The key to maximizing the benefits of antimicrobial and self-cleaning coatings is to fully determine their risks.

Antimicrobial and self-cleaning nanomaterial coatings have attracted significant research attention in recent years due to the growing global threat of infectious diseases, the emergence of new diseases such as COVID-19, and increases in healthcare-associated infections. Although there are many reportedly successful coating technologies, the evaluation of antimicrobial performance is primarily conducted under simple laboratory conditions without adequate testing under real environmental conditions that reflect practical use and more importantly, reveal unintended outcomes. Furthermore, there is no standardized evaluation methodology to assess the long-term stability or the consequences associated with coating deterioration, such as the ecological impacts of nanomaterials or the proliferation of antibiotic-resistant bacteria/genes. In this review, we propose a precautionary framework that integrates a rigorous assessment of potential risks and limitations of nanomaterial coatings for antimicrobial applications as intrinsic to a comprehensive evaluation of their benefits. In addition, we summarize some emerging coating technologies as promising strategies to minimize unintended risks and enhance performance.