Cleanup at Ga. prison hospital leads to yet another problem — asbestos

Notification of the discovery in floor tiles was withheld from healthcare workers at the facility for weeks, documents show

Credit: The Atlanta Journal-Constitution

Credit: The Atlanta Journal-Constitution

When the Georgia Department of Corrections began working earlier this year to improve conditions at Augusta State Medical Prison, the first order of business was a deep cleaning. After years of neglect, a thorough scrubbing of the building with disinfectant was desperately needed.

But what was supposed to be a major step in bringing the state’s flagship prison medical facility up to hospital standards in many ways has created more dysfunction.

No sooner had the cleaning begun then a new problem — asbestos — emerged. And that, in turn, has led to a spate of other issues. Dealing with the asbestos has caused the operating room to be shut down for more than two months, increased the cost of the project by tens of thousands of dollars and rankled employees who believe they were kept too long in the dark about a significant health hazard.

“I have had consistent respiratory issues since March 8,” an OR nurse, Laura Matthews, wrote in a March 16 email to her supervisor complaining about the asbestos. “I wanted to make you aware I am documenting these issues.”

The effort to clean up Augusta State Medical Prison began nearly five months ago after a series of stories in The Atlanta Journal-Constitution revealed how piles of trash, black mold and other unsanitary conditions had become commonplace in the 36-year-old building.

In an interview with the AJC in January, Randy Sauls, the Department of Corrections’ assistant commissioner of health services, vowed that the problems would be corrected, starting with what is called a terminal cleaning.

But new reporting by the AJC, based on emails and other documents obtained through open records requests, suggests that missteps have continued even as officials have tried to remedy the situation, casting doubt on whether dangerous conditions are being properly addressed.

Just days after the company hired to do the terminal cleaning, BriTen Janitorial of Edgefield, S.C., started work in late February, some floor tiles were found to be loose in a nursing unit where inmates with severe disabilities are cared for. The tiles were tested and found to contain asbestos.

When asbestos is disturbed or crumbled, tiny fibers too small to be seen can be released into the air. Years later, those fibers can cause lung cancer as well as mesothelioma, a rare form of cancer that typically affects the linings of internal organs.

The discovery of the asbestos caused the shutdown of the operating room in early March because inmates housed in the nursing unit had to be moved to beds in the post- and pre-operative unit while the tiles were removed.

Surgeries since the shutdown have been farmed out to other public hospitals, putting more strain on a system already dealing with a backlog that forces inmates to wait months for procedures. The OR is scheduled to reopen Tuesday.

Sauls, in a recent interview, said he doesn’t see the discovery of the asbestos and what it meant for the operating room as impacting his plans to fix the facility.

“Obviously, when you can’t do something, it’s an inconvenience,” he said. “But (dealing with the asbestos) was work that had to be done. We addressed it.”

Seeking answers

But the presence of asbestos in the building, first reported by Augusta television station WJBF, has raised fresh questions about the oversight provided by the Department of Corrections and Georgia Correctional HealthCare, the branch of Augusta University that employs the medical personnel working in the state prison system.

Although officials from the two agencies have assured the facility’s healthcare workers that the asbestos discovered in the nursing unit was contained and therefore not dangerous, they waited weeks before telling them.

Only after Matthews and two other operating room nurses wrote a long, scathing email to Danny Finn, Georgia Correctional HealthCare’s director of human resources, were steps taken to formally notify workers, records show.

“With regards to the recently found Asbestos, not once have we been formally addressed or notified by any member of our Management team that Asbestos is present in our environment and to what extent,” the nurses wrote on March 21, nearly three weeks after the tiles in the nursing unit had tested positive for the carcinogen.

Similar questions also were raised by a physician assistant, Laura Cain, in an email to Georgia Correctional HealthCare officials on March 12. Cain noted that “someone associated with environmental” determined that loose floor tiles in an office she shares with other PAs contained asbestos, yet no action had been taken.

“I found this a little concerning, especially since the 1A nursing unit was shut down and unfit for anyone to be on (duty) due to asbestos, but it was OK for us to continue to work in our office with exposed asbestos,” she wrote.

In that case, Department of Corrections officials deemed the room safe for occupancy after a sealant was applied to the floor, records show.

Christen Engel, Augusta University’s associate vice president for news and communications, wrote in an email that details about the asbestos were communicated to Georgia Correctional HealthCare employees when that information was made available to the agency’s administrators.

Sauls said he could not explain why some workers weren’t told immediately about the asbestos.

“We gave copious amounts of information in very timely periods of time,” he said. “How it was disseminated to people, I can’t attest to, but I was at numerous meetings … discussing these issues.”

Dust clouds

At a meeting on March 21 following the staff complaints, Hal Gibson, the director of engineering and construction services for the GDC, told hospital supervisors and others that the asbestos was not a threat.

Gibson told the group that the asbestos was encapsulated in the adhesive as well as the wax used to coat the floor. Even with regular buffing, the wax prevents the asbestos from becoming airborne, he said, according to the meeting minutes.

However, Dr. Timothy Young, the former prison physician who publicly detailed a litany of problems at the facility when he resigned as director of its outpatient clinic in January, said he and others often worried that they were being exposed to asbestos because of noticeable issues with the flooring.

Tiles have remained broken for years, exposing the adhesive below, and the floors are continuously buffed, producing clouds of dust, he said.

“We complained for years about the buffing of those tiles and the clouds, but it never stopped,” he said.

Asbestos was among the concerns Young said he included in his complaints about the facility last year to the Occupational Safety and Health Administration, the Environmental Protection Agency and the National Institute for Occupation Safety and Health.

A representative from the National Institute for Occupation Safety and Health, part of the Centers for Disease Control and Prevention, expressed a willingness to visit the prison. However, Sauls decided it wasn’t necessary because the GDC was far enough along with its own remediation plan.

Water on the floor

Despite such complaints, the Department of Corrections has largely viewed the discovery of asbestos in the nursing unit as a fluke event stemming from the cleaning.

In its order justifying an emergency expenditure of $68,500 for abatement of the asbestos in the unit, the department cited “flooring problems from (the) terminal cleaning process.”

David Smith, acting director of maintenance for the GDCsaid the amount of water BriTen Janitorial used in its cleaning caused the tiles to become loose. He believes the company changed its methods after the issue came to light because no further problems with the tiles were observed.

The owner of the firm, Brian Williams, vigorously disputed that claim and said the tiles were in poor condition before his company began its work.

“The abatement has been done, we are finishing the project and we have done nothing different,” he said. “(The trouble with the tiles) was a pre-existing condition. It has nothing to do with us. Whole patches of tile were missing.”

Gibson, in his discussion with hospital supervisors, also noted “isolated areas of broken tile” throughout the facility and indicated they would be abated, the notes from the meeting show.

As a result, the cost of the cleanup is likely to grow. The tab is already more than $200,000, including $134,568 for the terminal cleaning, records show.

Smith said the department assumes there’s asbestos in the tile throughout the building and will make sure it’s sealed and wet, but there’s little that can be done beyond that.

“Asbestos, in general, if it’s undisturbed, it doesn’t bother you,” he said. “That’s why frequently all you do is seal it.”

However, Linda Reinstein, president and CEO of the Asbestos Disease Awareness Organization, indicated a more expansive approach is necessary.

She said she was “deeply concerned” by the situation at the prison because, given the facility’s age, it could have many asbestos-related issues that have been ignored over the years.

“The only way anyone is now going to feel safe is if there’s an inspection throughout the entire building to identify additional asbestos-containing materials,” she said.

Reinstein knows the subject all too well. She started her nonprofit after her husband died from mesothelioma.

“I don’t minimize any of this,” she said. “If materials contain asbestos, then the hospital, the prison (system) and the university have a responsibility. As a mesothelioma widow, this is a reality for me.”

The asbestos risk

  • Asbestos refers to a group of minerals, including chrysotile, used for decades in floor and ceiling tiles, linoleum, pipe and duct insulation, roof shingles, vehicle brakes and other products needing fireproofing, insulating or soundproofing. Any home built before 1980 is likely to contain asbestos products. Other older buildings, including many hospitals and prisons built between the 1940s and 1970s, are also likely to have asbestos present.
  • Tiny asbestos fibers, too small to be seen by the human eye, can be released into the air when products with the mineral are disturbed or damaged. When they’re breathed in, the fibers may get trapped in the lung and remain there a long time.
  • No amount of asbestos is considered safe. Breathing asbestos can cause cancer of the lungs, the larynx and ovaries. It can also cause mesothelioma, a fatal tumor of the membrane of the chest and stomach. The disease may not develop until decades after exposure to the fibers.
  • OSHA sets standards for exposure in the workplace. The EPA is responsible for protecting state and local employees who may be exposed to asbestos in states including Georgia that do not have an OSHA-approved state occupational safety and health plan.

A troubled history

What else could go wrong at Augusta State Medical Prison? In a few months’ time over the past year, these problems have come to light:

  • Guards who beat inmates. In April 2017, three former guards were sentenced to probation for beating an inmate whose hands were cuffed behind his back. In July of that year, the Southern Center for Human Rights filed a federal lawsuit claiming a dozen inmates, many of them severely disabled, had been beaten by officers. The suit is pending in federal court.
  • Unsafe and unsanitary conditions. In a series of stories, the AJC detailed how trash was piled up outside the operating room, attracting flies and mosquitoes to the OR, and how other parts of the hospital had dirty floors and counters, leaking ceilings. black mold and other sanitation issues. Later, the AJC revealed that conditions were even worse, making the facility a breeding ground for infection.
  • Hospital staff fleeing. The AJC reported that security lapses were causing nurses and others to leave in fear for their lives.
  • Medical negligence. Dr. Timothy Young, who resigned his position as director of the facility's outpatient clinic in January, told the AJC that the prison system has failed to hold doctors accountable when their negligence caused inmate deaths.
  • Potentially deadly delays for medical careThousands of inmates were waiting months to undergo recommended tests or consult with specialists because of a massive backlog in the Department of Corrections' approval process, the AJC reported last year.
  • Secret recordings. The hospital’s top administrator was forced out after being caught secretly recording conversations with other corrections officials.