You are correct. Purple-top Sani Wipes are a cocktail of quat (quaternary ammonia) and alcohol for high-touch surfaces. Bleach tends to be used for floors.
If you’re wondering how ammonia interacts with copper, you probably guessed right: toxic copper salts.
Which toxic salt are we talking about?
Copper itself is moderately toxic when a lot is ingested as are things like copper (II) chloride, but I don’t see how how you’d be exposed to anywhere near enough to cause a problem just from touching surfaces.
Copper toxicity is usually something you see from severe corrosion problems in copper pipes or burning copper sulfates.
Hypochlorites aren’t the only chemical disinfectants. There’s hydrogen peroxide solutions, quaternary ammonium compounds and what not.
Looking at this review of copper touch surfaces in healthcare settings, it certainly looks promising to me.
We’re talking about clinical settings, not doorknobs and household railings. Potential exposures include to fragile patients (the articlle I was responding to above was examining ICU patient beds) and not just wound but bloodstream exposure. There is no such thing as “mildly toxic” in that setting.
I’m going to get just a little snarky here, since this part of your post seems to have skipped over most of the thread. The fundamental problem with copper in healthcare settings is exactly what gives it antimicrobial properties: its reactivity. It really doesn’t matter what disinfection solution you throw at it, it reacts to generate at least mildly toxic or harmful products. Copper chloride, ammonium hydroxide, copper hydroxide, gaseous oxygen are examples of dangerous products of reactions of copper with bleach, hydrogen perioxide, and quaternary ammonia. About the only disinfectant that doesn’t significantly react with copper is alcohol, which is also the least effective.
The single biggest barrier to use of copper surfaces is what I posted above: the inability to validate it, which is featured prominently in the article you linked as a limitation to its adoption.
Yup.
This conversation reminds me of a lot of conversations I started when I was fresh out of uni. I got a lot of “Yes, theoretically there are benefits, but [logistics, cost, less-than-spectacular improvement while making other things worse, …]”. The humbling was a very important part of my learning.
And I’ve met a few greybeard engineers who have stories about cleaning up substations after copper thieves decided to risk it. It didn’t end well for the thieves. But if they were willing to risk high voltage, then I can’t imagine how quickly copper surfaces would get snapped up from a hospital.
The solution is obvious: run a high voltage through the copper surfaces at the hospital! 
I wonder if that would make a decent disinfectant… 
This is just a tiny taste of the kind of splaining/condescension women constantly get in their respective fields of expertise, Duke.
I see it all too often, unfortunately. One of the most egregious examples I’ve witnessed was at the APIC/AORN workshop I mentioned above.
I know you know; just putting it out there for anyone who doesn’t.
Gonna go home and drop some pennies in bleach to clean them.
Just don’t lick it afterward. 
ICU bed rails, foot boards and controls - things people touch with their hands, not literally the whole bed. What’s being suggested being replaced with copper in healthcare settings are surfaces people touch with their hands like door knobs/push plates, railings, chair arms, switches, etc.
No one is suggesting replacing things that would be in contact with an open wound for any significant length of time let alone anything that goes inside bodies with copper.
It takes milligrams of excess copper in the blood stream to cause copper toxicity. That’s just not going to happen from touching copper surfaces.
Dosis sola facit venenum - the dose makes the poison.
Copper chloride, ammonium hydroxide, copper hydroxide, gaseous oxygen are examples of dangerous products of reactions of copper with bleach, hydrogen perioxide, and quaternary ammonia.
Cupric chloride isn’t a concern in trace amounts. We inject it into people to manage blood copper levels.
Copper hydroxide will slowly become copper carbonate as it reacts with CO2. Neither is any more concern than copper itself in trace amounts.
Gaseous oxygen? I really feel like you’re reaching here. Hydrogen peroxide will readily decomposes into oxygen all by itself. I’m not sure how a few mL of oxygen once a day is going to do anything. Might as well worry about chlorine gas being toxic and thus we shouldn’t be using bleach in hospitals.
I’m not sure where the ammonium hydroxide is coming from. Benzalkonium chloride, commonly used in hospitals to clean things like ICU beds, doesn’t react with copper.
What? That isn’t what the paper said. The paper concluded copper reduced microbial burden compared to the controls. It’s the first sentence. The paper did say more data is necessary to definitively conclude reducing that microbial burden reduces hospital acquired infections, but that alone wouldn’t be a barrier to adoption if copper was cheaper than steel.
I’ve done a literature search and I can’t find any paper that seems concerned about toxic chemicals from interactions with cleaning products. Most of the studies I scanned for copper touch surfaces in hospitals seem to use bleach to clean it. The concerns seem to relate to wear and whether some cleaning products might make copper less effective at sterilizing.
I’m not going to respond point-by-point, since you seem to not be reading my posts or the others in the thread.
Surfaces in patient rooms and procedure rooms have to be disinfected using a repeatable protocol that is validated through empirical testing. The studies I’ve read, including studies that were part of the review article you cited and were cited by it, as well as studies cited further up-thread, used various Stapylococcus bacteria as their target organism. For Staph bacteria, the target reduction to claim disinfection is a 10^5 reduction. The absolute best result from any article on copper surfaces was 94% reduction, or less than 10^2 reduction. Therefore, as things currently stand, copper surfaces alone cannot be validated for use in patient rooms or procedure rooms without additiinal primary disinfection between patients.
Byproducts from such disinfection with readily-available hospital-grade disinfectants that are validated to 10^5 reduction of Staph are toxic. You clearly do not understand anything about clinical environments if you think any hospital will allow such compounds in a patient room. That same lack of understanding is evident when you clain those surfaces won’t reach wound surfaces or bloodstream of patients. You know what part of a patient room can reach a wound surface or patient bloodstream? ALL OF IT! Patients fall. Wounds can be almost anywhere on their body when they are in the ICU. Many are immunocompromised or sensitive to a whole variety of compounds that are mundane to the rest of us.
Finally, before you go all-in on copper, there’s this nugget from the review that you linked:
Most studies have been funded totally or partially by institutions related to copper (Copper Development Association, Copper Institute, National Copper Corporation). The funding resources declared in five studies are the local Copper Development
That doesn’t disqualify the research from the get go, but it certainly leaves questions, especially when, as the author says several times, there is “high heterogenicity among results.”
There were two studies cited by the review article that were interesting. Both showed a practical, marginal reduction in HAIs with copper surfaces in patient rooms. Unfortunately, both were performed in that pre-2017 period I mentioned up-thread before there was a uniform guidance to ensure disinfecting liquids were allowed to dry completely prior to being wiped off or a new patient was allowed to occupy the room. It would be interesting to repeat them with contemporary disinfection protocols.
You clearly just don’t understand the influence of Big Stainless. Little Copper is just trying overcome the bias! (/s, in case it’s not obvious)
As a hospital worker who has to regularly clean things, I appreciate this discussion.
As a boinger, I appreciate that this discussion has not devolved into nothing but insults. That’s one of the reasons I keep coming back.
Thanks, happy mutants!
People arguing should listen to DukeTrout…
Im going to pile on the “big stainless” bandwagon as someone who also works on this stuff. Me - I work in a hospital, have a microbiology degree, and clinically validate things. I have also done level 3 biohazard training.
What I dont understand in the copper fixes everything posters is why a hospital wouldn’t use something if it is cost effective and safe? Hospitals have IPAC (Infection prevention and control) groups who have decades of experience and work really hard to protect patients. If there was a silver bullet they would use it…
In my opinion the part that the pro copper argument is missing is that the efficacy just isn’t very good in the real world. As DukeTrout mentioned log kills just don’t meet standards. And bacteria can and do develop resistance to copper, so you still have to clean the surface with an antimicrobial cleaner… This leads to a big problem. Bare copper kills bacteria. Copper covered in soil and films does not. There are several papers showing that copper is less effective after several cleanings due to material build up on the surface. Stainless steel however can be cleaned over and over again with a high degree of safety.
There are definitely uses for copper in health care this isn’t it.
Antimicrobial, anti theft, even wait times are down due to low numbers of patients making it into the building. We solved alot of problems today people, good job. /S
Too much like right; there are folks who honestly seem to believe that they are always more knowledgeable than everyone else, for whatever reason; and they will argue others into the ground to “prove it.”
@chenille, thank you for splitting out the topic; I wasn’t going to post any more in the other one, since we’d left the topic of coronavirus behind.
To your question (why did I find horrific bacterial forests in children’s water bottles?) it’s because children are adorable but filthy little beasts, and they don’t reliably follow rules - such as bringing home their water bottles to be properly cleaned. Those particular bottles came out of school lockers at year end.
Doorknobs are absolutely what we’re talking about. They are the primary touch surface of concern (although there are certainly others, such as cabinet and drawer handles, and the stainless grab bars every hospital in my area has in every bathroom). But door latches are the #1 issue, especially in clinical settings.
To the best of my knowledge, there have been no significant cases of copper or brass toxicity resultant from touch surfaces in at least two hundred years of use in a myriad of settings (including health care). There are brass stair rails at the train station in murdertown that are 114 years old. Passengers aren’t dying from touching them, though I suspect many cases of life threatening disease transmission have been prevented.
I have copper, brass and bronze touch surfaces and duct work in my own home and I recommend it. I’ll post some pictures later. I am fond of pragmatic experimentation. I can show some blue vitriol on a bronze air vent, which has not poisoned anyone to date.
Was stainless validated to the level you’re asking for other metals? I haven’t found any evidence of that, although I’ve looked pretty hard, and I’m prepared to be enlightened.
Basically, in health care, housing, and water processing we’ve been using plastic and stainless with wild abandon - replacing copper pipes with pvc, abs, cpvc, pb, etc. because it’s cheaper and replacing brass and glass with stainless because it’s more durable. Looking back, there are indications of health effects from this behavior, yet suddenly using well proven materials is “not validated” or “insufficiently documented” or even “not rigorous science”. Stainless was held to none of these standards, as far as I can tell. It was evaluated for resistance to heat and abrasion, but not for its tendency to harbor and transmit dangerous bacteria, viruses, and fungi.
