Bed bugs: the ick factor

After a suspected bed bug was found outside a courtroom in the John Sopinka Courthouse in Hamilton, Ont., in March 2015, court proceedings were soon moved to another, vacant room. That night, exterminators treated the affected area. The following weekend, a canine unit trained to detect bed bugs found an infestation in another courtroom, which also was immediately treated. Authorities said they would continue to monitor the courthouse to ensure the treatment was successful.

“[Bedbugs] are in every urban environment now,” Susan Harding-Cruz, manager of the vector borne disease program at Hamilton Public Health Services, said in an interview with the CBC. “The courthouse is no different than any other place.”

In the last two decades, there has been a significant resurgence of bed bugs worldwide. This comeback is likely due to several factors: the bugs’ increasing resistance to commonly used insecticides; restriction of pesticides for environmental and safety concerns; and the growth of international travel. Still very rarely seen in the 1990s, bed bugs can now be found in almost any place where people sleep or sit.

Bed bugs are not a safety issue, and they don’t generally cause major physical health problems. However, the discovery of an infestation can be mentally traumatic to the people who work and live nearby. Employers who find them in their workplace need to know what to do and understand their legal obligations.

Bed bugs are a brown, oval insect about the size of an apple seed. They are wingless and cannot fly or jump. They feed, usually at night, on human blood or, less commonly, animal blood. After biting, they become round and reddish. An adult bug will take repeated blood meals over several weeks.

Female bugs lay 200 to 500 viable eggs, which are white and about one millimetre long. They prefer to lay eggs on surfaces such as fabrics, wood, behind pictures, in furniture, along the edges of baseboards and under floorboards, but the eggs can be found anywhere in an infested area. Bed bugs spend most of their time in hiding, living in cracks and crevices or in the seams of soft-surface materials, such as mattresses and upholstered furniture.

HEALTH AND SAFETY EFFECTS OF BED BUGS
Bed bug bites are painless, but they are itchy, leave red marks on the skin and can cause an allergic reaction. Frequent scratching may cause infection. However, while bed bugs do not produce serious physical health effects and do not transmit infectious diseases, they can certainly cause psychological distress. The task of dealing with bed bugs creates anxiety and stress, including sometimes financial stress. Moreover, having bed bugs often gives rise to embarrassment and shame, largely because the parasites are widely associated with poverty or poor personal hygiene. The stigma attached to anyone who is known to have bed bugs is still a huge problem, says Angela Keenan, zone lead, occupational health, safety and wellness at Halifax-based Nova Scotia Health Authority.

“It can be a big concern for employees specifically, whether they’re exposed or they have an infestation themselves. That’s the challenge,” she says. “There is truly a psychological impact to some folks. It’s the ick factor.”

WORKERS AT RISK
Bed bugs usually make their way into a workplace by being carried in on furniture, handbags, clothing and luggage. They are often found in hotels, hostels and apartment and condo buildings, as well as furniture stores, especially those that have a high number of returns. Bed bug infestations also occur in temporary work sites.

“In Alberta, we have a lot of camps for our oilsands or other utility workers, and in Ontario, there’s temporary housing up north for hydro and some of the mining,” says Catherine Jevic, owner at Edmonton-based All-Safe HSE.

Because the bugs infest soft-surface materials, workers who are required to handle bedding, clothing or furniture — especially used furniture — are more likely to come in contact with them. And, of course, because they stay in hotels, people who travel for work are also at increased risk of exposure. Bugs are easily picked up in hotels and transferred back to the workplace or to home.

“In a hotel, people will sit and lounge on the bed while they’re watching television. They lay their clothing out on the bed. The clothing then ends up back in the suitcase. And, depending on how bad the infestation is, if the person uses the dressers and other furniture in the room, then the bed bugs can infest their belongings that way as well,” Jevic says.

Bed bugs can crawl up through walls and down hallways. They can easily go out one door and into other rooms or units within a building. They often enter rooms through holes, such as electrical outlets. Not surprisingly, they have recently started appearing in office and retail buildings and in the health and transport sectors.

EMPLOYERS’ LEGAL OBLIGATIONS
While occupational health and safety regulations do not specifically set out employers’ obligations in relation to bed bugs in the workplace, the general duty provisions still apply, says Christopher W. Spasoff, founder and OHS lawyer at Edmonton-based F2 Legal Counsel.

Under general OHS provisions and in all jurisdictions, an employer has an obligation to ensure the health and safety of its workers and to inform workers of the hazards present in the workplace. The employer is also obligated to eliminate or control the hazards at the work site or associated with the work. The fact that bed bugs can be regarded as a health and safety hazard is a result of a change in our understanding of what constitutes a hazard, he says.

“What's really interesting is that, although you won’t find bed bugs specifically referenced in the legislation, in recent years, the legislation has expanded beyond the notion of just physical health to include things like the psychological health, welfare and social well-being of workers. Whereas in the past an employer might have been able to argue that bed bugs were more of a nuisance than a danger and that their obligations were, therefore, limited, the counter argument is now a lot more compelling,” says Spasoff.

Whenever an employer has information that may affect a worker’s health and safety, it is obligated to share that information with workers, whether it concerns a hazard or potential hazards, the steps taken to eliminate or control those hazards or the practices and procedures needed to deal with the hazards, he says. An employer should never ignore the situation or try to keep it from workers.

“At a minimum, where bed bugs are identified in the course of a hazard assessment, I would expect an employer to communicate the potential risks that bed bugs, and any potential treatments, might pose to workers and the steps that the employer and workers will need to take in respect of [the bed bugs] in terms of both prevention and elimination,” says Spasoff.

If, when an infestation is discovered, some employees refuse to work, an employer must first determine whether the work refusal is valid. Work refusal provisions of OHS legislation across the country differ in the language they use to refer to what can trigger a valid refusal. In some jurisdictions, such as in Alberta, the provisions are still relatively new and open to interpretation, Spasoff says. As a result, what may constitute a legitimate work refusal in one province may not do so in another. An employer will need to look at the circumstances of the situation and the language of the applicable provision to determine whether the refusal is valid.

Above all, says Spasoff, employers must assess every work refusal fairly and with an open mind.

“It’s important that employers approach such work refusals not from the standpoint of their own temperament or preconceived notions of the hazard or dangerous condition in question but in accordance with the work refusal process that is provided for under their respective occupational health and safety legislation. Whether the refusal is ultimately found to have been legitimate will turn on both the facts in issue and language of the provision in question,” Spasoff says.

Employers that ignore evidence of a bed bug infestation and fail to tell workers about it may be liable to a penalty, he adds. Most likely, an order — such as a non-compliance order or stop work order — would be issued. An administrative penalty (a fine) could also be issued, depending on the severity of the situation and the infestation.

Sean Feeney, manager, facility support for central zone at Nova Scotia Health Authority (NSHA), says he and his staff have been dealing with bed bugs since 2008.

“At that time, it caught everyone off guard, including the lower-income landlords and the public housing group... This was something that came upon us all of a sudden, and we saw an influx of reports of bed bugs,” he says. “So, we had to develop a protocol for dealing with this, to support our staff and make sure it didn’t become a bigger issue.”

The authority has two procedures, says Feeney. When a live bed bug is found and confirmed in an area, they take a sample and then clean the entire area using a HEPA (high-efficiency particulate air) vacuum. A pest control company comes in, conducts a visible inspection and treats all enclosed areas. Four hours later, NSHA staff disinfects the area.

When a suspected bed bug area is identified, the staff HEPA vacuums and disinfects the area. The pest control company then does a visible inspection to make sure whatever bugs may have been present are gone.

“In our environment, there’s not the ability for a bed bug to survive. There are no carpets, and we have things like stretchers that are easily cleaned and disinfected. It’s much easier to manage compared with a residential setting, where there are more places to hide — carpets, fabric furniture and couches. We’ve moved away from many of the types of furniture that bed bugs will survive in and breed and flourish in,” says Feeney.

The NSHA also employs many community-based workers who provide health and wellness services in clients’ homes. While the authority conducts pre-home health and safety inspections, these workers — because the work setting is not controlled — are at higher risk of exposure to bed bugs and other pests. The authority educates workers to identify the bugs and on ways to reduce the likelihood of transporting them out of a client’s home, says Keenan.

Workers learn that wearing light-coloured clothing makes it easier to see bugs that may be on them. It’s a good idea to put personal belongings in sealable plastic bags before they enter the house. They also need to think about where they put their coat: Should they put it on the couch, hang it up against a solid surface, keep it with them or leave it in the car? (If there’s a possibility of bed bugs, the coat should not be touching anything). Anything being removed from a client’s house should also be put into a sealable bag.

“Just think about your physical presence in that environment: where you choose to sit, where you choose to have your interaction. And then when you get home, think about taking those clothes off, washing them in hot water and putting them in the dryer. So, we do a lot of education about how, if they are exposed, they can prevent basic transmission,” says Keenan.

WHEN AN INFESTATION IS IDENTIFIED
Detecting bed bugs early on is essential to prevent the spread of the infestation and ensure the success of the extermination, says Jevic. One way to check for bugs is to put glue traps on the floor. Covered traps are preferable and should be placed along the perimeter of the room, near bugs’ access points, such as electrical outlets.

Otherwise, a person can identify an infestation by checking around areas where people sit or sleep. Look for the live bugs, their carcasses, shells or fecal stains or droppings (which resemble small black spots or brown sugar granules). A musty odour (called alarm pheromones) and small blood spots on sheets and pillows are other typical signs of bed bugs.

If an infestation is found, the employer should contact a professional pest controller, who can first verify the presence of bugs and advise the proper means of eliminating them. If a chemical fumigation is to be done, the employer should first prepare the area for the treatment. All soft-surface materials that can be removed should be washed and put into a dryer at high heat, which will kill any bugs hiding in them. Also, do a thorough cleanup around the infested areas; this will allow the extermination chemicals to better penetrate all surfaces.

Pest control companies generally use a chemical proprietary to the company. A successful treatment will get rid of both adult bed bugs and their eggs.

TRAINING
To deal properly with an infestation in the workplace, workers need to know first how to identify bed bugs and their signs. They should also be aware of the ways in which bugs could enter the workplace and how to ensure they do not pick up and carry the bugs on their clothing or belongings.

For employees who travel for work, checking for bed bugs should be part of their routine. As soon as they go into their hotel room and before unpacking, Jevic says, they should pull back all the bedding from a top corner of the bed and look at the exposed mattress seams and edges. They should look at box springs, too. If they see any live or dead bugs or signs of them, they should immediately leave the room, inform the front office and go to another hotel. Using a flashlight can help them see the bugs and their droppings.

Workers also need to understand the extermination procedure. The company itself may be able to come in and give a seminar for employees. This training should include instruction on how to properly move in and out of the containment area without exposure.

Preventing the spread of bed bugs starts with a risk assessment that determines whether the pests are a potential hazard in the workplace, says Jevic. Assign a risk level to a possible infestation and determine how much damage it could cause to the organization and what the potential loss might be. Most important, introduce a reporting system, one that is perhaps anonymous. Early reporting is key to stopping the infestation from spreading to other areas of the workplace.

“It’s in the best interest of the organization to treat it quickly and make sure that reporting is transparent,” she says. “If you drive the reporting underground, no one is going to tell you anything and the problem is just going to get way bigger and way worse.”

This article originally appeared in the May/June 2020 issue of COS.