Hampton University.
They place 10 million MRSA cells on copper and stainless steel and observe both through an electron microscope and found that all the MRSA cell died on the copper in 9 minutes and all survived on the stainless steel.

[http://www.antimicrobialtouchsurface.com/|leo://plh/http%3A*3*3www%2Eantimicrobialtouchsurface%2Ecom*3/i5wf?_t=tracking_disc]

Ernst Bergmann
part-time consultant & writer, ski-bum, climber, SAR volunteer, Mountain Rescue Team Leader
My recollection is that all the noble metals Au, Ag, Cu are anti-microbial but Cu is also allergenic ( and fairly significantly so).
That is the main reason as far as I know that copper is not used in devices like wound dressings, unlike the more expensive silver.

Also, the antimicrobial properties are not necessarily significant in all forms of Cu and Ag.
Ag+ or various complexes are effective; metallic silver?

Jim Sweeney
President at Healthy Builds Inc
Very interesting topic. Dropping Bio Loads in medical setting can only help the problem. A friend of mine, makes a coating that can be applied to any surface and it will inhibit microbial growth. With the current cost of copper I think it will be restrictive. I think we should look at other solutions before copper.

Joe’s molecule goes on at a cost of $.01 per square foot and will hold to the surface for 90 plus days. If you add labor cost and product cost it will not will clearly work better than copper. These metals work well but become a food source for the microbes.

I think the metals will work better in areas that are not cleaned well. If you are cleaning your spaces regularly there are cheaper ways to do the task. I could see copper on subways and the like that are rarely cleaned.

Not sure. I know it is a very complicated process. I listen to Joe discuss it all the time. What is clear is we need to fix the HAI problem.

Debra Pollock
🌎 MedCepts Independent Network↔★Top Linked ★ | ✔ 30+ Yrs Healthcare | Medical | Sales & Marketing ★ Recruiter Network
Hi Rick, It appears you have expressed interest in aligning with a copper alloy product directly through the MedCepts network. We are assessing additional companies/products at this time and look forward to being able to offer rep/distributor members (and non-members) the opportunity for an introduction to an entire suite of products. I am confident you recognize it’s not completely all about simply obtaining the product, but also a significant factor is relative to the company’s ability to meet the needs of sales support and the end-users, our healthcare providers – your customers. (If you have not heard back from the company relative to your inquiry, please contact me directly and I will follow up immediately.)

Bob Nolan
President at OIT (Operator Interface Technology)
Solid copper and solid copper alloys are registered by the E.P.A and may make the claim that they kill bacteria. Copper and silver coatings can claim to be “antimicrobial” meaning they will inhibit the growth of bacteria but should not make the claim for killing bacteria. The E.P.A. has sued some large manufactures claiming to kill bacteria with antimicrobial products and the manufactures had to pay steep penalties.
OIT is registered with the E.P.A. and we use only E.P.A. registered CuVerro copper alloys in our keyboards and keypads. By the way the scrap value of the copper used in a full size computer keyboard would only be $3 or $4 so I don’t think theft is going to be an issue.
I am not sure why there would be resistance to using copper alloys since they are a very passive way to enhance infection control and 100% recyclable. They don’t tarnish like typical copper and can be cleaned with common hospital cleaners. They just kill bacteria 24/7.