IHs Play Key Role in Treatment of American Ebola Patients

As of early October, four American aid workers had contracted Ebola in West Africa—three in Liberia and one in Sierra Leone—and had been transported to the U.S. for treatment. The Ebola crisis has prompted industrial hygiene and health and safety professionals in the States to take extra measures to ensure that health, safety, and infection controls are properly implemented to safeguard healthcare workers and others during treatment of these patients.

Two of those professionals are AIHA members Shawn G. Gibbs, PhD, MBA, CIH, and John J. Lowe, PhD, who work as director and assistant director of research, respectively, at the Nebraska Biocontainment Patient Care Unit, which was commissioned by the U.S. Centers for Disease Control in 2005 and is designed to provide treatment for people affected by highly contagious and dangerous diseases. In September, the U.S. Department of State contacted the unit to see if their team would be willing to treat Richard Sacra, a Boston-area doctor who became the third American infected with Ebola. 
“Once our medical director agreed to take the case, we had to prepare for the patient’s arrival 72 hours later,” said Gibbs. “We immediately began coordinating with the U.S. Department of State and the Nebraska Department of Health and Human Services and took the lead on overseeing the preparation of the ambulance, the various stages of transport, and the decontamination of the ambulance.” 
Prior to the patient’s arrival, Gibbs and his team put administrative and engineering controls into place for transportation, including setting out 6-mil plastic barriers to create a fluid-impermeable envelope to prevent contamination of ambulance surfaces that are difficult to clean. The team also reviewed personal protective equipment that the paramedic, nurse, ambulance driver, and Lowe would wear during transport. When the patient arrived, the team implemented additional safeguards such as the use of N95 respirators and face shields and a pass-through autoclave for handling and processing solid waste.
Ensuring the safety of the healthcare workers who came into contact with the patient in the facility was a priority for the unit’s leadership team, according to Lowe. “We decided early on in the planning phase that, no matter what, everyone would follow the outlined donning and doffing protocols at any given time to avoid exposures,” he said. “All staff members were monitored on a daily basis for temperatures or any sign of illness. That will continue to happen for about 21 days after their last contact with the patient or entry into the unit.”

Diseases like Ebola create public concern for health and safety, and Gibbs and Lowe are actively working to answer questions and provide information to assure people that they have a good understanding of this disease. As the Ebola crisis evolves, Gibbs and Lowe believe that the role of industrial hygienists will become increasingly important.
“The expertise that we have as industrial hygienists has really driven both the environmental and engineered design of the infection control component of this case,” said Gibbs. “Our involvement in the process has also freed the clinicians of health and safety considerations so they can focus their attention on patient care.”
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