Twenty-one-year-old Ricky Lannetti was having the best football season of his life. Lannetti was a wide receiver for the Warriors, the football team at Lycoming College, Williamsport, Pa. He had already set a 2003 school record with 16 catches in one game. The following week, he broke the school's all-time record for the number of catches in a season. One Saturday, he caught five balls during a game; the Saturday after that, he was dead.
Toward the end of 2003, Lannetti had noticed a small welt on his backside, but he thought little of it. However, what Lannetti had contracted was MRSA (methicillin-resistant staphylococcus aureus), a rare “super bug” unheard of just two years ago.
Since Lannetti's death, doctors have learned how to diagnose and treat MRSA. But the infection is resistant to most antibiotics and is so aggressive that by the time it is diagnosed, it often is too late to fight it. Making matters worse is the significant increase in the number of MRSA cases in the past two years, reported by the Centers for Disease Control and Prevention (CDC), especially among young men, athletes, police cadets and prisoners. In fact, the agency's statistics show that MRSA accounted for 64 percent of the approximately 100,000 people who went to doctors or emergency rooms with skin infections last year.
The contagious toxins that breed MRSA thrive in humid conditions such as those found in steamy locker rooms and restrooms. These toxins or a kind of bacterial parasite enter the body through small cuts on the foot or body. Such cuts are not uncommon after a football game, wrestling match or other sports activity. Add a weakened immune system — also common after an aggressive sporting event — and the doors open wide for the disease to enter.
Instead of relying on doctors and medical science to develop new antibiotics to fight the disease, researchers say the first step in saving lives and reducing the frequency of MRSA is through improved personal hygiene. Hands should be washed frequently, and all cuts — especially those discovered after sporting activities and in humid conditions — should be cleaned, disinfected and bandaged immediately. Protective gear worn for different sports activities also should be cleaned after every use.
To this end, the National Football League (NFL) even has begun sponsoring hygiene workshops for players, coaches and trainers at schools around the country.
Personal hygiene is not the only answer, however. As one of the main breeding grounds for MRSA, locker rooms and restrooms must be cleaned more thoroughly to help eliminate the germs, toxins and bacteria that can cause the infection. Moreover, the facilities themselves should be designed or redesigned to stay drier through better humidity control.
“There is potential for MRSA to be everywhere in the locker room, around trash cans … floors, tiles, grout and benches — everywhere,” says Steve Antonopolus, head of the NFL's Trainers' Association. This potential remains undiminished despite the use of stronger and commonly used disinfectants and cleaners. This means that more effective cleaning — not just more, stronger disinfectants and powerful cleaning chemicals — is needed.
In addition to chemicals and disinfectants, traditional locker and restroom cleaning methods rely on labor-intensive cleaning tools, such as heavy buckets and string mops, cleaning cloths, chemicals and disinfectants. Using these tools, a cleaning professional must stretch to reach around toilets, below urinals and beneath counters to clean the locker room or restroom thoroughly.
Often in the course of cleaning, the cleaning tools become soiled, spreading as many germs and bacteria as they remove. Also, because this method is so labor-intensive, it is heavily dependent on the skill, training and performance of the workers.
Touchless cleaning is one method that an increasing number of facilities are using to clean locker rooms and restrooms effectively, while compensating for different skills, training and performance levels. With a touchless, or spray-and-blow-dry method, tiles, shower areas, floors, fixtures and even ceilings are sprayed with a cleaning chemical. Dwell time is about 10 minutes; then all surfaces are blast-rinsed clean. A wet/dry vac built into the machine facilitates quicker drying.
The Prince William County (Va.) School District, with 423 custodians, more than 66,000 students, 10 high schools, 13 middle schools and 50 elementary schools, uses the system.
“We use this system in our high school locker rooms on a nightly basis,” says Kelly Rice, the district's coordinator of custodial services. “It helps us deep-clean the tile and grout areas, removing more harmful soils and bacteria that can be difficult to clean effectively using traditional cleaning methods.”
Design and construction
Along with more thorough cleaning, locker rooms and restrooms must be kept dry. Not only do the shower areas in locker rooms generate a lot of humidity, but also they often are situated next to swimming pools and changing areas, which can increase humidity and cause chlorine fumes to permeate the air. Although adequate HVAC systems usually can tackle most humidity problems in the locker room itself, exhaust fans vented directly out of the roof also should be added. These help keep the locker room dry, and prevent humidity, chlorine and other odors from migrating to other parts of the building.
In addition to exhaust systems, many architects now recommend installing fans in locker rooms to increase airflow. The more air movement, the quicker the areas will dry, reducing humidity and the potential for mold, mildew, germs and bacteria.
Finally, floor drains should be installed throughout a locker room to remove excess standing water. The correct number of drains and the slope of the floor are crucial.
Fagan, after serving as a building service contractor in Chicago for more than 10 years, is now vice president of United Service and Supply, Inc., Chicago.
Prevention is key
As doctors grapple to understand and treat MRSA, they are finding its spread difficult to control. One reason is that the early symptoms are so benign that most people do not seek medical attention until the disease has become serious and has spread throughout the body. And, before this happens, an infected person unknowingly can spread the germs and bacteria that cause MRSA.
To prevent this, athletic staffs and school administrators are encouraged to inform locker-room users about the disease, the importance of proper hygiene, and of reporting any skin infections or rashes as soon as they are noticed.
Steps to prevent the spread of MRSA and many other infections:
Wash hands regularly. Although MRSA is resistant to many drugs and antibiotics, soap and water effectively can remove the bacteria on skin surfaces that cause the illness.
Clean, cover and bandage all wounds and cuts to prevent “entry” points for MRSA.
Pay attention to all rashes, boils, welts or skin infections, even if they appear insignificant. See a doctor at the first sign they seem to be worsening.
Avoid sharing towels and protective sports gear. Wipe down weightroom and other equipment before and after use.
Amount of the approximately 100,000 people who went to doctors or emergency rooms with skin infections last year who were diagnosed with MRSA.
Source: Centers for Disease Control