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Web links to and descriptions of relevant laws, standards, guidelines or books for each topic of EPIC interest.
AsbestosAsbestos refers to a specific group of Federally regulated natural minerals. In addition to being abundant and cheap to mine, asbestos possess desirable properties such as: high tensile strength, incombustibility, corrosion resistance, acoustical dampening, and thermal insulation. As a result, asbestos fibers were added to thousands of commercial products, including nearly every type of construction material. Unfortunately, the sought-after properties that make asbestos a great building material also make it detrimental to human health if fibers are inhaled or ingested. To this day, around 15,000 U.S citizens die from asbestos related diseases annually. In good condition and undisturbed asbestos poses virtually no inhalation or ingestion exposure potential, so intact asbestos containing materials in your SNF are generally best managed in place until damaged or slated for disturbance.
Asbestos bans are not what people think. Asbestos WAS AND IS used in various building materials. Since asbestos is in both new and existing buildings, the US EPA and OSHA regulate asbestos in building materials and regulate worker inhalation exposure regardless of the age of the structure. Identifying which materials contain asbestos in your building is critical to protecting health and to coming into compliance. Asbestos cannot be recognized by ordinary observation or even by reviewing SDS’s or product literature. Regulations require an AHERA Certified Asbestos Inspector conduct asbestos surveys. Samples must be tested in accredited laboratories utilizing microscopy.
It is strongly suggested Arizona SNFs minimally have asbestos sampling conducted on materials regularly disturbed during the course of SNF business, such as lay-in ceiling panels and drywall systems. This will prevent regulatory citations, it will speed mitigation response to emergencies like fires and floods, and it will allow you to protect your workforce and residents with confidence. Other materials should be presumed to contain asbestos fibers and must be tested before any capital improvements (e.g. roof replacement, flooring swaps, kitchen renovations, etc.).
- Fact Sheet
- OSHA asbestos guidelines
- EPA asbestos guidelines
- Maricopa County asbestos regulations help sheet
- Fact Sheet
- IICRC S500 Standard and Reference Guide for Professional Water Damage Restoration.
- EPA
- CDC
- American Red Cross
- American Lung Association
- Additional EPIC resources
- If you have additional questions:
- Leave a message on the Emergency Preparedness Infection Control (EPIC) hotline at 602-241-4644,
- Email at EPIC@AZHCA.org, or
- Visit the EPIC Web Resource Pages at epic.disasterreadyaz.org
- If you have additional questions:
- Infection Control
- Disinfectants
- CDC cleaning and disinfection guidance
- AIIR (Airborne infection isolation rooms)
- Additional EPIC resources
- Disinfectants, EPIC Video
- Wellness Checkpoints, EPIC Video
- If you have additional questions:
- Leave a message on the Emergency Preparedness Infection Control (EPIC) hotline at 602-241-4644,
- Email at EPIC@AZHCA.org, or
- Visit the EPIC Web Resource Pages at epic.disasterreadyaz.org
- CDC online guidance on infection control
- CDC cleaning and disinfection guidance
- List of EPA registered disinfectants
- CDC Water Management Toolkit
- Fact Sheet
- For more guidance on maintaining buildings to help prevent Legionella growth, consult the ASHRAE Guideline 12-2000 Minimizing the Risk of Legionellosis Associated with Building Water Systems and ANSI/ASHRAE Standard 188-2018, Legionellosis: Risk Management for Building Water Systems.
- Legionellosis Investigation Form Arizona Department of Health Services
- View the IAQTV video “Legionnaires’ Disease: What You Need to Know”
- View the IAQTV video on Legionella & Monitoring Building Water
- Additional EPIC resources
- If you have additional questions:
- Leave a message on the Emergency Preparedness Infection Control (EPIC) hotline at 602-241-4644,
- Email at EPIC@AZHCA.org, or
- Visit the EPIC Web Resource Pages at epic.disasterreadyaz.org
- If you have additional questions:
- Fact Sheet
- EPA publication 402-K-01-001: Mold Remediation in Schools and Commercial Buildings
- University of San Diego Water Intrusion and Microbial Response Plan
- University of Florida Guidelines to address Water Intrusion Problems
- CDC guidance on mold exposure and remediation
- EPA guidance on mold exposure and remediation
- AIHA guidance on mold exposure and remediation
- OSHA guidance on mold exposure and remediation
- https://www.cdc.gov/mrsa/healthcare/inpatient.html
- https://www.cdc.gov/mrsa/index.html
- https://www.cdc.gov/drugresistance/pdf/threats-report/mrsa-508.pdf
- Fact Sheet
- CDC page on Histoplasmosis
- NIOSH page on Histoplasmosis
- County of Maricopa flyer on Pigeons
- UofA cooperative extension office
- IAQTV video on Histoplasma capsulatum & Histoplasmosis
- IAQTV video on Pet Birds, IAQ & Your Health
- IAQTV video on Psittacosis: Chlamydia psittaci
- AHCA/NCAL Sample Policy for Emergent Infectious Diseases
- Checklist for Suspected Outbreak of H1N1 Influenza, Checklist for suspected outbreak of H1N1 Influenza (Swine Flu) in a long-term care facility from Pathway Health Services.
- Clean Hands Saves Lives – Poster A poster promoting washing hands (when and how).
- Flu Facts: General facts about the flu developed by ToucanEd
- General Procedures for Properly Putting On and Taking Off a Disposable Respirator: General Procedures for Properly Putting on and Taking Off a Disposable Respirator – Prepared by the Centers for Disease Control and Prevention (CDC).
- NHICS Incident Response Guide – Pandemic Influenza: To effectively and efficiently identify, triage, isolate, treat, and track a surge of potentially infectious residents and staff; and to manage the uninjured/asymptomatic persons, family members, and the media.
- Respiratory Hygiene/Cough Etiquette in Healthcare Settings: Link to a page on CDC – provides infection control measures to be implemented at the first point of contact with a potentially infected person.
- Fact Sheet
- The following resources are offered to help Providers understand respiratory protection program administration, respirator use, and fit testing:
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- IAQTV video on Respiratory Protection for Workers
- US Department of Labor OSHA Video titled “Respirator Fit Testing” issued Feb 7, 2012
- US Department of Labor OSHA Video titled “The Difference Between Respirators and Surgical Masks” issued Dec 16, 2009
- US Department of Labor OSHA Video titled “Respirator Safety” issued Dec 16, 2009
- Case Study: U.S. Department of Labor Cites Ohio Nursing Facilities for Failing to Fully
Implement Respiratory Programs to Protect Employees from Coronavirus - ANSI/AIHA Z88.10-2010 Respirator Fit Testing Methods. An American Industrial Hygiene Association publication by the ANSI/AIHA Z88.10 Subcommittee; 2010.
- Respiratory Protection Resource Page, Occupational Safety and Health Administration, U.S. Department of Labor. Includes general guidance, training videos, standards, compliance directives, and links to additional resources.
- OSHA Bulletin: General Respiratory Protection Guidance for Employers and Workers. (2011).
- OSHA Guidebook: Small Entity Compliance Guide for the Respiratory Protection Standard, OSHA Publication No. 3384 [3384-09]; 2011.
- OSHA Technical Manual (OTM) – TED 01-00-015 [TED 1-0.15A], Section VIII: Chapter2. Respiratory Protection.
- Respirator Trusted-Source Information Page, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Includes multiple resources related to selection of NIOSH-approved respirators, cleaning and maintenance, respirator standards, and links to other resources.
- Respiratory Protection. 29 CFR 1910.134, Occupational Safety and Health Administration, U.S. Department of Labor.
- Use of individual respiratory protection equipment. 10 CFR 20.1703, U.S. Nuclear Regulatory Commission; 2002.
- Comparable non-U.S. standards, as applicable.
- Annex A1, “Evaluation Form for Respiratory Fit Test Operator” of ANSI/AIHA Z88.10-2010, Respirator Fit Testing Methods.
- Assigned Protection Factors for the Revised Respiratory Protection Standard OSHA 3352-02-2009
- NIOSH Respirator Selection Logic, Nancy Bollinger, US DHHS / CDC, October 2004.
- Respiratory Protection Guidelines, American Thoracic Society, American Journal of Respiratory and Critical Care Medicine, Vol 154, pp 1153-1165, 1996.
- NIOSH Fact Sheet – What’s Special About Chemical, Biological, Radiological, and Nuclear (CBRN) Air-Purifying Respirators (APR)? 2013
- Respiratory Protection – A Manual and Guideline, AIHA, 3rd ed., 2001.
- Manual of Respiratory Protection Against Airborne Radioactive Material, NUREG/CR-0041; January 2001.
- USNRC Regulatory Guide 8.15, Acceptable Programs for Respiratory Protection, October, 1999.
- US Department of Energy, The Department of Energy Respiratory Protection Acceptance Program for Supplied-Air Suits, DOE-STD-1167-2003.
- NIOSH-Approved Particulate Filtering Facepiece Respirators
- National and International Industry Consensus Standards, as Applicable, e.g.:
- ANSI Z88 series standards on respiratory protection
- ISO/TC 094/SC 15 series standards on respiratory protective devices
- NFPA 1404, Standard for Fire Service Respiratory Protection Training
- NFPA 1852, Standard on Selection, Care, and Maintenance of Open-Circuit Self-Contained Breathing Apparatus (SCBA)
- NFPA 1981, Standard on Open-Circuit Self-Contained Breathing Apparatus for Fire and Emergency Services
- NFPA 1989, Standard on Breathing Air Quality for Emergency Services Respiratory Protection
- American Industrial Hygiene Association Body of Knowledge Respiratory Protection Program Administration and Fit Testing 2015
- Additional EPIC resources
- Respirators and Masks, EPIC Video
- If you have additional questions:
- Leave a message on the Emergency Preparedness Infection Control (EPIC) hotline at 602-241-4644,
- Email at EPIC@AZHCA.org, or
- Visit the EPIC Web Resource Pages at epic.disasterreadyaz.org
- IICRC S500 Standard and Reference Guide for Professional Water Damage Restoration
- EPA publication 402-K-01-001: Mold Remediation in Schools and Commercial Buildings
- University of San Diego Water Intrusion and Microbial Response Plan
- University of Florida Guidelines to address Water Intrusion Problems
Learn More:
If you have additional questions, leave a message on the Emergency Preparedness Infection Control (EPIC) hotline at 602-241-4644, or email EPIC@AZHCA.org.