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Facility Hygiene – EHOs and
Occupational Hygiene
Brett Cole. Biosafety Pty Ltd
Friday 1st September 2017
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1. Introduction
2. What is Hygiene, Occupational Hygiene and Facility Hygiene?
3. Potential Hygiene Projects EHO may be exposed to?
4. Methamphetamine/Clandestine Laboratories
5. Mould/Water damage
6. Outbreaks (Gastroenteritis)
7. Case Studies
8. Conclusion
9. Questions
Facility Hygiene: EHOs and Occupational Hygiene
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• Bachelor of Science with Honours Degree – Microbiology (Monash University)
• Masters Degree in Occupational Hygiene and Toxicology (Edith Cowan University)
• Over 20 Years experience in Infection, Waste and Contamination Control (Public Health, Healthcare, Pharmaceutical and Laboratory)
• IICRC Certified for Water Damage and Mould/Microbial Remediation • Committee Member of ABSANZ Regulatory Committee (OGTR, DAFF
and AS/NZS)• Internationally Certified Biorisk and Biowaste Management
Professional (IFBA)• Member of Australian Standards Committees (CH-029) Safety in
Laboratories Standards• Licensed with Department of Health and Human Services• Member of ANZLAA, ABSANZ, SCRIA, ISPE and ACPIC• 2017 Australian Restoration Awards – Most Innovative Specialised
Restoration Project – Microbial Infestation Restoration of a Medical Research Facility
Professional Experience-
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What is Hygiene?"Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases.” (WHO, 2017)
“Occupational hygiene uses science and engineering to measure the extent of worker exposure, and to design and implement appropriate control strategies to prevent ill health caused by the working environment. It helps employers and employees understand the risks, and promotes improved working conditions and working practices” (AIOH, 2017)
“Facility Hygiene is the process of identifying, measuring, researching, remediating and confirming safe, a property that has been contaminated or potential contaminated to ultimately preserve the health and safety of occupants, the public and the environment” (Brett Cole, 2017)
What is Occupational Hygiene?
What is Facility Hygiene?
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What is Facility Hygiene Process?
Irrespective of the contamination or potential contamination, the following process is key to successful outcomes:
1. Identify the source of the contamination
2. Measure and analyse the extent of contamination (Preliminary Testing) by a Indoor Environmental Professional (IEP)
3. Research Available Standards, Acts, Codes of Practice, Regulations, Guidance Materials, International Standards, Best Practice.
4. Discuss Project/Process with Stake holders.
5. Determine the Scope of Works (SOW) or Remediation Action Plan (RAP) to remediate the property to “Pre-existing conditions” or safe for occupancy/continuation of business. Works should be completed by a suitably qualified or licensed professional
6. Measure and analyse the extent of contamination post remediation (Post Remediation Verification or PRV) by IEP
7. Clearance based on passing minimum or regulatory requirements
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What is Indoor Environmental Professional?
1. A Qualified Occupational Hygienist
2. A Qualified Environmental Scientist or Engineer
3. A Qualified Indoor Environment Professional
4. A Qualified Environmental Health Professional
5. A Qualified Public Health Professional
6. A Qualified Building Biologist
7. Any of the above with IEP Experience
8. Professional Certifications or Memberships
9. Reference List
10. Appropriately Licensed or Certified
11. Appropriate Professional Indemnity Insurance specific to the nature of the testing required
12. Anybody else?
The IAQA Working Group on defining an IEP (2017)
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Possible Hygiene Projects that an EHO may face?
• Methamphetamine/Clandestine Laboratories
• Water Ingress/Flood
• Mould and Microbial Contamination
• Gastroenteritis/Norovirus outbreaks
• Contaminated Food Facilities
• Listeria/Salmonella Infestations
• MRSA/VRE Outbreaks
• Legionella Outbreaks
• Epidemics or Pandemics
• Asbestos and contaminated sites
• Ebola, Hendra virus or other category 3 or 4 biohazard.
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Possible Hygiene Projects that an EHO may face?
• Methamphetamine/Clandestine Laboratories
• Water Ingress/Flood
• Mould and Microbial Contamination
• Gastroenteritis/Norovirus outbreaks
• Contaminated Food Facilities
• Listeria/Salmonella Infestations
• MRSA/VRE Outbreaks
• Legionella Outbreaks
• Epidemics or Pandemics
• Asbestos and contaminated sites
• Ebola, Hendra virus or other category 3 or 4 biohazard.
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Methamphetamine/Clandestine Labs:
https://www.ag.gov.au/CrimeAndCorruption/Drugs/Documents/Clandestinedruglaboratoryremediationguidelines.pdf
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What is mould?
• From the Kingdom Fungi
• Not Animal or Plant
• Form of multicellular thread-like structures called hyphae.
• Some Fungi exist as single cells are called yeasts.
• Can cause disease or food/product spoilage, others play an
important role in biodegradation or in the production of various
foods, beverages, antibiotics and enzymes
• Can reproduce sexually or asexually via spore release
• Require high relative humidity to exist (>60% RH)
• Cannot produce their own energy
• Require organic material to feed on
• Can release airborne Mycotoxins
• Can cause adverse health effects
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What is mould?
• Some are good
• Some are bad
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Sources of mould:
• Spores are everywhere!
• Poor Heating, Ventilation and Air Conditioning (HVAC) maintenance
and hygiene
• Bought in from the external environment
• Cellulose material such as cardboard, paper and wooden pallets
• Contaminated equipment and furnishings
• Flooding introducing spores from external environments
• Poor or improper decontamination processes
• Inappropriate drying of construction materials
• Leaks in building structure
• Poor building hygiene
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• Identify the source of moisture or water ingress as soon as possible
and repair
• If floods occur, there is a need to react quickly to water damage
within a facility aggressively and fully dry or replace damaged walls
and ceilings within 72 hours to prevent mould growth.
• Temperature and humidity controls must be in place to discourage
fungal growth, that is, RH < 60% RH. Need to rapidly dry the
building materials to “pre-existing” condition to minimise mould
growth
• Minimise cellulosic materials such as cardboard and wooden
products from affected homes as they can become wet and support
fungal growth.
• Cleaning and disinfection procedures must be in place to prevent
people and property introducing fungi into facilities.
How to deal with a premises affected by mould/fungal growth?
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How to deal with a premises affected by water ingress and/or mould/fungal growth?
• Preliminary testing should be undertaken to determine moisture
levels of affected and unaffected areas to determine target moisture
levels and if mould present, microbial testing to determine viable
and non-viable microbial (performed by an Indoor Environmental
Professional or IEP)
• Set up containment zones to minimize the spread of contamination
and or spore spread
• Deploy dehumidifiers and air scrubbers/movers to bring affected
area moisture levels down to pre-existing condition.
• If mould present, follow IICRC S520 guidelines (HEPA Sandwich and
application of anti-microbial treatment)
• Post Remediation Verification (PRV) by IEP or Occupational Hygienst
• Make sure appropriate PPE and containment is always in use!
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Mould Standards:
• IICRC S500 Guideline for Water Damage
• IICRC S520/R520 Guideline for Mould Remediation
• Australian Mould Guidelines (AMG), 2010
• The Mould Workers Handbook
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Gastroenteritis Outbreak:
• Can occur anywhere
• Generally in communal areas such as aged care, childcare, schools,
workplaces, healthcare and other public areas
• An outbreak is considered to be 2 or more infected people from the
same cohort (DOH)
• Can be transmitted by poor facility, contact or hand hygiene
• Can be caused by viral, infection, bacteria or contaminated food
products
• Department of Health Website and disinfection guidelines -
http://www.health.gov.au
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Gastroenteritis Outbreak:
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Case Studies
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Documented Contamination Case Studies:
2015 - Mould in a anti-tuberculosis manufacturing facility in India. WHO issued
a Notice of Concern (NOC) for black mould found in GMP facility. Product recall
and shortage of supply.
http://www.in-pharmatechnologist.com/Regulatory-Safety/Black-mould-and-
rusty-equipment-lands-Indian-TB-drugmaker-WHO-warning
2012 – New England Compounding Centre shut down after 64 meningitis
related deaths from fungal contamination of products.
https://www.cemag.us/blog/2017/01/pharmacists-fatal-meningitis-outbreak-
facing-trial
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Case Study: Meth Lab in an inner city apartment
Preliminary Testing, Remediation and Post Remediation Verification
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Case Study: Cell Culture Laboratory with Mould Contamination caused by
Mould biofilm in the ceiling space:
Source removal and application of antimicrobial
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Case Study: Cell Culture Laboratory with Mould Contamination caused by
Mould biofilm in the ceiling space:
Source removal and application of antimicrobial
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Case Study: Mould Decontamination – Cool Room Fan Unit
Mould Decontamination in a Commercial Food Facility
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Case Study: Facility Decontamination – Animal Facility – Pinworm Outbreak
Facility with single stage physical clean and pinworm egg Inactivation using
Chlorine dioxide gas
Total Project Duration = 7 days (6 day clean, 1 day gas)
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Case Study: Facility Decontamination – Animal Facility – Pinworm Outbreak
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Case Study: Facility Decontamination – Remote Film Set – Norovirus Outbreak
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Summary:
1. Irrespective of the contamination or potential contamination following the process is key to successful outcomes
2. Identify the source of the contamination
3. Measure and analyse the extent of contamination (Preliminary Testing) by a suitable Indoor Environmental Professional (IEP)
4. Research Available Standards, Acts, Codes of Practice, Regulations, Guidance Materials, International Standards, Best Practice
5. Determine the Scope of Works (SOW) or Remediation Action Plan (RAP) to remediate the property to “Pre-existing conditions” or safe for occupancy/continuation of business. Works should be completed by a suitably qualified or licensed professional
6. Measure and analyse the extent of contamination post remediation (Post Remediation Verification or PRV) by a suitable IEP
7. Clearance based on passing minimum or regulatory requirements
8. If in doubt, retest, re-examine and repeat.
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What happens when we don’t get it right:
• The health and safety of people, property and the environment is
affected adversely. In other words, PEOPLE GET HURT!
But if we follow a good, sound, scientific approach and we get it right!
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Why we as EHO/IEP do what we do?
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ANY QUESTIONS?
Thank you for your time!
Please feel free to email me at [email protected]