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Building Health Sciences - Healthy buildings, healthy people, healthy business

Health Issues in the Restoration Industry

“We make it better. We promise.” I understand that this is the Restoration Industry Association’s motto published on your website. As a physician, however, I am not sure that, unless you are considering health, you can make that promise. I want to challenge you to think about health in a wider context than you, as a restoration professional, may have ever previously considered. Whether you realize it or not, health is a component of your business and you, by your actions, decide whether it is a competitive advantage or disadvantage. This is not mere theory, it is good business.


Everyone is familiar with worker safety. Site safety and job hazard analysis have progressed to a point where business owners simply cannot work in an unsafe manner. This awareness and acceptance was initially driven by OSHA enforcement and the threat of punishment. Now, safety is embraced as a vital component of a business. In fact, in many cases, the safety awards program is a well fixed tradition at the company picnic.

In today’s market, admittedly a tough economic environment, all of us are looking for something to differentiate ourselves and our businesses. At the same time, customers are seeking more value for a reduced cost. This isn’t theoretical; it is the reality of doing business in today’s market. Worker safety costs money, health insurance costs even more and workers’ compensation is no minimal expense.

Health and Healthy Businesses

Acknowledging the fact that health is expensive for businesses… how do you ensure that you maintain a healthy business in tough economic times? At one level, doesn’t that mean having financial and operating health, as well as a healthy relationship with clients? At another level, doesn’t it require that one have a healthy workforce, healthy work practices and a finished product that provides a healthy environment for the occupant or tenant?

Actually it is much more than worker safety. It is about having a healthy business and healthy workers committed to delivering a healthful, clean, restored environment. Health is not merely zero lost time accidents, it is the sum of worker safety, worker health, occupant and tenant health, and the delivery of a healthful environment — restored in a healthful manner.

White Coats and Hard Hats

“White Coats and Hard Hats…” what does that phrase mean? What can a medical doctor contribute to your expertise and experience as restoration and cleaning specialists? My focus, which I believe should be your focus too, is on all of the people in the incident environment and their health. I will be challenging you to consider broadening your focus, thereby enhancing the work environment you provide your workers, the distinctive image of your business, as well as the quality of the product you offer your customers. Are both worker and occupant health a key component of your incident response plan? If not, why not? Are you merely providing the appearance of being concerned about health, but not the reality? If all you do is dress in white and wear white gloves and booties — that’s Mr. Manners not Mr. Clean! Why should health awareness be part of your company’s culture? Clearly, if as a business owner you do not embrace safety and health, it will never become a key component of your company’s operations. Worker health directly impacts success by protecting your investment in your most valuable asset. A healthy workforce is a competitive advantage.

I am going to prove to you that making health a part of your company’s culture is a competitive advantage that will differentiate your company from all the look-alikes out there. If you truly believe that your company is much more than the bottom line of your job bid, you will need to do what Captain Jean-Luc Picard of the starship Enterprise said to his first officer, “Make it so.” Let me show you how.

Health-Based Business Solutions

Following are three examples from the physician’s reality show on problem environments.

Untapped Market Potential

Health is big business. It is relatively resistant to economic conditions because people requiring health care and the places where they reside and/or receive care will always exist. The hospital, nursing home, long-term care or convalescent facility, assisted living or retirement home environment: all of these represent an untapped market potential for many of you, but such a market requires health education and training.

Knowledge and training about health are essential to the pursuit of an opportunity, and such knowledge provides your company and your employees with a competitive advantage.

Normally, you train or educate your workforce in order to protect the worker or the contents undergoing restoration. Clearly, where there are opportunities to expand your business, there are business consequences if the employees are not educated to the health-risks. This is not a foreign concept. To work in such an environment requires a different level of health education for your employees before you can cross the threshold into the health-care facility. In some instances, physicians and the facility participate in additional training that all contractors have to undergo prior to initiating any work.

I do not regularly see employers, however, training their field personnel or supervisors about the health consequences of their actions on the environment and/or the ultimate occupant, patient or staff contributes to the successful management of a critical environmental incident.

Worker training should embrace:

  • understanding the infectious exposures and appropriate preventive measures for your employees;
  • awareness of the implications of their actions and equipment on a vulnerable population, many of whom are undergoing care;
  • some understanding of life safety systems and patient support systems;
  • state and federal regulations unique to that setting; and,
  • what constitutes a healthful, restored environment in the healthcare setting.

After providing this training, you will need to:

  • Differentiate your company with a competitive advantage by letting customers or clients know that providing a healthy environment upon the completion of your work is part of your company culture.
  • Let them know that you and your workers have been trained to return the restored or remediated environment in a manner that is health-protective during the work and after completion.

In some locations, you will have to undergo specific training by the facility itself. This does not negate the training you have already provided your personnel, but rather enhances that basic understanding so that you do not create a secondary risk to your business’ or client’s operations through naïve entry into the facility.

Emerging and Current Opportunities

There has been a tremendous amount of scientific research by many private professionals and federal agencies on Chinese drywall. The investigations so far have not been focused on remediation efforts, but rather understanding the source of the problem and the chemical reactions causing contamination and failure of mechanical and electrical systems. This has included failures of HVAC systems when corrosion eats through the refrigerant tubing causing leaks. Electrical and alarm wiring corrosion has developed causing life safety concerns although, to date, there are no reports of associated damage to the building or occupants as a result of corroded wiring.

Since the problem was first identified in mid-2008, there has been a huge, as-yet-unanswered demand for remediation and clearance protocols for this new environmental issue. In addition to mechanical and electrical system damage, occupant health-effects are alleged; odor has been a nuisance component in some homes with corrosive drywall imported from China. Some people have moved out of their homes; others have walked away from their mortgages, inviting foreclosure.

It is entirely possible that your firm may be called, or you may elect to position your firm to be called, as a contractor who can perform various remediation activities associated with corrosive drywall. This is a complex process which will require the residents to be moved out. Their possessions will need to be removed, aired out, stored and ultimately, returned. Upon completion of the tear-out of the drywall down to the studs, air out and reconstruction will be necessary.

Health is a component, but not a threat. Nonetheless, you will need to be educated and aware of potential health issues. Research to date has revealed primarily irritant effects associated with exposure to corrosive drywall, which has implications for both workers and occupants.

Media stories abound claiming that corrosive Chinese drywall is a hazardous material requiring special hazmat procedures, personal protection and disposal. At the present time, however, scientific research does not support such stories: corrosive drywall has not been designated a hazardous material requiring special handling and disposal procedures. There are considerations for worker health and worker safety, which recommend protection from nuisance dust. If NIOSH decides to investigate the drywall issues, it is possible that other protection will be advised. Since scientific investigation continues, it is important that you stay current with new governmental research.

Many homeowners are finding that because of the economy, their homebuilder is unable to undertake gratis the extensive steps necessary for remediating the drywall problem. Homeowner insurance coverage is routinely being denied. Therefore, the homeowner may have no choice but to fund the corrective remediation themselves, so you may find yourself dealing directly with homeowners. You clearly will need to know what to say and how to interact with these customers. Again, knowledge of the health aspects would enable you to seek these opportunities and handle them comfortably.

Chinese drywall is still an evolving field. Nonetheless, several federal agencies have recently issued guidance documents to be used in identifying problem drywall as a first step in the remediation process. For the past six months, I have been working with the National Association of Homebuilders to evaluate the available scientific and medical information and to develop protocols for corrosive drywall remediation/restoration. These are very close to being finalized and published. So—stay tuned.

Evacuation or Occupancy Determinations

Specialized health environments, for example, retirement communities or over 55 housing units, are places where the combination of health and medical engineering would enable you to differentiate you and your firm.

A real life example is a recent engagement of ours involving a newly-built, partially-occupied over 55 rental community which had been plagued from the start with significant mold issues in the individual units.

Careful investigation by building engineers and construction experts revealed design defects which could be corrected, but the owner, stretched financially, was in the process of renting the building and feared loss of rental leases and bankruptcy.

The corrective measures were designed by the construction and engineering consultants. In this case, the remediation contractor was familiar with the strategies necessary to correct the moisture and mold problems. Also cognizant that there could be health implications for the residents, the remediation contractor sought additional consultation from health professionals. As a result, he was confident in his firm’s ability to accomplish the remediation work required without having to evacuate the building, while protecting the health of the residents. That was a determining factor in his engagement in the repair and remediation of building condensation issues and associated mold growth in 155 units over an 18-month period of time.

The remediation workers underwent some additional instruction in the health challenges faced by older individuals who are frequently taking a number of medications and who may have chronic health conditions. With this increased awareness and a medically-engineered work schedule, all the trades were coordinated so that the remediation-caused disruption could be limited to hours rather than days.

Most of you are familiar with mold and moisture, but the occupancy issue is generally a decision made without consideration of the remediation contractor. If you understand this, but are aware of people who can work in tandem with you to execute a non-evacuation strategy without incurring a health risk — you could value engineer your proposal to make your company stand apart from other competitors.

Health, then, can be a strong differentiator, if you have an understanding of the medical drivers and an ability to monitor the work progress such that it is not an on-going danger or health-threat to occupants or your workers. The loss of revenue by unnecessary or less than fully thought out protocols can have drastic impact on the client.

It has been our experience that some of these adverse and unfriendly environments are disincentives to many businesses. Don’t be fearful of health: awareness of the issues and education about the health implications will not only differentiate your firm, it will improve the health of your workers, your customers and your business.

Barbara A. Manis, M.D., is the chief medical officer at Building Health Sciences, Inc. Her background and training bring a unique health perspective to the evaluation of building restoration issues, including indoor air quality, mold, building components, sewage contamination, infected materials, chemicals, combustion products, heavy metals and carbon monoxide.

Since 1980, she has supervised the review and analysis of hundreds of indoor environmental evaluations to determine the relationship between the environment and health complaints or diagnoses. Manis was the acting medical director for the city of Philadelphia, and for the past 20 years has specialized in environmental medicine dealing with commercial and residential IEAQ, including exposure issues, and building and health hazard evaluations for residents, occupants and workers. She has spoken at national meetings and symposia on issues related to indoor air, toxic exposures and adverse health effects.

Read the full article by Barbara A. Manis, MD, published in Cleaning & Restoration, May 2010.