CDC Guidelines Help Practices Safely Reopen After Disasters

Photo by NOAA/CIR.

Dentistry Today
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Photo by NOAA/CIR.

Hurricanes Harvey, Irma, and Maria left many dental practices damaged and even destroyed. Yet even those practices that survived relatively intact need to conduct a full safety inspection to guard staff and patients alike against potential infections. Now, the Centers for Disease Control and Prevention (CDC) are offering an online checklist for healthcare facilities to follow before reopening their doors after a disaster.

“Infection prevention and control must be a priority in dental settings to prevent transmission of infections to dental patients, dentists, and other dental personnel. There are many things to look at when reopening a facility that has been damaged during a disaster and it is important not to overlook infection prevention and control considerations,” said Dr. Sven Rodenbeck, chief science officer for the CDC’s Hurricane Response.

First, facilities experts should conduct a safety evaluation before any work can begin. Their work should include an assessment of structural integrity, hidden moisture, the electrical system, water distribution, the sewer system, fire emergency systems, the air system, and the disposal system for medical waste and sharps. Once the structure’s safety has been verified, standing water should be pumped out, and wet vacuums should be used to remove remaining moisture.

Practices should then continue to focus on water damage and mold remediation. Porous items that have been submerged or that have visible mold growth or damage should be disposed of as construction waste. Areas that need remediation should be isolated from occupied areas. Hard surfaces should be scrubbed and dried. Inspectors should look for residual moisture. And, structural materials that can’t be dried out should be removed and replaced.

Next, facility infrastructure should be inspected, repaired, disinfected, or replaced as appropriate. These systems include the HVAC system, the water system, steam sources, the electrical system, telecommunications and electronics, medical gas, hazardous chemicals, and radioactive storage. Areas and items that have been damaged by water and wind—including furniture, supplies, electrical equipment, and structures—should be inventoried and evaluated too.

“In dental settings, care must be taken in the assessment of damage and contamination to special equipment such as dental units, waterline treatment systems, and autoclaves. Failure to assess if such equipment is safe to use could lead to unnecessary exposures to bloodborne pathogens or environmental contaminants such as bacteria or fungi,” said Rodenbeck. 

Before reopening, facilities need to have potable water, adequate sewage disposal, and adequate waste and medical waste management. All areas should be thoroughly dried out, repaired, and cleaned. The number of air exchanges should meet recommended standards, and the negative-pressure rooms should function properly. Once the facility is opened, focused microbial sampling may be needed to evaluate if mold-remediation efforts were successful and to guarantee the integrity of the water distribution system.     

The CDC offers additional resources for practices looking to rebuild and reopen. 

“As a starting point, people can refer to the general considerations highlighted in CDC resources at www.cdc.gov/disasters/reopen_healthfacilities.html and cdc.gov/disasters/reopen_healthfacilities_checklist.html. These documents contain links to additional resources that may be useful depending on the assessment needs of the individual facility. Additionally, reopened dental practices should be able to meet recommended infection prevention and control practices: cdc.gov/oralhealth/infectioncontrol/guidelines/index.htm,” said Rodenbeck. 

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