Mattia Buratto

Healthcare cleaning services are essential for infection prevention and control, but they also contribute to the carbon footprint of healthcare facilities through recurrent consumption of detergents, disinfectants, textiles, water, energy, and transport-related resources. This sequential, non-randomized, single-facility evaluation compared a traditional cleaning protocol with a Green protocol oriented to the Italian Minimum Environmental Criteria (Criteri Ambientali Minimi, CAM) for cleaning services at Domus Nova Hospital, a private accredited healthcare facility in Ravenna, Italy. A risk-based microbiological monitoring plan was applied to low-, medium-, and medium-high-risk areas, prioritizing high-touch surfaces and using RODAC contact plates and sterile swabs. In parallel, a comparative Life Cycle Assessment was conducted in accordance with ISO 14040, ISO 14044, and ISO 14067 principles, using Global Warming Potential over 100 years as the main impact indicator and the functional unit of one square meter of cleaned hospital surface maintained for one year. The two protocols were assessed during different monitoring periods of unequal duration; therefore, the study was interpreted as a whole-system operational comparison rather than as a randomized trial or formal equivalence/non-inferiority assessment. After cleaning, all 64 observations obtained under the Green protocol met the adopted surface-hygiene acceptability criteria, compared with 55 of 64 observations under the Traditional protocol. No predefined target pathogenic indicators were recovered from post-cleaning samples under the applied culture conditions. From a climate-impact perspective, the Green protocol reduced the carbon footprint by 39.0%, corresponding to an avoided impact of 450 g CO2e m⁻² year⁻¹ and 2663.5 kg CO2e year⁻¹ at the facility scale. The main climate-related benefits were associated with the combined effect of textile-system redesign, lower energy consumption, optimized product use, and reduced operator transport. These findings support the use of integrated surface-hygiene indicators and life-cycle metrics to inform healthcare cleaning procurement, while highlighting that the results concern culture-based surface contamination indicators from a single facility and do not directly assess infection transmission or patient outcomes.

Healthcare cleaning services are essential for infection prevention but contribute significantly to the environmental footprint of hospital operations through the intensive use of chemicals, water, and energy. This study presents an integrated assessment of a conventional cleaning protocol (TT) and a CAM-compliant environmentally oriented protocol (GREEN, TG) in a real hospital setting (Bufalini Hospital, Cesena, Italy), combining microbiological monitoring with Life Cycle Assessment (LCA). Surface contamination was evaluated across different risk areas using standardized culture-based methods, while environmental impacts were quantified using a cradle-to-grave LCA approach, focusing on Global Warming Potential (GWP100). Both protocols achieved significant reductions in microbial load, with post-cleaning values consistently below established hygienic thresholds. No pathogenic indicator organisms were detected after cleaning, and the GREEN protocol demonstrated microbiological performance equivalent to or slightly better than the traditional system across all risk categories. LCA results revealed a substantial environmental advantage for the GREEN protocol, with a 43.7% reduction in carbon footprint (−273 g CO₂e m⁻² year⁻¹), corresponding to an annual saving of approximately 13.3 t CO₂e at the facility scale. These reductions were primarily driven by decreased chemical consumption, optimized dosing, and lower laundering temperatures. The findings demonstrate that environmentally sustainable cleaning strategies can maintain high standards of microbiological safety while significantly reducing environmental impacts. This integrated approach supports the adoption of CAM-compliant protocols in healthcare facilities and highlights the importance of combining infection control metrics with life-cycle environmental evaluation to inform sustainable procurement and hospital management practices.

The transition toward sustainable facility management requires cleaning systems that reduce environmental burdens while maintaining high hygienic standards. This study presents a comparative evaluation of a green cleaning protocol (EVA SmartClean), compliant with the Italian Minimum Environmental Criteria (CAM; D.M. 29 January 2021), compared with a conventional cleaning system implemented in a civil facility (Adriatico Guest House, Trieste, Italy; 8260 m²). The assessment integrates a cradle-to-grave Life Cycle Assessment (LCA), conducted in accordance with ISO 14040, ISO 14044, ISO 14067 and PCR 2011:03 for professional cleaning services, with an extensive microbiological surface monitoring campaign performed using RODAC plates and swab sampling. The functional unit was defined as 1 m² of representative surface maintained clean for one year. The green protocol achieved a 47.7% reduction in Global Warming Potential (GWP100 based on IPCC AR6 characterization factors), corresponding to −110 g CO₂e/m²·year and −908 kg CO₂e/year for the entire facility. Major reductions in climate impact were associated with chemical consumption (−82.6%), energy use (−49.5%), and textile waste generation (−92.4%). Microbiological analyses demonstrated that both protocols complied with reference hygiene thresholds, while the green system achieved reductions in total mesophilic counts that were comparable or superior across representative surfaces. The results confirm that environmental optimization in cleaning services can be achieved without compromising microbiological safety, supporting public procurement policies aligned with CAM requirements and Sustainable Development Goals (SDGs 12 and 13).

The transition toward low-impact facility management requires robust evidence that environmental optimization does not compromise hygienic reliability. In the professional cleaning sector, sustainability claims are often based on product substitution rather than on integrated performance validation. This study provides a dual-perspective evaluation comparing a conventional cleaning protocol with the Pfe Green system, an eco-designed approach compliant with the Italian Minimum Environmental Criteria (CAM, D.M. 29 January 2021), implemented in a civil building of Renault Italia S.p.A. in Rome. A combined Life Cycle Assessment (LCA) and microbiological evaluation was conducted under real operational conditions to quantify both climate-related and hygienic outcomes. The LCA, performed in accordance with ISO 14040–44 and ISO 14067 standards, demonstrated that the Green protocol achieved an approximately 30% reduction in Global Warming Potential over a 100-year horizon (GWP₁₀₀), mainly attributable to structural process optimization, including reduced detergent mass, lower laundering temperatures, improved dilution control, and energy-efficient machinery. Microbiological monitoring, conducted according to ISO 14698 and UNI EN ISO 18593, showed that both systems ensured high levels of microbial abatement, with the Green protocol exhibiting slightly higher average reductions in total viable counts (96.1% vs. 94.2%). These findings confirm that lower chemical input and eco-formulated products do not compromise hygienic performance when supported by standardized procedures and microfiber-based mechanical removal. By integrating life-cycle metrics with microbiological validation, this research proposes a replicable assessment model for sustainable cleaning services. The results demonstrate that CAM-aligned green protocols can simultaneously reduce greenhouse gas emissions and maintain hygienic effectiveness, thereby supporting evidence-based sustainable procurement and corporate environmental strategies. The originality of this study lies in the integration of life-cycle environmental assessment with real-world microbiological validation under operational conditions, providing a comprehensive framework for evaluating sustainable cleaning systems beyond product-level substitution.

Growing concern for environmental sustainability has resulted in the implementation of sanitization methods that respect ecological principles. This research evaluates a “green” sanitizing protocol that uses CAM (Minimum Environmental Criteria)-compliant products against a traditional protocol within two ASL Roma 1 facilities. The study performed a Life Cycle Assessment (LCA) following ISO 14040, ISO 14044, and ISO 14067 standards to measure greenhouse gases emissions. Microbiological sampling was conducted according to established protocols across three different risk zones utilizing contact plates and surface swabs. The Life Cycle Assessment showed that CO₂ emissions reduced by 49.6% to 53.3% at different sites due to reduced energy use together with concentrated detergents and improved washing cycles. Microbiological testing revealed notable decreases in contamination rates across both cleaning systems yet demonstrated the “green” system achieved superior results specifically within high-risk zones. The “green” protocol matched traditional cleaning methods hygienically but delivered significant environmental advantages which positions it as a sustainable hospital cleaning solution.

This research conducts a comparative life cycle assessment (LCA) to examine both the ecological footprint and microbiological performance of eco-friendly and traditional cleaning methods in non-clinical environments. Conducted in accordance with the updated Minimum Environmental Criteria (CAMs), the research follows the principles and framework established by UNI EN ISO 14040 and 14044. Additionally, the assessment of carbon footprint (kg CO₂e) adheres to ISO 14067:2018, with guidance from Product Category Rules (PCR 2011:03 v3.0.1). Our findings demonstrate that the Green Protocol implemented by Dussmann Service reduces the carbon footprint of cleaning activities by 20.0% compared to the traditional protocol, equating to an annual reduction of 156 kg CO₂ at the pilot site. Laboratory analyses confirm that the Green Protocol maintains hygiene standards equivalent to conventional methods, ensuring adequate microbiological quality while significantly lowering environmental impact. The study highlights the feasibility of integrating eco-friendly cleaning practices without compromising effectiveness. Future research should explore the scalability, cost-efficiency, and long-term benefits of this approach. This assessment provides a scientifically validated foundation for adopting sustainable cleaning methodologies in professional settings, supporting the transition towards environmentally responsible facility management.

This study investigates the environmental and microbiological effectiveness of two cleaning protocols—EVA (Ecological Visible Approach) and a traditional cleaning protocol—implemented in a healthcare setting. The cleaning procedures were conducted using specific equipment tailored to each protocol, with the EVA Protocol emphasizing sustainable practices. Microbiological evaluations assessed the effectiveness of each protocol in reducing microbial presence on various surfaces. The results demonstrated that the EVA Protocol not only met but often exceeded the microbiological standards achieved by the traditional protocol while significantly reducing the environmental footprint. The comparative Life Cycle Assessment (LCA) highlighted the EVA Protocol’s ability to lower CO₂ emissions by 31.5% compared to the traditional protocol. This study underscores the potential benefits of adopting sustainable cleaning practices in healthcare settings, contributing to both environmental preservation and effective infection control.

Although Herpes simplex virus type 1 (HSV-1) has been deeply studied, significant gaps remain in the fundamental understanding of HSV-host interactions: our work focused on studying the Infected Cell Protein 27 (ICP27) as an inhibitor of the Absent-in-melanoma-2 (AIM 2) inflammasome pathway, leading to reduced pro-inflammatory cytokines that influence the activation of a protective innate immune response to infection. To assess the inhibition of the inflammasome by the ICP27, hTert-immortalized Retinal Pigment Epithelial cells (hTert-RPE 1) infected with HSV-1 wild type were compared to HSV-1 lacking functional ICP27 (HSV-1∆ICP27) infected cells. The activation of the inflammasome by HSV-1∆ICP27 was demonstrated by quantifying the gene and protein expression of the inflammasome constituents using real-time PCR and Western blot. The detection of the cleavage of the pro-caspase-1 into the active form was performed by using a bioluminescent assay, while the quantification of interleukins 1β (IL-1β) and 18 (IL-18)released in the supernatant was quantified using an ELISA assay. The data showed that the presence of the ICP27 expressed by HSV-1 induces, in contrast to HSV-1∆ICP27 vector, a significant downregulation of AIM 2 inflammasome constituent proteins and, consequently, the release of pro-inflammatory interleukins into the extracellular environment reducing an effective response in counteracting infection.

In response to the growing global concern for environmental sustainability, a Life Cycle Assessment (LCA) study was conducted to evaluate the environmental benefits of the “Formula Servizi” GREEN protocol compared to a conventional cleaning protocol, as mandated by the updated Criteria for Environmental Sustainability (CAM—Criteri Ambientali Minimi) for cleaning services. The CAM, effective on 19 June 2021, requires companies to demonstrate the environmental advantages of their cleaning protocols over traditional methods. This study aligns with the new CAM guidelines and employs UNI EN ISO 14040–14044 technical standards for a comprehensive comparative analysis. The study highlights the significance of maintaining hygiene to ensure safety in various contexts, emphasizing the importance of environmental sampling and monitoring to prevent contamination and infection transmission. Despite the complexity and expenses associated with microbiological monitoring, this research affirms its crucial role in validating cleaning procedures, particularly in healthcare facilities, food service areas, and industrial settings. The findings reveal that both the “Traditional” and “GREEN” cleaning protocols demonstrate satisfactory effectiveness in controlling microbiological contamination according to established guidelines. Moreover, the LCA results indicate that the “GREEN” protocol, while exhibiting higher water consumption and wastewater treatment, showcases a strategic use of more sustainable cleaning and laundry detergents. Despite the increased water usage in certain phases, the significantly lower environmental impact per unit of weight demonstrates the potential for optimizing both environmental sustainability and operational efficiency in future Life Cycle Sustainability Assessment (LCSA) endeavors. The comparative LCA further reveals that the “GREEN” protocol enables an annual avoidance of 260 g of CO₂-e emissions per square meter of cleaned surface. The most significant reduction in absolute terms is associated with the use of eco-labeled detergents in the laundry system, resulting in the avoidance of 654.1 kg of CO₂-e per year of service (−77% compared to traditional laundry detergents).

The development of sustainable processes has an important role to play in balancing social productivity requirements, protecting the environment and natural resources. Up to date, efforts to combat microbial contamination have focused on the use of chemical-based sanitation procedures, which may have various limitations, as testified by the persistence of contamination itself, by the growing antimicrobial resistance of microbes and by the chemical related pollution. The purpose of this paper is to present a comparative analysis of the use of conventional and sustainable cleaning products and processes in civilian environments. The sampling campaign is conducted in a sports hall in Turin, Italy. Each sample comes from a specific environment, surface, furniture and sanitary and is taken using RODAC contact plates and swabs with a neutralizing agent in order to standardize the result of the microbiological evaluation. Sampling occurred before and after traditional and sustainable cleaning procedures. The sustainable experimental design using ecological products in the cleaning procedures of the analyzed areas proved to be a relevant technique. From CAM (minimal environmental criteria) requirements, the sustainable protocol must give equal or better results than the traditional protocol from both microbiological and environmental (LCA) point of view. It can be concluded that the ecological experimental system meets this criterion and has demonstrated better performance both in antimicrobial activity and in environmental impact than the conventional system: all findings are in an acceptable state of sanitation, with no evidence of pathogenic micro-organisms specified in the guideline.