At REA we have significant and unique experience in environmental infection control, and can offer clients a range of solutions to maximize workplace capacity to prevent and control infectious disease. Pandemic Influenza Prevention and Control · Occupational and workplace exposure risk assessment and exposure modeling · Evaluation of workplace infection prevention and control measures · Advice on ad hoc quarantine facilities and ventilation controls · Advice on respiratory protection, personal protective equipment, and hygiene control measures · Ad hoc barrier installation · Respirator fit testing · Education and information Legionella Contamination and Legionnaire’s Disease · Building mechanical system and water system risk assessment · Sampling and analysis · Evaluation of Legionella control measures and equipment · Mechanical system and cooling tower sanitization / disinfection · Domestic water system superheating and purging · Design and implementation of silver-copper ionization for domestic water · Education and information Prevention of Construction Related Nosocomial Infection · Preparation of specifications, procedures and guidelines · Auditing of compliance with standards and regulatory requirements · Project planning · Construction of containment and isolation structures · Air monitoring for verification of containment · Education and information Health Care Sector Infection Control Services · Preparation of specifications, procedures and guidelines · Risk assessment · Auditing of compliance with standards and regulatory requirements · Policy and program development · Specialized environmental sampling and analysis Infection Prevention Control Methods Poster Hand Hygiene Instructions Poster During the past decade, REA has been lead consultant for several high profile environmental infection prevention and control projects in Ontario. Pandemic Influenza Prevention and Control In 2008, REA was contracted by the Ontario Ministry of Government Services to evaluate the potential for occupational and workplace transmission of influenza in Ontario Public Service work settings, under a pandemic influenza scenario, and to recommend comprehensive environmental infection prevention and control measures. This project included influenza exposure risk assessment in virtually all Ontario Public Service workplaces, and work setting and pandemic-scenario-specific recommendations for control strategies. Between 2006 and present, REA completed similar smaller scale projects for clients in educational settings and conventional business environments. As of spring 2009, REA is actively providing pandemic preparedness consulting advice and services to clients in the healthcare and non-healthcare sectors. Severe Acute Respiratory Syndrome (SARS) During the Severe Acute Respiratory Syndrome (SARS) outbreak of spring and summer 2003, REA provided respiratory fit testing (qualitative and quantitative) and respiratory protection program consulting services to several Ontario “SARS Alliance” hospitals. These were sites designated to receive and treat SARS patients. We fit tested over 4000 hospital personnel at facilities in Toronto, Brampton, Georgetown and Hamilton, and assisted several facilities to establish in-house capability. Legionnaire’s Disease There have been only two healthcare setting Legionnaire’s disease outbreaks in Ontario in the past decade. REA was lead consultant in both outbreaks. In fall 2002, we worked closely with local, provincial and federal public and occupational health authorities in responding to the Grand River Hospital outbreak in Kitchener. Our mandate was to lead the environmental investigation and remediation aspects of outbreak response, and included sampling and analysis of potential Legionella reservoirs, identification of potential exposure pathways, mechanical equipment and water system remediation, evaluation of causation hypotheses, and implementation of long term preventive measures. In fall 2005, REA was retained by City of Toronto Long Term Care Homes and Services to develop and implement a comprehensive environmental remediation plan for the outbreak at Seven Oaks Home for the Aged. On this project, we specified and carried out mechanical system sterilization work, and worked closely with public health officials from the City of Toronto, Province of Ontario, and Health Canada to establish outbreak causation. We have completed many additional projects for hospitals and long-term care to develop and implement programs for prevention of Legionella amplification and exposure. This includes risk assessment, design and implementation of silver-copper ionization systems for domestic water, and sanitization of mechanical systems for preventive and corrective purposes. Prevention of Construction Related Nosocomial Infection REA has provided a range of services to health care facilities throughout Ontario for prevention of construction-related nosocomial infections. Our experience includes: advice on development of hospital construction infection control programs and procedures; preparation of project specifications for control of dust and mould during hospital construction and renovation work; inspection and air testing during construction, demolition and renovation work to verify adequacy of dust containment and control measures; and education and training for hospital infection control and facilities staff.