INTEGRATED PEST MANAGEMENT
IN HEALTH CARE FACILITIES
PROJECT
NEW MOMS PROJECT
STUDENT OUTREACH PROJECT
Matt Wallach, Project Director,
Maryland Pesticide Network &
Beyond Pesticides
INTEGRATED PEST
MANAGEMENT (IPM)
IN HEALTH CARE
FACILITIES PROJECT
Reducing
harmful
chemicals
for patients,
staff, and
the
environment
through the
adoption of
green
practices.
WHY LOOK AT HOSPITAL PEST
MANAGEMENT PRACTICES?
To protect the health of vulnerable
patients and staff from the dangers of
toxic pesticides through toxic-free pest
management that promotes healthy
indoor and outdoor environments.
Create a facility free of pests and hazardous
pesticides in order to protect people who
are at the highest risk because of:
 immune and nervous system weakness
 those with breathing problems
 allergies and reactions to chemicals
WHY LOOK AT HOSPITAL PEST
MANAGEMENT PRACTICES?
A significant number of facilities (45%) recognize
that their pest management program should
reduce reliance on pesticides by addressing the
root causes of pest infestation, such as poor
sanitation and mechanical or structural sealing,
an indication of their commitment to the care of
their patients and residents.
WHY REDUCE PESTICIDE USE?
Vulnerable Groups
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infants and children
pregnant women/fetuses
the elderly
compromised immune and nervous systems
those with asthma or respiratory problems
cancer patients and survivors
those sensitive to chemicals
PRECAUTION
IPM is a commitment
to precaution.
IPM is a commitment
to measures that
prevent pests and the
need for toxic
chemicals.
REDUCING TOXINS IN THE
FACILITY WITH IPM
IPM is a pest management strategy that
provides long-term pest prevention and
suppression through a combination of
practices such as:
 Regular pest population monitoring
 Site inspections
 Occupant education
 Structural, mechanical, cultural, and biological
controls
Least-toxic pesticides are only used as a last
resort
IPM AND PEST HAZARDS
 Pesticides treat but do not solve
or prevent pest issues
 IPM can eliminate fly breeding
areas and entryways into a facility
 Proper IPM implementation
removes the cardboard, water,
and dirty surfaces that rodents
and roaches enjoy
IPM IMPLEMENTATION
Eliminate Food - Restrict Entry
Control Habitat
Inspect - Detect - Correct
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Sanitation
Vacuuming
Pest proofing waste disposal
Structural maintenance
Mechanical traps
LEAST-TOXIC PESTICIDES
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Boric acid (borates, disodium octoborate tetrahydrate)
Diatomaceous earth / silica gel
Microbe-based insecticides (B.t.)
Soap-based products
Non-volatile insect and rodent baits
Liquid nitrogen (cold treatments)
EPA Exempt natural pesticides (FIFRA 25(b))
IPM IN HEALTH CARE FACILITIES
PROJECT - THE PROCESS
When we work with Health Care Facilities we offer:
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Written Pesticide Use Survey
Facility and Grounds Walk-Throughs by IPM Team
Vendor Contract and IPM Plan Review
Written Assessment Reports and Recommendations
Model IPM & Natural Land care policy, plan and vendor contracts
Development of IPM policy
Employee training in IPM
Implementation Assistance
Staff understand their role in maintaining a pest-free facility without the use of
toxic chemicals.
They understand the difference between IPM and conventional pest management
IPM IN HEALTH CARE FACILITIES
PROJECT - IPM COORDINATION
To effectively implement an IPM program it is essential for
the health care facility to establish an IPM coordinator
position.
The IPM coordinator is responsible for:
 Tracking actions of pest management technician
 Reviewing technician and complaint logs
 Coordinating addressing pest conducive conditions identified by
technician
 Periodically accompanying technician on walk-through of facility
 Approving use of least-toxic pesticides as a last resort
 Overseeing contract agreements with vendor
IPM IN HEALTH CARE FACILITIES PROJECT THE WALK-THROUGH ASSESSMENT
Focus on conducive conditions in pest vulnerable areas:
 Loading docks and receiving areas
 Kitchen, food storerooms, cafeterias,
dishwashing
 Staff lounges and break rooms
 Lavatories and locker rooms
 Custodial storage and utility rooms
 Mechanical and operations areas
 Dumpsters and anywhere trash is handled
 External grounds (habitat and entryways)
IPM IN HEALTH CARE FACILITIES PROJECT THE WALK-THROUGH ASSESSMENT
Working with the Technician
Hospital Staff must be
made aware of the
conditions at the hospital
This example log shows
positive work by hospital
staff. There are no pests,
no pesticide applications,
and no recommendations
If there are pests, the
technician will identify
the conditions conducive
to pests, list the
chemical or nonchemical actions, and
list recommendations
for the hospital to
eliminate the pest
conducive conditions.
IPM IN HEALTH CARE FACILITIES
PROJECT
Before IPM Implementation
After IPM Implementation
No understanding of what chemicals are
applied by the technician
Technician works and communicates with
vendors, maintenance, housekeeping to
ensure a pest free environment
No cooperation of hospital staff and
hospital departments to deal with
prevention of pest problems
Limited understanding of how cleaning
clutter and cracks contribute to pest
problems
Greater understanding by all hospital staff
of what is applied when a product is
needed
The hospital becomes a cleaner, healthier
place, with less clutter, cracks, and cleaner
conditions
NEW MOMS PROJECT
Protecting
babies
from
pesticides
WHY WE CREATED
THE NEW MOMS PROJECT AT UMMC
We are committed to
protecting the health of a
new baby
WHY WE CREATED
THE NEW MOMS PROJECT AT UMMC
 Infants and children are the most vulnerable to the
health effects of pesticide exposure.
 UMMC works to reduce pesticides throughout the facility
to protect patients from unnecessary exposure to
hazardous chemicals – so educating new parents is a
next logical step.
PESTICIDES AND CHILDREN’S HEALTH
Our children are exposed to
pesticides in:
 Air, Food, and Water
 Parks and Schools
 Day Care Centers and in their
own homes
A 2005 study concludes that children up to 4 ½ years old
put their hands to their mouth as much as 19.4 times per
hour.
The third National CDC Body Burden report tested 3,000 people for various
chemicals; the 6-to-11 year old children tested had very high levels of pesticides
in their bodies – four times the amount thought to be acceptable by EPA.
PESTICIDES AND CHILDREN’S HEALTH
The developing brains and bodies of children are in a complex
and fragile stage that regulates tissue growth and organ
development.
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Long-term potential consequences of even one pesticide exposure at a critical
state in fetal development include adverse health impacts on children’s
neurological, respiratory, immune, and endocrine systems, even at low levels of
exposure.
PESTICIDES AND CHILDREN’S HEALTH
CONTINUED
Studies show that pesticide exposures are associated with:
 Birth/Developmental Defects
 A study found that organophosphate (OP) pesticides exposure by pregnant
women may affect both length of pregnancy and birth weight. In some cases,
household uses of OPs have been cancelled because of the extreme health risks
to children, but agricultural, golf course, and mosquito control uses remain on
the market.
 Childhood Cancers
 A study in the Journal of the National Cancer Institute
found that household and garden pesticide use can
increase risk of childhood leukemia as much as sevenfold.
 Neurodevelopmental delays
 Endocrine disruption
PESTICIDES AND CHILDREN’S HEALTH
CONTINUED
 Asthma
 A study found that children exposed to herbicides in their
first 12 months were more than 4 ½ times as likely to develop
asthma. Children who were exposed to pesticides in general
were nearly 2 ½ times as likely to develop asthma .
Autism Spectrum Disorders (ASD)
A study linked the pesticide bifenthrin with increased rates
of autism. Bifenthrin is an endocrine disrupting pesticide
that was banned by the European Union in 2009.
Anxiety, depression and aggression
 Attention-Deficit/Hyperactivity Disorder (ADHD)
 A study analyzing umbilical cord blood from 600 children found that boys who
were exposed to higher levels of organochlorines – polychlorinated biphenyls
(PCBs) and DDE (a metabolite of DDT) – in the womb scored lower on focus and
concentration tests.
REDUCING TOXINS IN THE
FACILITY WITH IPM
 UMMC is a community leader with capacity to educate
patients on healthy lifestyles and safer alternatives to toxic
pesticides found in baby care, cleaning, and pest
management products
 UMMC puts an emphasis on housekeeping, recognizes the
importance of maintenance, strives to be a pesticide-free
facility and only uses least-toxic
pesticides as a last resort
 The nurses at UMMC educate the
patients in the mother/baby unit
on the dangers of toxic pesticides
and how they can protect the health
of their baby and family.
THE NEW MOMS PROJECT BACKGROUND
 Throughout 2011, the IPM in Health Care Facilities Project
in collaboration with the nurses in the mother/baby unit at
UMMC created educational materials for the new parents.
 Donated samples of safe products for pest management,
cleaning and baby care were
collected for distribution to the
new parents.
 The project launched in
December 2011.
THE NEW MOMS KIT
INSIDE THE NEW MOMS KIT
INSIDE THE NEW MOMS KIT
THE SURVEY
1. Please write the date that you gave birth to your
baby ____________________
2. Before reading the “Make Your Home Safe for
Baby” booklet and watching the video on protecting
your baby from pesticides,
a) How much did you know about safer ways to
control pests?
_ A lot _ A little _ Nothing at all
b) What was your main method of pest control?
Check all that apply_ We used an Exterminator
_ We sprayed pesticides
_ We used ant and/or roach bait stations
_ We did not use any pesticides
_ We used only natural/non-toxic pest control
products Please list products
3. If an exterminator services your house or
apartment, do you know what pesticides are used?
_ Yes _ No _ We do not use an exterminator
4. Before reading the booklet and watching the
video on protecting your baby from pesticides, did
you use cleaning and/or baby care products like the
non-toxic samples in the kit the hospital gave you?
_ A lot _ A little _ Not at all
5. After reading the brochure and watching the video
on protecting your baby from pesticides, what
following changes have you made or do you plan to
make to protect your baby and your family? Check all
that apply
_ Change how you store food and clean your kitchen
_ Use caulk and door strips to keep out bugs
_ Use natural products for pest control:
_ sometimes _ all the time
_ Use natural/non-toxic cleaning products:
_ sometimes _ all the time
_ Use safe/natural products on your new baby’s skin
such as soaps, baby wipes, and diapers:
_sometimes _all the time
_ Avoid sitting, lying, or playing on any grass with a
“CAUTION PESTICIDE APPLICATION” sign
6. Do you believe that using the information in the
brochure and the CD will improve the health of your
baby and everyone in your household?
_ Yes _ No
SURVEY: EARLY RESULTS
100 percent of the respondents indicated
that they believe that using the
information in the brochure and the CD
will improve the health of their baby and
everyone in their household.
REPLICATION?
This project can easily be replicated in
other Maryland health care facilities
interested in practicing IPM and
education on the dangers of toxic
pesticides and safer alternatives to
protect the health of staff and
patients - especially newborns.
The IPM in Health Care Facility Project
assists MD facilities at no cost on
implementing a defined IPM program
and New Moms project.
STUDENT OUTREACH
PROJECT
Educating
students
and making
changes in
the
community
THE IPM COMMUNIT Y OUTREACH
PROJECT
 Our goal is to first educate students on
the dangers of pesticides, IPM, and safer
alternatives to pest control
 Then have students educate community
members, community leaders and
community market and restaurant owners
about alternatives to the hazards of
pesticides.
LOCAL MARKET AND RESTAURANT PROJECT
OVERVIEW
Teams of students approach community stores and
restaurants and talk about:
Teach about the hazards of pesticides and
protection through IPM.
Talk about alternatives and less-toxic pest
management products
Suggest separating food from chemicals
Follow up with store owners
Students earn credit toward their student service
learning requirement!
STUDENTS LEARN!
Students learn:
 About the dangers of pesticides
 About the flaws in the regulatory process
 Where pesticides are found
 How to identify pest conducive conditions
 How to make recommendations to stores and
restaurants which will result in less pesticides
used in their businesses and communities
PRODUCTS COMMONLY FOUND IN STORES
GATHER BACKGROUND INFORMATION ON THE
PEST PROBLEM(S)
Interview the store
owner and record
information:
Thoroughly inspect
the property and
record:
Type of problem/pest
Evidence of
problem/pest
Location and numbers
of problem/pest
Potential sources of pest
Conditions conducive to pest
infestations (structural,
environmental, behavioral)
History of the problem
Actions taken by the
client and the results
Potential problems associated
with the pests
Questions?
Matt Wallach
IPM in Health Care Facilities Project
mwallach@beyondpesticides.org
410-605-0095