section 7:
Sanitation and Sterilization Course Material

Outline for Sanitation and Sterilization

1. Sanitation, Sterilization, andContagious Diseases

2. Bacteria, Harmful Bacteria, and Pathogenic Bacteria Classification

3. Growth and Reproduction of Bacteria, Active Stage and,Spore-Forming Stage

4. Bacterial Infections, How Bacteria Enter Our Bodies

5. Sources of Contagious Bacteria, Virus Fungi, and Parasites

6. Human Carriers

7. How to Sterilize Implements

8. Sterilizing with Chemical Agents. Demonstrates acceptable methods to sterilize with chemical agents.

9. Sterilizing Manicure Implements

10. Basic Rules

11. 61G5-20.002. Florida Administrative Code requirements for salon ventilation and cleanliness.

Course Overview:
This course covers the subjects that deal with proper sterilization to protect both you and the public. The subjects discussed in this course are sanitation and sterilization, of the different types of infectious agents. It defines what bacteria are and reviews the different types of bacteria. The course outlines the growth and reproduction of bacteria and how bacteria cause infection. Attention is given to how a person can be a carrier of disease, how to sterilize implements, procedures for sterilizing manicure implements, and the different ways to sterilize with chemical agents. It concludes with the basic rules to follow for a safe salon and, finally, rule G5-20.002: ventilation and cleanliness requirement for salons.

Sanitation and Sterilization
While we typically note how our doctors and dentists maintain a sterile environment, most of us don't consider that the same standards should be set for those who are digging, filing, and clipping away at our feet and fingernails. Yet, the consequences of an unsanitary salon can be the same as those at any medical facility.

The sanitation and sterilization of equipment and surroundings are very important and, in order for you, the cosmetologist or specialty-license professional, to understand how important and necessary it is, you must first study bacteria. You must understand how the spread of disease can be prevented and become familiar with the precautions that must be taken to protect you and the clients’, health. It is the responsibility of the salon staff to keep the salon clean and sanitary. It is the responsibility of the individual to keep the instruments that they use compliant with the law. Some states now have consumer complaint forms available online. These forms are quick and convenient to use. They allow the public to communicate possible infractions to the regulating board. A growing number of states are beginning to use electronic complaint forms. Along with the introduction of this method of communication by the consumer will come a closer scrutiny from the governing boards and, therefore, should aid in an improved salon environment for a growing number of salons. Keeping a clean and sanitary salon will not only protect the client and the salon professional, but it will also ensure the salon professional will not run into troubles resulting from non-compliance with the sanitation laws of the state. The Florida law governing salon sanitation will be discussed later in this course. For now let’s take a look at bacteria, the growth of bacteria, and how they reproduce.

Contagious Diseases
Skin infections, as well as blood poisoning, are caused by the transfer of infectious material from one individual to another. Another way which infectious material can transfer is by unsanitary implements (such as combs, hairpins, brushes, etc.). These tools of the trade can act as a vehicle, being used first on an infected person, and then on another without having been cleaned or sterilized properly.

Bacteria
Bacteria are tiny. They consist of one-celled microorganisms found roughly everyplace. Bacteria are particularly abundant in dust, dirt, refuse, and diseased tissues. Commonly, bacteria are not perceptible except with the aid of a microscope. Just to give you an idea of the size, fifteen hundred rod-shaped bacteria will barely reach across a pinhead. They will become noticeable when thousands of them grow to form a "colony" and can be seen as a mass. Bacteria are classified as to their harmful or beneficial qualities. It must be kept in mind that not all bacteria are harmful to us. In fact, a great majority of bacteria are helpful and useful. There are two classifications of bacteria:

1. Non-pathogenic organisms constitute the majority of all bacteria and perform many useful functions, such as decomposing refuse and improving the fertility of the soil. To this group belongs the saprophyte which lives on dead matter.

2.Pathogenic organisms (microbes or germs), although in the minority, produce considerable damage by invading plant or animal tissues. Pathogenic bacteria are harmful because they produce disease. To this group belong the parasites, which require living material for their growth.

Harmful Bacteria
Bacteria are responsible for a large percentage of illness and suffering. For this reason, the practice of sterilization and sanitation is absolutely necessary in a salon, barber shop or specialty salon.

Pathogenic Bacteria Classification

As to form or general appearance, there are three major groups of bacteria.

1. Cocci (singular, coccus) are round shaped organisms, which appear singly or in groups:

(a) Staphylococci (singular, staphylococcus)¾ pus-forming organisms which grow in bunches or clusters, and are present in abscesses, pustules and boils.

(b) Streptococci (singular, streptococcus)¾ pus-forming organisms which grow in chains, as found in blood poisoning.

(d) Gonococci (singular, gonococcus)¾ cause gonorrhea.

(e) Meningococci (singular, meningococcus)¾ cause meningitis.

2. Bacilli (singular, bacillus) are rod-shaped organisms which vary greatly in thickness. They are the most common and produce such diseases as tetanus (lockjaw), influenza, typhoid, tuberculosis, and diphtheria. Many bacilli are spore forming.

3. Spirilla (singular, spirillum) are curved or corkscrew-shaped organisms. They are further subdivided into several groups. The sub-group of chief importance is that of spirochaete organisms. The spirochaete called Treponema pallida is the causative agent in syphilis.

Growth and Reproduction

Bacteria consist of an outer cell wall and internal protoplasm. They manufacture their own food from the surrounding environment, give off waste products, and are capable of growth and reproduction. Bacteria may exhibit two distinct phases in their life cycle¾ the active stage and the inactive or spore-forming stage.

Active Stage

Bacteria grow and reproduce. These microorganisms live and multiply in warm, dark, damp, and dirty places where sufficient food is present. Many parts of the human anatomy offer suitable breeding places for bacteria. When conditions are as mentioned above, bacteria reproduce at an unbelievable rate. As food is absorbed and converted into protoplasm, the bacterial cell increases in size. When the limit of growth is reached, it divides crossways in half, forming two daughter cells. From one bacterium, as many as sixteen million more may develop in half a day.

Spore-Forming Stage

When favorable conditions cease to exist, bacteria either die or cease to multiply. Some bacteria can form spherical spores, which have a tough outer covering and are able to withstand long periods of dryness, periods of lacking food, or unsuitable temperature. Examples of bacteria that are capable of such action would be the anthrax and tetanus bacilli. In the spore stage, the spore can be blown about in the dust and is not harmed by disinfectants, heat or cold. When favorable conditions are restored, the spore changes back into the active, vegetative form and again starts to grow and reproduce.

Bacterial Infections

Pathogenic bacteria become dangerous to health only when they successfully invade the body. An infection occurs if the body is unable to cope with the bacteria or their harmful toxins. An infection may be localized, as in a boil, or a general infection (the most dangerous) may result when the blood stream carries the bacteria and their toxins to all parts of the body, which is what occurs in blood poisoning or syphilis. The presence of pus is a sign of infection. Pus contains bacteria, body cells and blood cells, both living and dead. An infection is considered contagious when it tends to spread more or less readily from one person to another by direct or indirect contact. Precautions must be followed to prevent the spread of infection when it is in this contagious stage.

How Bacteria Enter Our Bodies
Bacteria and other infectious agents can enter the body through any of the following routes¾ through the mouth, by food, drinking liquids, or items placed in the mouth; through the nose and mouth when we breathe; through the eyes by way of dirt, dirty hands, or unclean

objects such as poorly maintained contact lenses; and finally, through breaks or wounds in the skin.

Sources of Contagious Bacteria
Unclean hands and unsterilized instruments can be sources of contagious bacteria. Open sores and pus, mouth and nose discharges, and the common use of drinking cups and towels are a few other examples. Uncovered coughing or sneezing, and spitting in public can also spread germs. Personal hygiene and public sanitation can prevent and control many infections. The body attempts to fight infections by mobilizing its defensive forces. The first line of defense is unbroken skin. In a healthy person bodily secretions such as sweating and digestive juices discourage bacteria growth. Within the blood, there are white corpuscles to devour bacteria, and anti-toxins to counteract the toxins produced by the bacteria.

Filterable Viruses
These organisms are so small they will pass through filters. Such diseases as infantile paralysis, influenza, small pox, rabies, and the common cold are examples of viral infection. Rickettsia are microorganisms much smaller than ordinary germs, but are larger than the viruses that cause disease among insects, as well as, man and are responsible for the transmission of typhus fever and Rocky Mountain spotted fever. Insects, ticks, fleas, and lice can transmit and infect people with rickettsia.

Fungi
Fungi are not plants. Living things are organized for study into large, basic groups called kingdoms. Fungi were listed in the "Plant Kingdom" for many years. Then scientists learned that fungi show a closer relation to animals, but are unique and separate life forms. Now, Fungi are placed in their own Kingdom. Fungi are microscopic and consist of many cells. In this group are included the molds, mildews, and yeast’s. Fungi are incapable of manufacturing their own food. Some behave as parasites. These fungi cause diseases by using living organisms for food. These fungi infect plants, animals and even other fungi. Athlete’s foot and ringworm are two fungal diseases in humans.

Other Parasites
Protozoa are one celled animal organisms characterized by their distinct nuclei. There are various kinds of protozoa, among which are parasites. Animal parasites consisting of many cells and belonging to the insect class. They are responsible for such contagious infections as scabies, which are due to the itch mite.

Immunity
Immunity is the ability of the body to resist and destroy bacteria once they have entered the body. Immunity against disease is a sign of good health. It may be natural or acquired. Natural immunity is partly inherited and partly developed by hygienic living. Acquired immunity is secured after the body has, by itself overcome certain disease, or when it has been assisted by injections to fight bacteria.

Human Carrier
A person may be immune to a disease and still carry germs that can infect others. Such a person is called a human disease carrier. The diseases most frequently transmitted in this manner are typhoid fever and diphtheria. Physical agents such as heat (boiling, steaming, baking, or burning), and chemical agents such as antiseptics, disinfectants or germicides can accomplish destruction of bacteria.

Sterilization and Sanitation
As a cosmetologist serving the public, you will come in close contact with many clients. To avoid the spread of disease-producing bacteria, it is necessary for you to follow good sanitation and sterilization practices. You should understand the rules and the regulations, as well as the facts pertaining to this subject, for your own protection and for the protection of your clients.

STERILIZATION

How to Sterilize

Sterilization is the process of destroying all bacteria, whether they are harmful or beneficial. Here is a list of the most common ways:

Boiling:
Requires the immersing of towels, linens, or instruments in water heated to 212 degrees Fahrenheit.

Steaming:
Requires an airtight chamber in which steam is generated from water by the application of heat.

Baking:
A method of sterilization rarely used in beauty shops, but employed in hospitals.

Irradiation:
Articles may be sterilized by exposing them to ultra-violet rays in an enclosed cabinet. This method of sterilization should be used only if approved by your State Board of Cosmetology.

Sterilizing with chemical agents

Liquid Disinfectant
Mixing a disinfectant with water and immersing the article in the solution, as specified by your State Board of Cosmetology or Board of Health, is the most practical method of sterilization in salons.

Fumigation
Fumigants in a closed cabinet are used to keep sterilized articles sterile.

Antiseptics and Disinfectants

Antiseptic solutions are weaker than disinfectant solutions. They may not kill all the germs, but will prevent them from multiplying. They are gentle enough to be used on the skin. Disinfectants are much stronger and have the ability to destroy bacteria and prevent their multiplication. A germicide is a chemical agent that kills bacteria. The reason it is required that we sterilize is to destroy bacteria. It is a necessity to destroy bacteria in order to prevent the spread of diseases. This is the way we protect the public and ourselves.

Disinfectants and germicides are also antiseptic because they kill germs and retard the growth of more germs. Antiseptics, on the other hand, are not as powerful as germicides or disinfectants. Therefore they cannot be used as a germicide or disinfectant because they are not able to perform the necessary degree of germ killing. Always exercise caution when using any chemical on the skin. Many of the disinfectants and germicides are not manufactured with the intention of being placed on the skin and for this reason should not make contact with the skin. Read the manufacturer’s directions and the section on cautions posted on the label or the container, before you use any chemical product.

List of Germicides

FORMALIN	10% to 25%	POISON	Pungent odor
ALCOHOL	70%	HARMLESS	Effective
CHLOROZOL	2%	HARMLESS	Effective
AMMONIUM COMPOUNDS	1/1000 Solution	NON - TOXIC	Odorless
PHENOL	3% to 5%	POISON	Pungent odor
BICHLORIDE OF MERCURY	0.1%	POISON	Irritates

Many common germicides are extremely poisonous, and therefore should not be used in beauty culture practice. These germicides act differently on different types of bacteria. Each one has been standardized for the concentration that is most effective. Certain germicides, when concentrated enough to be deadly to bacteria, cannot be used safely on the skin. Phenol, or carbolic acid, is a dangerous germicide. Should your skin come in contact with this acid, you should immediately immerse in it alcohol and apply alcoholic dressings.

Boric Acid
A 5% solution is needed to be effective as an antiseptic. Prepare by adding a little at a time to distilled water in a sterilized bottle and shake it until no more will dissolve. To prepare a large quantity, add 6 1/2 ounces of boric acid crystals to 1 gallon of distilled water. Boric acid solution is often used to cleanse the eyes. Bichloride of mercury solution will corrode metals, so never use with metallic instruments. It should be noted that this chemical is poisonous.

Sanitizing Hands
As a licensed professional dealing with multiple clients per day, it is necessary to sanitize your hands even more than your implements, especially in the nail and facial industries. Before servicing any client, the following process of sanitizing your hands should be followed: First, you must have an antibacterial/hospital recommended cleanser. You must use tepid water with a generous amount of cleanser. Place the cleanser in the palm of your hand and rub vigorously to lather cleanser from inside to outside of hands and fingers. Once the surfaces of your hands and fingers have been cleansed thoroughly, rub the tips of your fingers and nails in the palm of the opposite hand to enable cleansing of the underside of the nails. Then repeat this same process a second time. Be sure to rinse thoroughly after each process.

Note: A sanitized nailbrush may be used for a more precise cleaning. This must be done before you service each new client. (Remember that cash is one of the dirtiest things you will handle. It is covered with germs that get passed from one individual to another.)

Dry Sterilization

Preparing for Dry Sterilization
Clean inside of cabinet and dry thoroughly. Prepare dry sterilizer. Full strength formalin can be used either one of two ways. (a) Mix 1 tablespoonful of borax with 1 tablespoon of formalin in a small tray, and place it into a dry sterilizer. (b) Place a piece of absorbent cotton in a small container, saturate the cotton with formalin, and place the container on the bottom shelf of a dry sterilizer. Have ready a supply of clean towels.

Cleaning Combs and Brushes
Remove the hair from combs and brushes. Immerse combs and brushes completely into a bowl of soapy water for several minutes. Clean each comb separately with a small brush. Clean the brushes two at a time by rubbing the bristles against each other. When thoroughly cleaned, rinse combs and brushes in bowl of clear, warm water. Drain off water and remove any adhering hairs.

Sterilizing Combs and Brushes
How to prepare a chemical sterilization: Clean sterilized receptacle, add soapy water and a sufficient quantity of 10% formalin solution or other approved disinfectant. Adding ammonia to the soap bath is optional in the proportion of 1 tablespoon to 2 quarts of water. Now prepare a bowl of warm water for rinsing purposes. Immerse combs and brushes into formalin solution for 20 minutes. Remove combs and brushes, rinse in clear clean water, and dry them thoroughly with a clean towel. When thoroughly dry rest combs and brushes on a clean towel in a dust free place.

Sterilizing Metallic Implements With Chemical Solutions
Prepare a bowl of warm soapy water. Prepare disinfectant in wet sterilizer (25% formalin) to which a small amount of glycerine has been added, or use any other type of disinfectant approved by the State Board. If necessary, replace chemical in dry sterilizer. Have ready a supply of clean towels and individual envelopes.

Formaldehyde and Formalin

Formaldehyde is a gas with powerful germicide properties. Formalin is a 37% to 40% solution of the gas in water.

2.5 % Formalin is used as a deodorant for sponging the armpits, etc. (Preparation: 1 part formalin, 39 parts water.)

5% Formalin may be used as an antiseptic to rinse hands, when you have come in contact with wounds, skin, eruptions, etc. Formalin may also be used to sponge shampoo boards, chairs, etc.

10% Formalin may be used to sterilize articles such as combs and brushes by immersing them in the solution for at least 20 minutes or as required by your State Board of Cosmetology.

25% Formalin solution is recommended to sterilize instruments by immersing them in the solution for about 10 minutes, or as required by your State Board of Cosmetology.

Full strength formalin is used when sterilizing will be done in a dry (vapor) sterilizer.

Ammonium Compounds

These compounds are effective as disinfectants. They are available under different trade and chemical names. The advantages are a short disinfection time, being odorless, non-toxic and stable. A 1:1000 parts solution is commonly used to sterilize implements. Immersion time ranges from 1 to 5 minutes depending upon the strength of the solution.

Using Chemical Disinfectants

Wash implements thoroughly with soap and warm water. Use final plain water rinse to remove all traces of soap. Immerse implements into wet sterilizer. Remove implements from wet sterilizer, rinse in water, and wipe dry with clean towel. Store sterilized implements in individually wrapped cellophane envelopes or keep them in a cabinet sterilizer until ready to be used.

Other Antiseptics and Disinfectants

Alcohol: A powerful antiseptic. On the skin use a 50% to 60% solution. 70% grain alcohol is used to sterilize instruments and electrodes.

Lysol: Is a cheap but efficient disinfectant with a disagreeable odor. A 10% soap solution is used for cleanses floors, sinks and toilets.

Iodine: Tincture of Iodine, 2% U.S.P. is a good antiseptic for the skin.

Hydrogen Peroxide: 3% to 5% solution liberates oxygen for its antiseptic action. It can be used for minor wounds.

Cleaning Metallic Implements
Clean shear blades, wipe razor blades, and clean the prongs of tweezers and ends of clippers.

Sterilizing Metallic Implements
Immerse implements in disinfectant solution for 10 minutes. Caution: In sterilizing razors or shears, dip only the blade into the solution. Remove implements and dry thoroughly with clean towel.

Storing Metallic Implements
Place sterilized implements in dry sterilizer or wrap them in individual envelopes until ready for use.

Sterilizing Electrodes & Sharp Cutting Implements
Electrodes: Clean surface of electrodes with warm, soapy water.

Sharp cutting instruments: Clean the blades with warm, soapy water, making sure the water does not make contact with the pivots of the razors or shears, as these parts of the instruments may corrode. Dry thoroughly.

Sterilizing Electric Clippers
Remove all hair from blades. Dip a piece of cotton pad into 70% grain alcohol, or other approved disinfectant, and rub over the surfaces of the electrodes and cutting blades of the instruments. Re-apply disinfectant. Dry electrodes and implements thoroughly.

Storing Electrodes and Implements
Place electrodes or implements in the dry sterilizer, or wrap in individual envelopes until ready to use.

Sterilizing Manicure Implements
Place cotton ball in jar, pour enough disinfectant into wet sterilizer so that the tip of the implements will be completely immersed. Keep implements in sterilizer for the required time as specified by your State Board of Cosmetology. Keep jar covered when not in use. Change cotton and disinfectant whenever necessary. Place implements in dry sterilizer until ready to be used.

· Nail File
Scrub particles off nail file with brush and warm, soapy water. Immerse file into wet sterilizer for the required time as specified by your State Board of Cosmetology. Dry nail file and keep it in a dry sterilizer when not in use.

· Emery Boards
Emery boards cannot be sterilized. Always destroy them after each manicure.

Steam Sterilization
To use steam sterilization in the salon requires special equipment. Follow the manufacturer's instructions for the particular steamer being used.

Sanitation
Sanitation is the application of measures to promote public health and prevent the spread of infectious diseases. Various governmental agencies protect community health by providing for a wholesome food and water supply and the quick disposal of refuse. These steps are only a few of the ways in which the public health is safeguarded. The State Board of Cosmetology and Board of Health, in each state or locality have formulated sanitary regulations governing beauty shops. Every cosmetologist must be familiar with these regulations in order to obey them.

A person with an infectious disease can be contagious to others. It is for this reason that a cosmetologist having a communicable disease or illness must not be permitted to handle clients. At the same time, clients having a communicable disease or infectious condition also must not be serviced in the salon. Following this practice protects the cosmetologist, the client, and the other clients as well, from exposure. In this way the best interests of everyone will be served.

Ventilation
The air within a salon must be circulated and should have some degree of humidity and should not be dry nor should it be stagnant. The room temperature should remain approximately 70 degrees Fahrenheit. Salons may utilize fans, air conditioners, and exhaust fans or devices. The use of this type of equipment provides an increased quality, as well as an increased quantity of air in the salon.

The Salons Drinking Water
The water supplied in the salon and intended for consumption must be odorless, colorless and free from any foreign matter. Crystal clear water may still be unsanitary because of the presence of pathogenic bacteria, which cannot be seen with the naked eye.

Basic Rules
The salon must be well lighted, heated, and ventilated, in order to keep the salon in a clean and sanitary condition. The walls, curtains, and the floor coverings in all work booths must be washable and kept clean. All salons must be supplied with running hot and cold water. All plumbing fixtures should be sufficient in number and properly installed. The premises should be kept free from rodents, vermin, flies or other similar insects through cleanliness, use of screens, and an exterminator. All hair, cotton, or other waste material must be removed from the floor without delay, and deposited in a closed container. Waste material should be removed from the premises at frequent intervals. Objects dropped on the floor are not to be used until sterilized. Hairpins must not be placed in the mouth, combs must not be carried in the pockets of uniforms, and hairnets must not be carried in cuffs or pockets of the uniform. When giving a manicure, provide finger bowls with individual paper cups for each client. Headrest coverings and neck strips must be changed for each client.

FLORIDA ADMINISTATIVE CODE

Ventilation and Cleanliness:

61G5-20.002 Salon Requirements

1.Each salon shall be kept well ventilated. The walls, ceilings, furniture and equipment shall be kept clean and free from dust. Hair must not be allowed to accumulate on the floor of the salon. Hair must be deposited in a closed container. Each salon which provides services for the extending or sculpturing of nails shall provide such services in a separate area which is adequately ventilated for the safe dispersion of all fumes resulting from the services.

2. Toilet and Lavatory Facilities: Each salon shall provide --on the premises or in the same building as, and within 300 feet of, the salon -- adequate toilet and lavatory facilities. To be adequate, such facilities shall have at least one toilet and one sink with running water. Such facilities shall be equipped with toilet tissue, soap dispenser with soap or other hand cleaning material, sanitary towels or other hand-drying device such as a wall-mounted electric blow dryer, and waste receptacle. Such facilities and all of the foregoing fixtures and components shall be kept clean, in good repair, well lighted, and adequately ventilated to remove objectionable odors.

3. A salon or specialty salon may be located at a place of residence. Salon facilities must be separated from the living quarters by a permanent wall construction. A separate entrance shall be provided to allow entry to the salon other than from the living quarters. Toilet and lavatory facilities shall comply with (c) 2. above and shall have an entrance from the salon other than the living quarters.

4. Animals: No animals or pets shall be allowed in a salon, with the exception of fish kept in closed aquariums, or trained animals to assist the hearing impaired, visually impaired, or the physically disabled.

5. Shampoo Bowls: Each salon shall have shampoo bowls equipped with hot and cold running water. The shampoo bowls shall be located in the area where cosmetology services are being performed. A specialty salon that exclusively provides specialty services, as defined in Section 477.013(6), F.S., need not have a shampoo bowl, but must have a sink or lavatory equipped with hot and cold running water on the premises of the salon.

(2) Each salon shall comply with the following:

(a) Linens: Each salon shall keep clean linens in a closed, dust proof cabinet. All soiled linens must be kept in a closed receptacle. Soiled linens may be kept in open containers if entirely separated from the area in which cosmetology services are rendered to the public. A sanitary towel or neck strip shall be placed around the patron's neck to avoid direct contact of the shampoo cape with a patron’s skin.

(b) Containers: Salons must use containers for waving lotions and other preparations of such type as will prevent contamination of the unused portion. All creams shall be removed from containers.

References:

http://www.clive.canoe.ca/Health9906/07_linton.html

http://www.chumd.com/LifeStyle/Personal_Health/12-NOV-2000/102901_en.html

http://www.epa.gov/region4/

Milady Textbook of Cosmetology The Van Dean Manual http://www.salonsafety.com/safetysheets

http://www.dca.ca.gov/barber/barbcmpl.htm

http://medicalreporter.health.org/tmr0499/hair_and_nail_salons_linked_to_i.htm

STERILIZATION

Dry Sterilization

FLORIDA ADMINISTATIVE CODE

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