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Pest Management in New York State Hospitals Page 1 of 36 3 1716 PDF Pest Management in New York State Hospitals Page 1 of 36 3 1716 PDF Home Pest Management in New York State Hospitals: Press Releases Risk Reduction and Health Promotion Attorney Gcneral's Page Attorney General of New York State Tour the AVs Office December 1995 Qntact thc A0':i Preface Oftice Links to Other Sites Chemical pesticides have been used in the United States since the 1950's. When effectively applied, pesticides can kill and control pests including insects, fungi, bacteria and rodents. In hospitals, chemical pest control has helped to contain Search -.- the smead of infection and has reduced infestations with vermin. On the negative side, pesticides have harmful side effects. Many pesticides are Privacy Policy known or suspected to be toxic to humans. 'They can cause neurologic damage, delayed development, cancer, reproductive dysfunction, and possibly Disclaimer impairment of the immune and endocrine systems. Concern about these effects was first expressed in the early 1960's and now has become widespread as knowledge has grown of the toxicity of pesticides. This balanced report from the Office of the Attorney General examines patterns of pesticide use in hospitals across the State of New York. The report recognizes the benefits that pesticides have brought to hospitals, but also it understands their potential for harm. The major finding is that pesticides are used widely in New York's hospitals. More than 30 different pesticide preparations are currently applied in hospitals across the state. They are used as fogs, sprays and powders. They are applied in virtually all areas of hospitals, including areas that contain patients. Very interestingly, the report finds that several hospitals in New York use only the least toxic pesticides. And three hospitals use no pesticides at all. The principal recommendation of this report is that all hospitals in New York should adopt the least toxic pest management policies and practices. This is an eminently sensible finding. It transcends partisan politics. It prescribes a highly reasonable course of action that every physician and hospital administrator across the state should follow. Indeed, this recommendation deserves to be heeded widely not only in New York but across the United States. Adherence to this recommendation will reduce pesticide exposures to patients and to hospital staffers and thus protect health. Additionally, adoption of this recommendation will save money. Pesticides are not cheap. Any approaches that sensibly reduce their use will help to contain hospital costs. iThe Attorney General's Office strongly recommends that hospitals adopt \ http://www .oag.state.ny.us/environment/hospital95.html 5/21/01 / Pest Management in New York State Hospitals Page 2 of 36 integrated pest management (IPM) programs. IPM is a systematic and sensible approach to pest control. It takes advantage of all the available options--non- chemical as well as chemical. The essence of IPM is an orderly decision-making process that reviews all pesticide use and then determines how to reduce that use. Wherever possible non-chemical approaches are employed. Several hospitals in New York and 10 major teaching hospitals in Boston have already adopted this approach and report great success with it. In summary, this is a landmark report. It deserves wide and careful attention. Its findings and recommendations will benefit the health of all New Yorkers. Philip J. Landrigan, M.D., M.Sc. (Dr. Landrigan is Chairman and Professor in the Department of Community Medicine of the Mount Sinai School of Medicine in New York City. He was Chair of the committee of national experts, convened by the National Academy of Sciences, which prepared the landmark report "Pesticides in the Diets of Infants and Children." He is also co-author of "Raising Children Toxic Free" published in 1994.) Contents 0 Preface Introduction 0 Survey Methods Results Discussion and Recommendations Hints for Hospitals Appendices o Survey Questionnaire o Hospitals Surveyed o Summary of Survey Responses Introduction A pesticide is "any substance or mixture of substances intended for preventing, destroying, or mitigating any pest...."' Over the last several decades, pesticide use has increased dramatically. As of 1991, Americans were using approximately one billion pounds of pesticides a yea?, twice what was used in 1964. Today, approximately 25,000 pesticide products, containing more than http://www .oag.state.ny.us/environment/hospital95 .html 5/21/0 1 , Pest Management in New York State Hospitals Page 3 of 36 600 different active ingredients, are on the market in the United States. An increasing body of scientific data on the potentially harmful effects of pesticide exposure on people and the environment raises environmental and public health concerns about the broad use of these toxic substances. According to the United States Environmental Protection Agency, "all pesticides are toxic to some degree, this means they can pose a risk to you, to your children and pet^..."^ As concerned citizens, we should evaluate the benefits pesticides bring to our lives and make reasoned choices about when, where and if pesticides should be used. Hospitals, with their lutchens and cafeterias, patient rooms, public areas and offices, are regularly treated with a variety of pesticides. People may be exposed to these pesticides without the opportunity to take precautions to avoid unwanted exposure. Pesticide use in hospitals may be of particular concern because exposure to pesticides is potentially more dangerous for children, the elderly and the infirm. Children, because of their physiology, are more sensitive than adults to many toxic chemicals, including pesticides. Some toxins will damage children's . growing and developing tissues more readily than fully established adult tissues4 Children eat more food, breathe more air, and drink more water per pound of body weight than adults; thus their exposure to and absorption of many toxic substances per pound of body weight is highe$,6. Further, "children taking medication may be at increased risk from pesticide exp~sure".~The elderly may have heightened sensitivity to pesticides as a result of the natural decline of various body systems which occurs with age. Patients of all ages may also be less resistent to the toxic effects of pesticides due to pre-existing disease, and the toxicity of pesticides may complicate illnesses. Pesticide exposure may cause symptoms which are not unique, such as headache, nausea, diarrhea, tingling sensations, numbness and respiratory distress. These symptoms may interfere with the diagnosis of a patient's primary illness. Conversely, symptoms of acute pesticide toxicity may be misinterpreted due to their similarity to the symptoms of pre-existing illness. Throughout New York State, and across the nation, individuals, organizations, schools and governmental entities are adopting Integrated Pest Management (IPM) as a means of reducing or even eliminating the use of toxic chemical pesticides. IPM strategies involve careful identification of the pest, establishment of levels of tolerance and an understanding of the biology of the pest so that a variety of physical, mechanical and biological means can be employed in controlling the pest. If it is necessary to resort to chemical controls, the least toxic alternative is selected. Choosing non-chemical alternatives constitutes a form of prudent avoidance of both the known and unknown risks of exposure to pesticides. IPM has already proven effective and economical in many different settings: homes, gardens, schools, government facilities and even in hospitals. The United States General Services Administration has established a successful program for 30 million square feet of government office space in http://www.oag.state.ny.us/environment/hospital95.html 5/21/01 Pest Management in New York State Hospitals Page 4 of 36 Washington D.C. The NYS Office of General Services has banned pesticide spraying in its more than forty office buildings and other facilities. Local governments from Nassau to Erie counties are acting as well. The Attorney General's office hopes that this report will provide a stimulus for hospitals and hospital associations to implement IPM programs at hospitals statewide. We wish to thank all the hospital administrators and staff who took the time to compile the information we requested and used in this report. Survey Methods In May, 1994 questionnaires were sent to all 296 hospitals listed under "New York" in the American Hospital Association's 1993 "Guide to the Health Care Field". We requested information on each hospital's pesticide use practices and policies, and pesticide use data for the most recent twelve month period for which such data was available. Given the need for hospitals to maintain the highest sanitary standards and to disinfect special areas (eg. operating rooms), we specifically excluded those pesticides found in cleaning agents and other disinfectants from the survey. We did not inquire about pesticide use on the hospital grounds. A copy of the Questionnaire is included as Appendix 1. A list of the hospitals we contacted, by county, is included as Appendix 2, with all responding hospitals identified. We appreciate the cooperation of these institutions and the time and effort devoted by the individuals who completed the questionnaires. Results Response Rate: One hundred and ninety-two questionnaires were returned in time to be included in our analysis. (Because some hospitals we contacted had more than one independent operating unit, some of which responded independently, we actually reached 302 hospitals.) This represents a response rate of 64% of the hospitals contacted. The responses were almost equally divided between public and private hospitals. About two-thirds of the respondent hospitals offered a wide range of general services; half of the remainder were psychiatric institutions and the rest offered a variety of limited services. One hundred forty- seven had intensive care units, 124 had pediatric facilities and 96 had nursery facilities. Respondent hospitals had as few as 15 beds and as many as 1478 beds.
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