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Integrated Pest Management


Controlling pests in healthcare facilities is important to prevent vector-borne disease transmission and to maintain cleanliness. However, pest control chemicals can themselves pose health risks. For example, pesticides may impact the indoor air quality both in exterior applications through building air intakes and in the use of chemical pesticides for indoor pest control. Pesticide exposures can cause a wide variety of symptoms and reactions in exposed individuals, including cancer, reproductive, nervous system and immune function, and respiratory illness. A 2003 hospital survey found that many hospitals were still using pesticides no longer registered under FIFRA, or whose active ingredients are being phased out due to concerns about health or environmental impacts.

Beyond the typical hazards associated with chemical pesticide use, healthcare buildings are unique in that a large portion of their occupants are sick or immunocompromised. The U.S. Department of Veterans Affairs has said, “Pest management in health care facilities differs from control practices in other types of institutions. The effect on patients in various stages of debilitation and convalescence, and in varied physical and attitudinal environments, requires that a cautious, conservative policy be adopted concerning all uses of pesticides.”[i]

By employing strategies that focus on pest prevention, while emphasizing non-chemical elimination strategies, facilities can protect people from unnecessary exposure to pests and pesticides. A good place to start is to develop an Integrated Pest Management (IPM) Program. Many health care facilities are choosing to significantly reduce the use of chemical pesticides through implementation of an IPM program.  IPM programs have the potential to reduce staff and patient exposure to toxic substances, reduce environmental compliance obligations and minimize pesticide impacts on the environment from health care facilities.

IPM programs rely on non-chemical controls such as improved sanitation, physical barriers, and repairs to stop pests from accessing food, water, and shelter. Least toxic chemical controls are used only as a last resort and only in contained or limited applications if non-chemical methods fail to control pests.

Moving Forward on IPM

There are a host of guidance documents that support an IPM approach. Here are a few core IPM strategies:

  • Design, construct, and maintain buildings to be as pest resistant as possible.
  • Ensure that roof parapets and caps are sealed, any other devices on roofs such as traps or bait stations are placed at documented locations and regularly checked, and nets for bird/pigeon activity are checked on a regular basis.
  • Eliminate cracks and holes to keep pests out. Lightly dust gaps between walls and other voids with boric acid before closing them up.
  • Inspect the grounds area around buildings and fill burrows with pea gravel. Keep vegetation at least 12 inches from building perimeter.
  • Ensure that devices such as bait stations placed in outside areas are locked, secured, clean, and in good working order. Rodents do not like dusty and unclean bait stations.
  • Use physical barriers to block pest entry and movement (such as door sweeps, screens at chimneys and air intakes, doors, and windows).
  • Train staff on proper management of food and drinks outside of the cafeteria or dining areas.

Hospitals across the country have been working hard to eliminate this chemical threat to patients, staff and the environment - utilizing pest management contractors that specialize in IPM, working with their facilities departments to ensure structural integrity and collaborating with their grounds and landscaping companies to make smart choices about types and placement of vegetation and irrigation strategies. Practice Greenhealth can assist your organization in learning how it can ensure it is reducing the use of hazardous chemical pesticides by utilizing an IPM approach to pest management:

  • Ensuring an IPM Approach
  • Handling, Storage and Disposal of Pest Management Chemicals
  • Key Resources on Integrated Pest Management

[i] Maryland Pesticide Network and Beyond Pesticides. Taking Toxics out of Maryland’S Healthcare Sector: Transitioning to Green Pest Management Processes to Protect Health and the Environment. October 2008. Available at:

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