When Hospitals Become Emergency Cases: Water Damage Cleanup and Restoration of Occupied Hospitals
Despite strict adherence to building codes and construction practice, hospitals are not entirely free from possible occurrence of water damage. Floods, broken air conditioners, burst water pipe, and burst sprinkler system are some of the common causes of water damage in hospitals.
Water-damaged hospitals require more cleanup and restoration protocols than ordinary residential and commercial properties. When a hospital gets water-damaged, it becomes a high-risk locale. During normal days, conditions inside hospitals are highly controlled, from temperature to moisture content to air condition.
When water infiltrates the hospital interior, it dramatically affects the conditions inside the hospital. The changes can seriously impact the ill patients inside the hospital. In extreme cases, it can damage hospital equipment, vials, oxygen tanks, injection needles, medicines, etc. The probability of spread of respiratory diseases, infectious diseases, and microbes is also high. Other than health issues, water-damaged hospitals also pose threats of electrocution and equipment failure.
Restoring water-damaged hospital buildings pose more challenges because there are a lot of factors to be taken account of--- not the least of them the patients inside the hospital. Though relocation of patients would depend on the severity of the damage and the degree of health threat caused by water damage, still in most cases this protocol is carried out. Changed moisture condition and presence of water can exacerbate certain kinds of illness.
The first step in restoring a water damaged hospital is to determine the level of threat in a water damaged hospital as to evaluate susceptibility of building occupants within and around the damaged area. This is done so that appropriate measure can be taken with regards to evacuation of patients and other building occupants. Air has to be tested for presence of microbial and viral threats. The type of water damage can also determine if occupants have to be relocated or not. How long has the water damage been? Is there stagnant water? Has strong odors associated with mold detected? Has symptoms potentially connected to mold reported? Does the water source have any level of bio-contamination?
The second in water damage restoration process of a hospital is to secure the patients and other hospital occupants. If the whole floor has been damaged, again, this is done by relocating the patients to a place studied to be safest for them. The patients will either be relocated to a different ward or floor level (where the hospital is multi-storied), or to a different facility. In severest cases where water damage water infiltration causes a facility to become highly dangerous, as when Law Hospital in Carluke, Lanakshire was damaged by rain, the hospital was abandoned. A hospital in West Cornwall, London had to be temporarily closed.
Complete evacuation of hospitals including of hospital workers, however, should be considered only in cases where there is widespread building-related illness, mould contamination, and where there is presence of microbial and viral threats.
Water damage restoration specialists should practice extreme caution when doing cleanup and restoration of a water-damaged hospital. Where hospital occupants (health workers, staffs) and restoration crews experience potentially-related symptoms during cleanup process, they should seek medical attention immediately. Sensitive individuals and people with low immune resistance may have to be relocated.
Occupants near restoration site have to be given adequate precautions. All work should be done under the regulation of an Infection Control personnel or a physician.
To carry out restoration process, the hospital should get highly trained and qualified workforce who knows how to deal not only with damaged floors, walls, and ceilings but also with damaged hospital documents and equipments.
Restoration personnel should also be protected and insured. Wearing protective suit with HVAC is very important because a water-damaged hospital is perhaps a hundred times more dangerous than residential or commercial buildings. Getting an insured workforce will also help the hospital avoid paying for damages incurred by workers during cleanup. Restoration crew has to classify work as well (Class 1-4).
Water damaged areas should be contained to avoid spread of airborne contaminants and microbes. Isolation of damaged area should be done using temporary plastic sheath walls.
Water-damaged documents such as papers, log books, hospital records, notebooks, X-ray films, microfilms, and other such items have to be placed in boxes then carried to refrigerated freezer tractor- trailer trucks. The damaged items will be transported to a document drying facility where they will be dried and restored using processes such as thermal freeze-drying or vacuum freeze drying. Since x-ray films can readily absorb moisture, x-ray films that have not been directly saturated with water should still have to be sent along with other items to a drying facility.
As it is with other property structures, restoration of water damaged buildings involve the basic cleanup, sanitization, and drying of affected areas and materials. Stagnant or standing water have to pumped and carried away from the hospital.
All absorbent finishes, dry walls, and porous materials have to be removed and discarded. Cottons, needles, pills, and other porous materials have to be discarded. Other materials that need to be gotten rid of as well include fiberglass insulation, cellulose insulation, ceiling tiles, and gypsum board.
Electronic devices and other hospital equipment like ECG, computer, x-ray machines, etc have to be checked by a professional to determine if they are safe for use, or if they can still be repaired.
All water-saturated surfaces have to disinfected, detail-cleaned, then disinfected again. Afterwards, structure has to be dried to 30%-50% RH (relative humidity) using a dehumidifier. Odor has to be removed as well by running deodorizer in the affected areas.
After cleanup and drying of water-damaged areas, the place has to be evaluated by a third party. Testing of air should be done to ensure there is no harmful microbial contamination and other public health issues.
If source of water damage is old (reported more than 24-48 hours after wetting took place), a qualified and insured mold investigator has to perform physical investigation and intrusive inspection to accurately determine presence of mold contamination as well as location of mold contamination, if there’s any. Air and bulk sampling must be carried out as well to figure out degree of mold spores in the building.
If mold growth is confirmed, the director, supervisor, or other hospital head should notify Infection Control when there are water intrusion or mold contamination concerns that can adversely affect Hospital and Patient Care areas. Along with patients, other building occupants who are old and have weak immune system, allergies, and asthma have to be relocated from the building as well. But if there is a widespread mold contamination of hospital building, then the hospital has to be completely evacuated.
To restore mold infested areas, mold remediation has to be carried out. The contractor that the hospital has to hire should be highly trained and qualified in mold remediation. Remediation crew must also be geared with full body suits, puncture-free gloves, and high-tech respirators. It is important that the crew should have insurance coverage also. Again, this is for the hospital to avoid paying workers for damages (health or physical damages) incurred during mold remediation process.
The contractor has to classify the level of mold remediation; that is, if it is Level I, II, III, or IV so that appropriate safety measures and precautions can be carried out by adjacent occupants. Occupants have to be removed from the actual remediation site, though. Again, susceptible occupants have to be removed from adjacent areas also.
Damaged porous materials that are highly valuable such as papers, hospital records, x-rays, etc, may be brought to a content cleaning and restoration facility to attempt recovery.
The application of control measures in water-intruded, mold-contaminated areas would vary depending on degree of damage and possible risk to building occupants. The hospital’s HVAC system must be protected either by shutting off HVAC or by sealing supplies and returns. To clean and restore mold damaged areas, openings such as windows and door slits have to be plasticized with critical barriers or protective sheaths. A negative or slight pressure has to be maintained to prevent spread of mold spores to adjacent areas. Affected areas should have to be HEPA vacuumed after surfaces are damp- cleaned. Ceilings and walls of Patient Care and other sensitive areas have to be damp-cleaned as well to remove released materials.
For Level III and IV work, it has to be supervised by an EH&S (Environmental, Health & Safety) professional who must also collect clearance air samples. The EH&S personnel has to provide guidance and oversight as necessary to assure compliance of restoration crew with EH&S policies. THE EH&S personnel must also consult with Infection Control for hospital-related cases.
24-48 hours after mold remediation, EH&S personnel has to verify that affected hospital areas have been restored to normal and safe conditions.
Water damage cleanup and restoration of a large and sensitive facility such as a hospital can take several days or even weeks to complete. While the process is being carried, occupants have to follow precautionary measures to avoid exposing themselves to danger. Restored hospital areas have to be evaluated first by Infection Control and EF&S to determine if the environment has already been completely sanitized and stabilized before patients are returned.