MASSACHUSETTS NURSE NEWSLETTER :: March 2004

Is your hospital healthy? Taking a look at use of harmful pesticides

By Kathy Sperrazza, RN, BSN, MSLR

A recent study entitled "Healthy Hospitals: Controlling Pests without Harmful Pesticides" found that many hospitals are regularly using harmful pesticides. The study, which was released in November 2003 by Health Care Without Harm (HCWH) and Beyond Pesticides, is a first-of-its-kind survey of top U.S. hospitals. "Hospitals are intended to be places of healing, yet many are using hazardous pesticides unnecessarily in a 'spray and pray' approach to pest management, when safer and more effective methods are available," said Ann McCampbell, a physician with HCWH.

Pesticides are just another avoidable hazard commonly used in hospitals. In many institutions, the assumption is that pesticide use is the only way to control pests and ensure a clean, healthy facility. Pesticides are hazardous chemicals designed to kill or repel insects, plants and animals that are undesirable or that threaten human health. Many of them contain volatile compounds that contribute to poor indoor air quality.

In addition to killing pests and beneficial organisms, pesticides can harmfully affect humans. Hospital patients who have compromised immune and nervous systems, the elderly, infants and children, and those who have an allergy or sensitivity to pesticides are particularly vulnerable to the toxic effects. Patients taking certain medications may also have heightened reactions to pesticides, and pesticides can also exacerbate asthma and cause other acute adverse reactions including nausea, headaches, aching joints, mental disorientation, impaired concentration, seizures, rashes and dizziness. Many pesticides are also linked to chronic effects, such as cancer, birth defects, neurological and reproductive disorders, and development of chemical sensitivities.

Shining the spotlight on this problem is just a logical extension of the work of HCWH, which has successfully influenced the reduction of dioxin and mercury emissions by hospitals and has advocated for the closure of many medical waste incinerators.

HCWH created a survey to gather additional data due to the scant amount of information available about pesticide use inside and outside of hospitals. It sent the survey to the top 171 hospitals profiled in 2001 in U.S. News & World Report, but it focused on 100 facilities in or near cities where HCWH members were located or had contacts. After numerous phone calls, letters and visits, 22 surveys were returned—not a fully representative scientific data collection, but an instructive "snapshot" of what some of the nation's pre-eminent facilities are doing for pest control.

The survey results show that while some hospitals report using the least hazardous approaches and/or provide notification of pesticide use, there is still considerable pesticide use at hospital facilities—even at hospitals that report using the safer method of pesticide management called Integrated Pest Management (IPM).

The survey's major findings show that of the 22 responding hospitals:

• 100 percent used chemical pesticide products either on their grounds, inside the building or both.
• 91 percent used chemical pesticide indoors and 71 percent used chemical pesticides outdoors.
• 36 percent used pesticides that are no longer registered for use by the U.S. Environmental Protection Agency (EPA).
• 18 percent used a pesticide product in which the active ingredient is being phased out by the EPA due to unacceptable risk associated with its use.
• 73 percent hired a pest control company to manage the majority of the hospital's structural pest management program and 41 percent hired a pest control company to manage the majority of the hospital's grounds.

The survey also found that at least some of the responding hospitals were making an effort to reduce their pesticide use and/or notify staff and patients when pesticides were being used:

• 73 percent reported using an IPM approach to pest management.
• 45 percent used one or more pesticide products containing boric acid (considered a low hazard pesticide)
• 14 percent posted notification signs for both indoor and outdoor pesticide application.
• 27 percent have provided pesticide-poisoning training for their staff.

IPM strategies are successfully being implemented at schools, parks, government facilities and hospitals nationwide. Institutions like Oregon Health and Sciences University, Brigham and Women's Hospital, and Harvard University, when reporting to Health Care Without Harm, demonstrate that IPM can be economically and effectively implemented.

Hospitals have a special obligation to demonstrate leadership in instituting effective and safer pest management in keeping with the medical profession's basic tenet of "first do no harm." You can make a difference at your hospital by joining your health and safety committee or speaking with a colleague who is on the committee. Find out what your facility's practice is. The survey can be used as a helpful tool for hospitals to assess their pest management and pesticide use and to monitor their progress in eliminating hazardous pesticide use over time. It's worth a little of your time to make your work environment a safer place for both you and your patients.

This article is excerpted directly from the report "Healthy Hospitals: Controlling Pests without Harmful Pesticides." It is available in its entirety at www.noharm.org or beyondpesticides.org.