Overview
Lower ATP levels equate to a higher BEMI score – on a one to 10 scale with 10 being best – showing that a surface has less biological contamination, including bacteria, viruses, and other microorganisms. This reduction in bioload, in general, means there are fewer infectious agents present to be transferred via fomites. By achieving a higher BEMI score, the risk of disease transmission—especially in healthcare settings or communal environments—is reduced. Regular assessment and improved BEMI scoring through effective cleaning protocols plays a vital role in maintaining safer spaces and reducing the chances for illnesses to spread.
BEMI also serves as a proxy for other types of surface contamination because it not only reflects the overall biological load present but other contaminants associated with these deposits including inorganic residues, chemicals, allergens, or environmental debris. When BEMI is high, it suggests that cleaning has effectively removed not only microorganisms but also these associated materials, leading to a more hygienic surface overall. Therefore, monitoring BEMI can provide a broader indication of surface cleanliness beyond just bioorganic or microbial contamination.
While BDC recognizes airborne transmission is the primary exposure path for respiratory illnesses (flu, colds, COVID-19, etc.) it will consider the relationship between surface/fomite and airborne spread, i.e., surface to air re-entrainment and vice versa. It will identify the need for additional research in this and other areas.
Duties of the BEMI Development Council (BDC)
and Stakeholder Committee (SC)
The BDC will consist of several scientists and healthcare experts including infection control and EVS persons of repute led by Dr . Chuck Gerba. BDC member bios and names will be posted to the BDC main page in January 2026. BDC will develop BEMI and its 1-10 scale through an iterative process with input from the Stakeholder Committee (SC)
SC will be a voluntary group that will comment on the provisions of the metric developed by the BDC (BEMI Development Council). SC involvement will be asynchronous (comments will be shared by email and or listserve to accommodate busy schedules and different time zones.) Those invited to the Stakeholder Committee will include ISSA, BSCAI, IICRC, and several healthcare orgs.
BEMI Stakeholder Committee
Linda Lybert
Linda is the Founder and Executive Director of the Healthcare Surfaces Institute (HSI), now a division of ISSA, where she also leads the newly established ISSA Healthcare Division. With 27 years of experience in the healthcare industry, Linda is a nationally recognized expert in infection prevention, with a specialized focus on the role surfaces play in the transmission of healthcare-associated infections (HAIs).
She developed the Seven Aspects of Surface Selection(C), a groundbreaking framework that addresses the complex factors influencing surface safety and hygiene in healthcare environments. Her work has consistently emphasized the need for a multidisciplinary approach, uniting professionals from infection prevention, materials science, design, and healthcare operations. To address the fragmented efforts across the industry, Linda founded HSI with a board of global experts, creating the first collaborative dedicated solely to surface-related challenges in healthcare. Under her leadership, the Institute has become a hub for research, education, and innovation aimed at reducing HAIs through improved surface design, selection, and maintenance.
In 2024, HSI merged with ISSA, and Linda is now spearheading the development of the ISSA Healthcare Division, which provides strategic guidance, training, and resources to healthcare professionals, manufacturers, and building service providers focused on healthcare environmental hygiene.
Linda and HSI are also widely published.