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Direct and Indirect Costs of Chronic Disease

Paul Cagle
Best Practices, News

Businesses are a major provider of health insurance in the U.S., yet rising health care costs are making it increasingly difficult for employers to afford coverage. Employee health benefits are the fastest growing cost component for many employers and represent an increasingly large percentage of total work force costs.

The prevalence of chronic disease within the U.S. work force is a key source of these challenges. Not only does a sicker U.S. workforce have higher health care costs, but it is also less productive. Chronic disease leads to absenteeism and presenteeism – decreased productivity at work. These problems now cost U.S. businesses $1 trillion per year.

Direct and indirect costs of chronic disease

$1 Trillion Cost Chronic Disease


Extensive work absence is associated with respiratory diseases:

Chronic Obstructive Pulmonary Disease (COPD)
3 weeks absent per year

2.5 weeks absent per year

1.2 weeks absent per year


According to the Partnership to Fight Chronic Disease, presenteeism is responsible for the largest share of lost economic output associated with chronic health problems. 21 percent of workers report that they have gone to work sick or burdened by a non-work issue six or more days in the last six months.

Family caregivers are a critical support structure for patients with a chronic illness. Family caregivers provide 80 percent of all long-term care services for chronically ill patients. In any given year, more than 50 million Americans find themselves in a caregiving role.

Employers pick up a large share of this cost when workers come to work sick, and when other workers are burdened by caring for a family member with chronic conditions.

The King’s cleaning for health reduces indoor air pollutants that contribute to respiratory chronic disease

In September 2009, the King’s completed a 90-day pilot project for a Houston-area medical clinic where a 31% reduction was documented in air particles down to 0.3 microns, including dust, dust mites, dust mite feces, dead skin cells, the H1N1 virus, fungal and mold spores, and harmful bacteria.

Armed with scientific data, The King’s employed a combination of work flow innovation and janitorial staff training to revolutionize the cleaning process in this medical clinic.

Read this Success Story.


¹Financial Forecast Center; CCH Unscheduled Absence Survey, 2007 (http://hr.cch.com)

²2009 Almanac of Chronic Disease, Partnership to Fight Chronic Disease (http://www.fightchronicdisease.org/sites/default/files/docs/2009AlmanacofChronicDisease_updated81009.pdf)

The Science and Engineering Behind Cleaning for Health

Paul Cagle
Best Practices

Cleaning buildings for health is the most fundamental activity building owners can employ to provide staff, students, tenants, patients and guests with a healthy environment in which to live, work, study and play.

Let’s face it, most people spend the vast majority of their lives indoors. With the knowledge that approximately 30% of the adult population suffers from some type of respiratory disorder (such as allergies or asthma), the social value of cleaning for health can’t be ignored any longer. Health experts from the CDC to the EPA agree that cleaning the indoor environment for health makes for healthier, happier workers who are absent less and more productive on the job. Dr. Michael Berry, retired deputy director of the EPA’s National Center for Environmental Assessment said this:

“Effective cleaning is the most fundamental activity we can employ to create healthy conditions where modern society spends the vast majority of their lives.”

Cleaning for Health Manifesto

The King’s first deployed our Training Camp approach in 2005 and we have continued to expand and build upon it.  The King’s Training Camp is designed to teach our cleaning teams how to clean, but also with the intent on changing the way they think about cleaning.

Being in the cleaning business makes us part of the health care business, whether you like it or not.


The heartbeat of our cleaning organization is found in our training room. When a new team member joins our staff, they start by going through The King’s Training Camp. No, we don’t make them do push ups, but we do make them stretch their minds and flex their brain muscles!

During this critical time cleaning team members learn:

  • our philosophy and purpose of cleaning, and why what we do is so darn important!
  • how to identify hazardous chemicals and how to protect themselves and others when cleaning up blood and bodily fluids, and
  • how to clean using our simplified process.

Our team members graduate with a diploma and a “Certified Cleaning Worker” badge and lanyard. They go from thinking “I just got a cleaning job” to “I’m a health care worker in the cleaning business!”

Training Supervisors

At the end of the day, the best system in the world is for naught without great leadership and supervision. You know that! Our supervisors and managers are schooled in our comprehensive cleaning system. Many of our current leadership staff members have worked their way up from being a cleaning specialist! Our supervisors realize that, more than anything else, they are coaches. Coaches train, educate, encourage, discipline, track progress and put their teams in a position to win.  This is the role of our supervisors.

Data Driven Processes

Health. Safety. Turnover. Labor Production Rates. Materials Standardized.

You’ve heard the saying from that old TV series Dragnet, “Just the facts ma’am, just the facts.”

Every other industry in America is driven by facts and hard data that prove the effectiveness of their service or product. The same has not always been said for our industry. Very little data has been derived from the cleaning industry.  The history of cleaning in American has been driven less by technology and science than it has been by the manufacturers and distributors. Historically, we have left the science to the manufacturing R&D guys who make the products we use, rather than us using scientific data and engineering to tell them what WE need. The King’s Operation System is driven by data that proves we are cleaning for health. It’s all about the process that captures and removes unwanted pollutants (seen and unseen) from your building, following a work flow that is efficient and capable of taking wasted cost out of your spend.

We have the data to prove it!

Medical Clinic Clean for Health

Paul Cagle
Best Practices, Success Stories

Indoor air pollutants reduced 31% in first 90 days

Case Study: Cleaning Medical Clinic Indoor Environment for Health.

Facility:  80,000 square foot medical office building in Houston, Texas.

Download PDF

Scientific Study: 90-day study on the status of 0.3 micron levels of indoor air particulates, beginning June 1, 2009. Multiple air samples were taken with testing that is typically deployed in laboratories, clean rooms, pharmacies and hospitals.

Situation:  The facility management company was concerned about the presence of 0.3 micron airborne particulates, known to cause respiratory disorders among 30% of the adult population. Examples of 0.3 micron airborne particulates include: dust, dust mites, dust mite feces, dead skin cells, the H1N1 virus, fungal and mold spores, and many harmful bacteria.

Solution:  The King’s conducted a Training Camp for their janitorial staff and suprvisors, implementing:

  • four-stage vacuum filtration system
  • high-quality micro-fiber cloths and duster covers, with capacity to reduce cleaning solvents by 90 percent
  • double sided mop bucket system and clean, color-coded mop heads used and replaced nightly
  • germicidal detergent in restrooms/locker rooms, not just simple disinfectants, to deter the spread of infection and harmful pathogens.

Results: The transition to The King’s system was smooth, with benefits realized in the very first week. Over the first 90 days, a 31% reduction in 0.3 micron particles was documented.

Long-term benefits affect the overall real estate investment value. The life expectancy of building assets, such as carpet, hard floor surfaces, paint, computers, servers, etc. is increased.