Episode 693: Thomas Licker - Responding to Fentanyl, Crime, Trauma & Other Biorecovery Situations

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Episode 693: Thomas Licker - Responding to Fentanyl, Crime, Trauma & Other Biorecovery Situations

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Show Resources: Show Discussion:

12:04:53 From cliff zlotnik : trivia: ID where in North America were biological weapons were first use in warfare?
12:10:25 From Robert Spielvogel : I understand China is supplying Fentanyl precursors to Mexico.
12:35:23 From Lorne McIntyre : Can you provide some insight on how the illicit drug debris is disposed? Is this considered regulated waste?
12:40:11 From Remmie Arnold : As a home inspector, I sometimes get realtor/investors booking us into unknown circumstance homes. what do I look for in terms of hidden drug contamination and can I do simple spot sampling to determine a full blown assessment?
12:48:15 From Lorne McIntyre : Regarding trauma industry…knowing the dangers of this work. Why have more states not followed Georgia in requiring licensing for contractors ? Thanks
12:50:15 From paul.yelle : Thanks for all the great info today!
12:51:13 From Ralph Froehlich : Why only be concerned with “sketchy areas” or homes with drug paraphernalia? Fentanyl may be present in “good areas” or in homes without visible drug paraphernalia.
12:51:50 From lee aenter : Do your workers have narcan on their trucks
12:54:20 From Ralph Froehlich : How do you minimize psychosocial stress for your cleanup crew members?
13:07:33 From Barry Costa : Thank you guys! Great job
13:07:36 From Lorne McIntyre : Great show everyone.
13:08:44 From Ralph Froehlich : Sorry to hear that Hal Levine has passed!
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Re: Episode 693: Thomas Licker - Responding to Fentanyl, Crime, Trauma & Other Biorecovery Situations

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Thanks to Tom Licker for a fascinating interview. If you ever wondered who cleans up after mass killings, suicided, overdoses, biological weapons, crime scenes and more Tom tells us. Great response and questions from our audience. I think the most important thing he showed us was the Recovery Risk Assessment checklist. You can find it on the ABRA website here:
https://cdn.ymaws.com/www.americanbiore ... ssment.pdf
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CliffZ
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Re: Episode 693: Thomas Licker - Responding to Fentanyl, Crime, Trauma & Other Biorecovery Situations

Post by CliffZ »

IAQ RADIO

Show Number: 693

Thomas Licker, CEICR, CBRM

Sr. VP First Onsite & Board President ABRA
Responding to Fentanyl, Crime, Trauma & Other Biorecovery Situations

Good Day and welcome to the IAQ Radio+ episode 693 AFTERTHOUGHTs

Nuggets mined from today’s episode:

Tell us about your current position and team at First Onsite? FirstOnsite understands the nature and special requirements of highly regulated business sectors such as: HAZMAT, healthcare, pharmaceutical manufacturing, asbestos abatement, HVAC cleaning etc. FirstOnsite is committed to providing a high and consistent level of service & expertise in the regulated business sectors in which we work. Tom is responsible for developing and delivering education on special regulatory matters to our production employees and sales staff and overseeing the delivery of these services to our clients.

What is ABRA? The American Bio Recovery Association (ABRA) is the only third party non-profit organization dedicated to the education and certification of technicians and companies in the Bio Recovery Industry. https://www.americanbiorecovery.org

What is Bio Recovery? Bio Recovery is the act of assessing risk, mitigating threats and remediating conditions resulting from the release of biological hazards. This may include crime and trauma mitigation (bloodborne and body fluids), suicide cleanup, outbreak response, zoonotic diseases, foodborne diseases, public health threats, illicit drugs and clandestine drug labs.
Do you need a license to perform biorecovery? Crime scene cleanup is licensed in Georgia and California

What are Biological Hazards? Also known as biohazards, refer to biological substances that pose a threat to the health of living organisms, primarily that of humans. This can include medical waste or samples of a microorganism, virus or toxin (from a biological source) that can affect human health. It can also include substances harmful to other animals.

What type of products do you and other biorecovery firms work on?
• Unattended Death (Decomposition)
• Mass-Casualties (Shootings)
• Transportation Accidents (Train, Auto, Bus, and Airlines)
• Outbreak Response (Ebola Crisis)
• Bio-Terrorism (911 Anthrax Attacks)
• Acts of Violence and Terrorism (Murder and Suicide)
• Healthcare Facilities (Hospitals)
• Pharmaceutical Plants (Clean-room) & Clandestine Drug Lab decontamination.
• Food Production Facilities
• Laboratories (Biosafety) (Compounding)

How long does is take for decomposition odors to be noticeable? Depending on temperature and other conditions, as little as 24-48 hours. Hoarders are known to become desensitized to decomposition odors.

What is your biggest fear? Fentanyl. Fentanyl is cheap to make and Mexican drug cartels use it to afford an extra level of high to users. Fentanyl is 100X stronger tan morphine. Carfentanil, a large animal tranquilizer, is even stronger and is showing up in the field.

What is the leading environmental hazard in unattended death scenes? Fentanyl. In Philadelphia, there was a fatal fentanyl overdose. First responders extracted the victim. Three days later the roommate returns and ODs on fentanyl. Fentanyl can kill through ingestion, inhalation and absorption, Friends and family of known drug users need to be very careful. Make frequent wellness calls and checks. When entering places where drugs are used wear PPE.

Fentanyl demographics? Fentanyl use crosses all demographics. Pain centers AKA “pill mills” had full waiting rooms and lines of “patients” addicted to oxycontin. When mills were regulated out of business, addicts turned to the streets. Cartels make counterfeit drugs and packaging which look like the real medications. One dose of counterfeit medication laced with fentanyl or carfentanil can kill. In addition to loss of lives, fentanyl is responsible for economic damage: drug treatment, hazardous drug lab cleanups, contamination of law enforcement vehicles and equipment, etc.

Finding Employees? The skilled trades are in trouble. Mike Rowe calls Biorecovery, the dirtiest of jobs. Finding suitable staff is challenging. When interviewing potential employees for biorecovery work. Ask if they are really fit for this work? Be careful not to trigger PTSD in potential employees who have personally experienced a traumatic event. Workers who care about other people, are empathetic and compassionate. Retired EMTs. policemen, firemen, hospice care workers, etc. FirstOnsite provides financial incentives for workers who volunteer to work on biorecovery projects. Police, EMTs. hospice workers, firemen know how to talk to family and relatives of victims.

How do you ensure payment? In some cases, there are insurance proceeds. Clients can charge 1 day’s service from the trauma team on a credit card, then reevaluate. Clients can use home equity line of credit, or home equity loan to pay. It’s more complicated in a condo or co-op building when there are other owners, tenants, etc.

The “Right to Know”, the Open Public Records Act of New Jersey (“OPRA”) was created to give the public greater access to government records sucg as permits, approvals, reports and more. OPRA, if used properly, can provide prospective purchasers with a wealth of knowledge at little cost or no cost.


How do you minimize psychological stress on your employees? An open door policy so that employees who wish to talk to management can? Debrief employees after every job either individually or in group. ABRA membership provides understanding colleagues to talk to.

What decon chemicals do you use?
Steri-Mist- Ionized Hydrogen Peroxide
Foaming products- (oxidizers+surfactant, e.g. deFcon foam (peracetic acid, hydrogen peroxide and surfactant)
Enzyme products- digest protein
Nonpathogenic bacteria based products, penetrate following the path of water digest protein
Apply Sporicidal product at end of project.
Uses hydroxyl generators for odor removal only.
Does not encourage workers to work exposure to hydroxyl radicals or Steri-Mist, workers wear full face respirators.

Biorecovery project workflow:
• Safety First
• Site Risk Assessment- gather intelligence,
• Job Safety Analysis & BSRA crew signs off on
• Don PPE
• Address cleanup from entry to path of extraction,
• Address gross contamination
• HEPA vacuum dried blood as it can become airborne.
• Foaming products
• Enzyme products- digest protein
• Nonpathogenic bacteria based products, penetrate following the path of water digest protein
• Apply Sporicidal product at end of project.

What about disposal of debris from biorecovery or drug lab projects? Disposal of debris from drug cleanup sites is not classified as hazardous YET.
Body fluid contaminated porous materials:
Mattresses and Upholstered furniture are stripped, metal removed and cleaned and disinfected, soft goods disposed as medical waste and incinerated. Unfinished wood and drywall considered porous material.

How can home inspectors protect themselves from fentanyl exposure? Use your best judgement. Only do what you feel comfortable doing. Fentanyl and methamphetamine test strips are available. Have Narcan available.



Toms’ Tips:
• Always Consider possible exposures, including big picture exposures (chemical + biological) (e.g. illegal dump sites).
• HAZWHOPPER assume the worst and downgrade as appropriate.
• Warning, soap and water only! don’t use alcohol hand sanitizers around fentanyl, the alcohol carries fentanyl through skin.
• Fentanyl and methamphetamine are commonly found in dust (ceiling fans, HVAC coils, backs of TVs, air ducts, etc.)
• Due to their liability concerns, its challenging finding Industrial Hygienists who will do PRV on drug scenes.
• Financial opportunity. Doing hypodermic needle sweeps in big cities (Seattle, Portland, etc.)
• Is this type of work covered by insurance? Maybe under vandalism

Roundup-Tom’s Final Comments:
• Safety First
• Use the buddy system.
• Training is available: HAZWHOPPER, Blood Borne Pathogens, ABRA courses
• Get Narcan, things are getting worse not better!
• Always err on the side of caution.

Z-Man signing off


References:
https://www.americanbiorecovery.org

https://cdn.ymaws.com/www.americanbiore ... ssment.pdf

https://www.osha.gov/anthrax/control-prevention
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