In response to heightened interest in antimicrobial building products spurred by the COVID-19 pandemic, HBN and Perkins+Will reviewed our 2017 report  “Healthy Environments: Understanding Antimicrobial Ingredients In Building Materials,” which included an extensive analysis of antimicrobial building products, including paints, countertops, door handles and light switches. We found then, and now, that there is no evidence that such products provide human health protection from viruses, including SARS-CoV-2, which causes COVID-19.  

Antimicrobial substances are, by definition and design, substances that are toxic to certain organisms: bacteria, viruses, fungi, or protozoa — collectively known as microbes. Certain chemicals, nanoparticles and metals may be used as antimicrobials in everyday products, including those used to construct and finish buildings. 

Our original research also documented industry marketing strategies designed to exploit consumers’ misperceptions about the efficacy of antimicrobial products.[1] We found that as early as 1994, the Federal Trade Commission, which polices truth in advertising, warned that consumers would be misled by such industry marketing claims. We advocated against the use of products advertised as antimicrobial because we found no evidence that they provide human health protection and the added chemicals can cause harm. 

Today, our conclusions remain the same. There is no evidence that the addition of antimicrobials to building products lowers the rate of infection, or that they lead to a healthier population. Despite this fact, there is an increase in  advertising and marketing of antimicrobial and disinfectant products. To understand the full picture with regard to how antimicrobials are used, regulated and marketed, we urge you to read our full report. Here are three facts to help you navigate the tides of commercial information as they rise in response to concerns about COVID-19.

1. Antimicrobials are not intended to be added to building products for infection control 

Some products need antimicrobials to protect the product itself from mold, mildew or spoilage. However, even in healthcare settings, antimicrobial technologies added to products have not been shown to reduce infections.[2] The CDC cautions against using antimicrobial mattresses or fabrics because “EPA has not approved public health claims asserting protection against human pathogens for treated articles.”[3] Leading healthcare institutions such as Kaiser Permanente have banned antimicrobial-infused building materials for infection control.[4] In response to the Covid-19 pandemic, the manufacturers of leading antimicrobial products added to building materials and consumer products belatedly affirmed the HBN’s 2017 findings stating that: “our antimicrobial technologies . . . are not currently proven to have any antiviral properties when built-into products.”(emphasis added)[5]

2. Products with added "antimicrobial" CAN cause harm 

Some antimicrobial substances can cause direct, physical harm to human health. This is of particular concern now as we face COVID-19 given that some common antimicrobials, such as quaternary ammonium compounds, adversely impact our respiratory system.[6] In our full white paper we discuss additional human health impacts, such as cancer and endocrine disruption, associated with various antimicrobials.

Furthermore, widespread use of antimicrobials may be associated with microbial resistance to these agents and, potentially, to therapeutic antibiotics.[7] Antimicrobials can not only directly and adversely impact human health, there is evidence that antimicrobial additives can migrate from the products in which they are incorporated and find their way into wastewater systems and the larger environment with unknown ecological implications, but with reasonable cause for concern.[8]

Lastly, products that contain pesticides or antimicrobials can create a false sense of security that may lead people to become lax in essential, everyday practices such as handwashing, cleaning and safely disinfecting surfaces that would make far greater headway in actually limiting infection and spread of disease.[9] 

3. Cleaning with soap and water is the first step in protecting against a coronavirus  

In our zeal to protect public health, it is crucial that we not overestimate or rely upon the effectiveness of chemical disinfectants to protect the health of our families, employees or the public. All public health experts, including the CDC, agree that disinfecting is not a substitute for cleaning; washing hands and high-touch surfaces with soap and water is the most important step in protecting against transmission of coronavirus. Directions for using disinfectants typically require cleaning before disinfecting because, as the American Cleaning Institute (ACI) notes: “Disinfectants contain antimicrobial ingredients that kill germs if surfaces are free from heavy soil[10] (emphasis added). Furthermore, according to cleaning, sanitizing and disinfectant  guidance available from the U.S. Environmental Protection Agency (EPA) by University of California, San Francisco School of Nursing’s Institute for Health & Aging and others: “Many people mistakenly think that if a cleaning, sanitizing, or disinfecting product is sold to the public it has been reviewed and proven safe by government agencies. The EPA requires that products labeled as sanitizers or disinfectants do kill the germs that the product claims to kill, but the registration review does not evaluate all possible health risks for users of the products.”[11]

When needed, use the disinfectants that pose the fewest human health hazards; they will be effective in killing viruses; and always follow manufacturer directions. While you can find a full list of disinfectants that meet EPA’s criteria for use against SARS-CoV-2  here, we recommend that you choose from among the products that have also earned EPA’s Design for the Environment label. If you prefer to compare the health and environmental hazards of those disinfectants yourself view the Pharos public comparison.  

Resources to help

Today, HBN is launching our new COVID-19 page.There you will find resources to help you make informed decisions about how to use disinfectants and antimicrobial products, or not, in accordance with guidelines from the experts.   

Both Pharos and our HBN Report “Healthy Environments: Understanding Antimicrobial Ingredients In Building Materials” are freely available to help you make informed choices about antimicrobial disinfectant products. If you have more detailed questions about antimicrobials, or helpful information to share, join the Pharos discussion forum. We look forward to hearing from you.


Footnotes

[1] Healthy Environments: Understanding Antimicrobial Ingredients In Building Materials, Healthy Building Network and Perkins + Will, March 2017, 10 and Appendix B.

[2] Ted Schettler, Antimicrobials in Hospital Furnishings: Do They Help Reduce Healthcare-Associated Infections? Healthcare Without Harm, accessed May 19, 2020. https://noharm-uscanada.org/sites/default/files/documents-files/3854/Antimicrobials%20Report%202016_1.pdf

[3]  “Environmental Infection Control Guidelines,” Centers for Disease Control and Prevention, https://www.cdc.gov/infectioncontrol/guidelines/environmental/index.html, (See Guideline G.VI.E accessed May 21, 2020.

[4] “Banning use of antimicrobial agents for infection control,” Kaiser Permante, Dec. 11, 2015, accessed May 21, 2020.
https://about.kaiserpermanente.org/total-health/health-topics/kaiser-permanente-rejects-antimicrobials-for-infection-control.

[5] “A Message from Microban International About Coronavirus (COVID-19), accessed May 20, 2020 https://web.archive.org/web/20200323132309/https://www.microban.com/message-about-covid-19.  “Covid-19 Notice,” Ultra-Fresh, Thomson Research Associates, accessed May 20, 2020 https://web.archive.org/web/20200515122847/https://ultra-fresh.com/covid-notice/.

[6] “Common disinfectant, benzalkonium chloride, CAS#8001-54-5 is a respiratory sensitizer per Association of occupational and environmental clinics Exposure Code Tool,” www.aoec.org/tools.htm 

[7] Schettler, 18-28.

[8] Antibacterial substances leaking out with the washing water – analyses of silver, triclosan and triclocarban in textiles before and after washing, Swedish Chemicals Agency, Feb. 2012, accessed May 21,2020. https://www.kemi.se/global/pm/2012/pm-1-12-antibact-en.pdf.

[9] Schettler, 27.

[10] “Cleaning for Health,” American Cleaning Institute, accessed May 21, 2020. https://www.cleaninginstitute.org/understanding-products/promoting-wellness/cleaning-health.

[11] Green Cleaning, Sanitizing, and Disinfecting: A Toolkit for Early Care and Education, University California, San Francisco, Institute for Health & Aging, University California, Berkeley, Center for Environmental Research and Children's Health, Informed Green Solutions and California Department of Pesticide Regulation, 2013, accessed May 21, 2020. https://www.epa.gov/sites/production/files/documents/ece_curriculumfinal.pdf