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VOL. XV NO. 4
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WINTER 2019/20
Sepsis: Major Killer Unknown to Many
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t can start as a simple infection. It can end in death. What triggers such a life-threatening condition is sepsis, the body’s extreme reaction to an infection. Without quick intervention, sepsis/septic shock can lead to tissue damage, organ failure and death. “Sepsis is a medical emergency,” notes the Centers for Disease Control and Prevention (CDC). “Time matters.” Dr. Steven Q. Simpson, chief medical officer of the Sepsis Alliance and professor of medicine at the University of Kansas, goes even further, labeling sepsis “a public health crisis.” According to the non-profit Sepsis Alliance, more than 258,000 people will die each year in the U.S. from sepsis, a number that is greater than those who die from prostate, breast and lung cancer combined. More than 1.7 million people in America will develop sepsis every year. Worldwide, sepsis affects 27 million to 30 million people annually, with 7 million to 9 million deaths, one death every 3.5 seconds, according to the Global Sepsis Alliance, co‑founded by the Sepsis Alliance. Depending on the country, mortality varies between 15 percent to more than 50 percent, said the global alliance, which represents 1 million caregivers in more than 70 countries.
By P.J. Heller
“The problem is that sepsis quietly sneaks up on unsuspecting victims, who often think they have a severe and sudden case of the flu. The symptoms can be tricky to spot.” “A relatively healthy person can get very sick, very quickly, sometimes before they even realize they have an infection,” said the Sepsis Alliance, founded in 2007 by retired endodontist Dr. Carl Flatley, whose daughter Erin died of septic shock when she was 23 years old. “Anyone can get sepsis,” agreed the National Institute of General Medical Sciences (NIGMS), part of the National Institutes of Health. “The people at highest risk are infants, children, older adults, and people who have serious injuries or medical problems such as diabetes, AIDS, cancer, or liver disease.”
The CDC says 80 percent of sepsis cases begin outside of the hospital. “More than 90 percent of adults and 70 percent of children who developed sepsis had a health condition that may have put them at risk,” it said. “The problem is that sepsis quietly sneaks up on unsuspecting victims, who often think they have a severe and sudden case of the flu,” said Regina Hoffman, executive director of the Patient Safety Authority, an independent state health agency in Pennsylvania. “The symptoms can be tricky to spot.” Sepsis can initially be hard to diagnose, because some of those symptoms — fever, increased heart rate, difficulty breathing and low blood pressure — mimic other conditions. Other symptoms can include extreme pain or discomfort, confusion or disorientation, chills, or clammy or sweaty skin. “Sepsis is a major challenge in hospitals, where it’s one of the leading causes of death,” NIGMS said. “It’s also a main reason why people are readmitted to the hospital. Sepsis occurs unpredictably and can progress rapidly.” Left unchecked, sepsis can progress to septic shock — dangerously low blood pressure and organ shutdown — which makes premature death more likely. Well-known personalities who died due
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Sepsis: Major Killer Unknown to Many Continued from page 1
to sepsis/septic shock include Oscar-winning actress Patty Duke, boxing legend Muhammad Ali, Muppets creator Jim Henson, and Microsoft co-founder Paul Allen. Frequently, deaths are attributed to “complications” from a particular illness and not directly to sepsis. Sepsis is the most expensive condition treated in U.S. hospitals, the Agency for Healthcare Research and Quality reported. An average hospital stay for sepsis is about $18,000, while the overall cost of treating sepsis patients runs anywhere from $24 billion to more than $27 billion a year, according to recent estimates. “Sepsis treatment is expensive,” NIGMS said. “It often involves a prolonged stay in the intensive care unit and complex therapies with high costs . . . People with sepsis are two to three times more likely to be readmitted to the hospital than people with many other conditions, including heart failure, pneumonia, and chronic obstructive pulmonary disease. Readmissions due to sepsis are also more expensive than readmissions due to any of these other conditions.” Lung, urinary tract, skin and gut infections are the most common infections linked to sepsis.
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PUBLICATION STAFF Publisher / Editor Rick Downing Contributing Editors / Writers P.J. Heller • Sandy Woodthorpe Production & Layout Barb Fontanelle • Christine Mantush Advertising Sales Rick Downing Subscription / Circulation Donna Downing Editorial, Circulation & Advertising Office 6075 Hopkins Road, Mentor, OH 44060 Ph: 440-257-6453 • Fax: 440-257-6459 Email: downassoc2@oh.rr.com Subscription information, call 440-257-6453. Healthcare Environmental Solutions news (ISSN #1557‑6388) is published quarterly by Downing & Associates. Reproductions or transmission in whole or in part, without written permission of the publisher, is prohibited. Annual subscription rate U.S. is $19.95. Outside of the U.S. add $10.00 ($29.95). Contact our main office, or mail-in the subscription form with payment. ©
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Rapid, effective sepsis treatments include giving antibiotics, maintaining blood flow to organs and treating the source of the infection, the CDC said. “Sepsis is deadly when it’s not quickly recognized and treated,” it said. “Doctors and nurses treat sepsis with antibiotics as soon as possible. Many p at i e n t s re c e ive oxygen and intravenous fluids to maintain blood flow and oxygen to organs. Other types of treatment, such as kidney dialysis or assisted breathing with a machine, might be necessary. Sometimes surgery is required to remove tissue damaged by the infection,” it added. Dr. Alice Gallo De Moraes, a pulmonary and critical care medicine specialist at Mayo Clinic, said quick response to sepsis is key. “Research has shown . . . that if treatment is started within the first few hours from the time sepsis begins, the mortality rate from sepsis falls significantly,” she said. “That makes early, aggressive treatment of sepsis crucial. If it is caught quickly, sepsis often can be managed effectively.” Prevention methods include promptly identifying and treating infections, practicing good hygiene, keeping vaccinations current and knowing the symptoms of sepsis. Simpson, writing in Outbreak News Today, estimates that 80 percent of sepsis deaths can be prevented. While some people recover completely from sepsis, others may have long-term issues. “ . . . Some people, especially those with preexisting chronic diseases, may have permanent organ damage. For example, in someone who already has impaired kidneys, sepsis can lead to kidney failure that requires lifelong dialysis,” NIGMS said. “There is also some evidence that severe sepsis disrupts a person’s immune system, making him or her more at risk for future infections. Studies have shown that people who have experienced sepsis have a higher risk of various medical conditions and death, even several years after the episode.” Memory loss, insomnia, anxiety or
depression may also be among the after-effects of sepsis, the Sepsis Alliance added. While sepsis cases appear to be increasing, part of that may be attributable to physicians getting better at diagnosing it and the public becoming more aware of it. A May 2018 survey showed that about 65 percent of American adults had heard of sepsis, up from 44 percent four years ago. However, one-third of American adults had never heard of sepsis and only 12 percent of the more than 2,000 people surveyed were aware of sepsis symptoms and the urgent need to seek medical attention. “The hope is that by alerting the public as well as general practitioners and other people who treat simple infections, that we can educate them about the signs and symptoms,” Chris Seymour, assistant professor of critical care and emergency medicine at University of Pittsburgh School of Medicine, told Bloomberg News. Researchers are also working to develop devices and technologies to more easily diagnose sepsis. At the Massachusetts Institute of Technology, researchers have developed a diagnostic tool that can identify a protein that the body produces when inflammation occurs. It requires less than a drop of blood with results available within 30 minutes. A blood test being developed over the last decade by researchers from several children’s hospitals also could eventually result in quicker and earlier treatment for sepsis. In yet another effort, researchers at the Feinstein Institutes for Medical Research have discovered a new way to reduce sepsis inflammation. The institute is the research arm of Northwell Health, the largest healthcare provider in New York. “We want everyone to realize that sepsis is a life-threatening medical emergency,” said Hoffman of the Patient Safety Authority. “Anyone can get an infection, and almost any infection can lead to sepsis. If you think you or a loved one might have sepsis, speak up quickly. Get to a hospital or call 911 and ask, ‘Could this be sepsis?’”
We are always seeking editorial content from our readers. If you have an article idea, or a big announcement about your business or healthcare facility, email it to: downassoc2@oh.rr.com. winter 2019/20
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News Briefs
Virginia Hospital Uses UV to Protect Babies from Germs
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OANOKE, VA — Carilion Roanoke Memorial Hospital has successfully cut central line infection rates in their NICU to zero in three years by using ultraviolet light to disinfect objects that come into contact with babies, reports ABC affiliate, WSET Channel 13 News. Before handling babies, individuals must first place watches, glasses, pens and cell phones in a UV sanitizer located next to the hand-washing stations in each of the NICU’s five pods. Roanoke Memorial also uses a robotic disinfection system with UV light technology to treat rooms of patients who have infections such as C. diff or norovirus, according to a Roanoke Times article. Although C. diff is not often found in NICUs, the UV boxes kill 99.9 percent of the germs on cell phones. The sanitation cycle takes just 45-seconds. NICU visitors also are asked to wash their hands and arms up to their elbows. The UV boxes are wiped down to lessen the risk of germs congregating on knobs and doors. The boxes are also used to disinfect stethoscopes, thermometers and blood pressure cuffs used on the infants. The five boxes, costing $5,000 each, were funded through community donations.
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FDA Approves Rapid Diagnostic Test Kit for Ebola Antigen
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ccording to a Medscape.com article, the US Food and Drug Administration (FDA) has given OraSure Technolgies approval to market the first rapid diagnostic test (RDT) for identifying Ebola virus antigens, The OraQuick Ebola Rapid Antigen Test delivers results within 30 minutes, allowing providers to assess infection with the virus, take measures to isolate and treat patients and contain devasting outbreaks, such as the one occurring in the Democratic Republic of the Congo in 2014. The test detects Ebola virus antigens in “human blood from certain living individuals and samples from certain recently deceased individuals suspected to have died from Ebola (cadaveric oral fluid),” the agency stated in a news release. The test is not intended to be used for general Ebola infection screening or testing of individuals at risk of exposure who are not showing observable signs of infection. The FDA cautions that negative test results do not mean a patient does not have Ebola virus infection and that definitive identification of the virus necessitates “additional testing and confirmation procedures (such as by a more sensitive but less rapid polymerase chain reaction test) and in consultation with public health and/or other authorities to whom reporting is required.” The FDA’s approval follows consideration of data from many clinical studies of blood and cadaveric oral fluid samples obtained during the 2014-2016 West African Outbreak and from various analytic studies. The agency noted that the device could be used to support safe and dignified burials while helping to reduce the risk of transmission during those burials. In 2016, the FDA recalled an early lot of the rapid test because it had failed stability testing at 8 months. Intermittent false negative results were reported for the positive kit control with devices stored at 30C conditions. According to FDA public records, OraSure contacted the sole customer and requested return of all the product from the affected lot.
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News Briefs
Infectious Disease Expert Explains Seriousness of Antibiotic Resistance Threat
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TLANTA, GA – According to the latest report on antibiotic resistance disease issued by the Centers for Disease Control and Prevention, everyone everywhere should take the risk seriously, reports a WBFO.org post. Of the 21 threats cited in the CDC report, Clostridioides difficile (C. diff) has risen to prominence among hard-to-treat infectious diseases. Some contributing reasons for this include the overuse of antibiotics for many years, repeat hospitalizations of patients and outbreaks in longterm care facilities. The CDC reports 223,900 cases in 2017 and at least 12,800 deaths. Dr. Kevin Shiley, an Infectious Disease physician and the Medical Director for Infection Prevention and Control for Catholic Health, urges individuals to not expect their doctors to prescribe antibiotics for illness that is not caused by bacteria. “I think the public needs to understand that the use of antibiotics for things that are unlikely to be beneficial really doesn’t just pose potential harm to the public at large in terms of developing resistance in the community, but it can pose potential harm directly to them with unnecessary treatments,” Shiley explained in an interview with National Public Radio affiliate, WBFO. Patients readmitted to hospital within 90 days or patients who have spent time in a nursing home or in a dialysis center or in a healthcare facility for any kind of period of time, are candidates for broaderspectrum antibiotics because those groups have a high likelihood for bacterial infection. Shiley also warned that the public should be aware that the newer drugs being developed to combat antibiotic resistant strains are very expensive and the restrictions for prescribing them have increased.
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Ebola Vaccine Approved in Europe
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ccording to a Stat News report, pharma giant Merck has received authorization from the European Commission to market an Ebola vaccine. The approval follows more than 20 years of research across several continents by scores of researchers and Ebola outbreak response workers. Successful clinical trials, including those conducted during the Ebola outbreak in West Africa in 2014-2016, preceded the approval. Currently, the vaccine, called Ervebo, is being used in the Democratic Republic of the Congo under “compassionate use,” a research protocol similar to a clinical trial, with some 250,000 doses administered thus far in the ongoing outbreak. The vaccine protects against the Zaire species of Ebola. Erevbo originally was developed at Canada’s National Microbiology Laboratory with funding from the U.S. government’s Biomedical Advanced Research and Development Authority. A team at Yale University developed the delivery system, based on a livestock virus, which safely exposes the immune system to pathogens for the purpose of vaccination. Merck has donating investigational lots of the vaccine but will begin producing licensed doses at its production facility in Burgwedel, Germany, and and those lots will become available during the third quarter of 2020. The company will make the vaccine available to countries eligible for purchasing assistance through Gavi, the Vaccine Alliance, at the lowest price possible, according to the Stat News article. The FDA is still considering the vaccine for approval in the U.S., and a decision is expected before next March.
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News Briefs
CDC Report Outlines Plans for Dealing with Antibiotic Resistance
T
he Centers for Disease Control, in its newly released report, Antibiotic Resistance Threats in the United States, 2019 (2019 AR Threats Report) has outlined the following plans for tackling antibiotic resistance: • Make sizable investments in every U.S. state in programs such as the AR Lab Network to rapidly detect and help prevent antibiotic-resistant infections. •
Work with federal partners such as the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality, as well as data experts and healthcare providers and veterinarians to improve the use of existing antibiotics.
•
CDC and the U.S. Food and Drug Administration will continue to supply samples of resistant germs from the AR Isolate Bank to drug and diagnostic test developers who can uncover new drugs and treatments.
•
Invest millions of dollars finding prevention strategies that can be scaled up across the nation.
•
Work with private industry to enhance food-product safety, medical devices, and surveillance capabilities.
•
Coordinate with domestic partners to expand the national response and prevention capacity, and with global partners to enhance the ability to combat the growing threat of antibiotic resistance worldwide.
Single-Use Plastic Bans Challenge Healthcare Industry
B
ans against single-use plastics, primarily bags and beverage containers, have been signed into law by California, Hawaii and Vermont legislatures in the U.S. and similar bans have been proposed by the Canadian government, according to Vermont Digger. But those bans don’t include single-use plastics used to prevent spread of disease in healthcare and research facilities, which generate a total 3,500 tons of plastic waste every day, reports a Thomas Insights article. Disposable medical tools, such as syringes, drug tests, bandages, gloves, plastic pipettes, vials, and sample bags typically fall into the single-use plastic category. Where recycling is not possible, these items are destroyed by incineration. While other alternatives, such as glass and stainless steel, have been proposed, they present challenges regarding decontamination and transportation. Additionally, these alternative materials have significantly higher manufacturing costs, which can have an adverse effect on the cost of private and public healthcare. Researchers are seeking ways to minimize the environmental impact of single-use plastics. One of the solutions is to gradually eliminate the use of PVC (one of the most environmentally damaging plastics) in the medical industry. Studies show that polyolefin-based elastomer provides better environmental performance in terms of energy used during production and emissions released during incineration. The proposed solution, therefore, is not to abandon plastics totally, but change the types of plastic being used. This solution maintains the benefits of single-use medical plastics while minimizing adverse impacts on the environment during end-of-life treatment.
CDC Raises Threat Level for Two Superbugs
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TLANTA, GA — According to an Infection Control Today article, efforts to reduce infection rates in the United States are working overall, but the Centers for Disease Control has raised the global threat level for two superbugs -- Candida auris and Carbapenem-resistant Acinetobacter. This year’s spike in the global incidence of the fungus Candida auris and the bacteria carbapenem-resistant Acinetobacter prompted the CDC to move them to the urgent threat level, joining Clostridium difficile, carbapenemresistant Enterobacteriacese (CRE), and drug-resistant Neisseria gonorrhoeae. Candida auris (C. auris) emerged on five continents at the same time. Some strains of the bug are resistant to all 3 classes of antifungals. C. auris outbreaks occur mostly in long-term healthcare facilities among patients with severe medical problems. Patients can carry it on their skin without being infected (making them silent carriers), and common healthcare disinfectants can’t always eliminate the bacteria. One in three patients infected with C. auris dies. Carbapenem-resistant Acinetobacter causes pneumonia in addition to wound, bloodstream, and urinary tract infections. Intensive care patients are particularly vulnerable. “Acinetobacter is a challenging threat to hospitalized patients because it frequently contaminates healthcare facility surfaces and shared medical equipment,” the report noted. “If not addressed through infection control measures, including rigorous cleaning and disinfection, outbreaks in hospitals and nursing homes can occur,” the CDC report authors say. Also, some Acinetobacter resists nearly all antibiotics and few drugs are in development to treat it. The CDC urges healthcare professionals to take more actions to address antibiotic resistance. “While the development of new treatments is one of these key actions, such investments must be coupled with dedicated efforts toward preventing infections in the first place, slowing the development of resistance through better antibiotic use, and stopping the spread of resistance when it does develop to protect American lives now and in the future.” winter 2019/20
News Briefs
Beebe Healthcare Sets Record for Zero CLABSIs
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EWES, DE — Beebe Healthcare has gone 166 days without a single Central Line Associated Bloodstream Infections (CLABSI) in 2019, according to a news release. The hospital went 466 days without a single CLABSI, beginning in 2018, a feat Marcy Jack, JD, BSN, CPHRM, CPHQ, Beebe Healthcare Vice President and the Chief Quality & Safety Officer attributes to procedural changes and a strict handwashing policy. When possible peripheral lines are used for IVs in hands or arms, rather than central lines. Another way the hospital reduced infection risk was to change the caps that cover the end of central line tubes more frequently on a set schedule. In early 2018, nurses on the Stepdown Unit proposed that all patients, regardless of when they had their lines inserted, would have their caps changed on Sundays and Wednesdays. This method complied with the best practice recommendation. After a trial on stepdown, the method was adopted throughout the hospital. The Vascular Access Team also checks on all patients with central lines, monitors that the cap changes occur, and puts into action other best practices, such as hand hygiene, to prevent these types of infections.
Surgical Wrapping Gets New Use as Sleeping Mats for Homeless
CDC Figures Show Mortality Related to Antibiotic‑Resistant Disease is Decreasing
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ORRANCE, CA — Several years ago, a surgical technician at a Southern California hospital got the idea to recycle surgical mats into sleeping bags for the homeless, according to the Daily Breeze. The blue, paper-thin material, which is used to cover trays of surgical instruments during sterilization, is waterproof and holds heat. It comes in large sheets that can be sewn together quickly into easy to carry sleeping bags or ground mats. The Providence Little Company of Mary Medical Center in Torrance surgical technician sewed sheets together and added elastic bands on one end so the creation could be rolled up like a yoga mat. She then stamped each mat with an image of a heart and the words “de cOeuR,” — French for “from the heart” — with the O and R capitalized as a nod to the operating room. After a while, she showed how to make the mats in a YouTube video. S i m i l a r p ro j e c t s s i n c e h ave t a ke n off at SSM Health St. Clare Hospital in Fenton, Missouri, which diverted 250 pounds of waste away from the landfill.
TLANTA, GA — Data compiled in the CDC’s 2019 Antibiotic Resistance Threats in the United States report show that related mortality has been decreasing since 2013. The burden of antibiotic-resistance threats in the United States has increased, however. Efforts aimed at preventing infections, stopping spread of bacteria and fungi, and improving use of antibiotics in humans, animals, and the environment, especially in hospitals, are achieving the intended results. Vaccination has proved to be an effective tool in preventing infections, including those that can be resistant in the community. In this latest report, CDC recalculated the previous (2013) estimate of deaths resulting from antibiotic-resistant germs. The number was adjusted from 23,000 to 44,000 deaths. The most recent number (35,000 deaths) reflects improvement. A c u t e c a r e h o s p i t a l s i n t h e U. S. reduced Clostridium difficile infections by 12%, central line-associated bloodstream infections by 9%, and catheter-associated urinary tract infections by 8% between 2017 and 2018, according to CDC figures.
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News Briefs
Spike in Candida Auris Cases in New York
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TLANTA, GA — As of November 18, 2019, the number of confirmed clinical cases of the superbug, Candida auris in New York was 428, according to the New York State Department of Health (NYSDOH) website. That figure counts individuals who were ill and had C. auris detected during their clinical care. NYSDOH reported that 642 cases were screened for C. auris, which includes individuals who were not ill from C. auris and were tested specifically for C. auris as part of a public health investigation. There were 66 individuals counted as both a screening case and clinical case based on Council of State and Territorial Epidemiologists (CSTE) definition. The New York cases are primarily concentrated among hospital patients and nursing home residents in New York City. NYSDOH is working with the Centers for Disease Control and Prevention (CDC) to contain the spread of C. auris in hospitals and nursing homes. The department has provided guidance and assistance to hospitals and nursing homes to strengthen readiness, enhance surveillance, and implement effective infection prevention and control measures. When C. auris is confirmed or suspected, NYSDOH recommends that the patient is housed in a private room or cohorted with other patients or residents also infected or colonized with C. auris. Facilities should also maintain adequate supplies of personal protective equipment and thoroughly clean and disinfect the healthcare environment. As of late October, the CDC reported one confirmed case of the superbug in Georgia, 227 cases in Illinois and 137 cases in New Jersey. Nationwide, more than 850 cases have been confirmed, along with 30 probable cases.
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Pneumonic Plague Reported in China
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ORONTO — Chinese authorities have reported two related cases of pneumonic plague, a serious infectious disease that can kill within 24 hours, reports The National Post. According to Chinese publication Xinhua, doctors in Beijing confirmed that the patients, a husband and wife, were residents of China’s Inner Mongolia Autonomous Region. They became infected with pneumonic plague when they consumed raw entrails of a marmot, a rodent similar to the American squirrel. Their deaths led to a a six-day quarantine of the area by health officials. In 2014, more than 150 people had to be quarantined in the Chinese city of Yumen after a man died due to the bubonic plague. A travel ban was placed on the city’s 30,000 citizens until officials ruled the disease was contained.
Serious Risk
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neumonic plague is more infectious than the bubonic plague, which killed an estimated 60 per cent of the European population in the 14th century. The plague is caused by Yersinia pestis, a bacteria typically found in mammals and fleas. Symptoms include fever, vomiting and nausea. The World Health Organization warns that pneumonic plague potentially could be more dangerous because it targets the lungs, incubates in a host in 24 hours and, unlike the bubonic plague, is more commonly transmitted from person to person and can cause death. Antibiotics must be administered within 24 hours and taken for seven to 14 days. When the plague gets into the blood, it can cause the septicemic plague, which represents 10 to 20 percent of cases, and triggers the entire immune system to fall into a dangerous condition called “sepsis.” In the U.S., the areas where the plague is more common include northern New Mexico, northern Arizona, southern Colorado, California, southern Oregon and western Nevada. The U.S. sees an average of seven diagnoses per year, mostly found in the country’s southwest regions, according to the Centers for Disease Control and Prevention. Since 2000, the Centers for Disease Control have received reports of one to 17 cases of the plague per year. In 2015, 16 cases of plague were reported and, in 2016, there were only 4 cases. In 2018, one case was reported in Idaho. No verified plague diagnosis has been made in Canada since 1939.
Prevention: •
Wear insect repellent during activities such as camping, hiking, working outdoors. This helps protect against fleas which carry Yersinia pestis.
•
Avoid sick or dead animals and wear gloves when handling or skinning potentially infected animals.
•
Keep pets from running loose in areas where the plague is common, regularly treat pets for fleas and take sick animals to the vet right away.
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To avoid attracting infected rodents, keep foods in rodent-proof containers.
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People that may have been exposed to the plague by being within about six feet of a person or animal sick with the infection, can also take preventive antibiotics.
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Food Waste Containers & Compostable Bags BioBag Ecosafe Zero Waste Natur-Tec®
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Solvent Recovery Systems B/R Instrument Corp
Medical Waste Device Recycling Stryker
Shredding Equipment (Plant-Based & Office Shredders)
winter 2019/20
Spill Control Materials SorbTech Mfg, Inc UltraTech International
Uniforms & Work Clothing UniFirst Corporation
Waste Tracking & Routing Software (Medical Waste Collection & Transport) Clear Computing EZshred Software Imec Technologies Inc PC Scale Inc™ RouteOptix Mgmt Systs Inc
X-Ray Film Recovery/ Silver Reclamation AMS Med Waste LLC Commodity Resource & Environmental Inc Pyromet Silver Refiners Rochester Silver Works LLC United DMS of Tennessee LLC
2019/20
hes Buyers’ Guide COMPANY INDEX
A 1 Priority Environmental Services, Inc Fort Worth, TX (817) 595-0790 www.go1priority.com
Aaqua Tools
Rancho Cordova, CA (800) 777-2922 www.AaquaTools.com
Abatement Technologies Suwanee, GA (800) 634-9091 www.abatement.com
Advanced Vapor Technologies, LLC Everett, WA (800) 997-6584 www.advap.com
AmeriVap Systems, Inc
BioBag
Palm Harbor, FL (727) 789-1646 www.biobagusa.com
BioMedical Technology Solutions, Inc Englewood, CO (866) 525-2687 www.bmtscorp.com
Biomist, Inc
Wheeling, IL (847) 850-5530 www.biomistinc.com
Bioquell Inc
Horsham, PA (215) 682-0225 www.bioquell.com
BN Green Technologies San Diego, CA (855) 294-2227 www.bngreentech.com
Dawsonville, GA (800) 763-7687 www.amerivap.com
AMS Med Waste LLC Lake in the Hills, IL (855) 633-9278 www.amsmedwaste.com
ARE Industries
Wichita, KS (316) 943-5000 www.areindustries.com
Assured Waste Solutions Gastonia, NC (704) 865-7550 www.assuredwaste.com
B
Bondtech Corporation
1278 Highway 461 Somerset, KY 42503 (800) 414-4231 Elsa Brown elsabrown@bondtech.net www.bondtech.net BONDTECH is a full service company designing, engineering and manufacturing autoclave systems, with material handling, for technical industries such as infectious medical waste treatment, aerospace composites, glass lamination, rubber vulcanizing, wood treating, yarn setting and many other applications in industry and medical waste management.
B/R Instrument Corp Easton, MD (410) 820-8800 www.brinstrument.com
Ansell Sandel Medical Solutions Chatsworth, CA (866) 764-3327 www.sandelmedical.com
Clean Waste Systems
Bomac Carts / Royal Basket Trucks
201 Badger Parkway Darien, WI 53114 (262) 882-5000 Melissa Dean sales@bomaccarts.com www.bomaccarts.com Heavy-Duty utility carts are our specialty. From Recycling, Manufacturing, Shipping/ Receiving, Commercial Laundry and Mailrooms, our offering meets a broad range of uses in many industries. See ad on pg 5
C
Century Products LLC
Greensboro, NC (800) 927-0981 www.centuryproductsllc.com
Clean Earth, Inc
Hatboro, PA (215) 734-1400 / 877-445-DIRT www.cleanearthinc.com
Clean Harbors
Norwell, MA (877) 500-6737 www.cleanharbors.com
Bemis Health Care
Sheboygan Falls, WI (920) 467-4621 www.bemishealthcare.com
Better Engineering
Baltimore, MD (800) 229-3380 www.betterengineering.com
Cleanint
Georgetown, TX (888) 715-0464 www.cleanint.com
Clear Computing
Tinton Falls, NJ (888) 332-5327 www.clearcomputing.com
ClorDiSys
Branchburg, NJ (908) 236-4100 www.clordisys.com
Clorox Professional Products Oakland, CA (800) 537-1415 www.cloroxprofessional.com
Commodity Resource & Environmental Inc
Burbank, CA (818) 843-2811 / (800) 943-2811 www.creweb.com
BD Medical
Franklin Lakes, NJ (201) 847-6800 www.bd.com
200 Birch Ave S Maple Lake, MN 55358-0304 (877) 478-5195 Peter Jude peter@cleanwastesystems.com www.cleanwastesystems.com Clean Waste Systems is the designer, manufacturer, parts and service company for its patented, OMW-1000 Ozone Medical Waste Processing System in the United States and foreign markets. Clean Waste Systems specializes in the design and development of ozone-based technologies using Humidizone™ for its sterilization and sanitation processes. See ad on pg 16
Target your products, equipment and services to more than 5,000 healthcare facilities and medical waste transporters throughout the U.S. Advertise in HES! call Today 440-257-6453 winter 2019/20
Compliance Publishing Corp Edina, MN (800) 242-9723 www.compliancepublishing.com
Copper Development Association Inc
New York, NY (212) 251-7200 www.copper.org
HEALTHCARE ENVIRONMENTAL SOLUTIONS news
11
2019/20 C Continued CS Medical, LLC
Creedmoor, NC (877) 255-9472 www.csmedicalllc.com
Curtis Bay Medical Waste Services Baltimore, MD (855) 228-1715 www.curtisbayenergy.com
hes Buyers’ Guide
COMPANY INDEX I
Envirotain, LLC
Hudson, OH (216) 255-5107 www.envirotain.com
Imec Technologies Inc Champaign, IL (217) 643-7488 www.imec.ie
Envirotek
Charlotte, NC (704) 351-7311 www.envirotekww.com
Infection Prevention Technologies, LLC
Auburn Hills, MI (800) 359-9855 www.infectionpreventiontechnologies.com
EZshred
Chesterland, OH (877) 392-7123 www.ezshred.com
J
D
Daniels Sharpsmart
Chicago, IL (312) 546-8900 www.danielsinternational.com
Daylight Medical
Middleburgh Hts, OH (800) 459-8500 www.daylightmedical.com
DebMed USA LLC Charlotte, NC (866) 783-0422 www.debmed.com
Dial Corp, A Henkel Company
Scottsdale, AZ (800) 253-DIAL www.dialprofessional.com
DiSorb Systems, Inc Philadelphia, PA (866) 287-6672 www.disorb.com
Dornoch Medical Systems, Inc Riverside, MO (888) 466-6633 www.dornoch.com
E
ECODAS
Seattle, WA (864) 381-8856 www.ecodas.com
Jani-King International, Inc
G
Addison, TX (800) JANIKING www.janiking.com
Geerpres Inc
Muskegon, MI (231) 773-3211 www.geerpres.com
JT Environmental Consulting
Germ Pro Products
Tampa, FL (800) 966-5367 www.germproproducts.com
Gient Heating Industry Co Chongqing, China (613) 794-6886 www.gient.net
Orlando, FL (888) 583-6826 www.jtenv.com
Akron, OH (800) 321-9647 www.gojo.com
Kessler Consulting Inc
Kimberly-Clark Professional Roswell, GA (678) 352-6207 www.kcprofessional.com
solutions@golder.com www.golder.com
McClure Industries, Inc
L
Liquitech Inc Environmental Solutions
Hubscrub Company
Lombard, IL (630) 693-0500 www.liquitech.com
Hygiena
Camarillo, Ca (888) HYGIENA www.hygiena.com
Ecosafe Zero Waste
Surrey, BC Canada (604) 560-5133 www.ecosafezerowaste.com
Elyptol, Inc
Santa Monica, CA (424) 500-8099 www.elyptol.com
12
9051 SE 55th Ave Portland, OR 97206 (503) 777-2821 Kim Nitsos kim@mcclureindustries.com www.mcclureindustries.com McClure Industries, Inc. manufactures over 80 models of Sanitrux laundry, linen and trash carts. Sanitrux are ASTM-E tested and certified Class II fire retardant and meet or exceed all NFPA fire codes. Sanitrux are specifically designed for the tough commercial environment. See ad on pg 8
Medasend Biomedical Inc Garden Grove, CA (800) 200-3581 www.medasend.com
Ecolab Inc
St Paul, MN (877) 927-9726 www.ecolab.com
15351 Texaco Ave Paramount, CA 90723 (562) 630-7950 www.mark-costello.com Celebrating 57 years of specializing and providing solutions to the most complex situations that have made us the leader in the Waste Handling Equipment, On-Site Medical Waste Sterilization Equipment and Industrial Recycling Equipment in the marketplace. See ad on pg 4
K
Golder Associates Inc
Manchester, NH (603) 624-4243 www.hubscrub.com
The Mark-Costello Co
Tampa, FL (813) 971-8333 www.kesconsult.com
GOJO Industries Inc
H
M
Attention Advertisers ! Now is the time to schedule your 4-color logo/photo listing in next year’s Buyers’ Guide Issue. For more information, contact Rick or Donna Downing at 440-257-6453 or downassoc2@oh.rr.com.
HEALTHCARE ENVIRONMENTAL SOLUTIONS news
winter 2019/20
MedAssure
Farmingdale, NJ (732) 363-7444 www.medassureservices.com
Micro-Scientic®
Rolling Meadows, IL (847) 454-0835 www.micro-scientic.com
COMPANY INDEX
2019/20
P
Palmero Health care
hes Buyers’ Guide
Professional Disposables Intl (PDI)
Stratford, CT (800) 344-6424 www.palmerohealth.com
Orangeburg, NY (845) 365-1700 www.pdipdi.com
Parker Laboratories N
PEAT International Inc Northbrook, Aston, PA IL (847) 559-8567 (610) 497-1743 www.peat.com www.pyromet999.com Pharma-Cycle Inc
F Natur-Tec® Circle MN (973)Pines, 276-9500 (763) 404-8700 www.parkerlabs.com www.natur-tec.com
Pc ScaleWash Inc™Solutions Neptune Orangeburg, Oxford, PA SC (866) 303-4437 (800) 962-9264 www.neptunewash.com www.pcscaletower.com NewWay Global Energy
PcM JohnsonMedical Creek, WI Waste (920) 988-0686 Recycling
PharmWaste Technologies Inc Frisco, TXIA Urbandale, (877) 321-1811 (515) 276-5302 www.pwaste.com www.questrecycling.com
Post Medical Inc
Pottstown, PA Newport, RI (610) 495-8214 (617) 755-0883 www.askonsite.com
www.pharma-cycle.com
PHS P West Inc
Hanover, Palmero MN Health Care Stratford, CT (888) 639-5438 (800) 344-6424 www.phswest.com www.palmerohealth.com
Post Medical Inc Paragon Waste Solutions Golden, CO GA Alpharetta, (720) 390-3169 (866) 330-4845 www.paragonws.com www.postmedical.com
Parker Laboratories
(973) 276-9500 Practice Greenhealth
www.parkerlabs.com Reston, VA (888) 688-3332 PC Scale Inc™ www.practicegreenhealth.org Oxford, PA (800) 962-9264
www.pcscaletower.com Prime compliance
Wyoming, MI PCM Medical Waste Recycling (616) 893-8243 Pinellas Park, FL www.thehipaaman.com (727) 547-6277 www.pcmmedicalwasterecycling.com
Proctor & Gamble PDI® Cincinnati, OH Orangeburg, NY (513) 983-1100 (800) 444-6725 www.pdihc.com www.pg.com
Winchester, VA (540) 667-8700 www.rubbermaidcommercial.com
S S Safety-Med Products Safety-Med Products Burlington, WI Burlington, WI (866)421-3400 421-3400 (866) www.safety-med.com www.safety-med.com
www.pharma-cycle.com Quest Recycling Services, LLc
One Sustainabile Method PEAT International Inc
OnSite Sterilization, Pharma-cycle IncLLC
Rubbermaid commercial Products LLc
Newport, RI Q (617) 755-0883
PHS West Inc R Hanover, MN
Recycling LLC Northbrook, IL Louisville, KY (847) 559-8567 (502) 561-3404 www.peat.com www.osmllc.net
Cullman, AL (256) 796-7898 www.regenllc.net
COMPANY INDEX
www.newwayglobal.net Pinellas Park, FL (727) 547-6277 www.pcmmedicalwasterecycling.com
O
ReGen LLc
(888) 639-5438 www.phswest.com
Alpharetta, GA (866) 330-4845 www.postmedical.com
Prime Compliance Wyoming, MI (616) 893-8243 www.thehipaaman.com
Proctor & Gamble
Red Bag Cincinnati, OHSolutions
(513) 983-1100 3431 Benson Ave Ste 100 www.pg.comMD 21227 Baltimore, (877) 973-3224 Pyromet Silver Refiners Ward Miller Aston, PA wmiller@redbag.com (610) 497-1743 www.redbag.com www.pyromet999.com Red Bag Solutions (RBS) is a manufacturing and waste management services company that provides environmentally friendly, Quest Recycling Services, LLC
Q
Frisco, TX (877) 321-1811 of treatment medical www.questrecycling.com
and bio-hazardous waste. RBS’s waste treatment and disposal technologies convert medical, clinical and infectious waste into sterilized, safe Red Bag Solutions material that and unrecognizable Baltimore, MD 21227 can be recycled or placed in a (877) 973-3224 municipal landfill. See ad on pg 5 www.redbag.com
R
Red Devil Co co Red DevilEquipment Equipment Plymouth, MNMN Plymouth, (800) 221-1083 (800) 221-1083 www.reddevilequipment.com www.reddevilequipment.com
Rehrig Healthcare 4010 East 26th St Systems 3002 Belingham Dr Los Angeles, CA 90058 Atlanta, GA 30345 (800) 421-6244 (844) 4-Rehrig (473-4744)
cmeissen@rehrig.com www.rehrighealthcare.com www.rehrighealthcare.com Combined with a widely recognized Combined a widelyservice, recognized commitmentwith to customer Rehrig commitment to customer has become a leading supplier toservice, many of the largest most innovative Rehrig hasand become a leadingcompanies supplier in the world. Now, Rehrig is applying our to many of the largest and most expertise in secure reusable injection innovative companies in improve the world. molded containers to help the Now, Rehrig applying Medical our expertise collection of isRegulated Waste (RMW) and Sharps. injection Our newmolded line of in secure reusable products offers sustainable solutions for containers to help improve the both generators and disposal companies collection ofon Regulated Medical Waste alike. See ad pg 2
(RMW) and Sharps. Our new line of sustainable solutions products Resurgent Health for generators and disposal andboth Medical Golden, CO alike. See ad on pg 2 companies (800) 932-7707 www.resurgenthealth.com
Republic Machine
Louisville, RochesterKY Silver Works (502) LLC 637-6778 Rochester, NY www.republicmachine.com (585) 743-1415 www.rochestersilverworks.com
Resurgent Health and Medical RouteOptix Management Golden, SystemsCO Inc (800) 932-7707 Kitchener, ON Canada (866) 926-7849 www.resurgenthealth.com www.routeoptix.com
Rochester Silver Works Rubbermaid Commercial LLc Products LLC
Rochester, Winchester, VANY (585) 743-1415 (540) 667-8700 www.rubbermaidcommercial.com www.rochestersilverworks.com
RouteOptix Management Systems Inc Kitchener, ON Canada (866) 926-7849 www.routeoptix.com
San-I-Pak, IncInc San-I-Pak, PO Box 1183 PO Box 1183 Tracy, CA 95378 Tracy, CA 95378 (209) 836-2310 Arthur McCoy (209) 836-2310 arthurmccoy@sanipak.com Arthur McCoy www.sanipak.com arthurmccoy@sanipak.com Since 1978, San-I-Pak, Inc. has been www.sanipak.com providing technological solutions for managing infectious & solid waste. Since 1978, San-I-Pak, Inc. has San-Ibeen Pak has proven to be a critical component providing technological solutions of the patient care infrastructure, especially for managing infectious & solid during times of crisis. Contact us at waste. San-I-Pak has to be sanipak@sanipak.com or proven (209) 836-2310 to find out component how we can help your patient hospital a critical of the become more financially and operationally care infrastructure, especially during independent. times of crisis. Contact us at sanipak@ sanipak.com sBioMed LLC or (209) 836-2310 to find out how we can help your Orem, UT (801) 922-1111 hospital become more financially and www.sbiomed.com operationally independent. Scott Distribution LLC sBioMed LLc DBA Scott Containers Orem, UTTX Grapevine, (817) (801)756-6909 922-1111 www.scottcontainers.com www.sbiomed.com Sharps MD Systems Schaefer Tarpon Springs, FL International, Inc (727) 940-5872 www.wastealliance.net Charlotte, NC
(704) 944-4500 Sharpsology www.ssi-schaefer.us
Largo, FL (540) 520-6341 Scott Distribution www.sharpsology.com
LLc DBA Scott containers
Shred-Tech Grapevine, TX Cambridge, ON Canada (817) 756-6909 (800) 465-3214 www.scottcontainers.com www.shred-tech.com
We are always seeking editorial content from our readers. If you have an article idea, or a big announcement about your business or healthcare facility, email it to: downassoc2@oh.rr.com. winter 2019/20
HEALTHCARE ENVIRONMENTAL SOLUTIONS news
13
2019/20 S Continued
hes Buyers’ Guide
COMPANY INDEX
Sporicidin by Contec, Inc Spartanburg, SC (800) 762-3472 www.sporicidin.com
Spurgin & Associates
Irvine, CA (949) 677-0700 www.spurginassociates.com
SRI Surgical
Tecni-Quip Carts
Tampa, FL (813) 891-9550 www.srisurgical.com
Snyder Industries Inc
6940 O Street, Suite 100 Lincoln, NE 68510 (888) 422-8683 sales@snydernet.com www.medwastecontainers.com Snyder Medical Waste is a specialty division of Snyder Industries, Inc. and was established in 1957. Snyder’s extensive line of returnable containers is considered the industry standard for the collection and transportation of medical waste. See ad on pg 5
960 Crossroads Blvd Seguin, TX 78155 (800) 826-1245 Jobeth Reilly tqcarts@tqind.com www.tqind.com Tecni-Quip Carts is a manufacturer of durable carts engineered to withstand the stress of transporting waste, biohazardous waste and soiled linen in any situation. All models are extremely durable and will last for years. Custom fabrication for any situation and in ANY quantity is available. Choice of fabrication and Aluminum. Standard features include: Variety of sizes, bumpers, fire retardant properties, equipped with large superior casters and wheels for any type of surface. Friendly and knowledgeable customer service. See ad on pg 6
Stericycle
Lake Forest, IL (847) 367-5910 www.stericycle.com
Sterilis Medical Corporation
Boxborough, MA (508) 875-1070 www.sterilismedical.com
Steriliz, LLC Rochester, NY (855) 882-2013 www.steriliz.us
SteriMed Medical Waste Solutions Inc Farmington Hills, MI (855) 783-7463 www.sterimedsystems.com
Steris Corporation Solutions Inc
6213 Gheens Mill Rd Jeffersonville, IN 47130 (502) 228-2901 / (812) 288-8644 www.medicalwastecontainers.com Solutions, Inc. is a leading provider of medical waste containers and accessories, in both the domestic and international markets. We provide solutions for waste haulers, hospitals, long-term care facilities, nursing homes, funeral homes, laboratories, clinics, research facilities, etc., by supplying our customers unlimited medical waste handling solutions with our large variety of containers, including medical waste containers, and all-purpose containers. See ad on pg 7
SorbTech Mfg, Inc Plaistow, NH (570) 371-8464 www.sorb-tech.com
Spartan Chemical Company, Inc
Maumee, OH (800) 537-8990 www.spartanchemical.com
14
Mentor, OH (440) 354-2600 www.steris.com
STI Biosafe
Indianapolis, IN (317) 858-8099 www.stibiosafe.com
Stryker
(269) 385-2600 www.stryker.com
Surfacide
Naperville, IL (630) 861-9000 www.surfacide.com
T
Toter Inc
Statesville, NC (800) 424-0422 www.toter.com
TRU-D LLC
Memphis, TN (800) 774 5799 www.tru-d.com
HEALTHCARE ENVIRONMENTAL SOLUTIONS news
U
UltraClenz
Vecoplan LLC
PO Box 7224 High Point, NC 27264 (336) 861-6070 Bob Gilmore info@vecoplanllc.com www.vecoplanllc.com Vecoplan engineers, manufactures, and provides parts and service on a range of shredders and systems for processing medical waste, destroying confidential records, and recycling scrap. An integral component in turnkey waste sterilization systems, our machines are used to shred sharps, textiles, plastics, and for red bag processing. AAA NAID compliant for secure destruction of paper, film, disks, and hard drives. See ad on pg 15
Vertisa
Orlando, FL (407) 852-8277 www.medicalwastetechnology.com
Visionary Solutions LLC
Jupiter, FL www.ultraclenz.com
Knoxville, TX (865) 482-8670 www.vs-llc.com
UltraTech International
Vital Vio
Jacksonville, FL (800) 764-9563 www.spillcontainment.com
UltraViolet Devices, Inc Valencia, CA (661) 295-8140 www.uvdi.com
Troy, NY (518) 268-1101 www.vitalvio.com
W
Wexford Labs
UniFirst Corporation
Kirkwood, MO (800) 506-1146 www.wexfordlabs.com
United DMS of Tennessee LLC
Xenex Healthcare Services LLC
Wilmington, MA (800) 455-7654 www.unifirst.com
Knoxville, TN (865) 637-2560 www.uniteddms.com
UVAIRx Inc
Centennial, CO (303) 327-5355 www.uvairx.com
X
San Antonio, TX (800) 553-0069 www.xenex.com
Z
ZeroWaste Energy Systems Kleinburg, ON Canada www.zwes.ca
V
Vaportek Inc
Sussex, WI (800) 237-6367 www.vaportek.com winter 2019/20
Zorbx
Strongsville, OH (800) 201-5530 www.zorbx.com
Vecoplan’s Universal Shredders Pull Double Duty! IT’S A MEDICAL WASTE SHREDDER...
...AND A SECURE DESTRUCTION SHREDDER...
• Vecoplan has years of med-waste experience developing systems used in hospitals world wide for red bag processing • Shreds sharps and other tough materials • Shreds to an unrecognizable consistency • Turnkey medical waste sterilization systems
• The same Vecoplan shredders are used for confidential data destruction. • Gain control of HIPAA compliance and costs by “in house” destruction of records, disks, drives and other media • Vecoplan shredders are AAA NAID compliant • Vecoplan shredders are currently being used in hundreds of secure destruction operations
! E N O IN L L A . ..
Phone: (336) 447-3565
www.vecoplanllc.com vecoplanllc.com
5708 Uwharrie Road • Archdale, NC 27263 winter 2019/20
HEALTHCARE ENVIRONMENTAL SOLUTIONS news
15
www.cleanwastesystems.com