1. Harold Michels, PhD, PE Copper Development Association MetaSUB Summit, New York City, June 20, 2015 Copper Alloys and Microbial Ecosystems

2. 2 80% of infectious diseases transferred by touch* * TIERNO, P. (2001): The Secret Life of Germs. Atria Books: New York, NY, USA.

3. 3  Rotavirus: 60 days  VRE: 4 months  Acinetobacter spp: 5 months  C.diff spores: 5 months  MRSA: 7 months  E. coli: 16 months  S. typhimurium: 4.2 years Germs can survive on surfaces for a long time 1)KRAMER, A., SCHWEBKE, I. & KAMPF, G. 2006. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis. 6:130.

4. 4 What is Antimicrobial Copper? A family of EPA- Registered copper alloys that intrinsically kill bacteria Solid, copper-based metal alloys (e.g. brass, bronze) Bent, formed, welded, cast, stamped, etc. Durable environmental surfaces Not a coating or surface treatment!

5. 5 Antimicrobial Efficacy: E. Coli O157:H7 Antimicrobial Copper Stainless Steel 31,300,000 CFUs 31,400,000 CFUs 0 minutes Epifluorescence Images after Staining with Viability Fluorophore CTC 25,933,468 CFUs 2,740 CFUs 26,899,425 CFUs 1,600,000 CFUs 21,066,000 CFUs <0.1% CFUs 30 minutes60 minutes120 minutes

6. 6 Three required test protocols  Efficacy as a Sanitizer  Does it kill bacteria?  Residual Self-Sanitizing Activity  Is the antimicrobial property a permanent effect?  Continuous Reduction of Bacteria  Will it still clean after repeated contamination?

7. 7 Norovirus unable to infect host cells after 2 hours exposure to copper surfaces at room temperature Infectious virus recovered from stainless steel surfaces No infectious virus recovered from copper surfaces Stainless steel Copper Warnes SL, Keevil CW (2013) Inactivation of Norovirus on Dry Copper Alloy Surfaces. PLoS ONE 8(9): e75017. doi:10.1371/journal.pone.0075017

8. 8 Clinical Testing of Antimicrobial Copper

9. 9 Antimicrobial copper components in Memorial Sloan Kettering Cancer Center

10. 10 Bacteria decreased by 83% on copper surfaces Schmidt et al. J Clin Microbiol 2012;50(7):2217-2223.

11. 11 Patients treated in ICU rooms with copper surfaces had significantly fewer infections Copper Rooms: 10 HAIs in 294 patients Control Rooms: 26 HAIs in 320 patients Normalize populations = 24 Infections in control rooms = 14 Infections prevented in copper rooms = 58% reduction in HAI (N=614, p=0.013) Salgado et. al. Copper surfaces reduce the rate of healthcare-acquired infection in the intensive care unit. Infection Control and Hospital Epidemiology, Vol. 34, No. 5, May 2013, pp. 479-486

12. 12 Do dirty surfaces cause HAIs? Can copper surfaces reduce HAIs? Investigating impact of copper surfaces on Healthcare Associated Infections over 1 year

13. 13 Contaminated surfaces increase infection risk Salgado et. al. Copper surfaces reduce the rate of healthcare-acquired infection in the intensive care unit. Infection Control and Hospital Epidemiology, Vol. 34, No. 5, May 2013, pp. 479-486

14. 14 Grand Central Terminal New York City How long will copper alloys retain their antimicrobial properties?

15. 15 Grand Central Station, New York City

16. 16 Brass retains antimicrobial efficacy throughout its lifetime 563 CFU/100cm 2 88 CFU/100cm 2 1,866 CFU/100cm 2 51 CFU/100cm 2 60+ year old brass hardware and railings Grand Central Station, New York City

17. 17 While hospitals are the obvious place to focus, Antimicrobial Copper has many benefits to offer beyond the healthcare sector MEDICAL & HEALTHCARE FOOD & HOSPITALITY PUBLIC TRANSPORT SCHOOLS PUBLIC BUILDINGS SPORTS FACILITIES Industries where microbial contamination is a major issue and where antimicrobial surfaces have a role to play Healthcare Associated Infections are costing society thousands of lives and billions of dollars Viruses caught in public buses and trains are costing society millions of sick days Viruses caught in public buildings and malls are costing society millions of sick days Viruses caught in schools and day care are costing society millions of sick days Viruses caught in gyms, leisure centers and locker rooms are costing society millions of sick days Bacteria and viruses picked up in hotels and restaurants are costing lost business and society millions of sick days These are just some of the environments where microbes, including bacteria, viruses, molds and fungi are costing money and lives today. Details of the other environments are contained on our website.

18. 18 Thank you Harold Michels, PhD, PE harold.michels@copperalliance.us (212) 251-7224 www.copper.org www.AntimicrobialCopper.com