Pathogens are a constant threat in any business, whether it’s a busy commercial kitchen, a crowded hospital floor, or a daycare center. These microscopic disease-causing organisms can survive on objects and surfaces without regular cleaning. For instance, C. diff can live for five months, and E. coli can live for up to 16 months.
It is crucial to stay on top of cleaning to keep these diseases in check and maintain the well-being of your employees and customers. You also need to ensure your business is regularly disinfected.
Low-level and high-level disinfection are two approaches that can help minimize the presence and spread of viruses, bacteria, parasites, and other pathogens. In this blog, we break down the key differences and similarities between the two so you can choose the right type of disinfection service for your organization’s needs.
Critical and Noncritical Items and Surfaces
Before diving deeper into low-level and high-level disinfection, it is crucial to understand the difference between critical items and noncritical items. These two terms refer to the level of risk for infection when using them.
Critical items refer to surgical instruments, medical devices, and implants. These come in direct contact with sterile body tissue and pose the highest risk of infection if contaminated by any microorganism.
Noncritical items are items and surfaces that pose a lower risk of infection. These include patient care items, like blood pressure cuffs and environmental surfaces like countertops and floors.
Understanding the Types of Disinfection
Disinfection methods are categorized into distinct types according to the level of disinfection provided. Below, we discuss two of them: low-level and high-level disinfection.
What Is Low-level Disinfection?
Low-level disinfection (LDD) refers to using an agent to destroy many types of vegetative bacteria, viruses, and fungi. “Vegetative” means these organisms are active. LLD agents also destroy most viruses, including the Hepatitis B virus (HBV) and the human immunodeficiency virus (HIV).
However, low-level disinfection does not kill spores or mycobacteria like tubercle bacilli, a significant cause of tuberculosis.
What Is Low-level Disinfection For?
Low-level disinfection is typically used on noncritical items and environmental surfaces. For instance, a low-level disinfectant may be used to sanitize and disinfect the following:
- Shared children’s toys at a daycare facility or school
- Kitchen countertops
- Gym equipment
- Restaurant tables and menus
- Doormats
Low-level Disinfection Examples
The following are some examples of agents used in low-level disinfection:
- A 1:500 chlorine bleach solution
- Quaternary ammonium compounds (quats)
- Hydrogen peroxide (O.5% or 3%)
- Isopropyl alcohol and ethyl alcohol
- Phenolic disinfectants
Commercially available low-level disinfection products are often labeled “hospital-grade,” “hospital disinfectant,” or “sanitizers.” If purchasing LLD products, check the label to ensure they are registered with the Environmental Protection Agency (EPA).
Before applying low-level disinfectants, it is crucial to clean the surface or item thoroughly. Dirt, grime, and organic material can form a physical barrier on the surface, preventing the disinfectant from reaching and killing the microorganisms.
What Is High-level Disinfection?
High-level disinfection or HLD refers to using an agent to destroy a broad spectrum of microorganisms on an instrument or device. It can eliminate bacteria, spores, enveloped and non-enveloped viruses, fungi, and some parasites.
Compared to low-level disinfection, a relatively straightforward process, high-level disinfection entails several steps. These include the following:
- Pre-cleaning to remove any organic material, such as blood and tissue
- Disassembly of instruments, if they are multi-part devices
- Immersing the instruments in a high-level disinfectant
- Rinsing in sterile or filtered water
What Is High-level Disinfection For?
High-level disinfection is meant to disinfect reusable medical devices that come into contact with mucous membranes or non-intact skin. As such, it is typically used in healthcare settings where a sterile environment is crucial for protecting the health and safety of patients, staff, and visitors.
HLD is generally not used to clean surfaces. For one, the chemicals used in high-level disinfection can damage surfaces when used in routine cleaning. Additionally, high-level disinfection involves immersing a medical device in a high-level disinfectant, which is impossible for surfaces.
High-level Disinfection Examples
The following are some examples of agents used in high-level disinfection:
- Hydrogen peroxide combined with peroxyacetic acid
- Glutaraldehyde
- Ortho-phthalaldehyde (OPA)
- Chlorine dioxide
Key Takeaways
To summarize, low-level and high-level disinfection are similar in that they both reduce or eliminate microorganisms, thus helping create a safer environment. However, they differ significantly in the following ways:
Level of effectiveness: HLD targets a broader range of microorganisms than LLD
Applications: HLD is typically used in healthcare settings to disinfect medical devices, while LLD is suitable for routine disinfection of objects and surfaces in homes, offices, businesses, and public spaces
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