Welcome

You can get garden variety health advice from the daily newspaper, the "health" section of most book stores, and of course thousands of web sites. I'm hoping to present thought provoking and maybe change provoking thoughts about individual and community health. This blog is not just what to do about health, but how to think about it. I'm looking forward to an exchange of ideas with readers. July, 2010

IF YOU WANT TO RESPOND TO A POST, CLICK ON THE WORD "COMMENTS" AFTER THE LAST LINE OF ANY POST.

Thursday, September 2, 2010

Complexity and Protecting the Public's Health

Recently I became aware of a case that illustrates some of the complexity of promoting the public’s health. My daughter is a restaurant manager at a resort in a northern location. The site has consistently been 20-25 degrees cooler than Louisville and the mid-section of the country. Now that fall is approaching, rodents are seeking warmer indoor temperatures. In the restaurant office they have found signs of infestation, including rat urine and droppings and paper and other items which have been chewed and ruined. There have also been signs of rodents in food preparation and storage areas, and this is likely to get worse unless something changes in the meantime.

I first became aware of this situation when my daughter called to ask if one could get sick from exposure to rats, and what the symptoms might be. This was not a question that had a chance of putting me at ease about her living on her own! While there are urban legends which greatly exaggerate the danger from exposure to rats, it is still true that exposure to rat droppings and urine can cause infection with hantavirus, salmonella, and a number of more serious, though rare, illnesses.


It seems like a simple task to eliminate rats and mice. They could get some cats, but they would not be permitted to roam in a food service facility. They could use rat poison, especially since there are no children in the area who might accidently ingest those chemicals. The downside is that the mice and rats may be well on their way to creating nests in the walls of the building. After eating the rat poison, it is likely that they will go back to their nests and die. The smell of dead rodents is not an option for a public food service establishment. This is getting complicated.

It turns out that there are several authorities with jurisdiction and several values in competition. The manager of the resort, my daughter’s boss, has to balance employee health against the cost of abatement of the problem and the potential impact of bringing in an inspector. There is also the potential cost of ruined food, or even worse, having to close the business while the rat problem is solved. The resort administrator cannot just go to a local home store to buy rat poison or traps. There are many rules and regulations that come to bear.

This resort is a corporate vendor on federal land. There are federal officials and rules regarding the use of effective chemicals that are safe for the human user. There are other officials and rules regarding the protection of the environment from toxic chemicals; while they are eliminating the rats, they have to be sure the chemicals won’t harm endangered animal species in the area.

The other conflict is between the interests of the public versus those of the restaurant and resort. The restaurant doesn’t want to serve contaminated food, and certainly doesn’t want the publicity of cases of food-borne illness being reported in the local media. On the other hand, restaurants operate on a slim profit margin; this one is only open from May through October because of the tourist season in the area in which it is located. The restaurant’s concern is not only about corporate profit, but also about jobs. Between 20 and 30 people are employed at the restaurant, and the combination of a weak economy and a rural area almost entirely public land means there are few other employment options. Closing down a restaurant because of the rodent problem will not only cut corporate profits, it will cause economic hardship for all the workers. Of course the compromise is for the management to collaborate with the appropriate officials to eliminate the problem just as quickly and efficiently as possible, to avoid the most serious consequences.

Finally, while the rodent abatement plan is being devised and implemented, all workers will have to be especially vigilant regarding hand hygiene. Efforts to educate and promote compliance cannot be limited to posting signs. There are several behavioral theories which can guide the development of effective strategies to help promote worker safety. Management should not expect to do this independently, but should seek out consultation from experts with training in developing health promotion programs. Economy of scale efficiency will be realized if the hand hygiene program is exported to other similar corporate facilities.

All of the issues illustrated in the above narrative have only academic interest, until the circumstances happen in your community, in your place of employment, in your favorite restaurant, and to your family member or friend. Then it is comforting to know that someone has thought about and dealt with these concerns before, and knows what to do.

No comments: