Hospital EVS Providers: Guardians Against Antimicrobial Resistance

Evidence suggests that the overuse of antibacterial and antimicrobial cleaning products, including disinfectants, produces strains of antibiotic-resistant bacteria, or superbugs. This means hospital environmental services (EVS) providers shoulder considerable responsibility to find the right balance between adequate use of disinfectants because of their vital infection prevention and the prevention of antimicrobial/antibiotic resistance.

Antibacterial Vs. Antimicrobial

Many people think that antibacterial and antimicrobial are synonyms, and no wonder since they are often used interchangeably. However, the terms are different in much the same way hospital cleaning services differ from hospital EVS providers because the latter includes so much more than cleaning duties.

According to, antibacterials destroy or inhibit the growth of bacteria and fungi. Antimicrobials destroy or inhibit the growth of all microorganisms, including bacteria, fungi, parasites, and some viruses. Interestingly, experts agree that antibacterial soaps are no more effective against their targeted pathogens than regular soap and water. Meanwhile, antimicrobials must be registered with the EPA as pesticides.

Scary Statistics

Many scientists believe the overuse of antimicrobials can lead to antibiotic-resistant germs. According to the CDC Antibiotic Resistant Threats Report, more than 2.8 million antibiotic-resistant infections occur in the United States annually, resulting in more than 35,000 deaths. When Clostridioides difficile (C. diff)—a bacterium that can cause deadly diarrhea and is associated with antibiotic use—is included, these numbers soar to three million infections and 48,000 deaths. Unless action is taken, experts estimate the annual number of deaths from antibiotic resistance globally could be as high as 10 million deaths by 2050 and could reduce global economic output by US $100 trillion.

Perhaps scarier still: These future estimates are just estimates; some health effects from antimicrobials are immediate, such as asthma attacks and other respiratory and eye and skin irritation. Yet the EPA admits other health effects from exposure to these toxins may not show up for years or even decades.

EVS Fighting Against Antimicrobial Resistance

The Role of EVS: Scale Up, Scale Down

There are three types of public health antimicrobials used by EVS for hospitals: sanitizers, disinfectants, and sterilizers. While EVS technicians are seldom responsible for sterilizing medical implements, sanitizer and disinfectant use is firmly in the EVS domain. Therefore it is up to EVS to determine when infection prevention takes precedence over all else and when it may be possible to scale back the heavy-hitting antimicrobials.

For example, when there is an outbreak such as the COVID-19 pandemic, there is a need for more frequent cleaning and disinfecting, especially when there are confirmed cases within the hospital. When, however, the threat of an outbreak is not present, EVS teams should follow standard operating procedures (SOPs) that call for less frequent disinfecting. In short, EVS should adjust the use of antimicrobials to fit the threat level of infection.

One example of the misuse of disinfectants during the COVID-19 pandemic was what was quickly termed “hygiene theater.” Remember the footage of flight attendants walking through aircrafts spraying everything from seatbacks to tray tables and then wiping the surfaces instantly? Not only were these poorly trained attendants sending disinfectant airborne, but without the proper dwell time, the surfaces were not being disinfected.

EVS technicians play an integral role in infection prevention, but we should never forget what they contribute to helping curb antimicrobial and antibiotic resistance.


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