What is the recommended management for a patient exposed to mold, rodent infestation, and rodenticide in New Zealand?

Management of Mold, Rodent Infestation, and Rodenticide Exposure in New Zealand

For patients exposed to mold, rodent infestation, and rodenticide in New Zealand, immediate implementation of comprehensive cleaning protocols with appropriate personal protective equipment is essential, followed by medical evaluation for any symptoms of exposure. 1

Initial Assessment and Safety Measures

Immediate Actions for Rodent Infestation

• Ventilate closed spaces by opening doors and windows for at least 30 minutes before cleaning
• Wear protective equipment:
  • Rubber, latex, vinyl, or nitrile gloves (mandatory)
  • Consider safety glasses and coveralls for heavy infestations
  • Use DEET-containing insect repellent on clothing, shoes, and hands if handling dead rodents 2, 1

Cleaning Protocol for Rodent Droppings and Nests

1. Never sweep or vacuum dry droppings as this creates potentially infectious aerosols 1
2. Prepare disinfecting solution:
   • Commercial household disinfectant OR
   • Bleach solution (1½ cups household bleach in 1 gallon of water) 1
3. Thoroughly soak droppings, urine, and nests with disinfectant solution
4. Use paper towels to pick up wetted materials and place in sealed plastic bags
5. Clean all potentially contaminated surfaces:
   • Mop floors with disinfectant
   • Disinfect countertops, cabinets, and other surfaces
   • Use disinfectant or steam cleaner for carpets 1

Disposal of Dead Rodents

1. Spray dead rodents thoroughly with disinfectant
2. Place in a plastic bag and seal it
3. Place first bag into a second plastic bag and seal
4. Dispose by:
   • Burying in a 2-3 foot deep hole, OR
   • Burning, OR
   • Placing in a covered trash can that is regularly emptied 2, 1

Mold Exposure Management

Cleaning Mold-Contaminated Areas

• Wear protective equipment as described above
• Correct conditions supporting mold growth:
  • Repair water leaks
  • Insulate cold water pipes to prevent condensation
  • Eliminate sources of moisture 2, 3

Medical Evaluation for Mold Exposure

• Monitor for respiratory symptoms (present in 64% of mold-exposed patients) 4
• Watch for neurologic symptoms (present in 70% of mold-exposed patients) 4
• Consider testing for:
  • Serum anti-mold immunoglobulin G antibodies
  • T and B cell abnormalities (found in >80% of patients with chronic mold exposure) 4

Rodenticide Exposure Management

Zinc Phosphide Exposure

• Immediate medical attention is required
• Monitor for:
  • Nausea, vomiting, dyspnea, and mental status changes
  • Delayed effects on liver, heart, and kidneys
• Treatment is symptomatic and supportive with aggressive airway management 5

Bromethalin Exposure

• Severity varies by age and amount ingested
• Pediatric exposures rarely result in serious effects (96.38% show no effects)
• Adult exposures: 65.73% show no effects, but can cause seizures in severe cases
• No specific antidote is available; treatment is supportive 6

Prevention of Future Exposure

Rodent-Proofing Measures

1. Eliminate food sources:

   • Store food and water in rodent-proof containers
   • Clean up food spills immediately
   • Store pet food in sealed containers
   • Dispose of trash regularly 2

2. Eliminate shelter:

   • Remove clutter inside the home
   • Keep items off floors
   • Place woodpiles and building materials >100 feet from house
   • Mow grass and remove dense vegetation near home 2

3. Block entry points:

   • Seal holes and gaps in walls, floors, and foundation
   • Keep exterior doors and windows closed or protected with tight-fitting screens 2

4. Ongoing monitoring:

   • Use spring-loaded traps with peanut butter bait
   • Place traps perpendicular to walls with bait end closest to wall
   • Continue trapping for at least one week after last rodent is caught 2, 1

Special Considerations

Heavy Infestations

• For severe or persistent infestations, contact professional pest control services
• Consider additional protective equipment including respirators
• More extensive cleaning and disinfection may be required 2

Monitoring for Health Effects

• Follow up with healthcare provider if symptoms develop after exposure
• Be alert for respiratory symptoms, unexplained neurological issues, or signs of toxicity
• Document all exposures and symptoms for medical evaluation 3, 4