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1. Hand Sanitizers In Public Facilities
Utilisation De Désinfectant À Main Dans Les
Installations Publiques |
That Council request that the Chief
Medical Officer of Health examine the use of hand sanitizers in our public facilities
(buildings) and the
state of our promotion programs with respect to hand washing as a means of
disease transmission control.
Que le Conseil
demande au médecin chef en santé publique d’examiner l’utilisation du
désinfectant à main dans nos installations publiques (immeubles), ainsi que
l’état de nos programme de promotion relativement au lavage de mains comme
méthode de lutte à la propagation des maladies.
Documentation
1. Transit Committee report dated 23 June 2009 (ACS2009-CCS-TTC-0011).
Report to /
Rapport au:
Transit Committee /
Comité du transport en commun
And Council / et au Conseil
23 June 2009 / le 23 juin 2009
|
City Wide / À l'échelle de la Ville |
Ref. N°:
ACS2009-CCS-TTC-0011 |
SUBJECT: HAND SANITIZERS IN
PUBLIC FACILITIES
OBJET: UTILISATION
DE DÉSINFECTANT À MAIN DANS LES INSTALLATIONS PUBLIQUES
That the
Transit Committee recommend
that Council request that the Chief Medical Officer of Health examine the use
of hand sanitizers in our public facilities (buildings) and the state of our promotion programs
with respect to hand washing as a means of disease transmission control.
Que le
Comité du transport en commun recommande au Conseil demande au médecin chef en
santé publique d’examiner l’utilisation du désinfectant à main dans nos
installations publiques (immeubles), ainsi que l’état de nos programme de
promotion relativement au lavage de mains comme méthode de lutte à la
propagation des maladies.
At the Transit Committee meeting of 17 June 2009, during consideration of a report about the provision of hand sanitizers on OC Transpo buses and at transit stations, the Committee suspended the rules to consider a related item. The aforementioned Motion was subsequently approved by the Committee.
On 17 June 2009, during consideration of a report from the Committee Chair (Councillor Alex Cullen), recommending that the Committee direct staff to review the proposal to install hand sanitizers on OC Transpo buses and at Transitway stations, the aforementioned Motion was raised and approved.
It should be noted that following detailed discussion of the Chair’s report, the recommendation was rejected 4 – 3 by the Committee. An extract of the draft Minute pertaining to that particular report is appended as Document 1, which also reflects discussion surrounding this report, including suspension of the rules of procedure to consider this new Motion.
Initially,
the Motion proposed by Councillor Legendre, which forms the basis of this
report, was suggested to be referred to the Community and Protective Services Committee (CPSC) as that is the
Committee to which Public Health reports.
At the time, Legal Counsel advised that the Motion was a new item and
the rules would have to be suspended in order for it to be considered. The Committee subsequently approved
suspension of the rules.
CONSULTATION
Regrettably, incorrect procedural advice was provided to the Transit
Committee with respect to this Motion in that it deals with a subject not
within the mandate of the Transit Committee.
Rather than delaying this matter by referring it to the Community and
Protective Services Committee for deliberation, the interests of the City would
be best served by Council exercising its authority in this matter and
proceeding with its consideration of the recommendation.
Public Health
Good hand hygiene, which includes effective hand washing, is one of the best defences against the transmission of bacteria and viruses. Hand sanitizers can be used to supplement effective hand washing and are a convenient option when hands are not visibly soiled and when soap and water are not readily available. While hand sanitizers are practical add-ons to thorough hand washing, previous discussions with concerned members of the public and schools have brought to light some risks associated with these products. The alcohol content in hand sanitizers makes these products flammable, and poisonous to ingest. In addition, some individuals are sensitive and allergic to these products.
Ottawa Public Health supports the recommendation to examine the use of hand sanitizers in our public facilities buildings. Should Council approve this recommendation, Ottawa Public Health will draw upon the expertise and service knowledge of our colleagues in Public Works, regarding the scope of City facilities appropriate for placement of hand sanitizer dispensers.
The promotion of good hand
hygiene is at the forefront of many Ottawa Public Health programs. Further to Council approval, we welcome the
opportunity to report on hand washing promotion campaigns.
Public Works
The Parks, Buildings and Grounds Operations and Maintenance Branch of Public Work will work with Ottawa Public Health to assess the implications of installing hand sanitizers in the City’s public buildings.
FINANCIAL IMPLICATIONS
Subject to Committee and Council approval of the report recommendations, the cost implications of installing hand sanitizers in the City's public buildings will be included in the report back to Committee and Council.
Further to the Legal Services comment above under
"Consultation" there are no Legal/Risk Management impediments to
Council approving this report's recommendation.
Document 1 – Extract of Draft Minute 17 June 2009
DISPOSITION
If
approved by Council, the
Chief Medical Officer of Health would report back on the issues related to
implementing the report recommendation.
Document 1
HAND SANITIZERS ON OC TRANSPO BUSES
DÉSINFECTANT POUR
LES MAINS DANS LES AUTOBUS D'OC TRANSPO
ACS2009-CCS-TTC-0007 City
Wide / À L'échelle De La Ville
Councillor Cullen left the Chair so that he could introduce and discuss the item. Vice Chair Wilkinson chaired the meeting for the duration of this item. Councillor Cullen provided a brief overview of the report then introduced the following delegation:
Jenn St. Jean introduced herself as a graduating
nursing student from the University of Ottawa/Algonquin College BScN Nursing
Program. She presented a PowerPoint
presentation on her proposal to place hand sanitizers on OC Transpo buses and
at Transitway stations in order to decrease the rate of transmitting
infection. The more salient points
highlighted were as follows:
·
8000-12,000 deaths per year in Canada result from MRSA
(Methicillin-resistant
Staphylococcus aureus)
·
the easiest way for germs to get into your body is
through your eyes, mouth and nose; the average person touches these areas with
their hands 200 times a day
·
hand sanitizers can stop the spread of viruses on
buses; passengers will feel better and safer about taking the bus and the
community will feel safer knowing there are less viruses being spread
·
hand sanitizers on buses do have a cost associated
with them, but the cost of health care is greater; it costs $7000 per night per person to stay in a
hospital whereas hand sanitizers would only cost $2303 per day
·
she
recommends the use of Soapopular, as it is a non-alcohol sanitizer that is non
flammable and has been proven effective against MRSA, SARS (Severe Acute
Respitory Syndrome) and the H1N1 virus
·
Using
hand sanitizers will reduce the spread of virues and as a result, will decrease
the number of days a person has to take off work because they are sick
Dr. Levy, Medical Officer of Health
commended the presenter and the Committee for focusing attention on an
important public health measure which is underutilized. He agreed that appropriate hand hygiene is a
fundamental mainstay of preventing transmissable infections in the community and
any awareness that can be brought to this issue is helpful.
In response to a question posed by
the Vice Chair, Dr. Levy advised that it is possible to raise the issue with
the Province, but would be surprised if they would support a suggestion like
this. The Vice Chair noted that the
savings illustrated in the presentation would be gained by the province and
would not be seen at the municipal level.
Dr. Levy suggested that if the literature can demonstrate that those
savings are directly attributable, the proposal would need a policy work up and
in the current context, he believed it unlikely that the Ministry would be
doing that because their attention is focused on other issues.
Councillor Legendre questioned the
accurateness of the sources used by the delegation with respect to her factual
statements. Dr. Levy explained that if
the Committee approves the recommendation, staff would verify those facts
before proceeding.
Councillor McRae inquired whether
the delegation’s presentation had been reviewed by her peers and Ms. St. Jean
advised that it had been shown to her Manager at CHEO and to her nursing
teacher at Ottawa U and both were supportive of her bringing this proposal
forward. The councillor felt that if
approved today, she might want to consider gaining that peer review in order to
strengthen the science of her findings.
The following public delegations
spoke in opposition to the proposal:
Daniel Oickle expressed support for hand washing,
but not to impose the use of hand sanitizers on buses. He was concerned about passengers getting
hurt if the bus starts moving while they are applying the cleanser and wondered
how people with disabilities would wash their hands with the sanitizer. He was concerned about the cost to the
taxpayer or transit user and believed people can carry their own hand
sanitizer.
Catherine Gardner objected to the proposal for the
following reasons:
·
having
to use hand sanitizers on the buses will delay boarding and people who have
applied it to their hands are vulnerable from falling if they are busy washing
their hands if the bus starts moving quickly
·
hand
sanitizers do not work if hands are dirty; people with cuts may not want to use
it
·
a
leaking dispenser could be hazardous for standing passengers
·
how
will the City prevent tampering of dispensers or protect the sanitizer during
extreme hot and cold temperatures throughout the year?
·
more
can be done in public education than spending money to provide hand sanitizers
on buses
Recognizing the pros and cons raised
by the three delegations, Alain Mercier, General Manager, Transit Services
advised that the current thought in the industry is to concentrate on the
transfer point, which is where people come into contact with the bus, i.e., to
ensure treatments can be applied to the bus to prevent the transmission of
disease.
When asked what City facilities
already have hand sanitizers in place, Dr. Levy explained that there may
be some specific facilities that have them, but these are probably specific
locations such as the Ottawa Public Health Service Command Centre. The mainstay of the approach has been to
promote soap and water. Councillor
McRae maintained that if the Committee approves this recommendation, it should
also be looking at installing hand sanitizers in libraries, community centres,
washrooms and meeting rooms at City Hall, et cetera and she would be looking
for leadership from the Medical Officer of Health in this. And, if endorsed, she would expect him to
recommend other locations where this should be reviewed and how to deal with
competing priorities. The councillor
recognized that as the Board of Health, Council has an obligation to deal with
these issues in a rationale and reasonable sense.
In speaking to his report,
Councillor Cullen believed this is the way to mitigate the transmission of
disease. He stated that hand sanitizers
are everywhere and more people are using them.
And, while washing hands is very effective, there are circumstances
where soap and water is not available and this is a relatively inexpensive
alternative which deserves review. He
believed the City was at the point where it ought to be looking at this and
what should be compelling the City to do this is the details provided in the
presentation with regards to the number of days lost as a result of infection
and the increasing public concern about H1N1.
Councillor Cullen went on to state
that this would not be a mandatory program, but if the City was to proceed with
it, public education is required and having it readily available on the bus
will help to change behaviour. He
explained that the idea is to provide an opportunity for people to use hand
sanitizers and through public education people will take advantage of it,
thereby reducing the transmission of disease.
He recognized the operational and safety issues raised would have to be
addressed by staff as part of their analysis of this proposal, as well as
whether or not it will produce the results it is hoped they will achieve.
Councillor Legendre asked what costs
would be incurred if this proposal is approved to which the General Manager
advised that staff is currently in the process of looking at the whole hygiene
chain of the system and he did not expect any incremental expenditure out of
the normal routine of trying to achieve continuous improvement in their
business. Since this was going to be
done in any case, the councillor thought having staff report back on this
proposal was not really necessary.
However, Mr. Mercier explained that this report would guide staff on the
specific topic of hand sanitizers or dispensers, which staff have not looked at
as a specific outcome. They would
incorporate the use of hand sanitizers in the form that is being suggested here
as an additional solution and look at the effectiveness in terms of improving
the hygiene on the system.
As a result of this, Councillor
Legendre proposed the following Motion:
That the
Transit Committee recommend
that Council request that the Chief Medical Officer of Health examine the use
of hand sanitizers in our public facilities (buildings) and the state of our promotion
programs with respect to hand washing as a means of disease transmission
control.
The
Vice Chair advised that this should more appropriately be moved as a Notice of
Motion at Council as it was not a Transit Committee oriented Motion. As an alternative, Councillor Cullen suggested it be referred to
the Community and Protective Services Committee (CPSC) because that is where
Public Health reports.
Ernest McArthur, Legal Counsel
confirmed that the Motion was a new item and since it is not currently on the
agenda, the rules would have to be waived for it to be considered.
Vice Chair Wilkinson felt it would
be better to refer it to the CPSC who act as the Board of Health. Councillor Legendre did not want to refer
the Motion.
When asked by Councillor McRae if
the Motion was Out of Order, Mr. McArthur advised it was not, but
reiterated that since it is not on the agenda, the Committee would have to
suspend the rules in order to consider it.
Moved by J. Legendre
That
the Transit Committee approve the addition of this item for consideration by
the Committee at today’s meeting, pursuant to Section 84(3) of the Procedure
By-law (being By-law no. 2006-462).
CARRIED
As a public health issue, Councillor
Bloess believed the City should be taking a more comprehensive approach (as
suggested in the Legendre Motion) and not just having hand sanitizers installed
on buses. He also did not want to
burden OC Transpo and suggested that putting sanitizers on buses will delay the
system because everyone would stop to apply it. He agreed to let the Medical Officer of Health take the lead on
this.
While he endorsed Councillor
Legendre’s Motion, Councillor Cullen did not understand the resistance to his
own report because what he was recommending would be incorporated with part of
the work Transit Services staff is already doing. He believed a better decision can be made this way.
Councillor McRae was hesitant to
support a Motion that would add unfair burden to the work of Public Health and
wondered whether the Motion from Councillor Legendre was something staff would
undertake willingly to review, or whether it was something they are already
examining. Dr. Levy explained that this
particular issue is something staff are examining on an ongoing basis with
respect to how they can better convey hand hygiene information. He noted that the City has a long and proud
tradition on this subject and acknowledged that all levels of government are
coming together to promote hand hygiene in the community. He welcomed the opportunity to explore this
in the context they are working in.
Vice Chair Wilkinson indicated that
many of the City’s buildings currently offer hand sanitizers and suggested that
if Dr. Levy’s staff approached the Real Estate Partnerships and Development
Office or the Parks and Recreation Department, they could probably obtain a
list of those facilities.
Moved by J. Legendre
That the
Transit Committee recommend that Council request that the Chief Medical Officer of Health
examine the use of hand sanitizers in our public facilities (buildings) and the state of our promotion
programs with respect to hand washing as a means of disease transmission
control.
CARRIED
That
Transit Committee direct staff to review the proposal to install hand
sanitizers on OC Transpo buses and at Transitway stations and report to Transit
Committee in time for the 2010 budget process.
LOST
YEAS (3): R. Bloess, M. Wilkinson, A. Cullen
NAYS
(4): J. Legendre, C. Leadman, M. McRae, C.
Doucet