ACEF Webinar – Defining Clean in School Facilities & Its Impact on Students

ACEF 4-10-13 Webinar
>>Dorris: Hello. My name is Denae Dorris and I am the Project Manager for the American
Clearinghouse on Educational Facilities. I would like to thank you for joining our webinar
today. ACEF is the educational facilities clearinghouse funded by the U.S. Dept. of
Education established to provide technical assistance, training, and resources to public
early childhood schools, K-12 schools, and institutions of higher education. ACEF provides
resources on facility planning, design, financing, construction, improvement, operation, and
maintenance. We invite you to follow ACEF online at and also encourage
you join the network of professionals already following the educational facilities discussions
on Facebook, Twitter, and blogger. We are excited to have Dr. Richard Shaughnessy
joining us today for this webinar entitled, Defining “Clean” in School Facilities & Its
Impact on Students. Dr Shaughnessy currently serves as a Program Manager for the Center
for Environmental Research and Technology at the University of Tulsa. In addition, he
has received numerous awards and appointments for his dedication to the overall field of
Indoor Air Quality. Dr. Shaughnessy has also published numerous pieces of research specifically
highlighting school indoor air quality. Welcome Dr. Shaughnessy, thank you for sharing your
expertise with our audience today.>>Shaughnessy: Today I will talk to you briefly
about the importance of defining clean in schools and
what that means in terms of impact related to the students themself.
I wanted to acknowledge my co-investigators, I will then go to introduce the issues related
to schools, why we should be more concerned or interested in these aspects of the indoor
environment. And then I am going to talk about research and co-investigators being Dr. Gene
Cole from Brigham Young and Dr. Ulla Haverinen from the National Institute of Health in Kuopio.
Churchill once said — and I really like this — first we shape our dwellings. Then our
dwellings shape us, and I think that’s very true. I mean, whatever we invest in our — in
our buildings, there is a return, and — and how much we invest will be a determinant as
well as what we get back. For many reasons, I travel internationally,
and I am able to visit and study schools in other countries. I wanted to show you just
briefly here — I mean, we are looking at schools from Finland that are exceptional
in terms of how they build them, how they maintain them, the — the attention paid to
the schools themselves, and — and there are paybacks associated with that. Some of the
things that are important related to schools I see in Scandinavian countries that are already
built in school, such as daylighting. The lack of clutter; the lack of clutter is very
important. Also, we understand that clutter represents allergen collectors and other problems
associated with it as well. So kind of taking those things into account.
I think the ideal classroom is spacious, it has a track-off
where you are preventing the pollutant from coming into the building. 80 percent of dirt
and particulate matter we find in building we actually bring in on our shoes. Daylight
is very important, as I’ve already mentioned. Adequate ventilation, its fundamental provision
must be looked toward related to and acceptable into our environment and ensuring that the
building and the classroom itself is clean and cleanable. I think those two have to go
hand in hand. Yet, here in the United States, I wouldn’t
call this the exception. I wouldn’t call it the norm, but unfortunately, we are dealing
with many problems here, and much of that is financial related. So I wouldn’t call it
indifference. I don’t know if it’s a lack of recognition of the importance of — of
good indoor environments related to learning. Fundamental provisions, such as ventilation,
are being lost in the equation. But with all of this, the lost revenue to the district,
the ignoring of basic provisions for health of a student population is something that
we can no longer ignore because there are financial returns related to that. We are
paying a price for that. The clutter factor in buildings is significant
in our schools. So I guess after 25 years of working in schools and working on behalf
of the EPA as best I can, supporting their tools for schools program, I found that administrators
and schools certainly appreciate the information related to indoor air, but in addition to
that, they need critical documentation to justify investments.
In other words, if they are going to invest in improved indoor environments, there needs
to be a tangible payback to that. By “tangible payback,” I am looking at — I am talking
about improved health. I am talking about student performance, and these are some of
the aspects that we always ultimately look toward related to our studies in schools.
Now, what kind of problems do we have that result in financial losses to schools? Well,
clearly, when schools shut down, there are losses. The norovirus outbreak just this year
exceeded 1 million globally, but in the U.S., just reported — and I am talking about reported
cases — we had more than 250 cases of the stomach flu, going about, and that’s significant
in terms of the impact on schools and being able to operate on a daily basis. You combine
that with the flu and schools having to completely close down as a function of — of the flu
running rampant throughout the building, very much a problem, and then you factor that in,
the flu season, children transmitting this, one to the other, by contact and by air, lack
of ventilation within this space, everyone breathing this same air. This is, again, very
much a problem. You take that into account — and here we have a significant cost where
on the average, schools, a district will lose $40-$50 per day when a student is absent,
not in that desk on that given day. Other things to consider have to do with performance.
Contaminated schools may lower kids’ IQ. We published extensively on this related to one
aspect of the environment being ventilation. Ventilation, again, a very basic,
fundamental provision if we are going to achieve acceptable air quality. And we found that
with the lack of ventilation, there is a correlation to — to lower test scores, and we found this
in two different studies. We have new research that we are now reviewing all of the data,
and we are going to be publishing on that as well.
We look at reading scores internationally and mathematics and we look at science here,
look how Finland ranks, number 3, number 6, number 2. Yet, the investment they put into
the schools per child is much less than what we put in the U.S. It’s how they go about
dealing with their students, the importance of education, and the importance of the environment
as well. Now, you compare Finland here to the United States and to the other countries
as well. The United States 17th in reading, 31st here related to mathematics, 23rd related
to science. I mean, this is unacceptable. We should be doing better and the environment
certainly factors into that. Teacher absence as well is very important. A recent report
indicated that one out of three teachers miss — are absent from school grader than ten
times per year. And these costs associated with teachers having to come in and fill the
role of the missing teachers at that point totaled greater than 4 billion-dollars annually,
so the substitute teachers and the costs associated with that is significant.
So — which brings us back to our topic today in how does “clean” play a role in this? What
impact does that have? If you look at the definition of “clean,” it is free from
pollution or free from contamination or disease. When we look at the cleaners we typically
use in schools, number one, they may be substandard, number two, substandard, not being effective;
number two, they may emit many organics into the air that are problematic for the children.
Here we are looking at a scan and every peak represents a different compound in one cleaner
we have here and if we look at the makeup of volatile organics inside cleaning products,
we have some that are carcinogens and others are irritants and we have reproductive concerns
as well. So we need to be paying attention, number one, to the types of cleaning products
we are using in schools, which brings us to the subject of green cleaning supplies. What
do we mean by that? Well, what — what we believe it to mean a that there will be a
reduce a reduced health hazard, lower toxicity, improved impact on improved air quality, recyclables,
having lower organic pollutions, reduced water pollution related to the products themselves,
some being vegetable based as opposed to chemical-laden materials and this is important that we understand,
number one, that conventional cleaners do release more VOCs into the air as compared
to green cleaners and many VOCs are considered endocrine distributors which are very much
a concern as we learn more and more about these. So, all green cleaners are not failsafe.
Some contain compounds to risks to children’s health and we also have to remember where
a compound may be green, is it effective? And the term “green” and “clean” should be
compatible. So the efficacy of a product is very important as well to achieve a desired
cleaning result. Endocrine disrupting compounds that I just
talked about, we find these just everywhere in the environment, baby products, paints,
flooring products, fragrances, pesticides and cleaning agents, what we have here, and
specific to what we are talking about today. The importance of endocrine disrupting compounds
is the fact that these — here we have a natural hormone, and what we have down here surrounding
it are other compounds, which mimic the natural hormone. In mimicking that, we have the hormone
in the body going to the receptor in the body and then we have the endocrine disruptor being
unable to distinguish between the hormone and the endocrine disruptor, it then sends
a different signal to the receptor, and that receptor — that’s how — how that may play
out. There are a number of things in terms of reproductive, in terms of general health
of the — of the child, the growth and development of behavioral. It gets down to our most basic
make-up of who we are. We are much — much more attention is being paid to this now and
should be paid to it as we move forward in the future.
The concern — well, the ubiquity of these products and everything that we have, metal
can linings and food linings and cleaning products and paints and fluorine products
and water and baby bottle products and the cleaning as well is significant.
And what we are learning in recent years related to these products is there are outcomes such
as asthma, reproductive concerns, cancer, autism, diabetes, obesity, birth outcomes.
So, again, this is a rapidly evolving area of research where we are learning more and
more about the impact of these endocrine disruptors and trying to identify them and eliminate
them or reduce them on the products we use on a daily basis. And with all of the cleaning
products we have on the market, there is a concern, and you have to wonder, what is green?
What does that essentially mean? Well, we talked about what a green cleaning product
should be, but how do we know, in fact, that a product on a shelf is — is in, well, what
it’s being marketed for, as a green product, which is better for the environment, lower
VOCs and everything else I mentioned. In 2010, a report came out, which talked, in fact,
indicated that more than 32% of green products on the market carry a fake green label. So
the Federal Trade Commission, the former FTC chairman recently said environmentally friendly
products are certainly beneficial but marketers’ claims must be trustful and substantiated.
The FTC put out guidelines in 2012 where the general principle that is apply to environmental
marketing claims should be followed and there they talk about the unqualified use of terms
like green and eco-friendly. The claim should be more specific and clear with respect to
the environmental benefits. The impact for cleaning for health, here,
again, intuitively we believe reduced absenteeism, improved health, improved performance and
reduced medical costs. Schools definitely — we have a challenge
in every facet that we work with and they are limited, financially and with personnel,
limited maintenance, janitorial staff, outdated cleaning equipment, exaggerated claims as
the cleaning product, which cleaning product should one use, and there is no direct information
on clean. What is clean in a school? How do we gauge that? How do we select the right
product? And so on. Cleaning research has indicated that visual
assessment is not a reliable indicator of surface cleanliness or of cleaning efficacy.
So that visual, that white glove test that we think of in the past may not be as effective
as we thought to determine what’s there that we can’t see, and that may be just as important
and more important than say, the subtle dust that we have on a surface.
Bugs get transferred in a number of ways. I mean, we have children — small children
putting their fingers in their mouth once every three minutes and children up to 6 years
with an average frequency of 9.5 contacts per hour, and then you have to wonder where
have those fingers been and then where do they get passed on to? And this is important.
Of course, they get passed on as such as we touch, shake hands, move about and — and
transfer to surfaces, and then surfaces back to other people.
Here we are looking at a magnified shot of a very small crevasse on a surface, and within
that crevasse itself, we have on the order of just a few microns many different types
of bacteria and other contaminants, bio-contaminants that can accumulate within that
space. Here, we are looking at a very small etch on a surface and what is ingrained in
that as well and what can grow in that and survive there for an extended period of time
such that contact being made can be picked up and passed on to others as well.
The CDC in 2011-2012 said that routine cleaning school staff should — school staff should
routinely clean areas that student and staff touch often with the cleaners they typically
use. Recent research shows that — that enhanced hygiene targeted cleaning of frequent contact
points, reduced — is tied in to reduced illness related to bacterial reservoirs, reduced building
syndrome symptoms, reduced absenteeism due to infectious illness. What we, through the
past six plus years, we have been working to try to look at different cleaning markers
and ATP is a marker for biomass within a — within a space, and if we — we look at that on residual
surfaces, it also becomes an estimation of contaminant load in hospitals and food industries
that’s been used for some period of time. The important thing its rapid, it’s portable.
It’s affordable. It’s a good marker for cleanliness in general. So we’ve looked at that and conducted
considerable research throughout the United States, and where we have looked at five regions
of the U.S. greater than 10,000 ATP samples as a gauge for that bio-contamination on surfaces
to develop — the end point was to develop a baseline of what is clean in schools, which
may help to establish some consensus standards of care. We’ve recently have published that
and I have a reference at the end of the — at the end of the presentation you could go to,
but I believe it’s online now and, in fact, it will be in print in June 2013, but it talks
about ATP as a marker per surface contamination of biological origin in schools. And essentially
it provides information on the baseline of how you might want to gauge what is clean,
what is substandard, a benchmark, a metric, if you will, for use in the future to try
to improve cleaning in schools. What we looked at in our study, we looked
at classroom desks. We did repeated measurements, pre-cleaning, post-cleaning. We did it on
cafeteria tables. We did it in bathroom stall doors and sink surround areas when we did
find, whereas we looked at ATP, we also took bacteria measurements as well, and we were
encouraged to find that the reduction in ATP very much correlated with the reduction in
bacteria within the space. So, again, a good marker at least for not only cleanliness,
but gives you some idea when we are cleaning also the reduction in terms of bio-contamination
of the surface. We went to four additional regions of the
union — of the United States, to validate whether or not that baseline is appropriate
or can be used, representative in other parts of the country. We took an additional 3,800
measurements, used the same protocol from the baseline collection effort that we did
initially, and from that, we are looking at data here — what we have here is the initial
set of data, pre and post. Then we have in — in another part — the first area was Texas.
Then, we went to Massachusetts, Michigan, North Carolina, and Utah. And you
see similar types of pre-cleaning levels that you would find and similar post-cleaning,
depending upon how well this surface would be clean, but, again, this is encouraging.
It supports the database that we put together that can be used as perhaps a metric in the
future. So the first — I guess in looking at our
data right now, we are encouraged that the ATP levels in the ranges of cleaning or what
is clean, what is not clean and so on, has been validated as representative across other
parts of the United States, different climates, different regions as a whole. The second thing,
which I think very much important, critical, is that we generate numbers related to cleaning,
but ultimately, how does this relate to children’s health? This is much more complicated, as
you might imagine. But from the initial data set, we took three separate data sets and
we looked at health data from school nurses. We looked at background information on the
fifth grade students and of course the ATP readings and we did find significant correlations
of gastrointestinal, abdominal pain, stomachache, headaches, cough, sore throat, right on down
the line, with the ATP levels. So, again, the information was useful in that there are
correlations we are beginning to see between the level of cleanliness and the health symptoms
but I must say that much more detailed analyses are needed and a larger population. We are
currently in another study looking at a large district with a number of schools control
and study schools, and we are gathering health information and we are trying, again, to get
to that end point. Difficult to do, it is costly, the research, many confounders, as
you might imagine, but we are working through it and that health end point has to be there
at the end of the day if we are going to justify that improvement in school�s better cleaning,
what do I get back for it again, which is what we started at the beginning of this talk.
What can be used as a simple marker in schools for clean. With that, they are now developing
a clean standard. The primary goal of the standard is to provide the schools with a
tool to help them objectively measure and monitor the level of cleanliness at their
facilities. But, again, all of this is good and wonderful to have a standard, but all
of it must come back to the health and learning ability and how that impact the student, which
is our end point related to our research. The clean standard is due out in 2013.
I was at a conference recently and somebody brought this quote up: “If we don’t change
the direction in where we are going, we will end up where we are headed.” And if you think
about it, there is a lot of sense in that, in that we truly need to reconsider where
we are headed, what direction we are going and perhaps change that end point based on
what we know, what we are learning at this point in time, and that goes for schools.
We have learned so much in the past 10-20 years of the importance of proper ventilation,
proper cleaning, proper reduction of — of clutter, the hygiene within the schools, animals
in schools. We have learned so much and we need to put that into effect. We need
to change as a function of what we’ve learned. And I am optimistic that will occur and is
occurring slowly as we also understand the benefits that come along with those improvements
in terms of financial benefits, real, tangible benefits for schools in the future.
Additional resources are here listed for you as well. And, again, with all of that said,
I appreciate your time and we have some questions. So at this point I wanted to announce that
participants can send questions via the text chat, which is an option located at the top
on the tool bar. The first one being: “What “– “What specific
best practices do you recommend for schools to improve their facility’s cleanliness?”
That’s a great question. I am not sure who submitted that but I can tell you this. That
so far at this point in time, we are focused on trying to determine what levels of cleanliness
there are in schools. And by that, I mean we are trying to gauge what is the typical
school in terms of level of surface bio-contamination, pre-cleaning, post-cleaning, what is that.
And in our study, we used a reasonable degree of cleaning in there, so reasonable in terms
of what might typically occur within a school. We, in fact, only got a 90% reduction on the
level of cleanliness when we used that approach. But with this all of that said, to answer
your question, I think there are many, many different methods in terms of cleaning that
are out there. We are not testing different types of cleaning practices, per se. We are
simply, right now, looking at the end points. There are a number of ways to get to that.
Some of that, I am sure, are going to be built into the clean standard eventually but right
now, the best I could say is, we are looking at the levels of cleanliness and what typically
is there and we are trying to relate that to health and of course ultimately as well
that’s going to parallel that our improved cleaning processes.
Looking for another question here. “What do we know about the use of white board
markers in the classrooms?” I can’t really answer too much on that. I
mean, there are different types of markers that are available that, in fact, do not have
significant volatile organics in them. Some of the first white board markers that came
out, you could open one at the front of the class, and by diffusion alone, you would be
smelling it in the back of the class within a matter of seconds, but there have been significant
improvements in markers available and alternative products that should be looked for when you
are looking for a white board marker. Here is another question.
“How does your research correlate to the issue of superbugs as a result of overuse of antibacterial
agents?” What is being referred to here is something
called the hygiene hypothesis. And that hypothesis is that some
degree of — of introduction of contaminants into a child’s early years and their exposure
to that may, in fact, help them to build their immunity system later in life. Along with
that is the idea that as we clean, as we try and turn our normal environment into a health-care-type
environment, like a sterile environment, we may, in fact, be creating these superbugs
because we know that microbes mutate. I guess my answer to that is, to stay tuned, because
there is more research related to the hygiene hypothesis. If you email me, I could send
you a recent report that came out of the UK which does not put much stock into the hygiene
hypothesis and the fact is that schools as a whole, I mean, we aren’t even close to getting
to the concern, to that level of concern that it — we are creating a sterile environment.
For the most part, schools, because of lack of funding and what, are not able to be maintained
to the level — to the degree that they should be, so it’s something to — to keep track
of and to watch but I don’t think that, in this case, by what we are talking about in
cleaning, we are getting to that point where we have to be concerned about over-cleaning.
We have a long ways before we get there, and there is much research on the hygiene hypothesis
that is questionable and — and certainly the cleaning methods that we have in place
now are going to be a problem related to that at this point in time.
Another question: “What can a teacher do? The top five things to impact the clean level
in his or her classroom.” That’s a good question. I would have to think
about that. But I think what comes to mind right off is — is definitely recognizing
the importance of different sources within the classroom. I mean, we shouldn’t be burning
candles or having incense. We shouldn’t have animals in the classroom. We should — the
lack — well, we should decrease the level of clutter in any way that we can. Look to
the different cleaning products that you are using and make sure they are compatible with
what the school was recommended. And these cleaning products as a whole should be green
cleaning products that are certified. And there so much more to do in a classroom. I
guess we can spend an afternoon on that. Ventilation is very important. You should
ensure it is working properly. If you have a unit ventilator on the side, don’t put books
on that because you are obstructing airflow into the classroom.
I am going to have to move on to another question, though.
“Is ATP available to schools to integrate into their own custodial program?”
ATP monitors to cost somewhere on the order of a few thousand dollars at this point in
time. However, the cost for a district, for one ATP monitor, should be, should be — there
should be payback associated with being able to do these measurements. In fact, the measurement
is very simple. It costs more than no more than 1-$2 to do an ATP measurement. You can
do it within a matter of seconds and you get an idea of cleaning levels related to that.
Yes, it can be built into custodial programs. No,
an ATP meter does not need to be incorporated into every school, but a district investment
in an ATP monitor is important and useful as a whole related to gauging cleanliness
on the school itself. And another question. Patrick asks: “Trying
to use Green Seal certified products in the school district has been successful in terms
of efficacy. However, the ability to disinfect touch points, particularly in rest room and
cafeteria environments leads us needing to use quaternary ammonium products which are
EPA related pesticides. Are there any other chemicals or techniques that provide a similar
efficacy?” You know, quaternary ammonium products are
used quite a bit to disinfect in certain areas of buildings. I believe there are alternatives
and what I would rather refer you to is someone like Marilyn black at UL or the Greenguard
Institute. They could talk to you more about this.
Another question. Robert asked: “Have you looked into five levels of cleaning from the
APPA Custodial Staffing Guidelines for Educational Facilities?”
This is actually related to the work that CIRI has been doing. And I have not been so
closely involved with the actual cleaning techniques and how they are going about it.
What we are looking at are just the cleaning levels itself within the — within the schools
and how those relate to health. Again, this isn’t prescriptive. I think the clean standard
would be more related to trying to meet a desired level of cleaning
but not being prescriptive in how you meet that, but I would refer you to maybe CIRI
for more information on that, or ISSA. Barbara asked something: “How effective is
induct UV light for infection control?” You know, it’s been known for years to be
important in health care scenarios. Do we need it in schools? I don’t — I don’t know.
I — we have done a lot of research on ultraviolet irradiation, do we need it in schools? It
is probably a good question. I think it is somewhat overkill as a whole in school environments.
It — it may not — it’s not going to do harm but at the same time, it should not give a
false sense of security that I can now reduce my level of maintenance within the school
itself. And UV is — has been shown to be effective for bacteria, not so effective for
fungal agents and only certain types of bacteria, vegetative bacteria, which is, one, a case
being tuberculosis, which is why UV was initially introduced into health care as a whole.
And one other question. Pam asked: “Most schools do not have nurses and certainly rarely do
they get into a classroom. The teacher has to be knowledgeable and act to keep room and
other spaces clean. How does one know when the room or facility has good ventilation?
I want to know if there is a practical rather than expensive way to determine this.”
Let me answer that in two ways. I certainly believe that schools
have a role. The maintenance and custodial staff have a role in improving, keeping the
indoor environment, but the occupants and teachers play a major role parallel to that
and I completely agree with the question, Pam, that — and the statement that the teachers
must be knowledgeable. And they must — and a lot of it is just informing and educating
and communicating. So much of that is important. We have science that often is not translated
into the practice. So I agree, you know, there must be an educational compliment with this.
If there is a clean standard to be developed, I strongly believe there needs to be education
associated with that as well, so it will be useful.
In terms of the ventilation, there are way — quick and simple ways to check ventilation.
You might, one, determine whether or not your system has — is operating properly as best
you can. Is air coming out of the supply grills? Is air going into a return? You would like
to know if the outdoor air dampers are functioning but that’s something I would expect a teacher
to have to go to look toward. But for facility people, this is secondhand, second nature,
they should know about the outdoor air supply. They should know about whether it’s being
provided. A simple way to look at it, inexpensive way, as opposed to doing more detailed measurements
is like carbon dioxide. The degree of carbon dioxide build-up in a classroom is an indicator
of how much ventilation there is. Now, with that said, there are many caveats
to that that you have to be very careful in using that, and we’ve done a lot of education
related to the proper use of carbon dioxide but as a simple surrogate for ventilation,
it’s something easy to measure and you get a rule-of-thumb measurement that can be used
to gauge, am I getting some outdoor air into the classroom and how much.
Sue asked: “What research have you done to measure particulate output from vacuum cleaners?
Do you recommend any models over others?” We — me personally have not done work on
vacuum cleaners, although the — there are over universities that have done a great — great
amount of work on that at the University of Cincinnati, I believe, Tina Reponen did some
work. I know one of my co-investigators, Gene Cole, has done work on vacuum cleaners at
Brigham Young University and so Gene Cole can lead you in that realm better than I could.
There are papers he has that are associated with that, and — and so — and there is actually
a green label related to carpets and adhesives and vacuum cleaners as well that’s now developed
by the industry themself that talks about what vacuum cleaners are more appropriate
or what can be used, what products are more appropriate and I — again, I would defer
that question more to Gene Cole and he might be able to lead you in that direction. So
if you email me that, Sue, I can send that on to him.
And final question. Tom asked: “Did you test any technologies in the rest rooms like spray
and vac or spray and squeegee?” No, Tom, we didn’t, and this again, goes back
to the question earlier, what we did in our studies and how
we went about doing the — it certainly is the next question to be answered now that
we understand what reasonable levels are in schools pre and post-cleaning, how do we improve
upon that? So we will be doing that in the future, looking to continue that type of work,
and, I — I am open to any suggestions you might have in looking into that, but the idea
of the squeegee and simple things such as that can be so much more effective in that
with the cleaning, something that will make the cleaning as a whole useful as a whole.
Once again, I appreciate you tuning in for a short time and at this point, I need to
sign off and — and you know how to contact me. I hope you have my email and stay tuned.
There will be a lot more information coming out on these types of topics, and the EPA
has a wealth of information related to tools for schools programs.
Thank you so much. Have a good afternoon.>>ACEF would like to extend a very special
thank you to our presenter, Dr. Richard Shaughnessy, and our participants for joining our webinar
today. We hope that you took this opportunity to learn from the content presented, engaged
with the speaker, and will use this content to advance your professional knowledge on
issues related to school indoor air quality. Please join us again soon for upcoming ACEF
events. Remember to visit our website at
and follow us on your preferred social media outlet. Please call if the ACEF staff can
assist you in any way. Have a great day! (Webinar concluded).

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