The role of the private sector in the identification and disinfection of surface pathogens is rapidly becoming a necessity. As bacteria continue to adapt and gain resistance to both antibiotics as well as commonly used disinfectants our indoor environments may become a safe harbor for organisms that could impact human health.
This issue is gaining public awareness which is leading to the development of private sector service providers. Historically, the service sector has addressed indoor environmental issues such as asbestos and mold (with mold a particular issue here in Florida) by responding with various abatement techniques which included removal of real or suspect contaminants, HEPA vacuuming and filtration and surface cleaning with a variety of antimicrobials that sprang to life once the market demanded them.
These industries (Asbestos & Mold) became billion dollar markets over the past ten years and gave life to laboratories, restoration companies, equipment suppliers and chemical distributors. While public awareness on mold issues created some hysteria, the truth is that bacteria not mold is the real threat to human health particularly in light of the many recent peer reviewed papers that document the increase in infection rates both within and outside of healthcare facilities. To address this need, some of the established restoration companies and hygienists are becoming trained in infectious disease awareness (the why of its importance, primary indoor areas of concern, sample analysis and how to properly disinfect). Their goal, as they see it, is to first determine if the pathogens exist on environmental surfaces and then once a disinfection plan (written by a hygienist) is in place, they can implement the cleaning process. While these services may be seen today as novel or only rarely necessary, it is possible at some time in the future, physicians will consider disinfection of the indoor environment as a necessary adjunct to the treatment of their patients. Many white papers have shown that some bacteria and viruses can remain viable on surfaces for hours, days or weeks. This allows for the potential exposure of occupants to such organisms likely through the oral/fecal route. Proper cleaning and disinfection of environmental surfaces is critical but few facilities or patients have the knowledge or take the time to clean properly even in the face of known infections.
How the environmental services companies (outside of the healthcare sector) respond to this issue is still emerging. Their first likely venture may be Norovirus outbreaks at nursing facilities where staff is ill prepared to properly contain and disinfect their environments. The inherent knowledge of restoration companies to build containments and deliver negative pressure systems to control the spread of viral particles (for example) may provide an important element in the decontamination process. This iterative process will likely lead to other response services both in homes, buildings, schools and healthcare facilities as concerns specific to ESKAPE pathogens as well as viruses dictate outside service providers.
Sampling to determine if a suspect pathogen is present will likely utilize both PCR & culture methods. Primers for specific organism and media specific cultures will be required to insure accuracy.
While bacteria will be found in literally all samples collected, the goal is to look for specific organisms of concern particularly if directed by treating physicians or during an outbreak with a suspect target.
Restoration companies should not conduct any sampling or prepare an environmental treatment plan. That shall be the purview of a qualified hygienist with support from an AIHA accredited laboratory.
The key to the success of the restoration industries move into infectious disease decontamination services is their skill, knowledge and technical support. This is a new area for this business sector and how many succeed is still to be determined.
Irv Kraut is an Environmental Hygienist who lives and works in Florida. He is a past director for the IESO (Indoor Environmental Standards Organization) and has been published by the USEPA and the American Chemical Society. Irv can be reached at irvkraut@gmail.com. His company web site is: www.industrialhygienepro.com
