By Richard Driscoll
In a previous article in Cleanfax, I spoke about the profitability of trauma scene cleaning and the business potential of this type of work.
For those who wish to engage in trauma scene cleaning and are really looking at it as a service to offer their marketplace, it is very important to be informed about the regulations that affect this industry.
Most of us come from a background of carpet cleaning and/or water damage, fire and smoke damage, or mold remediation, among other cleaning or construction backgrounds. In these types of services, we are usually minimally concerned about regulations. Sure, we need to understand the details of OSHA regulations for providing a safe work place, the proper use of personal protective equipment (PPE) if required on the job, the types of cleaning and restoration solutions we use, and the potential issues with asbestos and lead paint, as examples. But, for the most part, there are not any real, day-to-day regulations. In the trauma scene cleaning world, there are real regulations. Every day.
The government says. These regulations come from various federal agencies, and you know them all too well. They are full of acronyms, such as OSHA, CDC, FDA, EPA, etc. And they also come from state governments.
The OSHA/ federal regulations primarily deal with safety. The state regulations primarily deal with waste handling and disposal.
Let’s analyze these regulations.
“Safety first” may be a cliché to some, but it’s not to the federal government.
From the federal government’s perspective, it is up to the company to provide a safe workplace. This is referred to as the “general duty clause.”
In addition to providing a safe workplace environment, additional regulations, as in the Bloodborne Pathogens (BBP) Standard, mandate an exposure control plan, proper training, provision of proper immunizations, and proper use of PPE.
Trauma scene cleaning also has safety requirements known as Universal Precautions and those found in the Needlestick Safety and Prevention Act.
The federal government, specifically the EPA, has deferred to the states to establish the requirements for proper bio-medical waste handling and disposal.
Unlike federal regulations, which are the same across all states, each state has its own regulations on the definition of what bio-medical waste is and proper bio-medical waste handling and disposal methods.
Furthermore, these regulations are all over the map on their requirements. Some states allow the treatment of affected items — such as towels used in clean-up work and contaminated and removed carpet — with bleach. These items can be discarded in a regular dumpster. Other states are much more restrictive and require that all contaminated waste be taken to a proper disposal site and burned. There are many states whose regulations fall between these two extremes.
The question may come up: Why the need for all these regulations? And a couple of examples will show why.
We were called in to clean up a the scene of a recent suicide. We arrived, three technicians, to do the work.
We met the surviving family members, introduced ourselves, and asked for permission to come into the home. This was granted, and we scoped the job. Then we returned to the truck, performed a risk assessment, laid out our plan of action, and were in the process of donning PPE when a van from the local church pulled up to the home.
Out of the van came five adults, dressed in shorts, tee shirts, and flip-flops. They headed to the home. I interceded and asked if I could help. I was informed that the surviving family members were part of their church and that the five from the van were going to do the site cleanup — our professional services would not be needed.
I tried to explain to these church members that they really did not know what they were getting into. Also, I explained that the way they were dressed was not appropriate for the work they were planning on performing. I was advised again that our services would not be needed.
I checked with the surviving family members. They thanked us for trying to help but confirmed they would have the church members do the clean-up work.
In the trauma class I teach, I have been told by numerous students, from numerous restoration companies, that the “boss” does not believe in the technicians having or wearing PPE as it is an unnecessary expense.
Instead of properly protecting employees and technicians, these restoration companies concentrate on the bottom line. If proper PPE is not going be used, then the work should not be performed!
As these two examples show, many of us think that cleaning up blood and items affected by blood or bodily fluids is not a potential, major health concern or issue to address.
The term “common sense” often comes to mind. If we use common sense, we all know that blood potentially can be contaminated with HIV, other sexually transmitted diseases, and hepatitis, among others. And if there is any chance you could become infected, then you should protect yourself.
My dentist, when working in my mouth, wears protective glasses and a paper mask over his mouth and nose. Why does he do so? It’s common sense. He knows there is a chance body fluids, such as blood, could become a contamination issue.
If I, or another worker on my team, were cleaning up blood from someone we never knew, we would want to be protected. It’s common sense. In my opinion, if proper PPE is not provided by the employer, then the technician should not perform the work. And there is the issue.
Common sense is apparently not very common at all, so regulations are needed to force employers to protect their workers from exposure to possible contaminants in specific situations.
Let’s look closer at what these regulations mean.
From the federal level, the most important regulation is the Bloodborne Pathogens (BBP) Standard. The regulations have multiple parts:
- All blood must be considered to be contaminated,
- All workers must be offered hepatitis B vaccinations,
- All workers must be given BBP training,
- All workers must be provided proper PPE and training on how it should be used,
- Each company must have a mandated policy and procedures to minimize the potential for exposure, which includes how waste is handled (packaged),
- Each company must have a written exposure-control plan, of which OSHA has a prepared template to make this task easier.
As previously noted, the EPA has deferred bio-medical waste handling and disposal to the states, and these regulations continue to change. The EPA website has a map1 of the United States that allows users to choose the state they work in and be directed to the department in the state government that regulates bio-medical waste handling and disposal.
This is an area of regulations that must be checked routinely as states change the rules via either legislation or agency regulations. These changes occur with little publicity, so the state agency that controls these regulations should be checked for changes that could affect your business.
Follow the regulations
Some of the trauma scene clean-up and decontamination work that will be performed will be related to police activities. This means the potential to have someone who is familiar with the BBP Standard on the scene is a real possibility. Trying to avoid regulations, and/or skirting them, is just asking for trouble.
Follow the regulations, and price the job accurately for the work to be performed. Provide the training the technicians need to do this work properly. Invest in the proper equipment that is required and mandated.
If you do this, trauma scene cleaning can be a very profitable segment of your business.
Richard Driscoll has a bachelor’s degree in mechanical engineering from Clarkson College of Technology, an MBA from the University of Dayton, and is currently working on his doctorate. He is a professor at Webster University where he provides graduate and undergraduate level lectures. He is an IICRC Certified Master Restorer, Master Textile Cleaner, and approved instructor. He also is the author and instructor for Restoration Sciences Academy’s MR-110 and MR-210 microbial remediation classes and MR-211 trauma scene clean-up class. He can be reached at [email protected].