We generally expect health care facilities to, at the very least, do no harm. Yet, patients and staff at Maryland health care facilities may unknowingly be exposed to toxic chemicals linked to the very illnesses and conditions for which they are being treated.

The use of dangerous pesticides and disinfectants (most of them also classified as pesticides) in and around clinical settings must be replaced by safer alternatives for the health of all — patients, staffand visitors.

Health care facilities generally rely on contracted pest control companies to keep pests out of buildings. While these vendors have knowledge about pest control and the chemicals used for it, most lack expertise about the adverse health impacts pesticides can have on people, especially vulnerable ones.

Many pesticides cause or worsen health challenges, can lead to acute reactions and are linked to cancer, heart disease, psychiatric disorders, as well as neurological, developmental, immunological and respiratory issues, such as asthma and chronic obstructive pulmonary disease.

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Recent findings from the U.S. Environmental Protection Agency show that the notorious “forever chemicals” known as PFAS (per- and polyfluoroalkyl substances) have been found in pesticides. Worse, these PFAS-containing pesticides are being promoted for use in health care facilities.

Testicular and kidney cancer are linked to PFAS, as are breast and liver cancer, kidney and liver disease, high cholesterol, reduced fertility and low birth weight, immune and cardiovascular issues, and other serious health conditions.

Truth be told, PFAS-containing pesticides are uncharted territory — little is known about the chemical interactions or synergistic effects. So why are they being used in health care facilities?

Someone having just one exposure to PFAS can have the chemicals remain in their system for a decade or more. Imagine having to work in an environment with daily exposure to pesticides — and even PFAS-containing pesticides. The exposure can happen to someone in the hospital, flat on their back, recovering from an illness. Imagine such a substance that exacerbates asthma being used in an emergency room or pulmonary unit, or one that causes neurological damage being applied in a neonatal unit. It happens all too often.

Luckily, a 2023 Maryland law requires a study group with three state agencies and the EPA to assess existing testing methodology for PFAS in pesticides. This would be an initial step for legislators to consider banning all PFAS-containing pesticides in our state. But until this requirement is fully implemented, a better way is available.

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Some Maryland facilities have transitioned to a prioritized integrated pest management program, in which nonchemical prevention and intervention is the first line of defense against pests. When all nontoxic options have been exhausted or shown to be unreasonable, facilities can consider the least-toxic pesticides, which have been shown to be effective.

Facilities can best protect patients and staff from the outdated conventional pest management approach of “see ‘em, spray ‘em” — or “spray even before you see ‘em” — by contracting with vendors that abide by a prioritized integrated pest management program. We applaud those Maryland facilities that have instituted this prioritized approach for protecting thousands of patients, staff and visitors.

It is imperative that we take toxic substances out of health care facilities to protect vulnerable patients and staff. In doing so, we uphold the critical principle of “first, do no harm” and demonstrate our unwavering commitment to the well-being of our communities.

Sean Lynch is the Director of the IPM in Health Care Facilities Project, part of the Maryland Pesticide Education Network. Ana M. Rule is an Assistant Professor in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health.

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