Greetings!

In our June newsletter, we introduced troubling news about pesticides containing PFAS “forever chemicals” that are being marketed for the healthcare setting. We highlighted a new pesticide product, Fipronil Plus C, that the manufacturer is targetting to hospitals, healthcare, and nursing facilities. Alarmingly, the pesticide's active ingredient, Fipronil, is also a PFAS forever chemical! In today’s newsletter find out about another pesticide/PFAS product being promoted for health care it is best to avoid. 

Also check out Johns Hopkins School of Public Health professor, Dr. Rule’s short video on pesticide-registered disinfectants vs. safer EPA approved products and this newsletter’s “Joe’s Tips” on Preventative Measures for Common Early Autumn Pest Issues. And if you missed our June bi-monthly newsletter, we republished our Spotted Lanternfly post given the increasing presence of these critters.

At the first sign of a pest problem, go to our many fact sheets, sample policies and guidance, articles, and video library. The Project's IPM Toolkit is available online! Contact Sean at sean@mdpestnet.org or call 301-664-4374.

– Sean Lynch
IPM in Health Care Facilities Project Director
PFAS + Pesticide Products: Double Trouble
Some Pesticides Contain PFAS "forever chemicals" as Active Ingredients
Last month, the same Fipronil Plus C manufacturer has targeted the healthcare industry with yet another new pesticide product, Bifenthrin Plus C, also considered a PFAS according to the globally accepted definition by the Organisation for Economic Co-operation and Development (OECD), an international organization whose 38 member-countries includes the US. 
 
PFAS are a group of 12,000 man-made chemicals that are per- and poly-fluoroalkyl substances. Some PFAS chemicals never break down in the environment and can accumulate in our bodies, and are scientifically known to cause a multitude of long-term chronic and life-threatening illnesses: kidney, testicular, and breast cancers; high cholesterol; developmental damage to infants; birth defects; childhood obesity; thyroid disease, impaired vaccine response; and more serious COVID-19 outcomes. 

Protect Your Patients and Staff
Avoid all pesticides containing PFAS, which may be an active ingredient like Fipronil or Bifenthrin. Worryingly, some pesticides also contain PFAS as a hidden undisclosed "inert" ingredient or may be contaminated with PFAS from storage in plastic HDPE containers.

As our emerging PFAS crisis worsens and more products are tested and found to contain PFAS, embracing a prioritized IPM program that prevents the need for chemical pesticides is your best strategy for protecting your patients and staff from the dangers of PFAS and pesticides.

If you are using a prioritized IPM program, then pesticides, especially those containing PFAS are being avoided altogether with a non-chemical pest prevention and intervention program in place, and only least-toxic pesticides used as a very last resort.

Two recent studies have linked pesticide exposure and PFAS exposure to serious health issues for newborns: 


To minimize and even eliminate unnecessary toxic exposures to expectant mothers, newborns, and other vulnerable populations, ensure your vendor provides a prioritized IPM program at your healthcare facility. 
Safer Disinfectants for Infection Control
All too often, unbeknown to facility management, pesticide-registered disinfectants are used in healthcare, increasing patient risk.

Infection Control Challenges
High temperatures and humidity can contribute to the spread of infectious diseases and create an environment conducive to bacterial and fungal growth. Healthcare facilities should reinforce infection control protocols, maintain proper ventilation, and monitor humidity levels to minimize the risk of healthcare-associated infections.

The key: Prioritize using safer pesticide-free disinfectants to protect patients and staff from chlorine and quaternary ammonium pesticide-registered products linked to serious adverse health impacts. 


Johns Hopkins Bloomberg School of Public Health professor Dr. Ana Rule underscores adverse impacts of pesticide-registered disinfectants being used in healthcare and talks about Safer Disinfectants in this short 6-minute video. While Dr. Rule talks about this as it relates to a pandemic, it applies to the general use of disinfecting agents in the healthcare environment to address infectious disease concerns.

Our SaferDisinfectants website provides specific guidance on effective safe alternatives, verified by EPA’s List N for disinfectants at http://www.saferdisinfectants.org/
Did You Know?
Latest Tips from Joe
Joe Griffin had a 16-year tenure at Sheppard Pratt and a total of 35+ years of Senior Level Facility Support Operations experience. Joe is a consultant to the IPM in Health Care Facilities Project.

EVS Directors have their hands full, so we tend to rely on our contracted pest and land care vendors. That's why it's critical to remember: 
Your vendors work for YOU and under YOUR guidelines to provide
a safe facility environment, without adverse harm from pesticides.

Preventive Measures for Common Early Autumn Issues

Managing gnats, flies, and other summer pests is challenging this time of year. Common pests such as ants, flies, mosquitoes, and cockroaches may thrive and seek refuge indoors. However, with Prioritized Integrated Pest Management (IPM) strategies in place – a few examples outlined below – we can more effectively address these issues and maintain a clean and safe space for all.
Tip #1:
Require regular vendor monitoring & reporting
Ensure your pest management vendor is identifying and reporting pest conducive conditions to you and the appropriate department so that they can be addressed through housekeeping and/or maintenance interventions as the first line of defense.
Tips #2:
Institute indoor Autumn checklists
Housekeeping:
  • Promptly clean up spills, dispose of trash daily and properly, and ensure thorough staff education and sanitation practices to eliminate potential breeding grounds and food sources to make your facility less attractive to gnats, ants, roaches, and flies. Dietary staff break rooms and food debris at staff desks are frequent pest restaurants.
  • Loading docks and adjacent areas require regular and frequent cleaning and clutter reduction. 
  • 6” inspection/cleaning aisles should be maintained between stored items and walls for effective cleaning
  • Clean drains on a regular basis and fill dry drains with water
  • Space underneath dietary equipment requires regular, thorough, cleaning. Grease for example, is a pest attractant.
Maintenance:
  • Address any leaky pipes that can be an inviting water source to reduce pest pressures and keep stored mops off the floor.
  • Inspect and secure/seal entry points, including caulking with particular focus on gaps, cracks and openings in windows, doors, and vents, thus effectively preventing gnats and flies from infiltrating. 
  • With the arrival of cooler temperatures around the corner, now is the time to think about preventing rodents that seek shelter and warmth in healthcare facilities. 
  • Make sure to verify that your pest management vendor conducts a thorough inspection of the facility to identify and seal any gaps or cracks that could serve as entry points for rodents, as well.  
  • Reminder: Door sweeps have been shown to reduce rodent entry by 60%
Tips #3:
Discourage outdoor pest entry & breeding sites
  • Eliminate standing water; even a small amount serves as mosquito breeding sites. More tips here.
  • Keep shrubs/plants at least 6 inches away from building walls/windows to reduce pest roadways.
  • Piles of fallen leaves and yard debris can create hiding places and breeding grounds for pests.
Benefits of a Prioritized IPM Program
Does your facility adopt a prioritized, integrated approach to pest management? The benefits are many, and those benefits which are most important in the healthcare field are highlighted below.

We would love to learn if you’re implementing these practices, please contact Sean Lynch, Project Director of the IPM in Healthcare Facilities project, and let us know. We like to periodically highlight facilities that are using these best practices! 

  • Proactive, monitoring approach minimizes presence and damage from pests saving costly maintenance. 
  • Taking needed housekeeping and maintenance actions identified by the vendor and/or staff monitoring prevents unnecessary exposure to patients, staff, and visitors with only least-toxic pesticides considered as a last resort.
  • Targets specific pest harborage, entryways, and attractants to minimize pests and pesticides.
  • Prioritized IPM has other facilities benefits like improved energy efficiency from sealing door openings, cracks, and other openings. 
  • Addressing pest attractants like water leaks improves maintenance and saves water. 
  • Educates and engages the entire staff to understand their role in an IPM program and promotes a proactive mindset making your facility a clean and safe place to work, visit, and use as a patient. 

Contact Sean to see how you can benefit from our pro bono services regarding your implementation of a prioritized IPM program!
Schedule a Free Green Team Virtual Presentation
Invite us to provide your Green Team with a free virtual presentation addressing recent developments that can impact your facility's pest management practices.

Your Green Team is the central institutional committee responsible for identifying and implementing sustainability initiatives that reduce the environmental impacts of day-to-day operations. Protecting the population you serve, and your staff, from both pests and pesticides, is a critical aspect of reducing environmental impacts. 

We can help! Some topics we address in our Green Teams presentation and Q&A:
  • Ensuring the sustainability of your pest management program
  • How your IPM Policy is crucial to the health of patients and staff 
  • Safer alternatives to pesticides and pesticide-registered disinfectants
  • Recent research on widely used pesticides that impact healthcare
  • Pesticides that weaken immune systems and vaccine effectiveness, i.e. COVID-19 
  • Current Maryland-banned pesticides that your facility needs to be aware of
Manage Spotted Lantern Fly Non-toxically
Appropriate Management Steps Do Not Require Chemicals
Spotted lanternfly (SLF) has been making its way into Maryland and may be an alarming new pest in your facility's landscape. It is important to not overreact. SLF is harmless to humans. It is currently considered primarily a nuisance pest in residential landscapes. Death of ornamental and shade trees has not been directly linked to SLF to date. SLF is considered a plant stressor. High infestation levels may reduce photosynthetic activity and energy storage. Don’t attribute all plant health decline to SLF.
Mechanical removal methods
Removal of most host plants, notably the invasive Tree of Heaven, and retaining a few to attract SLF is recommended. Removal of egg cases can be done from late fall to early spring. In Maryland currently, SLF is in its nymph (instar) stage and these can be removed and crushed when found. Cone or circle tree traps are recommended for some trees; sticky bands are also effective but require screening as a wildlife barrier to protect non-target pollinators.

Reduced toxicity insecticidal control
Due to toxicity to people, pollinators, and fish, conventional chemical pesticides are not recommended in the health care setting. The good news is that Penn State, our nation's leading researcher on SLF, has found organic-certified insecticides to be effective. If you determine that you must spray a particular tree, these are the recommended choices:
Neem oil, natural pyrethins, insecticidal soaps, horticultural spray – look for "organic" or "OMRI" labelling – all are considered to be excellent or good at controlling SLF.

For more information, see Penn State's Spotted Lanternfly guide.
What's in Your Disinfectant?
Check your disinfectants for risk level
Some regularly used disinfectants in facilities are actually registered pesticides that can deplete a patient’s immune system and harm respiratory function – both of concern during our ongoing pandemic. Use the SaferDisinfectant.org website to see if what your facility uses is an “increased risk” or “safer” product.

Go to the SaferDisinfectants.org website's The List page and search your products by name, using your browser search keys, "Command + F" on Macs and "Control + F" on PCs. Type in the name to see if it has an increased risk or is a safer choice. View the Safer Choice list and sort by use site and need for better product choices.

The IPM in Health Care Facilities Project promotes safer pest and weed management best practices that are effective and protect the public and environment. Exposure to harmful pesticides can cause or exacerbate the very issues for which patients/residents are being treated. Especially during the challenging pandemic, we kept you updated on important news and research related to COVID-19 issues — from least toxic disinfectants to pesticides that do/do not exacerbate coronavirus symptoms. We support your efforts to ensure a protected and toxic-free environment for your facility and those you serve —
and ALL our IPM in Health Care Facilities Project services are FREE.
For information and help, 
contact us! 
call 301-664-4374
Our services are always free.
IPM in Health Care
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