Pest Problem?

Adopt an integrated pest management program to support safer chemicals purchasing.

By Beth Eckl and Matt Wallach on January 14, 2016

Bumblebee on top of a daisy

TODAY, MORE health care facilities are embracing practices to eliminate the need for toxic chemical pesticides. While conventional pest control is a reactive approach based on killing insects and rodents without attempting to understand or fix the underlying reason for the problem and involving scheduled pesticide applications, these new practices focus on removing or altering the pest-conducive conditions that lead to pest infestations. In doing so, their focus for pest management changes from the conventional pesticide application strategy to a preventive nonchemical approach.

Pesticide use—especially in a health care setting—poses a serious risk to human health and the environment. A growing body of scientific evidence links toxic pesticide use to numerous acute and long-term adverse health impacts, including respiratory problems, cancer, neurological issues, birth/developmental or reproductive effects, liver and kidney damage, and endocrine disruption.

Pesticides can also be irritants or sensitizers. Hospital patients who have compromised immune and nervous systems, the elderly, infants and children, and those especially sensitized to pesticides are particularly vulnerable to the chemicals’ toxic effects. Patients taking certain medications may also have heightened reactions to pesticides. Pesticides used for lawn or landscape care can also leach and contaminate groundwater and are major contributors to declines in bird, fish, aquatic organisms and bee populations.1

To address these hazards, leaders in health care are embarking on efforts to eliminate the use of toxic chemicals in buildings and grounds. Ninety percent of Practice Greenhealth award-winning hospitals self-report they have an integrated pest management program in place. IPM is a strategy focusing on long-term prevention and suppression of pest problems through a combination of practices, such as structural, cultural, mechanical, physical and biological controls. In a defined IPM program, least-hazardous pesticides are used only as a last resort after nontoxic actions have been exhausted. (However, be cautious: Some vendors include pesticides as part of their IPM toolbox.)

IPM Policy and Plan Development

Among leading hospitals, an important element for a successful defined IPM program involves changing the cultural and behavioral practices of the facility to support IPM practices. By establishing a structure for education and cooperation among management, staff and the pest-management vendor, sustainability is ensured, despite any turnover in staff or contacts. An effective IPM program changes the role that staff plays in pest management, and staff understands how their actions can contribute to or remove a pest-conducive condition.

Also important is the position of an IPM coordinator at the health care facility. Often from environmental services, safety or sustainability departments, this position has direct contact with the pest management service provider, hospital green team, housekeeping, environmental services and maintenance. The IPM coordinator collaborates with hospital departments to ensure recommendations are followed and the IPM program is successful.

The work is also accomplished through a fully developed organizational policy and plan. A facility’s IPM policy establishes the groundwork for pest management, including the prioritization of nonchemical preventive measures and intervention. The IPM plan from the vendor should detail frequently encountered pest problems, strategies to address those problems based on the facility’s IPM policy, plus detail communication, recordkeeping and other planning needs.2

Not All Vendors Are Created Equal

To assess pest and landscape care companies’ ability to provide a defined IPM program, health systems should clearly specify IPM responsibilities and standards. Rather than offering pesticide applications, the requests for proposals or specifications should focus on identifying and preventing pest problems in the first place. A company that practices defined IPM puts a priority on inspection and monitoring. Its technicians identify conditions that can lead to pest pressures, even in the absence of an identified pest problem. In advance of and in response to outbreaks, technicians educate staff; record detailed, site-specific conditions that are noted in log books; and use structural and mechanical control when necessary. Least-toxic pesticides are applied only as a last resort after nontoxic methods have been exhausted.

Why IPM? It Just Works

At Johns Hopkins Medicine in Baltimore, the decision to solicit integrated pest management services was financially driven. Staff reviewed bid submittals to service five facilities, and the results clearly demonstrated the economic benefit of using an integrated pest management approach. According to Rick Candy, environmental services director, “Chemical treatment was more expensive than using baits and traps.” And even more so: “IPM is the right thing to do.”

At Virginia Mason Medical Center in Seattle, the hospital has always focused on toxics reduction, and IPM services have been in place for some time. The medical center reports that IPM benefits the health of patients and workers by removing exposure to toxins. It has expanded IPM to include landscaping services with a focus on water reduction and creating habitats for insects and plants that are beneficial to the environment. Following the city of Seattle’s pollinator pathway design plan, Virginia Mason has set a goal to make 80 percent of its landscaping pollinator friendly. Brenna Davis, director of sustainability, describes IPM as a way to support the natural environment, to support food systems and to serve as a net benefit to the community.

In Maryland, the Integrated Pest Management in Health Care Facilities Project is a partnership of the Maryland Pesticide Education Network and Beyond Pesticides and was founded in 2005 after the Healthy Hospitals report found that hospital staff and patients were being exposed to unnecessary levels of pesticide use. Since then, the project has worked to implement defined IPM programs in Maryland’s health care facilities. Currently, the project works with 12 health care facilities and three medical systems, including seven Practice Greenhealth members. The project offers a range of support and resources to facilities interested in implementing IPM by providing staff training, vendor contract review, model IPM policies, walk-throughs with pest management technicians, pest management log book reviews and reports on IPM progress.

According to a statement from the IPM in Health Care Facilities Project: “We believe that all health care facilities have the ability to create an IPM policy that clearly outlines a commitment to IPM in order to protect patients, staff and visitors from toxic exposures. By implementing advanced IPM practices, a health care facility will be at the forefront of green pest management, serving as a model for nontoxic approaches to building and land management.”

1. Taking Toxics Out of Maryland’s Health Care Sector,
2. ibid

Getting Started With IPM?

Practice Greenhealth has recently updated several member-only resources for purchasers and for others who are interested in procurement of IPM services for building interiors and landscapes, including resources for IPM RFPs, specifications and policies. Visit the IPM section of the EPP Specifications and Resources Guide at Additional resources: The Maryland Pesticide Network,, and Beyond Pesticides,

Beth Eckl is director of Practice Greenhealth’s Environmental Purchasing Program, and Matt Wallach is project director at the Maryland Pesticide Network and the IPM in Health Care Facilities director for Beyond Pesticides.