Hazard hotels: What’s lurking in your guest room?

As outpatient treatment grows and the hospitality industry serves more patients, medical waste poses a bigger threat

Aura Berciano-Reyes has worked as a housekeeper at the Wyndham Boston Beacon Hill for nearly two decades. The hotel, located just a few blocks from Massachusetts General Hospital, offers discounts to patients at nearby medical facilities and attracts a steady stream of people who are recovering from procedures or receiving outpatient treatment.

More than once, said Berciano-Reyes, she has “cleaned up blood in the morning and used the same gloves to clean the rest of the rooms.” Her employer, one of 41 large hotels nationwide owned by real estate investment trust FelCor, didn't reliably provide gloves or other protective equipment, she said. At times, she has used dishwashing gloves she’d purchased herself.

Her husband, José Berciano-Reyes, who works as a houseman, cleaning and maintaining the hotel’s public areas, said he has encountered syringes more than once in bathroom trashcans. The containers rarely have liners, so he and other staff members reach in bare-handed. Juan Carlos Espinal, a night shift employee, relates similar experiences. He said he has cleaned up blood, vomit, human excrement and syringes — all without the aid of gloves. At least two employees have been pricked by needles they found in trashcans and in hotel rooms, according to a complaint filed with the Occupational Safety and Health Administration and an anonymous report to a local hotel workers union.

In May, Wyndham workers filed a complaint with OSHA alleging inadequate workplace-safety assessments, training and access to personal protective equipment such as gloves. Following a two-month investigation, the agency affirmed their concerns, citing the Beacon Hill property for failing to provide adequate gloves, facemasks and equipment; for not isolating laundry that had been contaminated with bodily fluids; and for providing insufficient training on how to use protective equipment and cleaning chemicals. The hotel was fined $12,000 and given a January deadline to meet training requirements and purchase appropriate supplies for workers. In an emailed statement, a spokesperson for Wyndham wrote that the hotel was reviewing the proposed citations. “Please know we take these matters very seriously and will work with OSHA to reach a resolution,” she wrote. 

The Wyndham case may not be an isolated one. As more people travel for medical care and outpatient treatment becomes increasingly common, hotel chains are adding facilities near, or even on, hospital grounds. These so-called hospital hotels advertise to patients and families and sometimes negotiate contracts with hospitals to provide discounts and other incentives such as free shuttles for patients. Yet some housekeepers, union leaders and biohazard experts say the hotels may be unprepared for the attendant health risks.

“More and more, we’re seeing housekeepers coming into rooms sometimes used by hospital patients. They’re finding bodily fluids and potentially infectious materials, waste products, blood, used syringes,” said Tiffany Ten Eyck, an organizer with Unite Here Local 26, a union that represents many hotel employees in Boston (though not those at the Wyndham). 

Hotel workers in biohazard gear at a protest.

Hospital hotels are growing more popular as executives realize they provide a reliable market: People are always getting sick. Michael Hughes, an executive vice president at FelCor, which owns seven other hotels located near hospitals, in addition to the Boston Wyndham, noted in an October shareholder call that revenue per room at the company’s Wyndham Houston - Medical Center Hotel and Suites, which directly advertises itself to patients at several hospitals within walking distance, grew by 13 percent in the third quarter of 2015. Across all hotels in the Houston area, revenue per room dropped by an average of 3.7 percent, he said.

Of the top 10 facilities listed in U.S. News & World Report’s 2015 rankings of the nation’s best hospitals, two — Barnes-Jewish Hospital, in St. Louis, and New York-Presbyterian — maintain residential facilities specifically for patients and families. Barnes-Jewish, Massachusetts General and Mayo Clinic have partnered with hotels to provide lodging on or near their campuses. Additionally, the University of San Francisco, Cleveland Clinic, Mass General, UCLA Medical Center, Johns Hopkins Medicine, and Brigham and Women’s Hospital have negotiated medical discounts with neighboring hotels, often big-name chains such as Wyndham, Holiday Inn and Marriott. On the section of their websites dedicated to patient information, the Hospitals of the University of Pennsylvania-Penn Presbyterian maintains a list of nearby hotels and references discounts, while New York-Presbyterian provides a list of nearby hotels that offer patients free shuttle service.

But there are signs that some hotels are not taking the necessary safety steps to protect staff and guests. Between October 2015 and September 2015, U.S. hotels received more OSHA citations for failing to inform staff of known hazards such as medical waste and cleaning chemicals than for any other safety standard violation. In that period, 73 hotels were cited for such lapses. Twenty-five hotels received citations for violating OSHA’s bloodborne pathogens rules, which include standards for educating staff and providing gloves and other protective equipment.

In August 2014, OSHA proposed $9,000 in penalties against Marriott’s Fairfield Inn & Suites, a 10-minute drive from the Eastern Maine Medical Center in Bangor. OSHA said the hotel hadn’t properly assessed employees’ risk of exposure to potentially infectious materials, failed to train workers in how to respond to such hazards and lacked a plan for stopping the spread of illness. The hotel also neglected to provide a detailed hazard plan and other written safety materials to all employees and to stage refresher training sessions on OSHA’s bloodborne pathogen standards, as required by law, the agency said.

Andrew Whitmarsh, operations safety and compliance manager at Aftermath, a company that specializes in biohazards cleanup, says employee training is crucial to prevent contagion. Housekeepers at many hotels, he said, are “probably not properly trained to handle [biohazards like body fluids] and dispose of it correctly.” The risks are great: In a worst-case scenario, a needlestick incident could result in HIV infection or a few inhaled spores of the bacterium Clostridium difficile might lead to cross-contamination between hotel rooms.

Biohazard experts worry that without proper training and equipment, hotel workers could spread illness from room to room.

Norovirus outbreaks facilitated by cross-contamination occurred at hotels in Orlando, Florida, in 2013; New Jersey in 2014; and Nashville, Tennessee, in 2015 (though none were related to hospital patients or care). Meanwhile, at least two needlestick incidents at hotels have resulted in significant litigation. In 1994, Audrey Malena, a Nebraska resident who was staying at a San Francisco Marriott, sued for negligence after she was stuck in the hand while reaching to pick up something that had fallen behind a nightstand. In 2001, the family of 2-year-old Madelynn Rogers brought a lawsuit against Seattle’s Claremont Claremont Club & Spa after she stepped on a needle left in a carpet of their hotel room. Neither Malena nor Rodgers was infected with HIV or other diseases as a result of the incidents.

Misuse of cleaning chemicals also poses a risk to workers and guests, Whitmarsh said. Mixing bleach and Windex, for example, can cause a dangerous chemical reaction.

Workers at the Wyndham say they’ve seen some improvements since the OSHA citation. The hotel added a sharps container (one with a locking lid for needles and other sharp objects) in the housekeeping office, for example. But housekeepers are required to call down to the engineering department if they encounter a needle so an employee with tongs can dispose of it. Hotel staff are urging the Wyndham to provide tongs and sharps containers on every housekeeping cart, as well as additional gloves and biohazard bags to isolate contaminated laundry. José Berciano-Reyes also said that guest education is a concern: When people check into the hotel, the front desk doesn’t provide information on what to do if they have dirty bandages or used needles or other circumstances that require special attention or equipment, he said.

After facing pressure from staff, some hotels have begun to strengthen safety protocols. In 2006, employees at the Hampton Inn in Boston launched a successful union drive and campaigned for improved housekeeping conditions. Since then, the hotel has taken steps to improve its practices around hazards and bloodborne pathogen safety, said Kathy Foster, a housekeeper and union steward. The hotel, which is located near several major hospitals and in the past provided medical discounts to patients, started giving employees tongs for picking up needles, along with sharps containers.

“I like my job,” said Foster, 60. “If I didn’t like this job, I would have been in another field. I’ve been there for 37 years.” She, like so many of her colleagues, just wants to be safe.

Editor's note: This version of the story corrects the characterization of how often Wyndham provided gloves to employees. 

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