coppertalk

By Wilton Moran, Copper Development Association Project Engineer, Material Sciences 

Last month, CDA and a team of researchers presented clinical trial results in a poster session at the Fifth Decennial International Conference on Healthcare-Associated Infections. These trials, which are funded by the U.S. Department of Defense, assessed the ability of Antimicrobial Copper to reduce the amount of bacteria on surfaces commonly found in hospital rooms. More than 3,000 physicians, pharmacists, nurses, infection preventionists and other health care decision-makers attended the conference. The Society for Healthcare Epidemiology of America (SHEA), Centers for Disease Control and Prevention (CDC) the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) and the Infectious Disease Society of America (IDSA) sponsored the conference.

It was important for us to create a buzz at the conference because people just don’t know enough yet about the work we’re doing. We got the EPA registration in 2008 and currently have clinical trials going on at Memorial Sloan-Kettering Cancer Center in New York City, the Medical University of South Carolina and the Ralph H. Johnson VA Medical Center, both of which are in Charleston, S.C.

The first phase of the study showed that the most heavily contaminated objects are those closest to patients, such as bed rails, nurse’s call buttons and visitor chair arms. The study found high levels of Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant enterococcus (VRE) on those common objects. We know these bacteria can survive for long periods of time, so these contaminated surfaces can spread bacteria to people – patients, visitors and health care workers.

On the poster, findings from the second phase of the trial were presented. This phase involved replacing stainless steel and plastic versions of bed rails, tray tables, chair arms, nurse’s call buttons, monitors and IV poles with copper in the ICU rooms of the three hospitals participating in the study. The results attracted a lot of attention.

Researchers, who are specialists in infectious diseases, were very interested in our work. Many stopped by our booth, provided their contact information and requested periodic updates on the progress of the program. People from the National Institutes of Health (NIH) were also interested in what we had to say. We also had several visitors from the CDC. When we first started this work, we learned that CDC needed to see a large body of published research papers in the public domain. At the conference we saw their interest and at this point, we know we’re getting their attention and they’re taking us more seriously.

 There’s much more recognition now of the role of surface contamination in hospital-acquired infections. That’s a huge plus for us because obviously if they think that’s a problem, health care decision-makers may consider antimicrobial surfaces in the future.

 If you’d like more information on the antimicrobial properties of copper, check out our brand website, Antimicrobial Copper.

By Wilton Moran, Copper Development Association Project Engineer, Material Sciences

Wilton Moran is a member of CDA’s Technical Services Team, which manages the Public Health Initiative. Wilton, Harold Michels, the CDA’s Senior Vice President of Technology and Technical Services, and other members of the team last month attended the Fifth Decennial International Conference on Healthcare-Associated Infections in Atlanta. The CDA spearheaded the effort to get EPA registration of copper alloys as antimicrobial public health products in 2008. The CDA presented findings from the second phase of a clinical trial at the conference.

Attending this conference has been one of the goals of the CDA. It’s a conference that happens once every 10 years and infectious disease experts from all over come to the meeting. There were many important people to reach and we had a story to tell. Two things were happening. We were presenting the results of the second phase of our clinical trials and we had a booth in the exhibit area that allowed us to talk to people about what we were doing and to show our new brand – Antimicrobial Copper.  

The results from the second phase of the hospital trials were presented by the clinical research team in a poster session. They attracted a lot of attention. Many of the people that saw the poster subsequently visited the booth to see Antimicrobial Copper components. Many provided us with their contact information and asked to be updated on the progress of the program. People would ask us about antimicrobial copper surfaces and how they were made – if there was a coating or something applied to the surfaces. We explained that the metals are intrinsically antimicrobial. They were curious and wanted to know more. Our goal was to create awareness and from that perspective our booth was a big success. We were busy throughout the convention talking to people and explaining what Antimicrobial Copper has to offer.

We also had questions about what type of organisms copper can kill. Companies that make infection control products also wanted information from us. This also gave us an opportunity to debunk some of the misconceptions about copper. People were concerned about the cost of copper and how they might incorporate it into their products. We were able to tell them that copper alloys have very good fabrication properties and are very easy to work with, so the fabrication process is much less energy intensive than for many other metals, including steels.  They may pay a little bit more for the materials, but they also have a product with an added value. We also explained that the cost of materials is only a small fraction of the final cost of a product. We want potential customers to know that working with copper is not prohibitively expensive.

At times, we were overwhelmed by the number of visitors at our booth. The conference was an incredible experience and it tells us our work is important and infectious disease specialists are excited about the potential of antimicrobial copper once they learn about it. Our hope is to inspire people to see what copper alloys can do and how they can benefit from what we’re doing.

Adam Estelle, guest blogger

By Adam Estelle, Copper Development Association, Inc. Project Engineer, Materials Science

Adam Estelle received his bachelor’s degree in Materials Science and Engineering from the University of Arizona.  He joined the CDA in August of 2008 and works primarily on the Public Health Initiative promoting the antimicrobial properties of copper-based metals. 

Of all the exciting opportunities I’ve had with the Copper Development Association (CDA), the Annual Meeting is by far the most intriguing.  Industry giants from across the country gather every December to learn about emerging markets and get the latest news on copper’s role in applications ranging from plumbing to architecture to antimicrobial.  It’s quite inspiring to witness an industry come together as a whole and combine insight and experience to overcome collective challenges.

During December’s meeting, I presented new opportunities brought about by the EPA registration of copper as an antimicrobial and summarized CDA activity in the supply chain.  Ever since the EPA registered copper as an antimicrobial, we’ve been working with members to:

• strengthen awareness of the antimicrobial effort
• provide information about the science behind the EPA registration
• assist with new product development
• bring copper products to market with health claims

Once product manufacturers understand the science behind the antimicrobial message, and the large socioeconomic burden of healthcare-associated infections, they see the potential for copper touch surfaces used in products like door knobs, work stations, hand rails and IV poles.  CDA then points them to our membership to help find a supplier of antimicrobial copper.  As the process evolves, more and more suppliers will register with the EPA so they can market their products with public health claims.  As stewards of the EPA registration, CDA also helps product manufacturers convey the antimicrobial message accurately and responsibly. 

From scientific studies to marketing support, CDA is proactive throughout every step of the exciting process.  The Winter Meeting was a great opportunity to show our membership how we’re helping the pieces come together.  Since December, we’ve received more and more phone calls and emails from fabricators and manufacturers who want to move to the next level. That’s great news, because it will generate business for CDA members and help foster this young market.

By Wilton Moran, Copper Development Association Project Engineer, Material Sciences 

Wilton Moran is a member of CDA’s Technical Services Team, providing direct technical support to copper alloy end-users, and managing critical copper and copper alloy data and property information.  The team also manages other CDA programs, including the Public Health Initiative, which encompasses the registration of copper alloys with the EPA, and other projects that don’t fall under traditional product areas.

For years infection control programs in hospitals, outpatient clinics, long-term care facilities, doctors’ offices and ambulances have employed two main methods to kill bacteria in the environment and reduce their transmission:  hand washing and regular cleaning and disinfection of surfaces.  Now that the Environmental Protection Agency has registered copper and its alloys as antimicrobial touch surfaces, copper has emerged as a strong third weapon to supplement these two traditional infection control practices. 

Many hospital-acquired infections are the result of the transfer of pathogens.  The pathogens can be acquired from frequently-touched surfaces as well as from the patients themselves.  Currently, most hospital touch surfaces are made of stainless steel, aluminum, wood, or plastic, which have no inherent effect in controlling pathogens.  Hand washing and regular surface cleaning are essential, but the addition of touch surfaces that are inherently antimicrobial would make these practices even more effective.  Enter antimicrobial copper alloy surfaces. Think of copper bed rails, door handles, IV poles and more.  In short, if the bacteria* are killed before they get a chance to build up and grow on the surface, there will be less available.  Copper surfaces must be cleaned like any other surfaces, but their use can substantially improve infection control efforts. 

The EPA regulates sanitizers and disinfectants being used in homes, schools, medical facilities, etc.  Just as those products are first tested in the lab, copper has been similarly tested and proven effective*.Copper surfaces should be used to supplement these products, not as a replacement, by killing bacteria* between routine cleaning and disinfection.

By Wilton Moran, Copper Development Association Project Engineer, Material Sciences 

Wilton Moran is a member of CDA’s Technical Services Team, providing direct technical support to copper alloy end-users, and managing critical copper and copper alloy data and property information.  The team also manages other CDA programs, including the Public Health Initiative, which encompasses the registration of copper alloys with the EPA, and other projects that don’t fall under traditional product areas.

When I joined the CDA I pretty much concentrated on the antimicrobial copper project. The EPA’s registration of copper, brass and bronze as antimicrobial materials with public health claims was a breakthrough not only for our industry, but for a variety of industries, especially health care.  But the approval was hardly an overnight process. 

One of the things my team is currently doing is helping copper and copper alloy fabricators and manufacturers of end-use products legally market antimicrobial copper products with public health claims. The EPA is not in the business of helping companies get products to market. They exist to help ensure there’s sound science behind products that make health claims.  The fact that copper and its alloys are solid presented a unique issue for them.  The office within EPA that we are dealing with usually registers other forms of antimicrobial substances, like liquids, gases and powders, but applying the rules to solid materials was a different matter, so a lot of uncharted territory had to be covered. They’re also used to approving a specific amount of an active ingredient, but we registered a range of alloys with 60-99.9% copper.  Our experts worked with the EPA throughout the process, asking questions and helping find precedents for different aspects of our situation.  As a lot of people now know, the process was completed early in 2008 with five EPA registrations for copper and copper alloys. 

There’s nothing more powerful than EPA registration for giving your product credibility. It is also illegal to make public claims without EPA registration.  Six alloy fabricators have already obtained EPA registrations:  PMX Industries, Cerro Flow Products, Revere Copper Products, Brush Wellman, Chase Brass and Copper Company, and Olin Brass.  I’m sure we’ll be seeing more very soon.

By Harold Michels, Copper Development Association Senior Vice President of Technology and Technical Services

Harold Michels, PhD, senior vice president of technology and technical services for the Copper Development Association, spearheaded the effort to get EPA registration of copper alloys as an antimicrobial. The EPA registration became official in 2008. Clinical trials focusing on the ability of copper metals to kill deadly pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA) on touch surfaces are being carried out at Memorial Sloan-Kettering Cancer Center in New York City, the Medical University of South Carolina and the Ralph H. Johnson VA Medical Center, both in Charleston, S.C. Dr. Michels gives an update.

We’re at a critical point in this project. We started using copper components in hospital rooms in late September 2009. Before that, our time was spent developing and approving protocols, measuring the amount of bacteria in the rooms and fabricating the copper components to be installed there. We hope to demonstrate – and I’m confident we will – a reduction in bioload on the copper vs. the non-copper surfaces. The doctors leading our clinical trials will also look at changes in infection rates in the next phase of the trials. Apparently no one ever demonstrated a reduction in infection rates as a consequence of a reduction in surface bioload. So this would be a first, but they feel the database should be robust enough to do it.

What we need now is to get the people who can make these components out of copper alloys to do it and believe it is a worthwhile business endeavor. We could use copper alloys for hospital beds, IV poles or even the mundane items, like rails along the hallway, chairs in the visitor waiting rooms, bathroom fixtures and elevator buttons. There’s also potential for a retrofit market, where we can substitute copper items for things like doorknobs, for example.

We have a public health registration. We can say we killed within two hours 99.9 % of the five bacteria we tested, including MRSA. To our knowledge it’s the only time they ever granted a public health registration to a solid or coating. So this is landmark. Our competitors don’t have this public health registration, but I’m sure they’re trying to get it.

If you manufacture copper alloys and would like to like to learn more about what we’re doing, you can contact me: hmichels@cda.copper.org. I especially want to hear from component makers. I’d like to talk to you about the unique antimicrobial properties of copper.