Daniels International are now evaluating their Clinismart system in the UK and elsewhere. Surrounded by the full range of ‘in your face’ advertising that has been a feature of Daniels Sharpsmart system, some of the claims made so far need careful consideration, a big pinch of salt and a great deal of scepticism.

The UK evaluation, at University Hospitals North Staffordshire NHS Trust, is described in some little detail in a recent article published in Inside Hospitals. Related advertising copy includes a glossy Sterihealth brochure that makes the most ridiculous claims about this system:

Terry Grimmond, a Microbiologist for Daniels, states:

“ The Clinismart cleaning process was tested by coating bins with 6-log blood-suspensions of Staph aureus, E. faecalis and Mycobacterium phlei. On swabbing them after the wash, not a single pathogen remained. The risk of infection was less than 1 in 100 billion!”

That is bad science. It is nonsense science. It is simply rubbish, to equate the results of some unconfirmed in vitro tests of pathogen survival on hard surfaces with the potential for infection. And 1 in 100 billion? 1 in 100,000,000? If you killed 10⁶, 0r 1,000,000, pathogen cells how does that correlate to a risk reduction of 10⁹? Quite simply, and by a very substantial margin, it does not.

It would be appropriate instead to consider the inherent risk of infection with a conventional system and then by epidemiological study assess any change to the infection rate in a suitably controlled long-term study after introduction of Clinismart. If any risk exists, though we all agree that it does, it has not been quantified and probably cannot be quantified even in the most rigorous of scientific studies. That is no reason to dream up such silly claims that we read about Clinismart.

Other bold and prominent advertising copy includes:

“Reduces infection transfer“

How does this system “reduce infection transfer”, and for that matter what on earth does “infection transfer” mean?

 “Using a foot-pedal opening mechanism and a bagless system now means hand contact with the collector is no longer required. This results in a dramatic reduction in the infection transfer risk that currently exists with standard clinical waste collectors.

Back to this nonsense of infection transfer risk?

If they refer to contamination risk, that is a completely different thing. This might be true for the ancillary staff and waste handlers, for whom contamination events and related infection risks are a sometimes understated risk, but this is no different from the pedal operated bin holders used by healthcare professionals when placing waste into a clinical waste container. Except now, they must first wheel the Clinismart clinical waste container to the bedside.

That can only happen if nobody else is using it, and on a 30 bed ward several of these will be required. Where will they be stored? Will we wheel a non-clinical equivalent container to the bedside also, or place those other wastes into the Clinismart system, thus defeating the key purpose of this system? And with all those waste containers wheeled to the patient’s bedside, will there be any room left for the patient?

The implied claims that this Clinismart system will eliminate hand contact by use of a foot operated pedal may be true for the user, though as we note above this is equally true for conventional bag holders also. But how does the Clinismart move from point A to point B, and C, and D and onward around a busy ward? Do we kick it, aiming a toe at the Clinismart foot pedal? Or does the user push it, by hand, defeating by necessesity one more of the key claims made for the system?

“…each container is removed from your premises, emptied, and then subjected to a rigorous 6-stage wash and sanitation process. This process is so effective that the risk of infection from a returned empty collector is less than 1 in 100 billion!

 Oh no, back to this ridiculous claim of a 1 in 100 billion risk of infection”

Daniels may have a useful product in the Clinismart system, and until there is a body of fully independent user feedback and analysis we should hold our breath – wait and see, in the hope that some properly peer-reviewed and independent assessments from more than one centre and more than one assessment group are available for scrutiny.

However, the ridiculous claims made make a mockery of microbiological science and would, in the UK, fall foul of the ASA guidelines that require advertising material to be legal, decent, honest and truthful. So far, these claims in my opinion fail on at least 2 counts and thereby presumably fail on the legal count also. Since this document is available via the internet and thus in all countries worldwide we should be concerned, but the web address is Australian and we will leave it to the Australians to decide.

In all other respects, we must Ask for Evidence of these bold and misleading claims.

Ian Blenkharn