On January 4th, 2011, the EPA ordered the Monmouth-Ocean Hospital Corporation (MONOC) to cease use of fogging disinfectants in ambulances. The orders came after the emergency responders union PEMSA, and specifically Local 4610 President Deborah Ehling, began to push for the ban, citing symptoms such as nausea and migraine in emergency professionals. The EPA orders cited MONOC in violation of regulations regarding the safe use of pesticides. Fogging disinfectants, such as Zimek QD and Sporicidin, use a fine mist to kill microbial bacteria. Under EPA regulations, any chemical used to kill microbes is a pesticide.
Exposure to Fogging Disinfectants a Clear Violation
“MONOC had been put on notice that what they were doing was not authorized, yet they continued to apply these powerful disinfectants using a fogging system,” said Judith Enck, EPA Regional Administrator.” MONOC applied Zimek QD no less than 125 times and misused Sporicidin at least once. PEMSA described the FDA order to cease use of fogging disinfectants as “a clear victory.” Deborah Ehling, who spearheaded the campaign against fogging disinfectants, wants to push further, saying, “Now is time for a national standard requiring the evaluation of chemicals used in the workplace with new technology to ensure safe use by our emergency medical personnel and firefighters.”
That EMTs suffered from headaches and nausea after prolonged exposure to Zimek QD is unsurprising. Zimek QD's Material Safety Data sheet lists “Nausea” and “Headaches” as direct effects of inhalation of the product, and recommends removal of the victim to open air and the use of supplemental oxygen or ventilation if breathing complications ensue. The Material Safety Data identifies the main hazard of Zimek QD as an “alkaline liquid mixture” within the product. Alkaline liquid mixtures are commonly found in industrial cleaners and solvents. And just like the mixtures found in industrial cleaning compounds, Zimek QD also warns that prolonged skin contact can cause severe burns or discomfort.
Zimek QD was developed as an antibacterial cleaner for hospitals and industrial facilities in 1962 and is effective against MRSA, E. Coli, influenza, hepatitis C, toxic mold, other viral threats, fungi and insects. Zimek QD used in its “normal” or liquid form is an effective and trusted disinfectant. It was only when MONOC began converting Zimek QD to vapor and using a “Dri-Mist Micro Particle Generator” to pump the fog into their ambulances that EMTs began complaining of symptoms. The DMMPG, a device patented by Zimek, creates a mist that can theoretically reach and disinfect areas of emergency vehicles inaccessible by other methods. The problem is that converting the state of the disinfectant from liquid to vapor violates EPA laws regarding pesticides, specifically the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA).
A Baffling Case for Investigators
Sporicidin Products
EPA officials were initially baffled by the case - having never heard of this type of disinfectant being used in this way on this scale. Neither the EPA nor MONOC have been able to satisfactorily determine whether fogged-disinfectants in enclosed spaces are safe for humans. Zimek QD's label also does not suggest the product is intended for “fogging”.
When Zimek QD's registration elapsed in New Jersey, MONOC switched to another antibacterial fogger, Sporicidin, while renewal was pending. A disinfectant developed for use in “clean room” environments such as biological labs or high tech microchip development labs, Sporicidin is intended for fogging use. In such clean rooms, a completely sterile environment is accomplished by keeping humans quarantined via bio-suits and respirator. Consequently, the effects of Sporicidin on humans have not been adequately studied.
Size Matters: The Major Effects of Micro-Particles
Zimek fogging into an ambulance
PEMSA, having previously filed a complaint with the New Jersey EPA against the use of Zimek QD, filed a second complaint against the (mis)use of Sporicidin by MONOC. OSHA and private labs hired by MONOC conducted tests on emergency vehicles to determine toxicity levels. While results indicated that the presence of toxic materials was well below tolerable levels, the unique fogging system may have created situations in which even low levels of Zimek QD became dangerous.
The fogging systems designed by Zimek (not intended for use with Zimek QD, incidentally) create micro-particles in what is called a “dry fog.” The cleaning chemicals are particalized and bonded with the least amount of moisture necessary for delivery. The problem with micro-particles is that they can be absorbed into the body much quicker and in much greater quantities than the larger particles resulting from natural vaporization (evaporation) and thus may pose more of a danger, even in smaller quantities.
