Anti-Microbial Copper

Antimicrobial Copper
Copper kills viruses and bacteria so why
aren't our surfaces covered in it?

Copper
• Copper is a chemical element with the symbol
Cu (from Latin: cuprum) and atomic number
29.
• It is a soft, malleable, and ductile metal with
very high thermal and electrical
conductivity.
• Copper is one of the few metals that can occur
in nature in a directly usable metallic form
(native metals)

Copper
• Copper used in buildings, usually for
roofing. Copper is sometimes used in
decorative art, both in its elemental metal
form and in compounds as pigments.
• Copper compounds are used as
bacteriostatic agents, fungicides, and wood
preservatives.

Introduction
• Copper a material with the power to kill
bacteria and viruses in their tracks — has
long been exploited for its health benefits.
• In ancient times, Egyptian and Babylonian
soldiers would use it to sterilise their
wounds; the Greeks, Romans and Aztecs used
it to treat headaches and ear infections; and in
India, copper vessels have been used for
millennia in the transportation of water.

Egyptian and Babylonian soldiers would
use it to sterilise their wounds

Surgical Instruments used by
Susruta

Copper a material with the power to kill
bacteria and viruses

Introduction
• Today, we understand why copper is strong
against viruses: because it is antimicrobial.
• It kills bacteria. when influenzas, bacteria like E.
coli, superbugs like MRSA, they can die within
minutes and are undetectable within hours.
• That’s a massive difference compared to the
four to five days they can last on other
surfaces.
• what’s more, copper and its alloys like brasses,
bronzes, cupronickel, copper-nickel-zinc can self-
sterilize its surface without the need for
electricity or bleach.

Introduction
• During the repeated cholera epidemics in
the mid-nineteenth century, physician victor
burq discovered that using the material
could help prevent widespread disease.
• He recommended using it for preventive and
corrective ingestion of copper, after observing
that smelter workers were unaffected by the
disease.

Physician Victor Burq Discovered That Using The
Material Could Help Prevent Widespread Disease

Introduction
• The studies continue — as fast company
reports, using copper has been shown to
reduce bacteria in health care settings by 90
percent.
• A study from 1983 found that hospital door
knobs made of brass barely had any E. coli
growth on them, compared to stainless steel
knobs which were ‘heavily colonized.’

A Study From 1983 Found That Hospital Door
Knobs Made Of Brass Barely Had Any E. Coli
Growth On Them

Introduction
• A more contemporary study, conducted by
researchers working on a department of
defence in 2015, compared infection rates at
three hospitals, and found that when copper
alloys were used in three hospitals, it reduced
infection rates by 58%.
• A similar study was done in 2016 inside a
paediatric intensive care unit, which charted a
similarly impressive reduction in infection rate

when copper alloys were used in three
hospitals, it reduced infection rates by 58%.

Introduction
• As a result of research like this, the united
states environmental protection agency
(EPA) has even approved the registrations of
copper alloys as ‘antimicrobial materials
with public health benefits’ allowing
manufacturers to make legal claims to the
public health benefits of products made of
registered alloys.

environmental protection agency (EPA) has even
approved the registrations of copper alloys as
‘antimicrobial materials with public health benefits’

Introduction
• So why don’t we make the most of this
material today?
• while copper boomed during the industrial
revolution as a material for objects, fixtures, and
buildings it was later pushed out by new materials
like plastic, tempered glass, aluminium and steel.
• In addition to that, there’s not enough data on
copper and other technologies to make
recommendations on what hospitals should do.

So why don’t we make the most of
copper today?

Introduction
• The research that has been conducted is
significant because of how much of a
problem healthcare-acquired infections are,
not to mention the current climate.
• In the US alone, there are about 1.7 million
infections and 99,000 deaths linked to HAIs
per year, a total cost between $35.7 and $45
billion annually, from the extra treatments
people need when they get infected.

Health Care Associated Infection

Introduction
• Virus that causes COVID-19 was shown to
hang around on plastic packaging and plastic
medical equipment for up to three days after
contamination, according to a pre-print paper
from researchers at the national institute of
health. the team behind the paper looked at how
long the virus that causes the new corona virus
(SARA-COV-2) can survive on different
substances from cardboard to copper, comparing
its lifespan to the virus that causes SARS (SARS-
COV-1).

Introduction
• the results show that the COVID-19 virus
appears to survive longest on polypropylene
and stainless steel, where it can survive for two
to three days after the initial contamination.
• On cardboard, it survived for nearly an entire day
in some cases—up to 24 hours—post-
contamination. not surprisingly, it lasted the least
amount of time on copper, where it survived only
up to four hours.

How long can corona virus live on
surfaces

Historical Uses of Copper for Hygiene
• Copper is humankind’s oldest metal being used for
water transportation, coins and jewelry, weapons
and more.
• Long before the germ theory of disease was
developed, civilizations used copper to kill diseases-
causing organisms
• Egypt (2000 BC) – Purify drinking water and treat
wounds
• Hippocrates (400 BC) – Treat leg ulcers related to
varicose veins
• Aztecs- Copper Oxide and malachite for Skin
Conditions

• The Ancient Egyptians, Greeks, Romans
and Aztecs used copper-based preparations
to treat burns, sore throats and skin rashes,
as well as for day-to-day hygiene.
• Greek soldiers are reported to have scraped
the bronze from their swords into open
wounds to reduce the likelihood of infection
during battles.

The Ancient Egyptians, Greeks, Romans and Aztecs used
copper-based preparations to treat burns, sore throats and
skin rashes, as well as for day-to-day hygiene

Greek soldiers are reported to have scraped the
bronze from their swords into open wounds to
reduce the likelihood of infection

• In the last few decades, extensive research has
been carried out on the antimicrobial
properties of copper and its alloys against a
range of microorganisms including those
responsible for HCAIs.

Antimicrobial Properties of Copper
• Copper and its alloys (brasses, bronzes,
cupronickel, copper-nickel-zinc, and others)
are natural antimicrobial materials.
• Ancient civilizations exploited the
antimicrobial properties of copper long
before the concept of microbes became
understood in the nineteenth century.

• In addition to several copper medicinal
preparations, it was also observed centuries
ago that water contained in copper vessels
or transported in copper conveyance
systems was of better quality (i.e., no or little
visible slime or bio fouling formation) than
water contained or transported in other
materials.

• The antimicrobial properties of copper are
still under active investigation. Molecular
mechanisms responsible for the antibacterial
action of copper have been a subject of
intensive research.
• Scientists are also actively demonstrating
the intrinsic efficacy of copper alloy "touch
surfaces" to destroy a wide range of
microorganisms that threaten public health.

Mechanisms Of Antimicrobial Action
• In 1852 Victor Burq discovered those
working with copper had far fewer deaths
to cholera than anyone else, and did
extensive research confirming this.
• In 1867 he presented his findings to the
French Academies of Science and Medicine,
informing them that putting copper on the skin
was effective at preventing someone from
getting cholera

Victor Burq discovered those working with copper
had far fewer deaths to cholera than anyone else
Victor Burq

• The oligodynamic effect was discovered in
1893 as a toxic effect of metal ions on living
cells, algae, molds, spores, fungi, viruses,
prokaryotic, and eukaryotic microorganisms,
even in relatively low concentrations

• In 1973, researchers at Battelle Columbus
Laboratories conducted a comprehensive
literature, technology and patent search that
traced the history of understanding the
"bacteriostatic and sanitizing properties of
copper and copper alloy surfaces", which
demonstrated that copper, in very small
quantities, has the power to control a wide
range of molds, fungi, algae and harmful
microbes

• Currently, researchers believe that the most
important antimicrobial mechanisms for copper are
as follows:
• Elevated copper levels inside a cell causes oxidative
stress and the generation of hydrogen peroxide. Under
these conditions, copper participates in the so-called
Fenton-type reaction — a chemical reaction causing
oxidative damage to cells.
• Excess copper causes a decline in the membrane
integrity of microbes, leading to leakage of specific
essential cell nutrients, such as potassium and
glutamate. This leads to desiccation and subsequent cell
death.

• While copper is needed for many protein
functions, in an excess situation (as on a copper
alloy surface), copper binds to proteins that do
not require copper for their function.
• This "inappropriate" binding leads to loss-of-
function of the protein, and/or breakdown of the
protein into non-functional portions.
• These potential mechanisms, as well as others,
are the subject of continuing study by
academic research laboratories around the
world.

Antimicrobial efficacy of copper alloy
touch surfaces
• Copper alloy surfaces have intrinsic
properties to destroy a wide range of
microorganisms.
• E. coli
• E. coli O157:H7 is a potent, highly infectious, ACDP
(Advisory Committee on Dangerous Pathogens, UK) Hazard
Group 3 food borne and waterborne pathogen. The
bacterium produces potent toxins that cause
diarrhoea, severe aches and nausea in infected
persons

touch surfaces

touch surfaces
• Recent studies have shown that copper alloy
surfaces kill E. coli O157:H7.
• Over 99.9% of E. coli microbes are killed after
just 1–2 hours on copper. On stainless steel
surfaces, the microbes can survive for weeks.
• Results of E. coli O157:H7 destruction on an
alloy containing 99.9% copper (C11000)
demonstrate that this pathogen is rapidly and
almost completely killed (over 99.9% kill rate)
within ninety minutes at room temperature
(20 °C)

Recent studies have shown that copper alloy
surfaces kill E. coli O157:H7.

MRSA
• Methicillin-resistant Staphylococcus aureus
(MRSA) is a dangerous bacteria strain because
it is resistant to beta-lactam antibiotics
• In 2008, after evaluating a wide body of research
mandated specifically by the United States
Environmental Protection Agency (EPA),
registration approvals were granted by EPA in
2008 granting that copper alloys kill more than
99.9% of MRSA within two hours

Influenza A
• Influenza, commonly known as flu, is an
infectious disease from a viral pathogen
different from the one that produces the
common cold.
• Symptoms of influenza, which are much more
severe than the common cold, include fever, sore
throat, muscle pains, severe headache, coughing,
weakness and general discomfort.
• Influenza can cause pneumonia, which can be
fatal, particularly in young children and the
elderly.

Influenza A
• After incubation for one hour on copper,
active influenza A virus particles were
reduced by 75%.
• After six hours, the particles were reduced
on copper by 99.999%. Influenza A virus was
found to survive in large numbers on stainless
steel.

Inactivation of Influenza A Virus on Copper

Fungi
• An increased die-off of fungal spores was
found on copper surfaces compared with
aluminium

Antimicrobial Properties Of Copper And
Its Alloys

Laboratory Research
• Laboratory tests have been developed to
simulate contamination events under typical
indoor temperature and humidity to measure
the survival of bacteria on samples of
copper and copper alloys such as brass and
bronze.

Antimicrobial Effectiveness:
Copper vs. Stainless Steel

Laboratory Research
• The procedure is outlined below and
simulates a splash or a sneeze landing on a
surface:
• The control is stainless steel, a material
commonly used in hospitals but with no
antimicrobial properties.

Laboratory Research
• This graph is the kill curve for MRSA on
copper, brass (80% Cu, 20% Zn) and nickel
silver (55% copper, 27% zinc and 18% nickel)
at 20o C and typical indoor humidity.
• There is complete kill in less than 90 minutes on
copper.
• The two copper alloys also showed good kill rates
but the kill times were longer and dependent on
copper content.
• Note that even after six hours, there is no
reduction on the stainless steel coupon.

Laboratory Research
• A similar protocol was used for extensive pass/fail
laboratory testing as part of a United States
regulatory registration process, where a >99.9%
reduction of bacteria within two hours was
required.
• Copper alloys with copper contents greater
than 60% passed this test, as well as two even-
more demanding recontamination and wear
tests, so this has become the minimum copper
content for antimicrobial copper alloys.

Laboratory Research
• The graph below shows how the kill time falls
as the number of MRSA bacteria deposited on
the copper surface reduces to more typical
levels.
• A hospital door handle could have 1000 colony
forming units (cfus) on its surface and these
would be totally eliminated in less than 15
minutes.
• Because of the very high numbers of bacteria
being investigated, these kill curves are shown
with a logarithmic (log) scale, expressed as
shown: 104 is equivalent to 10,000.

Clinical Trials
• Having established the inherent ability of
copper and copper alloys to eliminate bacteria
and viruses in the laboratory, the next logical
step was to discover how this would
translate into real world environments and
have practical application.

Clinical Trials
• The first clinical trial was undertaken at Selly
Oak Hospital in Birmingham, UK. The
researchers replaced frequently-touched
surfaces on a general medical ward – including
over-bed tables, taps and door handles – with
antimicrobial copper equivalents, measuring
the contamination on these and comparing it
with that on non-copper surfaces.
• The copper surfaces were found to have 90–100%
fewer micro-organisms on them than the same
items made from standard materials.

Clinical Trials
• Trials in the US, Chile, Germany and
Finland have supported the Selly Oak
findings and verified that the effect is a
continuous reduction in contamination –
occurring 24/7 and in between regular
cleaning.

Clinical Trials
• The largest trial to date was a multi-centre clinical
trial, funded by the US Department of Defence.
The group identified the most heavily
contaminated touch surfaces and upgraded
them to copper in 8 single ICU rooms.
• They then sampled these and standard
components in 8 control rooms regularly over two
years and recorded the total bacteria recovered.
They then reviewed the infections acquired by
patients in the copper and control rooms.

US Department of Defence. The group identified the most
heavily contaminated touch surfaces and upgraded them to
copper in 8 single ICU rooms

Clinical Trials
• The surfaces identified as most contaminated
were those closest to the patient:
• Bed rail
• Over bed table
• IV pole
• Computer input devices (mouse/monitor bezel)
• Visitor chair arms
• Nurse call button

Clinical Trials
• This graph shows the number of bacteria
found on these components in the copper
and control rooms. The copper items had
83% fewer bacteria than the control items.
• There were 58% fewer infections in the copper
rooms than the control rooms. This result
challenges current thinking that the
environment only accounts for 20% of
infections.

How does Copper Kill Bacteria?
• Copper is an essential nutrient for bacteria as well as
humans but, in high doses, copper ions can cause a series
of negative events in bacterial cells.
• The exact mechanism by which copper kills bacteria is still
unclear, however several processes exist and are being
studied. One proposed sequence of events is given below:
• A. Copper ions dissolved from the copper surface cause
cell damage.
B. The cell membrane ruptures, leading to loss of the cell
content.
C. Copper ions lead to the generation of toxic radicals
that cause further damage.
D. DNA becomes degraded and leaves the cell.

How does Copper Kill Bacteria?

Won’t Microorganisms Develop Resistance to
Copper?
• As bacteria evolve resistance mechanisms to antibiotics,
might resistance to copper develop? This is highly
unlikely for three reasons:
• Copper is naturally present in the Earth’s crust and, to
date, no resistant organisms have been demonstrated.
Copper-tolerant organisms do exist but even these die on
contact with copper surfaces. In comparison, resistance to
penicillin by certain bacterial species began to appear
within 30 years of its introduction.
• Copper kills microorganisms by multiple pathways rather
than by acting in a specific way on one receptor like most
antibiotics.
• Microorganisms are killed before they can replicate, thus
they cannot pass on genetic material that could ultimately
lead to the development of resistance.

How Hospitals are Using Copper to Improve
Infection Prevention and Control
• Infection control professionals review scientific
literature to keep abreast of developments and
some believe there is now sufficient evidence to
use copper to fight HCAIs in their hospitals.
Others await further trials or official
recommendations in infection control guidelines
(these are starting to emerge in other countries
e.g. Finland).
• This is a relatively new field of research – not
just on copper, but on the whole concept of the
role of the environment in the transfer of
infection.

Healthcare Associated Infections

• Those installing copper have started to replace
items such as door handles, bed rails, light
switches, over-bed tables and taps – with
copper and copper alloy (brass, bronze) items
to help limit pathogens and prevent their
transfer around the hospital and to susceptible
patients.
• These are some of the high-risk surfaces
identified where contamination occurs and staff,
patients and visitors touch.

• The Environmental Protection Agency (EPA) has
recognized copper as the world’s leading anti-
bacterial metal. This has led to a number of uses and
opportunities for copper in medical applications. Here
we explain the benefits of using copper in comparison
to other materials on the market.
• When you think of a typical hospital environment,
you’ll probably think of a sterile setting that is likely
adorned in white. However, many hospitals are
beginning to punctuate the clinical white with
another colour; the reddish glow of copper.

The Environmental Protection Agency (EPA) has
recognized copper as the world’s leading anti-bacterial
metal

• For example, a hospital in Chile recently
started applying copper or copper alloys to
medical applications that require repeated
touching and handling.
• This includes pens for inputting data on
computers screens, bed levers and chairs for
hospital visitors — all of which were traditionally
made of plastic.
• This is just one example. More and more
healthcare equipment designers are swapping
out plastics for time-tested copper.

Antimicrobial Copper Ballpoint Pen

• According to the Environmental Protection
Agency (EPA), copper can kill 99.9 percent of
bacteria that lands on its surface within two
hours.
• In comparison, additional chemicals and
contaminants can leach onto plastics and
make them harmful to both humans and
wildlife.

According to the Environmental Protection Agency
(EPA), copper can kill 99.9 percent of bacteria that
lands on its surface within two hours.

• With these antimicrobial features in mind, it’s no
surprise that copper has become increasingly
popular as an alternative to plastic in medical
applications, such as sterile table tops and medical
cart handles.
• By replacing the current surfaces in hospitals
with antimicrobial copper surfaces, it’s
reported that the number of healthcare-
associated infections could be reduced by 58
percent, according to the Infection Control and
Hospital Epidemiology.

By replacing the current surfaces in hospitals with
antimicrobial copper surfaces, it’s reported that the number
of healthcare-associated infections could be reduced by 58
percent

• Turning to traditional materials, like
copper, offers designers some surprising
benefits compared to the materials that are
currently used in medical applications.
• By helping healthcare professionals to
significantly reduce the risk of spreading
infections across a hospital, copper can help
medical staff improve the overall quality of
care for their patients.

copper can help medical staff improve the
overall quality of care for their patients.

Copper Kills COVID-19 Within 4 Hours
• While you may think that antiseptic wipes or
sprays are necessary to kill germs, there's
actually a metal that kills germs on contact —
no cleaning supplies necessary.

Copper can kill viruses and bacteria
• Studies have shown that copper can kill
many types of germs on contact.
• According to a 2015 study published in Health
Environments Research and Design Journal,
some of the common germs copper has been
proven to kill are:

Copper can kill viruses and bacteria
• MRSA
• E. coli
• Influenza A
• Nor virus
• Brand new research published in the New England
Journal of Medicine found that copper can be effective
against SARS-CoV-2, the virus responsible for the
corona virus pandemic.
• The study showed that after four hours, the virus was no
longer infectious on copper's surface.
• In comparison, corona virus was still infectious on plastic
surfaces after 72 hours.

Copper Kills COVID-19 Within 4 Hours

The applications of antimicrobial copper
• One of the main applications of copper is in
hospitals, although the use is not
widespread.
• In the same study as above, researchers
determined the germiest surfaces in a hospital
room – bed rails, call buttons, chair arms, tray
table, data input, and IV pole – and replaced
them with copper components.

Touch Surfaces replaced with Copper
• For Clinical Studies in UK, USA & Chile
• Push plates
• Thumb turns
• Cubicle locks
• Grab rails
• Hot & cold taps
• Toilet seats
• Switches & sockets
• Bed table tops
• Drip pole stand
• Sanitizer buttons

Touch Surfaces replaced with Copper
• Light pulls
• Cistern flush levers
• Dressings trolleys
• Soap dispensers
• Apron dispensers
• Towel dispensers
• Commodes
• Sink traps & wastes
• Call buttons
• Door handles

The applications of antimicrobial
copper

The Applications Of Antimicrobial Copper
• The results were very promising. Compared to
the rooms made with traditional materials,
there was an 83% reduction in bacterial load
on the surfaces in the rooms with copper
components.
• Additionally, infection rates of patients were
reduced by 58%.

The Applications of Antimicrobial
Copper

• Technically, you can use copper at home. However,
according to Johnson, the majority of copper
products for the home have a treatment on it to
prevent the oxidation that causes the beautiful
original color of the copper to turn to a greenish-
blue over time.
• This treatment prevents you from getting the
beneficial antimicrobial properties of copper. That
being said, copper still has the ability to be toxic to
bacteria when it's at this oxidized greenish state,
however, according to Johnson, scientists still don't
know exactly how this mechanism works.

The Applications Of Antimicrobial Copper
• According to current research, the downside of
using copper is that it isn't as effective at
destroying viruses as it is at killing bacteria –
particularly if it's an airborne virus.
• Much of this has to do with the fact that
viruses are technically not living organisms
— they are infection agents, which are not
"alive" like cells are, and as such they are
more durable.

According to current research, the downside of using
copper is that it isn't as effective at destroying
viruses as it is at killing bacteria

• "Viruses are different in that they are not cells but
rather infect healthy cells that allows them to
replicate. The virus can come in direct contact with the
upper respiratory tract and eyes and enter healthy cells,
so a copper strategy would be largely ineffective.
• Another downside is that there are some
unsubstantiated claims that may mislead people.
Some companies try to market copper jewellery or
copper-infused socks as antimicrobial protection for
the wearer, but these are ineffective.

• Hopefully, more research will continue to be
conducted so we can better understand the
antimicrobial properties of copper and the
most effective ways to use it in everyday life
to keep us healthy.

Terminology
• Oligodynamic effect
• The oligodynamic effect (from Greek
oligos "few", and dynamis "force") is a
biocidal effect of metals, especially heavy
metals, that occurs even in low
concentrations.

“Contact Killing”
• Bacteria, yeasts, and viruses are rapidly killed on
metallic copper surfaces, and the term “contact
killing” has been coined for this process.
• While the phenomenon was already known in ancient
times, it is currently receiving renewed attention. This
is due to the potential use of copper as an antibacterial
material in health care settings.
• Contact killing was observed to take place at a rate
of at least 7 to 8 logs per hour, and no live
microorganisms were generally recovered from
copper surfaces after prolonged incubation

Antimicrobial
• An antimicrobial is an agent that kills
microorganisms – bacteria, viruses and fungi
(including moulds) – or inhibits their growth.

Healthcare-associated Infections
• A healthcare-associated infection (HCAI) is
an infection that a patient develops in a
hospital either as a direct result of medical
or surgical treatment, or from simply being
in that setting. The important criterion for
defining an infection as an HCAI is that the
patient did not have the infection when they
were admitted to the hospital.

• The spread of these infections affects
hundreds of millions of people worldwide.
They increase patients’ suffering and
prolong the length of stay in hospital. A
growing number of bacterial HCAIs are
resistant to the antibiotics used to treat
them. This situation can be summed up by
‘bad bugs, no drugs’.

How long does the novel corona virus
live on different surfaces?

How long does the novel corona virus live on
different surfaces?

Ted Talks
• The Secret and the Solution: Michael Schmidt
• https://youtu.be/mIFjAvkomoA

Copper Kills Germs On Contact See The
Science.
• https://youtu.be/fJB16x0t3pE

The Schmidt Lab
• Michael G. Schmidt, Ph.D.
Professor of Microbiology and Immunology
• https://medicine.musc.edu/departments/microb
iology/research-program/schmidt-lab

References
• Antimicrobial Copper: Everything Old is New Again
• https://www.copper.org/publications/newsletters/ba-news/2010/january/article3.html
• Antimicrobial copper-alloy touch surfaces
• https://en.wikipedia.org/wiki/Antimicrobial_copper-alloy_touch_surfaces
• Antimicrobial properties of copper
• https://en.wikipedia.org/wiki/Antimicrobial_properties_of_copper
• Antimicrobial efficacy and compatibility of solid copper alloys with chemical
disinfectants
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086424/
• Copper, Pathogens and Disease
• https://copperalliance.org.uk/knowledge-base/education/education-resources/copper-
pathogens-disease/
• Copper is great at killing superbugs – so why don’t hospitals use it?
• https://theconversation.com/copper-is-great-at-killing-superbugs-so-why-dont-hospitals-
use-it-73103

References
• Copper takes aim at corona virus with killer coatings
• https://www.indiatoday.in/science/story/copper-coronavirus-study-1675845-2020-
05-08
• Copper’s Virus-Killing Powers Were Known Even to the Ancients
• https://www.smithsonianmag.com/science-nature/copper-virus-kill-180974655/
• Does copper kill germs? Yes, it's effective against COVID-19 within 4 hours
• https://www.insider.com/does-copper-kill-germs-and-viruses
• The bacteria-fighting super element that’s making a comeback in hospitals:
copper
• https://www.washingtonpost.com/national/health-science/the-bacteria-fighting-
super-element-making-a-return-to-hospitals-copper/2015/09/20/19251704-5beb-
11e5-8e9e-dce8a2a2a679_story.html

Anti-Microbial Copper

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