Disinfection and the prevention of infectious disease: No adverse effects?

Abstract

We write in response to the publication by Cozad and Rhona in the American Journal of Infection Control, which we have read with great interest. The review was undertaken to assess what evidence there is to support disinfection as an infection control measure. The authors reach the conclusion that the use of disinfection is beneficial in preventing infectious disease and thus results in a public health benefit. However, we believe the scientific approach used in the work and, correspondingly, the authors’ findings deserve comment. The work was financed by the Consumer Specialty Product Association, a ‘‘premier trade association representing the interests of the consumer specialty products industry—a dynamic industry that provides households institutions and industrial customers with products that help provide a cleaner and healthier environment.’’ The association’s product range includes among other things items designed to control or eliminate microbes in any environment. Moreover, both the authors are members of Scientific and Regulatory Consultants, Inc, whose staff offers ‘‘expertise gained from over 50 years of combined service to the antimicrobial industry.’’ Thus, the work is not without bias, takes a one-sided approach, and disregards the known adverse effects of using surface disinfection in infection control. What do we know about the role of the hospital environment as a reservoir for infectious diseases? According to current scientific knowledge, microbial contamination of the patient’s inanimate environment seems to be only a minor causative factor within the complex nature of nosocomial infection. Maki and