Summer 2020 Newsletter - SPECIAL PANDEMIC ISSUE
Co-sponsored by Maryland Pesticide Education Network & Beyond Pesticides
The World Health Organization (WHO) advisory warns,
“Spraying or fogging of certain chemicals, such as formaldehyde, chlorine-based agents or quaternary ammonium compounds, is not recommended due to adverse health effects…”
The Risk of Chemicals Used in Facilities During this Pandemic
Health Care Facilities and COVID-19 Best Practices
Empowering facilities to ensure patient & staff safety from COVID-19 exacerbating chemicals
Your healthcare system focuses on providing high-quality health care to ensure best patient outcomes. In an effort to provide a clean, safe and pest-free environment, sometimes facilities unknowingly use cleaning products, disinfectants and/or toxic pesticides that can actually exacerbate the very illnesses/challenges patients/residents are being treated for—including symptoms of COVID-19. Especially during this pandemic, it is critical for facilities management to know about practices and products that do not exacerbate COVID-19 symptoms.

Learn how to protect your facility:
  • Avoid the chemicals that exacerbate respiratory symptoms of COVID-19
  • Provide safer disinfecting alternatives that kill COVID-19
  • With implementing best practices regarding protocols and product use

"With the increased need for disinfectant use in healthcare facilities because of COVID-19, it is important to use products that don't have the potential for respiratory tract irritation whenever possible."

"Certain pesticides have been found to be especially harmful to children. It is critically important to prevent irreversible childhood disorders by preventing exposure to such pesticides."

Mike Ichniowski MD, Chair/Environmental Health Committee,
American Academy of Pediatrics, Md Chapter

"Hospitals must use disinfectants regularly to protect patients from dangerous bacteria, viruses
( like corona virus), fungi and mold. Employees regularly using disinfectants must be provided PPE to protect against chronic lung disease. EPA has hydrogen peroxide but not chlorine bleach on its “safer anti-microbial list.” 

Gwen DuBois, MD, MPH, President of Chesapeake Physicians for Social Responsibility
and a member of the Public Health Committee of the Maryland State Medical Society

For over 10 years the I PM in Health Care Facilities Project has provided pro bono consultation to Maryland hospitals to help you ensure the safest health care environment for patients and staff. We're available to support you, as you continue to save lives during COVID-19, and beyond.  Call on us!
Disinfecting Your Facility
Many disinfectants on EPA's List N for institutional use against COVID-19 contain the active ingredients Quaternary ammonium compounds (Quat) or chlorine. These registered pesticides are known to cause or exacerbate respiratory problems and compromise immune systems , among other serious health impacts.
Protect patients and staff — avoid dangerous disinfectants and choose safer products approved for COVID-19 .

Quaternary Ammonium: a concerned warning for health care workers 
A professional & personal account by Paxson Barker, RN, PhD
In the 1990s, a disinfectant named Quat (Quaternary ammonium) produced by 3M was introduced into our workplace for disinfecting the room between patients. Since time was a monitored benchmark of our performance, indiscriminate spraying of Quat was the norm for everyone. After 2-3 years of using Quat, in 1998 I developed adult onset asthma, recognized as a workplace induced asthma in 9-15% of cases.

At the time, the antigen responsible was not identified so continued exposure to Quat eventually sensitized my airway and I developed a condition known as Reactive Airway Dysfunction Syndrome (RADS).

The damage from Quat has seriously limited my life. Exposure to disinfectants, other cleaning chemicals, cigarette smoke, synthetic fragrances, and roof and street tarring causes closure of my airways.

By 2003, I was unable to care for patients and left the cardiac catheterization laboratory… I know that my adult onset asthma resulted from a toxic exposure in the workplace .
Warning: QUAT (or QA) & Chlorine Disinfectants
(Many) products included on the Environmental Protection Agency’s N list of disinfectants for use against coronavirus have active ingredients that belong to a class of chemicals known as quaternary ammonium compounds, which release formaldehyde. Studies have shown these compounds can cause asthma, fertility issues and birth defects, and irritate the skin, eyes and lungs.

Excerpts from article: Johns Hopkins Bloomberg School of Public Health & George Washington University:
Ana Maria Rule, PhD,
Director, Exposure Assessment Lab, Johns Hopkins Bloomberg School of Public Health

  “...these cleaners (QUATs) were most likely bought by the hospitals for very specific uses, such as sanitizing bed railings or other highly touched areas in isolation units. Now these chemicals are being used everywhere. So, you’re increasing the risk and the exposure and the concentration because you’re using them more broadly.”
Lesliam Quiros-Alcala, PhD, Assistant Professor, Johns Hopkins Bloomberg School of Public Health, and environmental epidemiologist

“Using these (Quat) disinfectants so frequently, especially inside the hoods, could pose acute and long-term health risks. It’s in the breathing zone. It’s right there. It’s prolonged periods, because they’re going to be there with patients for a while, so it is a concern.
 …we don’t want to adopt practices for the long-term that may be detrimental to human health.”
Melissa J Perry
Chair, Environmental and Occupational Health, George Washington University

 “The only protocols that appear to safely disinfect these masks are hydrogen peroxide vapor, UV radiation and a 65-90C heat treatment.”
Better Option: Hydrogen Peroxide
Hydrogen peroxide provides comprehensive sanitation
based on the EPA’s Emerging Viral Pathogen Policy

  • 30-60 second bactericidal & virucidal claim
  • Safe for workers (lowest EPA toxicity category, IV)
  • Fast kill times on over 38 pathogens— including 13 antibiotic-resistant ones
  • Benign for the environment
  • Fast contact times for fast room turnover
  • Surface compatible

Chlorine gas is a pulmonary irritant with intermediate water solubility that causes acute damage in the upper and lower respiratory tract. Exposure to low concentrations of chlorine for prolonged periods may have destructive effects, as might very short-term exposure to high concentrations.”

- Gerald F O’Malley, Chlorine Toxicity, Medscape, Updated May 13, 2019 
“Many pesticides (disinfectants) are sensitizers or irritants capable of directly damaging the bronchial mucosa, thus making the airway very sensitive to allergens or other stimuli. Pesticides may increase the
risk of developing asthma, exacerbate a previous asthmatic condition or even trigger asthma attack by increasing bronchial hyper-responsiveness.”

- Hernandez AF, Parron T, Alarcon R., Pesticides and asthma. Curr Opin Allergy Clin Immunol. 2011 Apr;11(2):90-6 
Your Facility's IPM During the Pandemic

Use a defined, prioritized IPM program , based on non-chemical pest prevention and intervention as the first line of defense with emphasis on maintenance and housekeeping. Least toxic pesticide are only to be used as a last resort.

During this pandemic it is critical to avoid using pesticides that known to exacerbate respiratory issues and can negatively impact the immune system.
Endocrine Disrupting Pesticides

Commonly used synthetic pyrethroid pesticides are endocrine disruptors and can have adverse impacts on people suffering form COVID-19.

- Environmental Health News, 4/23/20
Responding to COVID-19: The Spirit of Resilient Health Care Leadership
The secrets to a defined IPM program’s success are communication, coordination, and collaboration.  There are many different silos of activity that must be integrated within the Environmental Services (ES) Department. Only when these silos are purposefully linked can the best possible outcomes be achieved. We can help you.

Now is the time to prepare and reduce exposure
IPM in Health Care Facilities Project is the only non-profit dedicated to providing free resources and services to Maryland health care facilities.

Our mission is to serve your healthcare facility. Contact us, today.