Editor’s Note: The following is a Q&A discussion between ISSA Today and Dr. Gavin Macgregor-Skinner, senior director of the Global Biorisk Advisory Council® (GBAC), a Division of ISSA.

Question: As we think about the built environment and facilities under the watch and care of the cleaning industry, what’s the next big opportunity?

Dr. Gavin Macgregor-Skinner: The primary purpose of cleaning is to protect human health. In 2023, this needs to be our mission–the center of everything we do as an industry.

But traditionally, we have cleaned to restore and maintain the appearance or smell of valuable property. We have cleaned for appearance and smell but failed to consider health implications. This approach has led to an illusion that this way of cleaning is healthy — that neat and tidy equals clean, which equals healthy.

As a result, in an environment that appears neat and clean, some people will still have adverse reactions in the form of skin or eye irritation, difficulty breathing, general malaise, and outright illness and infection. No matter how hard we brush, scrub, or sweep, we have a limited ability to see harmful substances.

To prevent adverse health effects, the best environmentally informed cleaning strategy is to remove or reduce the amount of anything that can cause harm.

With this in mind, ISSA will aim to train one million workers to do this. Our workforce development will focus on cleaning for health, which means that every cleaning professional will be trained to understand what needs to be cleaned and disinfected, and how often.

Q: How can a cleaning professional explain the most likely places to find germs that cause disease in buildings and what they need to survive?

Dr. Macgregor-Skinner: “Reservoirs” are the places on and in our bodies and in the built environment where germs live. Germs frequently spread between and among these reservoirs.

Four reservoirs in the human body for germs are: the skin, the gastrointestinal (GI) system or gut, the respiratory system, and blood and body fluids (e.g., anything wet from a person’s body).

Five reservoirs in the built environment for germs are: water and wet surfaces, dry surfaces, dirt and dust, equipment, and air.

There are four main pathways that spread germs: through touch, when they’re breathed in, through splashes or sprays, and through cuts and abrasions that bypass or break down the body’s natural defenses.

Trained cleaning professionals understand that germs are found in certain places, called reservoirs, and need a pathway to spread to other places and people. Their cleaning for health actions decreases the likelihood of germs spreading to and from these reservoirs to different parts of the body, from one person to another, from people to things, or from things to people.

Q: What do cleaning professionals need to understand about the risk of germs in the workplace?

Dr. Macgregor-Skinner: Cleaning surfaces and the air is one of our key defenses in the battle against infectious diseases, allergies, and exposure to harmful contaminants.

A cough produces approximately 3,000 droplets, whereas a sneeze releases an estimated 40,000. Each droplet may contain as many as 200 million virus particles. Particles from your sneeze can travel up to 26 feet, coughing up to six feet, and breathing up to three feet. Even a toilet flush without the lid closed can release particles that can travel up to eight feet away. In addition, a person can be infected with 1,000 infectious virus particles.

Q: How can cleaning professionals improve indoor air quality in buildings, which would then reduce the risk of the airborne spread of viruses and other contaminants?

Dr. Macgregor-Skinner: Understand that dirty air can lead to dirty surfaces, and dirty surfaces can lead to dirty air. Every facility should have an indoor air quality (IAQ) plan. If a plan has yet to be made, then ISSA can help you develop a plan that works for your facility and ensure it is doable, affordable, and will help you do better.

Every facility should be using an indoor air quality monitor to measure the air we breathe. They are about the size of a smoke detector.

So, let’s think about particles in the air. We usually see particles 50 micrometers or larger. The average diameter of human hair is 50 micrometers.

To protect people’s health, we must remove particles of all sizes, especially the small ones of 10 micrometers or less. An indoor air quality monitor measures these small particles, 10 micrometers or less, and gives you the results right there and then, in real time. They are too small to be seen by the eye alone.

It’s these small particles that call for our best efforts and equipment. When indoors, humans are exposed to the entire building environment—air and surfaces. Reducing these harmful particles should be a top priority.

Most of us spend 90% of our day indoors. So if you live to 80 years old, you have been indoors for 72 years.

Q: How can cleaning professionals recognize risk and protect building occupants?

Dr. Macgregor-Skinner: For too long, clean has been a subjective term, determined by a simple visual assessment. Two people inspecting the same room, or the same object, might have different opinions about whether it passes the “test.” The fact is, surfaces that appear to be clean might not necessarily be clean when scientifically quantified or qualified.

Remember, what you can’t see can hurt you.

Everyone should strive for health-based cleaning. To do that, you need to measure cleanliness. A well-trained worker, given adequate time and equipped with the best tools, products, and processes, will deliver a clean, healthy, and safe built environment.

Use evidence-based, objective measurements of air, water, and surfaces. These include:

Chemical markers. These are invisible to the naked eye but show up under ultraviolet light or when a cleaning product or disinfectant is applied, showing what has been cleaned.

Hand-held meters. These test surfaces for adenosine triphosphate or ATP, which is the energy molecule inside all living cells. ATP is found in bacteria, mold, fungus, and other organic matter that provide a food source for germs. An ATP meter provides feedback in less than 30 seconds, enabling cleaning professionals to verify how clean surfaces are with respect to germs.

Indoor air quality monitors. These are the same size as a smoke detector. They measure particles of various sizes. If there are particles in the air, then they may be germs, allergens, contaminants, or even particles that germs can piggyback on and move around the room.

Be intentional about measuring the important factors for cleanliness. Measurement is key to process improvement.

Q: How can cleaning professionals communicate to building occupants that the action steps they have taken help create a safe and healthy built environment?

Dr. Macgregor-Skinner: You can start by showing how you clean and what you measure. Be able to tell your cleaning story. The time has come to be transparent and explain the what, how, and when of what cleaning professionals do.

Every cleaning professional needs to be able to explain five key things:

1. That they are trained professionals.
2. That they are equipped with the necessary tools to clean and disinfect.
3. That they are allowed the correct time to do necessary tasks to clean and disinfect different surfaces.
4. That they use tools to enable scientific measurement of cleanliness.
5. That they are educated and trained about the prevention and transmission of disease-causing germs and other contaminants harmful to people’s health and the environment.

Q: As an infectious disease expert, what would you like to see next for the cleaning industry?

Dr. Macgregor-Skinner: I would like to see the cleaning industry meet the goal of training one million workers to know how to help maintain a balanced ecosystem by using the right product in the right place at the right time.

Good training facilitation requires practice, commitment, and an eagerness to engage with others. Our ISSA members have prior knowledge and experience in cleaning but are always looking for ways that new information adds to what they already know, and they want to apply new knowledge as soon as possible.

Our ISSA workforce development program emphasizes the “why” behind cleaning for health actions so that no matter how varied the experiences, backgrounds, and work environments are, ISSA members will have the skills and knowledge to make informed decisions to keep themselves, their coworkers, and users of the built environment both safe and healthy.