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What are high level disinfectants? Where can we use them?

What are different types of disinfectants? Where can we use high level disinfectants? 

Woman using High Level Disinfectant

HAIs nearly cause 1,00,000 deaths annually in the US. How do you reduce the death toll? Learn about high level disinfectants (HLDs), which are chemicals that help in eliminating pathogens from equipment that are heat-sensitive.

Cleaning, sanitation, and disinfection may seem easy but are more complicated than they look. Choosing the correct method becomes vital as one needs to weigh the pros & cons before choosing them. You can also check out our article on cleaning vs disinfecting for more insights before you arrive at the final decision. Once you are super sure that you are up for disinfection, you need to choose between high level disinfectants & l0ow level disinfectants. Disinfectants are chemicals that are capable of neutralizing & destroying pathogens. Before delving into the meaning of high level disinfectants, it is vital to understand the working of disinfectants.

How do disinfectants work?

Disinfectants work in two ways to destroy pesky pathogens. Most disinfectants act on the protective cell wall or cell membrane of pathogens. They completely annihilate the protective protein layer that keeps their vitals safe. Once the outer layer is dealt with, then the inner structure of the pathogen is exposed and destroyed. In some cases (for example, viruses), disinfectants only make the pathogen incapable of reproduction. A few disinfectants directly interfere with the metabolism of the pathogens and destroy them. So, how do we distinguish between low level disinfectants & high-level disinfectants?

What are high level disinfectants (HLDs)?

HIgh level disinfectants

Disinfectants are distinguished into three types - High level disinfectants, intermediate level disinfectants, and low level disinfectants. The high level disinfectants are capable of destroying all types of pathogens, bacterial & fungal spores, mycobacteria, lipid & non-lipid viruses, and other vegetative microbes. Intermediate level disinfectants are also called tuberculocides which are not capable of eliminating bacterial & fungal spores. Whereas low level disinfectants can only kill select viruses, fungi, bacteria, and other pathogens. HLDs are often used for devices & instruments processed along with water (for rinsing). It ensures the removal of chemicals as well as the elimination of pathogens. Rinsing is often followed by proper handling & storage.

Bonus - Disinfection Versus Sterilization

What is the difference between disinfection and sterilization? The major difference between the two processes is that the latter eliminates all the microbes (whether pathogenic or not) while the former may or may not destroy all the pathogenic microbes (depending upon the types of the disinfectant).

Why are high level disinfectants necessary?

Which of the following kills more people in the US? - AIDS, influenza, pneumonia, cholera, car accidents, breast cancer, and HAIs (healthcare-associated infections)? Surely only less than 1% of the readers would have guessed it as HAIs. HAIs are related to nearly 99,000 deaths which are just slightly less than the deaths due to diabetes in the US. So, basically, HAIs can be considered more dangerous than breast cancer & AIDS. What about the awareness of HAIs? Only a few people know about them. It is estimated that HAIs cost anywhere around a whopping $50 billion in the US! 

How does one acquire HAIs? It can take anywhere from 2 days spent in healthcare institutions (which include clinics, nursing homes, hospitals, medical centers, testing labs, rehabilitation centers, and the list goes on) to 7 days after discharge from healthcare institutions. According to the CDC (Centers of Disease Control), the main types of HAIs are - Ventilator-associated Pneumonia (VAP), Central Line-associated Bloodstream Infection (CLABSI), Catheter-associated Urinary Tract Infections (CAUTI), Surgical Site Infection (SSI). The most commonly occurring HAIs are SSIs, bloodstream infections, and MRSA.

Man using High Level Disinfectant

While the US government does take efforts in spreading awareness, building strong reporting systems & other techniques. All these techniques directly or indirectly promote the best way to tackle the HAIs is proper disinfection. These techniques help in setting up the standards for sterilization & disinfection. High level disinfectants are the most important weapons against HAIs. While the use of low level disinfectants & intermediate-level disinfectants is one of the initial prevention strategies. The most widely used HLDs (approved by FDA) contains the following active ingredients - peracetic acid, H2O2, hypochlorite, hypochlorous acid, and glutaraldehyde. 

Bonus -

According to a survey which was conducted by healthcare professionals (who regularly handle HLDs) on HLDs, it was found that safe handling practices were not practiced regularly. It proves that there needs to be more efforts applied in the awareness related to the handling & use of HLDs.

FAQ - Do HLDs affect human health?

If HLDs are inhaled or come in contact with the skin, it can cause skin irritation, dermatitis, respiratory troubles, asthmatic attacks, sneezing, and difficulty in breathing.

High level disinfectants in Bathrooms & Toilets

Application of High Level Disinfectant

Pathogens feel at home in bathrooms & toilets. The use of HLDs in bathrooms & toilets is a must to keep them clean & disinfected. While one may argue that even intermediate level disinfectants will do the trick, why not be 100% sure and use HLDs that will ensure complete safety?

High level disinfectants in Healthcare institutions

As previously mentioned in the article, HLDs are the saviors of healthcare institutions from HAIs. HLDs are mostly used to disinfect semi-critical reusable medical instruments & devices. These HLDs eliminate all the pathogenic microbes (with a few exceptions). HLDs may also be used to get rid of pathogens from medical instruments & devices that are sensitive to heat (where sterilization is not possible).

To know more about the medical equipment types (such as semi-critical), check out the article on reusable medical devices.

High level disinfectants in Offices

Use of High Level DIsinfectants

Offices & co-working spaces are the places where people of various backgrounds interact. There is a high risk of transmission of pathogens from one person to another. Even the diversity of the pathogens may be huge. To avoid any ill health, management often uses HLDs as they are known for destroying most pathogens.

High level disinfectants in Homes

high level disinfectants

While it is not always recommended to use HLDs at home, especially if there are kids & pets at home. One must always use HLDs if there is any epidemic or if a family member is seriously ill. Even if a family member is quarantined due to suspicion, HLDs should be employed. They help in eliminating pathogens & ensuring a safe & healthy home.


With the number of deaths due to HAIs nearing 1,00,000, the US government takes many initiatives whose focus directly or indirectly emphasizes the use of HLDs. These chemicals are known to destroy all pathogens, hence ensuring that the applied surface is devoid of the pesky little creatures. The article highlights HLDs, their role, and their uses.