People entering your office can have allergic reactions to a host of substances. The severity of these reactions can range from mild to life-threatening, so it’s smart to try to rid your space of the most common allergens for patients and staff in a medical office.
MOT spoke with several experts in the field of allergen control to find out what substances found in medical offices most frequently cause allergic reactions and how practices should approach them. Read on for their advice.
Found in a wide range of medical supplies including surgical gloves, syringes, gown elastic, rubber stoppers in IV bottles and bags, IV tubing, stethoscopes, catheters, dressings, bandages and in some rubber-capped medicinal vials, latex can be a major allergen in medical offices.
According to Dr. Frederick M. Schaffer, M.D., chief medical officer of United Allergy Services in San Antonio, Texas, those most at risk for latex allergies include patients with spina bifida and congenital genitourinary abnormalities, healthcare workers, rubber-industry workers, patients with allergic disorders (such as asthma, rhinitis and atopic dermatitis) and patients who have undergone multiple medical procedures.
Since latex gloves are the most likely culprit for latex allergic reactions in your office, review your use of medical gloves and banish the latex variety from your practice. There are many latex-free options in the marketplace, says Wendy Yu, licensed acupuncturist with the Eastern Center for Complementary Medicine in Los Angeles. You can also find non-latex substitutes for medical supplies and devices.
In addition, make sure patients with latex allergies are aware of any potential exposure in your office, and advise them to wear Medic-Alert bracelets, says Schaffer.
The most manageable forms of indoor airborne allergens are particles of dust mites, pollen, mold and pet dander.
Dust mites can be found in carpeting and in upholstered furniture, particularly in humid environments. Maintaining the humidity level below 50 percent will significantly diminish the dust mite population; do this by keeping the air conditioner on throughout most of the summer and during hot and humid weather periods, or use dehumidifiers to maintain a low humidity.
“The best way to diminish the dust mite population in carpet is to remove all rugs and/or carpeting,” says Schaffer. If this is not feasible, consider using commercial products containing tannic acid.
Dust mites and pollen may be carried into an office on clothing and shoes. Providing floor mats where people can wipe off their shoes before entering and coat hooks outside the office area in a vestibule, for example, can help reduce the amount of dust mites and pollen brought into your office, says Anthony M. Abate, vice president of operations for Clean Air Group in Fairfield, Conn.
Additionally, make sure your cleaning company uses micro-fiber cloths and mops that pick up and retain the dust into the fibers rather than those that stir dust into the air. HEITS Building Services in Hasbrouck Heights, N.J., uses a color-coded micro-fiber system to eliminate cross-contamination and increase the amount of germs and bacteria that gets picked up by rags. “Also, using a HEPA filtration on vacuums is going to capture more particulates that would otherwise get back into the air,” says David P. Heitner, HEITS’ founder/CEO.
Mold and mold spores are especially prevalent allergens that can often trigger other allergies and increase sensitivities after continued exposure. “Mold, in particular, is of greater concern as it can also lead to dangerous healthcare-associated infections (HAIs),” says Jeff Dudan, CEO of AdvantaClean Systems, Inc. in Huntersville, N.C.
Elevated humidity levels, poor air circulation and previous and existing water damage can all contribute to mold growth; therefore, prevention via proactive management of indoor air quality is the best course of action. This includes routine air-duct cleaning, scheduled filter maintenance and regular cleaning of materials that harbor allergens, such as carpets, drapery and upholstery.
Water and air leaks can allow allergens to enter indoor spaces and foster mold growth. Make sure that building maintenance and test reports are current and available, and use air purification in waiting and exam rooms to inhibit mold growth.
Diminish indoor mold exposure by decreasing the number of indoor plants, closing all windows and doors during periods of high mold spore counts, utilizing HEPA air conditioning filters and changing the filters monthly. Yu’s practice uses the IQ Air, a Swiss air-filtration system recommended by the American Lung Association.
Mold infestation can be difficult to detect; you may wish to contact a certified indoor air-quality specialist to determine the scope of your problem and to develop and implement a plan for remediation.
Pet dander may be an issue if patients bring pets or guide dogs in with them. If there’s no way to avoid having pets in our office, keep the windows closed during high-pollen season and use a good HVAC system, says Marjorie L. Slankard, M.D., clinical professor at Columbia University and an allergist at Columbia Doctors Eastside in New York City.
Finally, be aware that environmental disturbances associated with construction activities near your office can release significant airborne particulates that could enter your office and create an allergy issue.
Cleaning chemicals, solvents, paints and pesticides
Chemicals meant to do good can often create allergic reactions among sensitive patients. Being aware of the chemicals present in your office can help you reduce them if necessary.
Also, something as simple as the method of use for chemical products can affect how much of the allergen is exposed. HEITS teaches staff to apply cleaning chemicals into the microfiber cloth rather than spraying into the air.
In addition, choosing “green” chemicals can help reduce allergic reactions, plus they’re better for the environment. Also, air purifiers that cleanse with ozone can make a huge difference in purifying chemicals, says Darcy Ward, a chiropractor at the Center for Chiropractic & Wellness in Greensboro, N.C.
In addition to giving off potentially objectionable aromas – particularly if too much is used – perfumes can be a major source of allergens in a medical office. “Patients should be encouraged not to wear perfume on the day of their appointment, and doctors should never wear it to work,” says Ward.
Set a no-fragrance policy in your office, and enforce it. Patients’ comfort is far more important than an alluring perfume or cologne.
By Carrie Rossenfeld
February 22, 2012