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Architectural Armor: Preventive Biocidal Surfaces

Alongside the general trend seen in medicine shifting toward an illness prevention model, the design of the built environment is following suit. In 2015, Michels, Keevil, Salgado, and Schmidt featured a Health Environments Research & Design Journal (HERD) research paper entitled “From laboratory research to a clinical trial: Copper alloy surfaces kill bacteria and reduce hospital-acquired infections.” This translational science article reviewed the evidence for the antimicrobial properties of copper alloys and their ability to kill a broad range of infectious pathogens. In addition, the study correlated microbial burden with infection rates, suggesting that these components of the healthcare built environment are a potential solution toward controlling and limiting hospital-acquired infections (HAIs) in an efficient and cost-effective manner. In 2016, the world’s largest known clinical trial on the impact of biocidal surfaces, particularly copperimpregnated surfaces, on HAIs was undertaken by Sentara Healthcare and published in the American Journal of Infection Control (Sifri, Burke, & Enfield, 2016). We felt that both the scope of the trial and the statistically significant results warrant discussion about the potential brought about by the study. Also since the 2015 HERD publication, a new category of biocidal surfaces has been developed—preventive biocidal surfaces—a term coined and trademarked by the manufacturers of the unique hard surfaces deployed in the Sentara Trial to better communicate the differences between its capabilities and those of other antimicrobials. We felt it would be of benefit at this time to summarize the traits of a preventive biocidal surface and related evidence, which we believe eliminate some of the previous concerns that may exist with copper and copper alloys and provide an additional new option in our design tool kit for infection prevention and control. Currently, there are two materials that qualify as preventive biocidal surfaces. Copper and copper alloys are one material, as covered by Michels et al. (2015). However, there is now an additional material that suspends cuprous oxide in a polymer, resulting in an equally efficacious substance that can be used both as a slab and as injection-molded shapes. This material was invented and is made by a Norfolk, Virginia company. The proprietary cuprous oxide created by a Richmond, Virginia company, used in medical textiles is integrated into the polymer at the time of fabrication, so it permeates the material (Mitchell, 2016). Distinguishing itself from copper alloys, the cuprous oxide in a polymer looks and feels like any other synthetic quartz surface with a smooth, natural stone appearance, without rusting or oxidizing, and fabricates like any other hard surface, with lower cost implications.