Several years ago, MONOC briefly used a disinfectant fogging system known as Zimek in some of our ambulances. It was in use by many public safety agencies and healthcare organizations around the country at the time. It was also used by such federal agencies as the Department of Homeland Security. We conducted our normal product research and manufacturer vetting, and determined it would improve the safety for staff and patients by adding another level of disinfection within our ambulances.


The union which represents our EMTs, paramedics and nurses claimed this process, and the chemicals used with it, were causing harm to our employees. No such concerns had ever been raised by any other users in the country, nor have ever been raised subsequently. The union communicated its concerns to the company, the employees, the media and several government agencies.


Shortly thereafter, a group of field staff began complaining of assorted health issues. These complaints were different for each employee, but included various combinations of irritated eyes, skin rashes, breathing trouble, asthma, fatigue, vomiting, diarrhea, ulcers, and neurological problems, to name a few. Several of the employees had pre-existing medical conditions that would cause them to exhibit these symptoms, some claimed their symptoms started on a date that actually preceded MONOC’s use of Zimek, and others claimed their symptoms were new.


MONOC immediately ceased using the Zimek system and its chemicals. We researched, again, the product and the chemicals it used. OSHA, the EPA and the New Jersey DEP investigated the situation. In the end, the EPA issued an order to MONOC to not use the Zimek system because its use, as directed by the manufacturer, was not allowed by the label on the chemicals it used; (quaternary ammonium compounds {QACs} and phenol). MONOC had already ceased using the Zimek system before we received the EPA order.


Some of the employees who complained of symptoms they associated with the Zimek system filed Workers’ Compensation claims. In addition, the union continued to communicate with its members that it believed Zimek was the cause of the health issues employees were having. At this time MONOC contacted the United States Department of Health and Human Services’ National Institute for Occupational Safety and Health (NIOSH), to conduct an in-depth scientific review and study of the Zimek system and the chemicals it used, for the purpose of determining whether they were the cause of the health complaints raised by the union and several employees.


After more than three years of investigation and study, NIOSH has completed their work and issued a final report. It was sent to both the union, who requested a similar study by NIOSH, and MONOC. MONOC received this report yesterday (September 17th, 2014).


The NIOSH report concludes the following;

1)      Our [NIOSH] evaluation showed that phenol fogging could not explain any of the reports of symptoms or illnesses.”

2)      “…our [NIOSH] evaluation did not show that any of the reported symptoms and illnesses were related to disinfectant fogging with phenol or QACs.”

3)      Our [NIOSH] evaluation found no relationship between the disinfectant fogging of ambulances and the reported symptoms and illnesses…”

4)      The types of information included in and omitted from the PEMSA-NJ letter and the EPA Stop Sale, Use or Removal order might have been perceived by employees and their physicians as (1) support for the cause-and-effect relationship between disinfectant exposure and health problems and (2) validations of employees’ concerns. However, these perceptions were not supported by our evaluation.”


MONOC is pleased that a final scientific determination has been made concerning this issue. It demonstrates that our product research at the time was appropriate, that our reaction to the situation at the time was appropriate and that, most importantly, our employees’ health was not adversely affected by our use of the Zimek system.


This episode also demonstrates how conveying misinformation or making unsubstantiated claims, no matter how well intended, can result in employees drawing false conclusions and cause unnecessary fear.


Lastly, as always, MONOC will continue its commitment to safety of the workplace and for our staff.