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Several years ago, I was attending a plumbing industry annual meeting and the topic of discussion during one of the social events was hazardous medical waste. Several of the plumbing contractors in attendance spoke up and talked about their experience with repairs and renovations while working in hospitals. The stories included a story where they cut into existing sanitary drain from an area that served fixtures in an infectious disease wing of the building.
The contractor said they were sprayed with the waste that was partially filling the pipes. He talked about what it felt like to be on a ladder and have a pipe come apart and pour waste in your face and down your clothes. He said they were exposed to the bacteria and smelly waste in the drains, which most likely included waste from many sick people in the hospital.
The discussion covered many of the bacteria, germs and diseases that plumbers are exposed to when working on existing plumbing systems. One of the plumbers said, “This kind of exposure was not really covered in the safety training topics I attended as a tradesman.”
We listened intently as each contractor told a story about an exposure to various hazards they had seen over the years. One of them said, “Some of the safety issues we discussed were covered by OSHA, but I cannot recall any OSHA training on exposure to pathogens and bacteria in drains.”
One of them, a plumber from Portland, Ore., suggested maybe even developing a separate training program for exposure to blood borne pathogens in wastes. I pointed out that plumbers are exposed to much more than just blood borne pathogens. There are many exposures including numerous organic pathogens, live bacteria including Legionella, viruses, radioactive waste, bodily fluids, etc. All of these from people infected with various communicable diseases that are staying in hospitals and using fixtures connected to the drains that are being repaired or maintained.
The discussion came full circle as everyone agreed there needed to be something to address this hazard. They agreed there should be a standard or some kind of procedures for working on hazardous plumbing systems for the health and safety of the workers. They agreed that many tradesmen are generally unaware of the hazards in the various plumbing pipes. The hazards discussed included: flammable gasses, compressed gasses, stagnant or dead-end water pipes with Legionella bacteria or other pathogens growing in stagnant water. There was also: drainage from hospitals with all kinds of flu viruses, bacteria, chemotherapy (radioactive) waste, blood, bodily fluids, AIDS, and nitroglycerin, which is an explosive used for heart medication.
One of the plumbers told a story about exploding drains where someone was cutting into a drain with a build-up of Sodium Azide residue in it. The Sodium Azide is a colorless, odorless, crystalline solid that is readily soluble in water. It was poured down a drain and formed as a sediment in the bottom of the drain. Apparently it is very explosive. It is typically used as a preservative of samples in hospital laboratories. Generally, it is used in strengths of 0.1 to 2 percent. Pure Sodium Azide and concentrated solutions of Sodium Azide are acutely toxic and can be reactive when heated near their decomposition temperature. Diluted solutions of Sodium Azide should not be poured down a drain because it can react with metals in the plumbing systems to form explosive metal halides. One of the contractors said Sodium Azide is also used as an explosive trigger in automobile airbags. I remember a plumbing engineer friend, the late John E. Matthews, PE, telling me a similar story about Sodium Azide and drains many years ago.
Other hazards they discussed were slippery floors, proper marking of hazards, and chemical labeling, handling of, and repairing pipes carrying infectious and chemical wastes. They also discussed spill and emergency procedures, and use of appropriate personal protective equipment when working with hazardous wastes and when exposed to hazards.
There was also a discussion of a need for adequate hand-washing facilities, the possibility of the presence of needles and other sharp objects in hospital drains, and the need for containers for catching hazardous liquids when making repairs on existing piping systems. Many of these things are covered in the OSHA standards.
There was a discussion about proper exhaust ventilation for ethylene oxide sterilizers. Obviously the plumber or maintenance technician working in a hazardous environment, like a hospital or industrial facility, needs to be aware of all of the potential hazards associated with that facility.
What might seem like a simple or routine plumbing system maintenance or repair could be deadly if the workers, hospital staff and patients are exposed to hazards associated with the plumbing systems. Someone said there needed to be training and education for these hazards and suggested that ASSE develop a standard to provide general knowledge of pathogens, biohazards, and infectious diseases for plumbing, piping, and mechanical systems workers. The standard would also help any individual who has the potential for exposure to pathogens, biohazards or other potentially infectious material.
Soon after that informal meeting, the word made it back to the board at ASSE and they soon formed a committee to take on the task of developing a standard for the health and safety of construction and maintenance personnel. The standard is titled ASSE SERIES 12000 - Professional Qualifications Standard for the Health and Safety of Construction and Maintenance Personnel.
The following persons participated in the development of the standard: Edward Lyczko, chairman of Cleveland Clinic - Cleveland, Ohio; Ron George, of Plumb-Tech Design & Consulting Services, LLC; Matthew King, III, of Berwick, Pa.; Gary Howard, of the Cook County Dept. of Building & Zoning, Illinois Plumbing Inspectors Association, and UA Local 130, Chicago, Ill.; Rita Neiderheiser, of UA Local 669, Denver, Colo.; Richard J. Prospal, of Prospal Consulting Services, Inc., Brunswick, Ohio; Donald Summers Jr., of UA Local 562, St. Louis, Mo.; Russell Thomason, of the Dept. of Veterans Affairs, Hines, Ill.; and Marianne Waickman, of ASSE International, Mokena, Ill.
This group has worked hard through many conference calls and e-mail drafts to produce the standard. A special thanks goes out to Ed Lyczko for a great job chairing this standard.
The standard was recently approved by the American National Standards Institute (ANSI), and is now available for purchase from ASSE or IAPMO. This standard will help to address the critical nature of blood-borne pathogens and other infectious diseases that present a serious hazard to workers and occupants in a facility. This unique standard series sets minimum criteria for the training and certification of pipe trades craftspeople, and other construction and maintenance personnel, on how to safely work in an environment with potentially deadly diseases. The Series 12000 standard addresses the need for construction personnel, field engineering personnel and maintenance personnel. This new standard will benefit pipe tradesmen by helping them become more proficient in identifying and managing potential hazards where they may be exposed to pathogens and other environmental hazards.
The Series 12000 standards also sets a minimum level for training and certifying construction and maintenance personnel on the proper methods of protecting a facility’s occupants. The new standard acknowledges that during construction and maintenance activities, tradespeople are not the only individuals exposed to hazards, and it addresses the responsibility of construction and maintenance personnel to protect building occupants and building operations from pathogens, diseases and hazards that may be present during repairs or maintenance activities; especially in health care facilities.
The ASSE/IAPMO/ANSI Series 12000 contains several standards and appendices as follows:
1. Standard #12010 - Biological Pathogens Professional Qualification Standard for Construction and Maintenance Personnel.
2. Standard #12020 - Biological Pathogens Professional Qualification Standard for Construction and Maintenance Employers.
3. Standard #12030 - Waterborne Pathogens Professional Qualification Standard for Construction and Maintenance Personnel.
4. Standard #12040 - Professional Qualification Standard for Construction and Maintenance Personnel for Contamination/Infection Prevention Procedures to Protect Facility Occupants and Operations.
5. ASSE Series 12000 – Appendix A - Personal Protective Equipment
6. ASSE Series 12000 – Appendix B - Infection Prevention/Control Risk Assessment
7. ASSE Series 12000 – Appendix C - Vocabulary and Definitions
8. ASSE Series 12000 – Appendix D – Referenced Standards
Currently, there is no code requirement to follow this standard because it was just recently published. However, it is an industry consensus standard that provides for a minimum level of training for workers and occupants. This standard could be followed by forward-thinking owners and engineers, should they want to consider adding language in their specifications or construction standards to require plumbing tradesmen and maintenance personnel to be trained or certified to the ASSE 12000 series. The training would provide a minimum level of safety for the workers and the occupants of the facility.
Ron George, CPD, is president of Plumb-Tech Design & Consulting Services LLC. Visit www.Plumb-TechLLC.com.