Healthcare EHS Services
Without properly-designed, consistent protocols and well-trained staff, hospitals and other healthcare facilities may face significant environmental health risks over time. These risks can be particularly high when facilities are being updated, renovated, expanded, or repaired by construction teams. Fortunately, Higgins’ experienced EHS consultants are available to help identify and manage risks, providing effective solutions that follow guidelines set forth by the EPA, ANSI/ASHRAE, and other regulatory organizations. Some of our services include:
EPA Controlled Environment Testing (LAFW, CAIs, PE, cleanrooms, operating rooms, ante-rooms)
Pharmaceutical Compounding and Sterile Preparations Air Testing (USP <797>)
Environmental Dust and Discrete Particulates Sampling (construction, demolition)
Bioaerosols (culturable & non-culturable) and 8-Panel Array Allergens Sampling
Aldehydes, Heavy Metals, Welding Fumes, and other VOC Air Sampling
HVAC/Air Handling Unit / Fan Coil / Maintenance Protocol Infection Control Reviews
NO2, SO2, Airborne Lead Testing, Radon, Nitrous Oxide, Halogenated Agents
Medical Gases Ambient Air Sampling, Radon Testing & Water Sampling
Welding / Brazing Fumes, Diesel Exhaust, Asphalt Air Emissions
Surface Microbial Contamination Sampling (via: ATP, RODAC, tape lifts, swabs, etc.)
Pesticides and Semi-volatile Organics Air Sampling
Indoor Air Quality for Healthcare Facilities
As you can imagine, it is imperative that the air quality in hospitals and other healthcare facilities be properly monitored and maintained to avoid environmental health risks to both clients and staff. This is especially important in operating rooms, intensive care units, oncology units, and other facilities that treat immune compromised patients. If you are concerned that your facility and/or air handling system may be susceptible to risk, such as the air quality risks imposed by construction crews working inside your facility, consider contacting Higgins to conduct a detailed on-site evaluation.
Industrial Hygiene and Environmental Health Assessments
Industrial hygiene is dedicated to the anticipation, recognition, evaluation, communication, and control of environmental stressors in or arising from the workplace that may result in injury, illness, impairment, or affect the well being of workers and members of the community. These stressors can be categorized into five groups: 1) biological, 2) chemical, 3) physical, 4) ergonomic and 5) psychosocial stressors. Much like other industries, healthcare staff and clients are susceptible to environmental stressors and health risks. However, healthcare facilities also pose a unique set of challenges and an increased array of risks.
Microbiological Water, Air, and Surface Testing
The Centers for Disease Control and Prevention (CDC) states that “scheduled microbiologic monitoring for legionellae remains controversial because the presence of legionellae is not necessarily evidence of a potential for causing disease." The CDC recommends aggressive disinfection measures for cleaning and maintaining devices known to transmit legionellae, but does not recommend regularly scheduled microbiologic assays for the bacteria.
However, the CDC does state that “scheduled monitoring of potable water within a hospital might be considered in certain settings where persons are highly susceptible to illness and mortality from legionella infection (e.g., hematopoietic stem cell transplantation units and solid organ transplant units).” Also, after an outbreak of legionellosis, health officials agree monitoring is necessary to identify the source and to evaluate the efficacy of biocides or other prevention measures.
HVAC System IC Sampling
The Centers for Disease Control and Prevention (CDC) states that heating, ventilation, and air conditioning (HVAC) systems in healthcare facilities are designed to maintain the indoor air temperature and humidity at comfortable levels for staff, patients, and visitors; control odors; remove contaminated air; facilitate air-handling requirements to protect susceptible staff and patients from airborne healthcare-associated pathogens; and minimize the risk for transmission of airborne pathogens from infected patients. Decreased performance of these systems, filter inefficiencies, improper installation, and poor maintenance can contribute to the spread of healthcare–associated airborne infections.
Environmental Infection Control During Demolition/Construction
The CDC published the Guidelines for Environmental Infection Control in Healthcare Facilities in 2003, which outlines recommendations for environmental infection control (EIC) during demolition and construction. Special attention should be given to engineering and EIC concerns during construction, demolition, renovation, and repair of healthcare facilities. The use of an infection control risk assessment (ICRA) protocol is also strongly supported before the start of these or any other activities expected to generate dust or water aerosols.
Pharmaceutical USP Controlled Environmental Testing
In January of 2004, USP Chapter <797> “Pharmaceutical Compounding-Sterile Preparations” became the first official, enforceable requirement for the compounding of sterile preparations. The goal of USP <797> is to protect clients from harm resulting from microbial contamination or medication errors in compounded sterile preparations. An official revision of USP Chapter <797>, which took place in June 2008, now dictates that compounding be performed under ISO 5 (Class 100) conditions. Compliance with this chapter is something that will be strictly enforced and can be a challenging requirement to meet for some facilities. Additionally, the Joint Commission on Accreditation of Healthcare Organizations (The Joint Commission) is enforcing USP Chapter <797> within their standards. For high-risk compounding, the Joint Commission may require stricter compliance to this chapter than the state Board of Pharmacy in some areas.
Sewage and Water Intrusion Environmental Health Testing
A serious threat to human health exists when a building is contaminated with sewage. Gastrointestinal illnesses, infections, and other adverse health effects can result from the ingestion or inhalation of infected materials. Sewage or “black water” intrusion events can occur when septic lines back up, become damaged, or become flooded during periods of heavy rainfall. Extensive health risks and damage to building materials can occur if appropriate action is not taken in a timely manner. A quick response may prevent extensive permeation and contamination of absorbent materials, such as wood, gypsum drywall, paper and other construction materials. Penetration with water and organic matter (i.e. sewage or black water) can potentially lead to the growth of disease- and infection-causing microorganisms or pathogens. For these reasons it is imperative to create a plan of action quickly.
Hospital Operating Room Theater
Environmental Infection Control Testing
Surgical-site infection is one of the leading complications of surgical procedures. The use of ultra-clean air in operating rooms (ORs) has been shown to reduce surgical infection rates significantly, especially during implant surgery. Under normal circumstances, the main source of airborne microbial contaminants is microscopic skin fragments given off by the patient and staff members within the OR theater. Air testing of operating rooms should be performed after any substantial renovations or modifications have been made that may have affected airflow patterns, or to confirm the effectiveness of sterile cleaning of the air handling systems.