2. Our Services Methamphetamine Testing & Remediation
Crime/Trauma Scene Remediation
Blood Spills
Hoarding
Toxic Chemical Spills
Mold Remediation
Asbestos Removal

3. Bio-Absolute
I, Amie Dulay-York, attest that I am certified by Amdecon in: Personal Protective Equipment Training in accordance with 29 CFR ; Awareness Level Fall Protection Training in accordance with 29 CFR Appendix C; Awareness-Level Permit-Required Confined Spaces Training in accordance with 29 CFR ; Awareness-Level Lock-Out/Tag Out Training in accordance with 29 CFR ; Crime & Trauma Scene Decontamination in accordance with 29 CFR Part 1910 IICRC Event # 2125; Bloodborne Pathogen Training in accordance with 29 CFR ; Respiratory Protection Training in accordance with 29 CFR ; Meth Lab Decontamination IICRC event # 2748; HAZWOPER 40.
78 hours of Annual Education, 9 certifications, 4 IICRC CEC’s

4. Health Departments & Code Enforcement
Local Health Departments guards multiple fronts to defend the people from any health threat, regardless of the source, and works tirelessly to prevent disease outbreaks. LHD makes sure the tap water we drink, the restaurant food we eat and the air we breathe are all safe.

5. Health Departments & Code Enforcement
Code Enforcement: To meet existing and emerging health, safety and welfare needs of residents and businesses by evaluating existing standards and procedures and effectively administering property maintenance compliance, infrastructure construction and repairs, historic preservation and public safety services.

6. What is Methamphetamine?
Methamphetamine is one of the
most addictive drugs in history.
Known as "speed," "meth," and "chalk." In smoked form, referred to as "ice," "crystal," "crank," and "glass.“
The coloration of meth may vary significantly due to the manufacturing process and as a result, it may have a foul rancid odor. Possible colors include: colorless/white, red, orange, purple, green, and brown.  
Meth’s high lasts anywhere from 8 to 24 hours, and 50 percent of the drug is removed from the body in 12 hours.
Meth is a cousin of stimulants routinely prescribed to children who have ADHD. Amphetamines such as Adderall and Ritalin have similar effects as meth, and the body actually metabolizes meth into amphetamine.
However, because illicit meth has undergone a process called double methylation (as opposed to being methylated just once), it is processed in the body more quickly and powerfully

7. METH
Meth is commonly manufactured in illegal, hidden laboratories, mixing various forms of amphetamine (another stimulant drug) or derivatives with other chemicals to boost its potency. The meth “cook” extracts ingredients from those pills and to increase its strength combines the substance with chemicals such as battery acid, drain cleaner, lantern fuel and antifreeze.
These dangerous chemicals are potentially explosive and because the meth cooks are drug users themselves and disoriented, they are often severely burned and disfigured or killed when their preparations explode. Such accidents endanger others in nearby homes or buildings.
The illegal laboratories create a lot of toxic waste as well— For every pound of finished product, 5 or 6 pounds of chemical waste is left at the illicit lab site.   People exposed to this waste material can become poisoned and sick.

8. What Can be Used to Make Meth
Quiz: Which of these is not a common ingredient in Meth?
Nail Polish Remover
Lithium
Nitroglycerine
Drain Cleaner
Brake Fluid

9. Answer to the Quiz! Nitroglycerine
Nitroglycerine is used to make explosives. Although explosions can happen while methamphetamine is being made, nitroglycerine is not involved. All of the other ingredients are commonly found in Meth.

10. Let’s talk about Ingredients
GO TO WEBSITE

11. CHEF METH MAKER
LETS TRY TO MAKE METH!

12. Statistics in Missouri for Meth Labs Source: MO Highway Patrol Through September 2014: GUESS???!!?!?!? 2013: 1,496 Drug Labs 2012: 2,006 Drug Labs
800 Drug Labs Through 9/2014 – believe this is a bit low. What are the reporting structures and requirements of each municipality? Where are we missing the boat on reporting?

13. STL City -17

14. Types of Methamphetamines
THREE TYPES OF METH Levo-meth - raises the blood pressure and causes the heart to beat rapidly, but does not increase alertness very much. Shakes/tremors and stomach cramps are common physical side-effects.
Dextro-levo meth is made with the P2P method. It was popular during the 1960s, but it is still made and distributed. It has to be injected to get the desired rush and produces side effects such as shakes, tremors, and stomach cramps.
Dextro-meth is currently the most common. It is made by the ephedrine reduction process. It is 2 to 10 times as physiologically active as L-meth. It increases the heart rate, blood pressure, body temperature, and rate of breathing and dilates the pupils, and has fewer adverse side effects than the other two types of meth.  

15. Forms of Meth
Ice (crystal) - It can be found in the form of translucent to white shards as well as powder; typically smoked.
Powder -It tends to be less coarse, so it is often snorted, but it can also be swallowed, injected (after being dissolved), or smoked.  
Ice - high purity (which tends to be coarse) can be uncomfortable to snort, as the granules sometimes remain sharp enough to cut nasal passages.

16. Forms of Meth (cont’d)
Liquid - Meth is often dissolved in water for the purposes of transportation.  It tends to be placed in familiar containers (e.g., liquor bottles) which are commonplace at points of inspection (e.g., ports of entry).  Once shipped to its destination, the water is boiled away, leaving the drug in solid form. 
Base/Gooey - sometimes distributed in an oily, waxy, gooey form.  Information on this form is limited.  Some have suggested that it results from an incomplete cooking process.  This form can be difficult to dissolve since it is not soluble is water, and it can be difficult to snort

17. Forms of Meth (cont’d)
Tablets/Pills - referred to as “Yaba” (which means “crazy medicine” in Thai) are typically produced in Southeast and East Asia.  They are usually no larger than a pencil eraser, and are brightly colored, including reddish-orange or green.  The tablets sometimes have a logo; for example, R or WY.  In the United States, these tablets tend to be used by Asian communities, though they are also sometimes available at raves and techno-parties. Ecstasy tablets imported into the United States from Canada sometimes contain methamphetamine as well

18. $Show Me The Money$ Term Amount Going Rate Quarter
1/4 gram (0.01 ounce)
$20 - $40
Half
1/2 gram ( 0.02 ounce)
$40 - $80
Teenager
1/16 ounce (1.8 grams)
$120 -
8-Ball
1/8 ounce (3.5 grams)
$250 -
Ounce
1.00 ounce
$1200 -
$60 to $65 to make an ounce of meth, and that ounce would sell for $1,200 to $1,400. So each case is unique, On average an active binge user, can consume 1 ounce in 2-3 days.

19. THE ABUSER
Meth head (regular user), Meth monster (one who has a violent reaction to methamphetamine), or Speed freak (habitual user of methamphetamine).
User may exhibit anxiousness; nervousness; incessant talking; extreme moodiness and irritability; purposelessness; repetitious behavior such as picking at skin or pulling out hair; sleep disturbances; false sense of confidence and power; aggressive or violent behavior; disinterest in previously enjoyed activities; and severe depression.

20. The Abuser (cont’d)
The chronic user of powdered methamphetamine is often undernourished with a gaunt appearance, poor hygiene, and bad teeth.
Addicts' habit of teeth-grinding, combined with a hankering for sweet foods during meth highs, only worsen the problem. That leaves many users with rotted teeth and the characteristic "meth mouth" shown in many anti-drug campaigns.

21. Health Risks Associated With Meth
SHORT TERM LONG TERM
Extreme weight Loss Increase Heart Rate
Disturbed Sleep Patterns Heart Attack
Hyperactivity Increased Blood Pressure
Nausea Damaged Blood Vessels
Hallucinations Brain Damage
Paranoia Stroke
Convulsions Cardiovascular Disease
Lung Burn Liver Damage
Severe Headaches Kidney Damage
Respiratory/Breathing Problems Lung Damage
Eye and Skin Irritations
Blisters/Skin Burns **Otherwise known as a Cialis Commercial
Dizziness

22. Additional Health Hazards of Meth
Environmental - cooks may dispose of the used meth gear away from the lab. This results in a “meth dump”, which can be a roadside ditch, a wooded area or remote public places. The trash may look innocent enough – soda bottles, household cleaning bottles and small lengths of plastic hose used in the cooking process. Do not touch any of these items as they can cause skin irritation, blindness, and other adverse health effects from the chemical residue.
Residential – MO is 1 of the 14 states that require property owners to disclose former drug production to potential buyers or tenants.
The cooking process releases a cloud of toxic chemicals, including hydrochloric acid, phosphorous, iodine and methamphetamine itself, that seeps into floors and walls and can cause long-term health problems

23. Cleaning Up the Illegal Meth Lab
(Lab is discovered by law enforcement personnel, Inspector orders vacate/condemns
What’s next?)
BEFORE Law Enforcement or Fire Department personnel enter a home, they SHOULD:
Apply a face mask – N95 – most used and inexpensive
Apply PPE Suit
Apply Shoe covers
Apply Gloves
Apply eyewear
Applying PPE is called Dawning
Upon inspecting the home, if you touch anything in the home, DO NOT touch any part of your exposed skin
Properly discard PPE (most of the time, NARC unit will have BIO-Hazard bags, containers, etc., to utilize. Use buddy system when de-gowning and de-gown from inside out-Gloves being the last thing to remove. Taking off your PPE is called Doffing.

24. Volatile Organic Compounds (VOCs)
SO WHY DO WE REMEDIATE?
VOCs are emitted as gases from certain solids or liquids; emitted by a wide array of chemicals found in meth labs
Benzene and toluene are two VOCS that are often found in contaminated meth lab homes.
According to the Minnesota Department of Health ” While most people can smell high levels of some VOCs, other VOCs have no odor. Odor does not indicate the level of risk from inhalation of this group of chemicals. Breathing low levels of VOCs for long periods of time can increase some people’s risk of health problems.

25. VOC’s & Health

26. First Things First: Property should immediately be aired out
The home should be condemned, or an “Order To Vacate” issued. (It is now a matter of public safety and the premises is considered a bio-hazardous threat).
Once the owner has been contacted, a list of requirements should be established:
Get the Home Tested, Remediate the Home, Post-Test,
Obtain certified affidavit of remediation
Make sure Electric is shut off. (It is now an extremely volatile environment). You do not want the HVAC or Gas on.
NEVER ALLOW THE HOME OWNER OR TENANTS TO TAKE ANYTHING, INCLUDING THEIR CLOTHES OR PERSONAL EFFECTS OUT OF THE HOME. ONCE AN ITEM IS REMOVED AND TAKEN TO ANOTHER LOCATION, THAT AREA IS NOW CONSIDERED CONTAMINATED AS WELL.
ONE OF THE BIGGEST CONCERNS OF OUR INDUSTRY IS THE LIABILITY THAT THE DEPTS INVOLVED FACE IS ALLOWING TENANTS/OCCUPANTS BACK INTO THEIR HOMES NOT KNOWING IF THE STRUCTURE IS CONTAMINATED OR NOT
LETS SAY THERE IS AN EXPLOSION – FIRE DEPT SHOWS UP, POLICE SHOW UP, GRANDMA, MOM & 2 BABIES ARE OUTSIDE. MOMS BF WAS INSIDE COOKING METH. GMA & MOM BEG TO LET GO GET BABY’S ITEMS. THE BABY’S BOTTLE PARTS WERE LAYING ON THE COUNTER, METH VOLATILES HAVE ALREADY CONTAMINED THOSE PARTS THAT MOM IS GOING TO STICK IN BABYS MOUTH OR THE FIBERS ON BABY’S BLANKETS HAVE ABSORBED THE VOLATILES. BABY GETS SICK, BABY IS CONTAMINATED. MOM & GRANDMA SAY THE PD & FD LET US IN, LET US GET OUR STUFF, THEY SHOULDVE KNOWN. NOW THEY HAVE A WINNABLE LAWSUIT.
ANOTHER SCENARIO, THEY LET JR GO BACK INTO A HOME, RETRIEVE CONTAMINATED HOME, WHICH HE TAKES TO ANOTHER HOME AND NOW HAS CONTAMINATED THAT PROPERTY. GRANDMA GETS SICK. NOW YOU ARE LIABLE

27. NIOSH Guidelines Sampling
100cm2 template in each room of the structure using an authoritative approach; wipe sample with EPA approved solvent
If a structure has a sprayed-on, “popcorn” ceiling, it should be sampled

28. Sampling under NIOSH
Solvent typically used for testing is Methanol alcohol, but other approved solvents are isopropanol, Methylene Chloride, & Acetonitrile.  
The wipes are prepared on-site, opening one sample container at a time.  With gloves on (nitril or latex)
Remove dry wipe sample from container and wet with 3-4 ml of solvent, apply no more solvent than needed to moisten approximately the central 80% of the area of the gauze wipe.   Too much solvent can cause sample loss due to dripping from the wipe, squeezing out and discarding any excess solvent from the gauze wipe. 
Place the 100cm2 template over the area to be sampled (tape along outside edge of template). 
Method to sample consists of firm pressure using vertical S-strokes, folding the exposed side of the pad in and wiping the area with horizontal S-strokes, folding the pad once more and wiping the area again with vertical S-strokes.  Place the sample in the shipping container and seal.   We use an Integrity seal along with a label to show the lab that the sample has not been compromised.  Use a new pair of gloves each sample.

29. Example of a lab report with identifiable omitted information

30. CONTAMINATION
If a property is contaminated, all absorbent or “Soft Good” items must be removed. They accumulate vapors that are disbursed through the air during the cooking process and collect dust and powder from the chemicals involved in the manufacturing process.
Soft goods include some of the following:
Curtains Carpeting Clothing
Ceiling Tiles Bedding Food
Surfaces that are porous hold contamination from the Meth. These items must be cleaned with a decontamination solution and in some cases, encapsulated. Some of these items include:
Walls Counters Floors Appliances
Ceilings Cabinets Woodwork
In some cases, complete HVAC units to include the ductwork needs to be removed.
Waste products are dumped down sinks, drains, and toilets. The waste collects in traps, septic systems, and drains. The plumbing must be decontaminated.

31. Hoarding /Animal Hoarding

32. Hoarding “Excessive Storage”
Hoarding is the persistent difficulty discarding or parting with possessions, regardless of their actual value. The behavior usually has deleterious effects—emotional, physical, social, financial, and even legal—for a hoarder and family members.
Property is condemned, ordered for remediation, re-inspected for structural issues
Municipal services involved: Fire, Police, Health Dept., Code Enforcement, Social Services
Changing from a “personal to public problem” – Right of the Community – Public Health Nuisance

33. Risks Associated with Hoarding
Increased Health Risks & Spread of Diseases
Unsanitary conditions resulting in Molds, Bacteria, Fecal Matter, Dust & Dirt (exacerbating asthma & other pulmonary conditions, allergic reactions, headaches)
Mice, Rat, Bug Infestation
Hoarding of Animal Feces & Decomposing of Animal Remains (Hanta Virus, tapeworm, cat scratch disease, etc.
Fire Hazards
Combustible materials near stove, radiator, heating vents, electrical outlets, extension cords, lamps
Resident may be a smoker
Blocked Exits
Inability for Emergency Personnel to Enter
Inability for Resident to Exit in event of Emergency
Risks of Falls
Cluttered walkways
Structural Damages
Increased volume & weight can add stress on a home
Increased health risks – general rule is if you can still smell it, its still airborne.
Heavy accumulations of feces and urine can damage dwellings beyond repair, release a host of potentially toxic bioaerosols and gases into the air, and create odor problems for neighbors. Disease exposure could occur through inhalation, contact, or via vectors (eg, insects).

34. Protect Yourself Masks Gowns Gloves
LHD, CEO, Police/Fire should take extra precautions by wearing
Masks
Gowns
Gloves
Shoe covers – Think about the host you become of diseases
Remain aware of Air Quality
The main components affecting air quality include gases such as ammonia and bioaerosols. Bioaerosols include a wide variety of inflammatory and physiologically active components, including endotoxin, fungal cell wall fragments, and respirable dust particles that can reach lower airways.
Lets talk about the shoes, I have a 1.5 & 3 year old, the first thing my kids do when I walk in is grab my high heel shoes and start clomping through the house. They touch them and I have caught my 1.5 munching on my shoe. That could be you. Be conscious of the host for these health risks that you become.
The house needs to be properly remediated. Meaning, the contents are removed, the house is decontaminated, and an odor control cycle begins

35. Mold
Mold is the term used for a group of “fungi” common on wet materials.
Process: Property owner calls upon discovery, Mold is sampled by hygienist, abatement plan is followed through by contractor, to include air duct cleaning, area is resampled by hygienist for post work check.
EPA advises that any moldy areas less than 10 square feet (about 3 feet by 3 feet) can be remediated by the homeowner.
Remediation – Address moisture, Consists of AFD’s, containment barriers, proper ventilation, clean/disinfect, seal, resampled
It is very important to have an area contaminated by mold properly remediated and resampled

36. The Facts about Mold: For the Professional
How should a building be evaluated for mold growth?
Perform an inspection to check building materials and spaces for visible mold growth, signs of moisture damage indicating a history of water leaks, elevated humidity levels, and/or condensation. Occupant complaints, as well as any musty or moldy odors, should be noted
Components of the building’s ventilation system should be inspected, with emphasis on filters, cooling coils, the fan chamber, & any internal insulation.

37. Mold & Health
Health problems associated with excessive damp conditions and mold include:
ALLERGIES
Symptoms include sneezing; irritation of the nose, mouth, or throat; nasal stuffiness and runny nose; and red, itchy or watery eyes. Inhaling or touching mold or mold spores can cause a person who was not previously allergic to mold to become allergic to mold. For people with known allergies, molds can trigger asthma symptoms such as shortness of breath, wheezing, or cough. Irritation can also occur in non-allergenic (non-sensitized) people.
ASTHMA
Indoor environment research has identified evidence of an association between damp buildings and asthma symptoms in individuals with pre-existing asthma. There is also new evidence of an association between damp buildings and new-onset asthma
HYPERSENSITIVITY PNEUMONITIS
Hypersensitivity pneumonitis (HP) is a kind of lung inflammation that occurs in persons who develop immune system sensitization (similar to an allergy) to inhaled organic dust.
Those typically affected: infants, elderly, pregnant, Individuals with respiratory conditions or allergies and asthma
Persons with weakened immune systems

38. Legal Aspects Of Mold Contamination
Landlord and Tenant: The landlord has a responsibility to ensure proper living conditions for his tenants; it is the duty of the landlord to get the mold removed and pay for any such removal. Landlords who fail this can be sued by tenants.
Buyer/Seller: if there is any present mold contamination in the house, then the seller is required to make this fact known to any prospective home buyer.
Employers and Employees: duty of employers to see that the workplace is fit for employees to work in. If the air quality at the workplace has been compromised due to any mold contamination, then employees are entitled to recover damages for any illnesses suffered by them. The employer also has a legal responsibility to remove all signs of mold contamination from the workplace.
Landlord/Tenant: Under the law, it is not the duty of the landlord to provide or pay for such proof, or to get the premises tested for any signs of mold contamination. The burden of providing such proof lies with the tenant. But if there is in fact any mold contamination found, and the landlord has been proved guilty of neglecting his responsibilities, then a tenant can recover any expenses relating to gathering of the proof, as well as any other damages that may arise due to mold contamination.

39. Blood Borne Pathogen Remediation
Governed by OSHA
Must use an EPA approved disinfectant
Dwell time is dependent upon the disease
Certified licensed medical waste hauler
Proper PPE, Packaging, and Documentation
Manifestation of Disposal Records
Clean up can take place anywhere
outside, inside

40. THANK YOU!