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Antimicrobial copper-alloy touch surfaces can prevent frequently touched surfaces from serving as reservoirs for the spread of pathogenic microbes. This is especially true in healthcare facilities, where harmful viruses, bacteria, and fungi colonize and persist on
doorknob A door handle or doorknob is a handle used to open or close a door. Door handles can be found on all types of doors including exterior doors of residential and commercial buildings, internal doors, cupboard doors and vehicle doors. There are man ...
s, push plates, railings, tray tables, tap (faucet) handles, IV poles,
HVAC Heating, ventilation, and air conditioning (HVAC) is the use of various technologies to control the temperature, humidity, and purity of the air in an enclosed space. Its goal is to provide thermal comfort and acceptable indoor air quality. ...
systems, and other equipment. These microbes can sometimes survive on surfaces for more than 30 days. Coppertouch Australia commissioned the Doherty Institute at the Melbourne University Australia to test its Antimicrobial Copper adhesive film. Lab tests proved a 96% kill rate of Influenza A virus with the film as compared to non treated surfaces. The surfaces of
copper Copper is a chemical element with the symbol Cu (from la, cuprum) and atomic number 29. It is a soft, malleable, and ductile metal with very high thermal and electrical conductivity. A freshly exposed surface of pure copper has a pink ...
and its alloys, such as
brass Brass is an alloy of copper (Cu) and zinc (Zn), in proportions which can be varied to achieve different mechanical, electrical, and chemical properties. It is a substitutional alloy: atoms of the two constituents may replace each other wi ...
and
bronze Bronze is an alloy consisting primarily of copper, commonly with about 12–12.5% tin and often with the addition of other metals (including aluminium, manganese, nickel, or zinc) and sometimes non-metals, such as phosphorus, or metalloids suc ...
, are
antimicrobial An antimicrobial is an agent that kills microorganisms or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals ar ...
. They have an inherent ability to kill a wide range of harmful microbes relatively rapidly – often within two hours or less – and with a high degree of efficiency. These antimicrobial properties have been demonstrated by an extensive body of research. The research also suggests that if touch surfaces are made with copper alloys, the reduced transmission of disease-causing organisms can reduce patient infections in hospital
intensive care unit 220px, Intensive care unit An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensi ...
s (ICU) by as much as 58%.Cassandra D. Salgado, Kent A. Sepkowitz, Joseph F. John, J. Robert Cantey, Hubert H. Attaway, Katherine D. Freeman, Peter A. Sharpe, Harold T. Michels, Michael G. Schmidt (2013); "Copper Surfaces Reduce the Rate of Healthcare-Acquired Infections in the Intensive Care Unit"; ''Infection Control and Hospital Epidemiology'', May 2013"Copper Surfaces Reduce the Rate of Health Care-Acquired Infections in the ICU", April 9, 2013; ''Science News'', https://www.sciencedaily.com/releases/2013/04/130409110014.htm Several companies have developed methods for utilizing the antimicrobial functionality of copper on existing high-touch surfaces. LuminOre and Aereus Technologies both utilize cold-spray antimicrobial copper coating technology to apply antimicrobial coatings to surfaces.


Evidence

As of 2019 a number of studies have found that copper surfaces may help prevent infection in the healthcare environment.
Microorganism A microorganism, or microbe,, ''mikros'', "small") and ''organism'' from the el, ὀργανισμός, ''organismós'', "organism"). It is usually written as a single word but is sometimes hyphenated (''micro-organism''), especially in old ...
s are known to survive on inanimate surfaces for extended periods of time. Hand and surface
disinfection A disinfectant is a chemical substance or compound used to inactivate or destroy microorganisms on inert surfaces. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than st ...
practices are a primary measure against the spread of infection. Since approximately 80% of infectious diseases are known to be transmitted by touch, and pathogens found in healthcare facilities can survive on inanimate surfaces for days or months, the microbial burden of frequently touched surfaces is believed to play a significant role in infection causality.


EPA registrations

On February 29, 2008, the
United States Environmental Protection Agency The Environmental Protection Agency (EPA) is an independent executive agency of the United States federal government tasked with environmental protection matters. President Richard Nixon proposed the establishment of EPA on July 9, 1970; it ...
(EPA) approved the registrations of five different groups of copper alloys as "
antimicrobial An antimicrobial is an agent that kills microorganisms or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals ar ...
materials" with public health benefits. The EPA registrations now cover 479 different compositions of copper alloys within six groups ''(an up-to-date list of all approved alloys is available).'' All of the alloys have minimum nominal copper concentrations of 60%. The results of the EPA-supervised antimicrobial studies demonstrating copper's strong antimicrobial efficacies across a wide range of alloys have been published.


Microbes tested and killed in EPA laboratory tests

The bacteria destroyed by copper alloys in the EPA-supervised antimicrobial efficiency tests include: * ''
Escherichia coli ''Escherichia coli'' (),Wells, J. C. (2000) Longman Pronunciation Dictionary. Harlow ngland Pearson Education Ltd. also known as ''E. coli'' (), is a Gram-negative, facultative anaerobic, rod-shaped, coliform bacterium of the genus '' Esc ...
'' O157:H7, a foodborne pathogen associated with large-scale food recalls. * Methicillin-resistant ''Staphylococcus aureus'' ( MRSA), one of the most virulent strains of antibiotic-resistant bacteria and a common culprit of hospital- and community-acquired infections. * ''
Staphylococcus aureus ''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often posit ...
'', the most common of all bacterial ''staphylococcus'' (i.e., Staph) infections that cause life-threatening disease, including pneumonia and meningitis. * ''
Enterobacter aerogenes ''Klebsiella aerogenes'', previously known as ''Enterobacter aerogenes,'' is a Gram-negative, oxidase negative, catalase positive, citrate positive, indole negative, rod-shaped bacterium. The bacterium is approximately 1-3 microns in length, an ...
'', a pathogenic bacterium commonly found in hospitals that causes opportunistic skin infections and impacts other body tissues. * ''
Pseudomonas aeruginosa ''Pseudomonas aeruginosa'' is a common encapsulated, gram-negative, aerobic– facultatively anaerobic, rod-shaped bacterium that can cause disease in plants and animals, including humans. A species of considerable medical importance, ''P. a ...
'', a bacterium in immunocompromised individuals that infects the pulmonary and urinary tracts, blood and skin. * Vancomycin-resistant ''Enterococcus'' (VRE), a pathogenic bacterium that is the second leading cause of hospital-acquired infections.


EPA test protocols for copper alloy surfaces

The registrations are based on studies supervised by EPA which found that copper alloys kill more than 99.9% of disease-causing bacteria within just two hours when cleaned regularly (i.e., the metals are free of dirt or grime that may impede the bacteria's contact with the copper surface). To attain the EPA registrations, the copper alloy groups had to demonstrate strong antimicrobial efficacies according to all of the following rigorous tests: * ''efficiency as a
sanitizer A disinfectant is a chemical substance or compound used to inactivate or destroy microorganisms on inert surfaces. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than st ...
'': This test protocol measures surviving bacteria on alloy surfaces after two hours. * ''Residual self-sanitizing activity'': This test protocol measures surviving bacteria on alloy surfaces before and after six wet and dry wear cycles over 24 hours in a standard wear apparatus. * ''Continuous reduction of bacterial
contamination Contamination is the presence of a constituent, impurity, or some other undesirable element that spoils, corrupts, infects, makes unfit, or makes inferior a material, physical body, natural environment, workplace, etc. Types of contamination ...
'': This test protocol measures the number of bacteria that survive on a surface after it has been re-inoculated eight times over a 24-hour period without intermediate cleaning or wiping.


EPA registered antimicrobial copper alloys

The alloy groups tested and approved were C11000, C51000, C70600, C26000, C75200, and C28000. The EPA registration numbers for the six groups of alloys are as follows:


Claims granted by EPA in antimicrobial copper alloy registrations

The following claims are now legally permitted when marketing EPA-registered antimicrobial copper alloys in the U.S.: The registrations state that "antimicrobial copper alloys may be used in hospitals, other healthcare facilities, and various public, commercial and residential buildings."


Product stewardship requirements of EPA

As a condition of registration established by EPA, the Copper Development Association (CDA) in the U.S. is responsible for the
product stewardship Product stewardship is an approach to managing the environmental impacts of different products and materials and at different stages in their production, use and disposal. It acknowledges that those involved in producing, selling, using and dispos ...
of antimicrobial copper alloy products. CDA must ensure that manufacturers promote these products in an appropriate manner. Manufacturers must only promote the proper use and care of these products and must specifically emphasize that the use of these products is a supplement and not a substitute to routine hygienic practices. EPA mandated that all advertising and marketing materials for antimicrobial copper products contain the following statement: Antimicrobial copper alloys are intended to provide supplemental antimicrobial action in between routine cleaning of environmental or touch surfaces in healthcare settings, as well as in public buildings and the home. Users must also understand that in order for antimicrobial copper alloys to remain effective, they cannot be coated in any way. CDA is currently implementing an outreach program through written communications, a product stewardship website, and through a Working Group which meets periodically to expand educational efforts. More than 100 different potential product applications were cited in the registrations for their potential public health benefits.


EPA warranty statement

The EPA warranty statement is worded as follows: Note: With the exception of the product name and the percentage of active ingredient, the EPA-approved Master Labels for the six groups of registered alloys are identical.


Antimicrobial copper products

Many antimicrobial copper alloy products have been approved for registration in healthcare facilities, public and commercial buildings, residences, mass transit facilities, laboratories, and play area equipment in the US. A complete list of registered products is available from EPA.EPA Office of Pesticide Programs; Antimicrobial Copper Alloys; List of Approved Fabricated Products; pp. 5–10; http://www.epa.gov/pesticides/chem_search/ppls/082012-00001-20130322.pdf


See also

*
Antimicrobial properties of copper Copper and its alloys (brasses, bronzes, cupronickel, copper-nickel-zinc, and others) are natural antimicrobial materials. Ancient civilizations exploited the antimicrobial properties of copper long before the concept of microbes became understood ...
*
Copper alloys in aquaculture Copper alloys are important netting materials in aquaculture (the farming of aquatic organisms including fish farming). Various other materials including nylon, polyester, polypropylene, polyethylene, plastic-coated welded wire, rubber, pat ...


References

{{DEFAULTSORT:Antimicrobial Copper-Alloy Touch Surfaces Copper in health Antimicrobials Medical hygiene Disinfectants