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Mold and bacteria thrive in warm, wet environments. Damp showers, cracked tiles and leaky drains create ideal environments for pathogens. In settings with continual water use, such as healthcare settings and dormitories, mold and bacteria are a serious health risk.

 

Hospital-acquired infections
Hospital-acquired infections (nosocomial) are estimated to occur in 5% of all acute-care hospitalizations. Further complicating the problem is the increase in multidrug-resistant organisms, partially due to the increase in antimicrobial cleaning agents and additives.

 

Many different bacteria, viruses, fungi and parasites may cause nosocomial infections. Some organisms may be acquired from an inanimate object or substances recently contaminated from another human source.

 

What strategies can we use to prevent the growth of mold and bacteria in these environments?

 

Infection Control Strategies
• Use non-porous surfaces
• Limit spaces where bacteria can become trapped
• Inhibit microbial growth

 

AIA Guidelines for Design & Construction of  Healthcare Facilities

Qualities to look for in a surface:

• Ease of maintenance, cleaning and repairing
• Does not support microbial growth
• Non-porous, Seamless
• Non-flammable (Class 1 rating)
• Durable, Sustainable, Low-VOC
• Slip resistance
• Ease of installation and replacement
• Initial and life-cycle cost effectiveness

 

More Information about Bacteria and Mold

Bacteria

Bacteria are the most common nosocomial pathogens. Organisms such as Pseudomonas spp. are often isolated in water and damp areas. Selected other infectious agents include Staphylococcus aureus from nurseries, surgical suites, surgical recovery areas, and other areas; salmonella and shigella or other enteric organisms; Klebsiella found on floors and other surfaces; Pseudomonas aeruginosa found in the air and on surfaces; and Bacillus anitratum found in frozen plasma, water baths, and respiratory equipment.

 

Bacteria commonly grow in bathroom drains and prefer slow or non-moving water. Known as “biofilm”, bacterial colonies grow on the inside of pipes and around leaky drains. As bacteria grow, they produce a slime. The slime contains the bacteria as well as all of the secretions that the bacteria produce. Listeria, E. coli, and Salmonella can grow on biofilm.

 

Mold
The presence of mold is considered to be one of the most serious threats to indoor air quality. Molds can be found almost anywhere. They can grow on virtually any organic substance, as long as moisture and oxygen are present.

 

The most common molds found on building materials include certain species of Aspergillus, Penicillium, and Stachybotrys. Molds also produce a variety of volatile organic compounds (VOCs). Exposure to high levels of VOCs, from either organic or inorganic sources, irritates the mucous membranes and affects the central nervous system, producing such symptoms as headaches, breathing difficulties, skin irritation, allergic reactions, aggravation of asthma symptoms, inability to concentrate, and dizziness.

 

To prevent mold growth, it is critical to prevent moisture problems. Bathrooms, showers, counters and cleaning areas are constantly getting wet. Mold on bathroom tile grout, in shower stalls, and on bathtubs is a common occurrence. A key strategy is to choose materials that inhibit this growth.

 

 

What's Behind the Tile?

Rotted Wood

This is an actual photo from a recent client. This extensive mold was revealed once all the old tile was removed. There was extensive water damage throughout the years, leading to serious structural weakening.

 

Moldy Drain

Another actual photo from a recent client. You can see that water had been leaking around the tile/drain connection, leading to mold and possible bacteria growth.

 

Problems with Tile and Grout
Non-epoxy grout is a porous material and absorbs water. Grout is often sealed to compensate for this weakness, but proper sealing requires moisture conditions to be so low it is often impossible to achieve. Operator error also leads to improper and ineffectual application. Pieces of grout often break which also compromises the seal.

 

Once moisture gets into the grout, it stays there, breeding mold. This forces us to clean with harsh chemicals and caulk continuously. Sometimes, water continues past the grout and into the wall. In some cases, subsurface drywall absorbs moisture and swells, dislodging tiles, providing even more routes for moisture to get in. We have seen several applications where water behind the tile leaked down onto wood joists and floorboards, causing structural problems (see top image).

 

Problems with Antimicrobials
An increasing number of building products and cleaning agents are being manufactured with biocides to protect against microbial growth. Antimicrobial agents are, in some cases, becoming less effective because of resistance. As an antimicrobial agent becomes widely used, bacteria resistant to this drug eventually emerge and may spread in the health care setting. Many strains of pneumococci, staphylococci, enterococci, and tuberculosis are currently resistant to most or all antimicrobials which were once effective. The Centers for Disease Control called for an evaluation of “the benefits and risks of incorporating antimicrobial disinfectants or antiseptic chemicals into consumer products (e.g., soap, toys, kitchen utensils, clothes, paints, plastics and film preservatives).”

 

Sources:

- Environmental Protection Agency, Mold Remediation in Schools and Commercial Buildings

- Centers for Disease Control, Mold Fact Sheet

- Practice Greenhealth, Mold Elimination

- Guidance for Clinicians on the Recognition and Management of Health Effects related to Mold Exposure and Moisture Indoors

- World Health Organization, Prevention of hospital-acquired infections

- Handbook of Environmental Health: Biologiical, Chemical and Physical Agents of Environmentally Related Disease by Herman Koren and Michael Bisesi

- AIA Guidelines for Design & Construction of Healthcare Facilities