Healthcare providers ranging from hospitals to urgent care facilities are confronted daily with a wide variety of environmental liability issues. Three areas affected by these exposures include onsite operations, the transport of supplies and waste, and waste disposal. Although each area must be explored independently to identify the leading risks, one of the biggest operational problems involves indoor air quality issues created by the microbial growth of mold, bacteria, and even viruses.
On-Site Environmental Risks
Not managing or addressing the growth of potentially hazardous
toxins can lead to what is now called "sick building syndrome." In fact, a recent
review of RT Environmental and Construction Professional's book of insureds found
that indoor air quality was the leading cause of pollution legal liability insurance
claims among the healthcare-related policies purchased. This was closely followed by
incidents involving spills on the premises and contractors uncovering or
inadvertently hitting existing structures like utility lines, tanks, and so
forth.
Whether it's the result of fungal or mold growth (Aspergillus and Stachybotrys are the usual suspects) in the building or ventilation system,
or bacterial build-up (Legionella pneumophila is
the typical culprit) in the air conditioning or drinking water systems, the growth
and transmission of these materials can have dire consequences for anyone affected.
According to the Centers for Disease Control (CDC), 1 in 10 people who contract
Legionnaires' disease will die.
Hospital-acquired Legionnaires' disease typically originates in
hospital water systems, which can be extremely complex in their designs. Plus, Legionella will not only thrive in hot water
tanks, but also in the biofilm found throughout the entire hospital water system.
For example, a brand-new hospital that opened in April 2019 in Grove City, Ohio, had
a Legionnaires' outbreak that sickened 16 people and possibly caused 1 death. This
unfortunately happened shortly after the 200-bed hospital celebrated its grand
opening. In fact, one of the first patients treated at the hospital was diagnosed
with Legionnaires' disease. The suspected source was the facility's hot water
system, which was not properly disinfected prior to the hospital's opening,
according to hospital administrators. The results included five separate lawsuits,
although the outcomes were never disclosed.
In certain situations, methicillin-resistant Staphylococcus aureus, H1N1, and a variety of
facility-borne infectious viruses or bacteria have been confirmed by the CDC or
local health professionals as unique environmental risks that can pose potentially
deadly problems at these facilities. Others include the following.
Lead (paint and pipes) and asbestos (insulation and tiles) can lead to the illness of third parties that are working in and around the property.
Improper use of hazardous chemicals (e.g., cleaning chemicals, fuels,
lubricants, red bag waste, lab chemicals and waste, pesticides/herbicides,
paints, solvents, or volatile organic compounds) can be released when improperly
stored and contained and/or vandalized.
Improper handling or storage of gases such as oxygen, chlorine, and ethylene
oxide at sites like maintenance areas, laboratories, cafeterias, etc. can lead
to explosions and the release of contaminants.
Incinerators can cause the air emission of pathogens if the burn rate or temperature is not properly controlled.
Release of laser smoke contains toxic gases such as benzene, hydrogen
cyanide, formaldehyde, bio-aerosols, and dead/live cellular material (e.g., bone
fragments or viruses).
Improper disposal or use of sterilization unit waste, disinfectants,
antiseptics, or reagents, as well as biological and infectious waste (e.g.,
bandages, needle tips, specimen containers, or blood bags) and radioactive
waste.
Inadvertent transport and subsequent disposal of unknown contaminated soil
or materials from on-site activities such as waste product spills.
Cleanup and liability associated with the disposal of waste/materials at
disposal facilities or recyclers may expose the organization to Superfund
liability. Such materials typically include air conditioning units containing
chlorofluorocarbons, acids, adhesives, halogen lights, waste oil, batteries, red
bag waste, and waste sludge.
Property-Related Environmental Risks
Another key exposure area pertains to the healthcare properties themselves. Many healthcare facilities and hospitals have likely operated at the same premises for more than 50 years. During this time, the past improper disposal of waste materials may have caused adverse soil and groundwater conditions that may not even be known to the organization or surrounding property owners.
Furthermore, in many instances and especially with large or
university-owned hospitals, large parcels of property that are "donated" to the
hospital can present the owners with potential environmental problems if not
properly assessed from the get-go. The problem is that these transactions often
include poor or inadequate record keeping that could potentially identify the
activities and challenges that will likely only be revealed once the property is
developed.
Then again, even if the environmental assessments are performed,
they, in many instances, only entail Phase I inspections and cursory
"walk-throughs," which do not oftentimes reveal significant environmental issues
such as the "midnight" dumping of waste. So, healthcare providers, no matter the
locale or industry, should never underestimate the value of properly devised and
implemented risk management strategies. The problem is that these tools often become
an afterthought while all of the organization's operations are being put in place—a
problem that has produced a wide array of costly delays and financial issues for
many unprepared healthcare institutions.
Opinions expressed in Expert Commentary articles are those of the author and are not necessarily held by the author's employer or IRMI. Expert Commentary articles and other IRMI Online content do not purport to provide legal, accounting, or other professional advice or opinion. If such advice is needed, consult with your attorney, accountant, or other qualified adviser.
Healthcare providers ranging from hospitals to urgent care facilities are confronted daily with a wide variety of environmental liability issues. Three areas affected by these exposures include onsite operations, the transport of supplies and waste, and waste disposal. Although each area must be explored independently to identify the leading risks, one of the biggest operational problems involves indoor air quality issues created by the microbial growth of mold, bacteria, and even viruses.
On-Site Environmental Risks
Not managing or addressing the growth of potentially hazardous toxins can lead to what is now called "sick building syndrome." In fact, a recent review of RT Environmental and Construction Professional's book of insureds found that indoor air quality was the leading cause of pollution legal liability insurance claims among the healthcare-related policies purchased. This was closely followed by incidents involving spills on the premises and contractors uncovering or inadvertently hitting existing structures like utility lines, tanks, and so forth.
Whether it's the result of fungal or mold growth (Aspergillus and Stachybotrys are the usual suspects) in the building or ventilation system, or bacterial build-up (Legionella pneumophila is the typical culprit) in the air conditioning or drinking water systems, the growth and transmission of these materials can have dire consequences for anyone affected. According to the Centers for Disease Control (CDC), 1 in 10 people who contract Legionnaires' disease will die.
Hospital-acquired Legionnaires' disease typically originates in hospital water systems, which can be extremely complex in their designs. Plus, Legionella will not only thrive in hot water tanks, but also in the biofilm found throughout the entire hospital water system. For example, a brand-new hospital that opened in April 2019 in Grove City, Ohio, had a Legionnaires' outbreak that sickened 16 people and possibly caused 1 death. This unfortunately happened shortly after the 200-bed hospital celebrated its grand opening. In fact, one of the first patients treated at the hospital was diagnosed with Legionnaires' disease. The suspected source was the facility's hot water system, which was not properly disinfected prior to the hospital's opening, according to hospital administrators. The results included five separate lawsuits, although the outcomes were never disclosed.
In certain situations, methicillin-resistant Staphylococcus aureus, H1N1, and a variety of facility-borne infectious viruses or bacteria have been confirmed by the CDC or local health professionals as unique environmental risks that can pose potentially deadly problems at these facilities. Others include the following.
Property-Related Environmental Risks
Another key exposure area pertains to the healthcare properties themselves. Many healthcare facilities and hospitals have likely operated at the same premises for more than 50 years. During this time, the past improper disposal of waste materials may have caused adverse soil and groundwater conditions that may not even be known to the organization or surrounding property owners.
Furthermore, in many instances and especially with large or university-owned hospitals, large parcels of property that are "donated" to the hospital can present the owners with potential environmental problems if not properly assessed from the get-go. The problem is that these transactions often include poor or inadequate record keeping that could potentially identify the activities and challenges that will likely only be revealed once the property is developed.
Then again, even if the environmental assessments are performed, they, in many instances, only entail Phase I inspections and cursory "walk-throughs," which do not oftentimes reveal significant environmental issues such as the "midnight" dumping of waste. So, healthcare providers, no matter the locale or industry, should never underestimate the value of properly devised and implemented risk management strategies. The problem is that these tools often become an afterthought while all of the organization's operations are being put in place—a problem that has produced a wide array of costly delays and financial issues for many unprepared healthcare institutions.
Opinions expressed in Expert Commentary articles are those of the author and are not necessarily held by the author's employer or IRMI. Expert Commentary articles and other IRMI Online content do not purport to provide legal, accounting, or other professional advice or opinion. If such advice is needed, consult with your attorney, accountant, or other qualified adviser.