U.S. EPA is interceding in a New Jersey public-health flap that could have national implications, ordering a hospital services company to stop disinfecting its ambulances with finely misted pesticides after a local union complained of workers falling ill.
In an order last Tuesday to Monmouth-Ocean Hospital Services Corp., or MONOC, EPA's Region 2 office in New York forbade the emergency-medicine company from using a "micro-mist" system that sprays "a sub-micron fog" of antimicrobial chemicals inside its ambulances. The EPA action validated complaints from a local union that as many as 100 MONOC paramedics it represents were sickened by on-the-job exposure to the misted pesticides.
"EPA has reason to believe that in distributing the antimicrobial pesticides Sporicidin and Zimek QD to MONOC" -- the company used both chemicals to sanitize vehicles in its 100-strong fleet -- "Zimek and/or its representatives made claims for a use not accepted in connection with the registration of either product," the Region 2 order states.
"EPA further has reason to believe that MONOC has applied at least these two antimicrobial pesticides to the interior of its ambulances in a manner inconsistent with their labeling and likely to cause harm to humans," the federal order continued.
Zimek and MONOC officials take issue with the charges by the New Jersey union, the Professional Emergency Medical Services Association (PEMSA), that the micro-misting product is behind the skin and eye irritation, asthma, headaches and ulcers reported by paramedics after the fogger was put to use in mid-2009. But while the short-term impact of the order may be local, the dispute may well reverberate in other localities where Zimek's pesticide misting caught on as a high-tech shield against the H1N1 flu virus, hospital "super-bugs" and other recent public health scares.
PEMSA President Deborah Ehling said the push launched by her union, a chapter of the International Association of Fire Fighters, is aimed at strengthening chemical safety regulations as well as protecting workers.
"The problem here is that this machine is a relatively new technology ... there's got to be 100 other companies out there developing technology to administer chemicals," she said. "And before those technologies are going to be allowed to hit the broad market, somebody's got to be sitting down and evaluating what [they're] going to do."
In the case of Zimek's micro-mister, its company literature touts a technological advance that effects a conversion of pesticides into microparticles with a negative charge and a sub-micron size. The chemicals dry "virtually on contact" after fogging inside a vehicle with "no visible or toxic residue," according to Zimek materials.
The labels for the pesticides MONOC used in its ambulances, however, refer specifically to "hard non-porous surfaces." Longtime occupational health official Eileen Senn, who has advised PEMSA on an unpaid basis on its concerns, pointed to the contact of tiny chemical particles with blankets, bandages and other porous items as a pathway to potential poisoning of ambulance workers.
"How do you fog an ambulance without contacting porous surfaces?" Senn said. "I'd love to see their protocol for how ambulances should be fogged. I'll bet it doesn't say to take the seats and carpet out -- on the contrary, they tout the fact that this gets on everything and is therefore more protective."
Zimek spokesman Noah Lichtman, in an e-mailed statement, strongly defended the company's "impeccable safety record" and said it "takes very seriously the nature of these allegations" but has not been contacted by EPA concerning the order to MONOC.
Ehling and Senn raised questions about whether the micro-mister could be generating nanoparticles of pesticides, taking the debate into the controversial and scientifically evolving territory of sub-molecular technology, but Lichtman disputed any such assertions.
"Characterizations that the Zimek equipment renders disinfectants into nanoparticles are completely baseless and contradict basic laws of matter," he said. "All liquids used in Zimek equipment remain a liquid when they exit the equipment."
For MONOC, the EPA order represents a simple disagreement over the wording of the labels for the pesticides misted inside its ambulances. MONOC support services director Peter Dworsky described the New Jersey case as "a red herring" in an interview, saying he has found no evidence of any other Zimek clients experiencing negative health consequences.
"We believe it is a good system, we believe it works as intended, and we believe that once people's issues are resolved, we'll be able to start using it again," Dworsky said of the Zimek product.
Responding to Ehling's estimate that 100 out of the union's 600 MONOC-affiliated workers have reported adverse symptoms linked to the pesticides, Dworsky said he had "not been provided with documentation" of any specific number of complaints but that workers' compensation officials were investigating, as well as the Occupational Safety and Health Administration (OSHA). MONOC and OSHA also have screened samples from misted ambulances and not reported chemical levels above permitted limits, according to Dworsky.
Ehling said she is beginning to receive reports that indicate PEMSA workers may not be the only ones experiencing symptoms, but declined to elaborate given the still-early nature of the data. EPA's order to MONOC states only that exposed workers "continue to suffer ill effects" consistent with pesticide poisoning.
Material safety data sheets for Sporicidin and Zimek QD, the two chemicals used at various times by MONOC inside ambulances, note that respiratory protection should be used whenever ventilation cannot be relied upon to remove mists of the substances from an area.
"We look forward to an opportunity to speak with the EPA and learn more details about the allegations so we can either address this isolated incident -- if it is related to the Zimek equipment -- or else fully clear our name from these spurious claims," said Lichtman, spokesman for the company.
Zimek has forged high-profile alliances in Washington during its rise in a biotechnology sector that experienced major growth in the wake of the anthrax and "bird flu" scares in the early 2000s.
The company counts James Lee Witt, Clinton-era chief of the Federal Emergency Management Association and an adviser to BP PLC's Gulf of Mexico cleanup work, as a senior adviser. Its lobbying team at International Government Relations Group, an affiliate of Mercury Public Affairs, is led by former Rep. Max Sandlin (D-Texas), according to disclosures, and Mercury counselor Emil Jones Jr. -- a mentor of President Obama's during their time in the Illinois state Legislature -- sits on the company's advisory board.
"We were concerned from day one, looking at their advisory board, that there would be a lot of political pressure to suppress any investigation," Ehling said.
But at the moment, PEMSA members are counting the EPA order as a victory that vindicates their health concerns, while Zimek and MONOC vow to counter any suggestion that the chemicals were improperly used. "Hundreds of government, public and private sector facilities worldwide have used Zimek's disinfectant application process thousands of times without a single documented health incident," Lichtman said in his statement.