With a background in chemistry, public health, and failure analysis, Cooper has spent more than 20 years managing and directing corporate environmental health and safety programs for industries with both national and international sites. He is an instructor for UC Davis, and in 2015 he started his own business, M Cooper Consulting. When his son graduated from college and traveled to Haiti to volunteer with , a Catholic charity that has worked in the country for approximately 30 years, Cooper went for a visit. His trip marked the beginning of his involvement with industrial hygiene projects in Haiti, where his focus has been X-ray and CT radiation monitoring, sharps management, and hospital water purity. Cooper is a member of AIHA’s International Affairs and Biosafety and Environmental Microbiology Committees. He can be reached . The Synergist: What were your first impressions of Haiti? Haiti is a small country with big problems. It’s the land of NGOs; however, the NGOs are not well coordinated with the government or other NGOs in terms of all the efforts going on there. The massive earthquake in January 2010 devastated the country and leveled most of the government buildings, including medical and nursing facilities. That was followed by cholera. Even in 2016, six years later, there’s still evidence of the destruction and a very keen memory of the cholera clinics, homelessness, and deaths. A lot of work has gone in, a lot of money’s been spent, and rebuilding has taken place, but there are still signs of the difficult situation that happened some years back. I first got involved with two hospitals run by the NPH Catholic charity. They had several needs as they were looking to use some United States Agency for International Development (USAID) funds to build a hospital building, which meant that they had to do some coordination work with the U.S. Embassy in Port-au-Prince. I worked with the people who were planning that effort to assess the environmental impact in Haiti. That work revealed a number of different industrial hygiene needs at these hospitals, including radiation equipment monitoring and water purity. While I was walking on the beach near Cité Soleil, one of the poorest urban areas, I found kids playing soccer on the beach with needles in the sand. That scene led me to find out how the hospital was dealing with their sharps and what their sharps disposal procedures were. Since everything at the hospital is supported by donations, somebody had given them a medical incinerator, but it was in need of repair. Since the hospital generates a volume of sharps, my efforts included providing some industrial hygiene training on sharps management and bloodborne pathogens and figuring out ways for people to collect needles with magnets and punch-proof gloves to help prevent exposures. Another thing that was eye-opening to me was the hospital morgue. Obviously, the hospital loses patients, many of whom seek care very late in the disease cycle, often due to poverty. But because it serves the poor, sometimes an individual will pass and they’ll be brought to the hospital because their family doesn’t have money to bury them. The morgue at the hospital was a large Conex unit—a modified shipping container—that didn’t have very good refrigeration and wasn’t up to the standards of a U.S. morgue. Haitian and volunteer staff prepared the deceased, put them into the temporary Conex morgue, and then tried to find a place to bury them on available land. My son, who is in medical school for international medicine, was helping with the bodies, so I’ve provided gloves, respirators, and other equipment to help with that work. TS: ​What other industrial hygiene projects were you involved with at the hospital? MC: I also did survey work for the radiation equipment. The results from one-month thermoluminescent dosimeter (TLD) badges appeared a little high, but there was a question as to whether or not the badges were exposed in the multiple X-rays that were done in the airports when the units were shipped from Haiti back to the U.S. for analysis. After that, I went back and did some surveys of their radiation technicians and scatter from the X-ray units to determine exposures. I identified issues concerning recordkeeping, evidence of surveys after equipment repairs, signage, and lack of personnel dosimetry. The equipment was being operated in a proper manner by the Haitian technicians, who had received some training in U.S. hospitals. However, they had no dosimetry and no means of detecting scatter because they didn’t have survey instrumentation. Instrument scatter is typically checked on a routine basis and after any maintenance on the units. Protective lead aprons are also checked periodically to make sure they’re not cracked or separated. This type of survey is typically done on an annual basis in the U.S. to meet Nuclear Regulatory Commission and state requirements for X-ray machines. The U.S. also requires film badges so that it is possible to determine if an exposure occurs, allowing for an investigation and corrective actions. The hospital has volunteer medical and nursing teams coming in from around the world to do surgeries and sometimes there’s an X-ray tech that comes with them. Having someone come in from another country who’s operating equipment without dosimetry raises a question as to whether or not there are issues there. I spent a lot of time with the X-ray operators, talking about scatter from X-rays, why you have a maintenance log, and why you do surveys. They’d received some training on those topics, but it had been a while.