Control of Biological Agents

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Control of Biological Agents
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Training Objectives

• By the end of this session participants will
• Understand WorkSafeBC Regulations regarding this
  topic
• Understand the purpose of the program
• Be able to identify Biological Hazards and
  control procedures

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Agenda

• WorkSafeBC Regulation Requirements
• Definitions
• Symptoms and Effects
• Method of Transmission
• Exposure Control Plan

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Agenda (continued)

• Risk Identification Assessment
• Controls
• Hepatitis B Vaccine
• Response Procedures
• Labeling and Identification

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WorkSafeBC OHS Regulation

• Compile list of tasks with possible exposure
• If exposure is possible, an Exposure Control Plan
  is required
• Develop work procedures
• Labeling of materials
• Vaccination available

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Definitions

• Biological Agents include
• Viruses
• Bacterium
• Prion
• Fungus
• Some other biological agents

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Definitions

• Bloodborne Diseases
• Bloodborne pathogens such as
• Hepatitis B and C (HBV, HCV)
• Other WorkSafeBC specified biohazardous materials

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Definitions

• Occupational Exposure
• Reasonably anticipated exposure as a result of
  employment

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Symptoms and Effects

• HIV Human Immunodeficiency Virus
• Causes AIDS
• No cure or vaccination
• HBV Hepatitis B virus
• Causes liver disease
• Vaccination available
• HCV Hepatitis C virus
• Causes liver disease, liver cancer
• No cure

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Symptoms and Effects

• HIV
• Causes AIDS (Acquired Immune Deficiency Syndrome)
• May take many years before AIDS develops
• HIV attacks the bodys immune system
• AIDS is a fatal disease

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Symptoms and Effects

• Hepatitis B Virus (HBV)
• Short or long term liver swelling
• Permanent liver damage and scarring (cirrhosis)
• Liver cancer in some

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Symptoms and Effects

• Hepatitis B Virus - continued
• Symptoms range from flu-like to none at all
• Person is infectious even if no symptoms
• 1 die from initial infection
• 10 are chronically infected

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Symptoms and Effects

• Hepatitis C Virus (HCV)
• Acute and chronic liver disease
• More likely to cause chronic hepatitis, liver
  scarring and liver cancer than HBV

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Symptoms and Effects

• Hepatitis C Virus continued
• Often no symptoms initially
• 90 become chronically infected
• 1 2 of population in BC is affected

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Method of Transmission

• Transmitted through contact with infected human
  blood and other body fluids such as

• Semen
• Vaginal fluids
• Cerebrospinal fluid
• Synovial fluid
• Pleural fluid
• Peritoneal fluid
• Amniotic fluid
• Saliva HBV only

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Method of Transmission

• May be transmitted in 3 ways
• Through cut or punctured skin
• Splash of infectious fluid on mucous membranes
  (eyes, mouth, nose)
• Splash of infectious fluid onto non-intact skin

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Method of Transmission

• HIV
• very fragile outside the human body
• HBV
• can live in dried blood for 10 days or more
• HCV
• unknown how long it survives in the environment

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Exposure Control Plan

• The Exposure Control Plan must
• Be in writing
• List responsibilities
• Include
• Risk assessment
• Training
• Written work procedures
• Hygiene and decontamination facilities

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Exposure Control Plan

• The Exposure Control Plan continued
• Health monitoring
• Documentation

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Exposure Control Plan

• The Plan is based on
• Statistical information
• History at similar workplaces
• Known exposures and/or near misses
• Input from workers

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Risk Assessment

• Risk Assessment
• A systematic approach to quantify a risk
• Components include
• Likelihood
• Frequency
• Consequence

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Risk Assessment

• Identify at risk jobs/tasks. Examples include

• Police
• Firefighters
• Parks workers
• Solid waste disposal workers
• Cleaning Staff
• Sewage workers
• Recreation staff
• Plumbers
• Road Crews
• First Aid Attendants

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Risk Controls

• Elimination
• Substitution
• Engineering Controls
• Work Practice Controls, which may include
• Standard Infection Control Precautions
• Good housekeeping practices
• Safe work procedures
• Personal Protective Equipment

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Risk Controls

• 1. Elimination
• Must be the 1st option
• Is it necessary to do the task?
• Can it be done another way?

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Risk Controls

• 2. Substitution
• Substitute the process with a less hazardous
  procedure
• Substitute the process with an alternate procedure

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Risk Controls

• 3. Engineering Controls
• Remove or isolate the hazard(s)
• Use of
• tools to control
• sharps containers
• splatter guards
• biohazard cabinets
• good laboratory practices

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Risk Controls

• 4. Work Practice Controls
• Reduce the likelihood of exposure by altering the
  way a task is performed

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Risk Controls

• Work Practice Controls include
• Standard Infection Control Precautions
• Treat all human blood and other potentially
  infectious materials as infectious.
• Take appropriate precautions in all cases
• Do not assume there is low risk

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Risk Controls

• Work Practice Controls include
• Housekeeping practices
• Identify locations of concern
• Clean high risk areas
• Size and nature of the spill
• Cleaning instructions
• Type of disinfectant (MSDS)

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Risk Controls

• Work Practice Controls include
• Safe Work Procedures

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Risk Controls

• 5. Personal Protective Equipment (PPE)
• Vital in all situations
• Must be available to workers
• Must be suitable to the hazard
• Workers must be instructed in its use
• Must fit properly

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Risk Controls

• PPE may include
• Face shields
• Gloves
• Aprons, gowns, shoe covers

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Risk Controls

• Safe Work Procedures

• General rules
• Handling and disposal of contaminated laundry
• Picking up sharps
• Removing disposable gloves
• Handling garbage
• Hand washing
• Spill cleanup
• What to do if exposed

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Risk Controls

• General Rules
• Wash hands and remove protective clothing before
  eating, drinking, smoking, handling contact
  lenses, applying lip balm or cosmetics

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Risk Controls

• General Rules - continued
• Keep hands away from eyes, nose, and mouth
• Frequent hand washing is best defense against
  spreading infection

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Risk Controls

• Contaminated Laundry
• Isolate and minimize handling
• Separate contaminated laundry from other laundry
• Bag the laundry at point of use
• Identify if taken to outside facilities
• Do not sort or rinse on site

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Risk Controls

• Picking Up Sharps (1)
• Must be trained
• Use the proper equipment and PPE
• No sharps in pockets
• Do not put sharps in regular garbage

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Risk Controls

• Picking Up Sharps (2)
• Disposable waterproof gloves
• Place container next to sharp (do not hold)
• Use tongs or pliers (or pick up by shaft)
• Place the needle end or sharp end first
• Do not fill container
• Dispose of container

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Risk Controls Removing Disposable Gloves
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Risk Controls

• Handling Garbage (1)
• Handle as little as possible
• Watch for sharps
• Do not compress
• Do not reach into containers with bare hands
• Do not pick up loose garbage unless using
  puncture/liquid resistant gloves

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Risk Controls

• Handling Garbage (2)
• Do not completely fill bags
• Hold by top of bag only
• Hold away from the body
• Do not support bottom of bag with your hand

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Risk Controls

• Hand Washing (1)
• One of the most important and easiest prevention
  practices
• Frequent hand washing is the best defense against
  spreading infection
• Keep hands away from your eyes, nose and mouth

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Risk Controls

• Hand Washing (2)
• Wash hands and remove protective clothing
• Before eating, drinking, smoking, handling
  contact lenses, applying lip balm or cosmetics
• Suspect glove torn or leaking
• After removing gloves
• After contact with with blood or body fluids
• Before leaving work area

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Proper hand washing
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Risk Controls

• Spill Cleanup and Decontamination
• Use proper PPE
• Spills must be cleaned up immediately
• Use a freshly mixed 110 bleach solution or an
  approved germicide / disinfectant
• Refer to written safe work procedures

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Exposure Response

• What to do if exposed (1)
• Get First Aid if injury requires it
• Get medical attention immediately
• Report the incident to your supervisor
• Document complete the report form

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Exposure Response

• What To Do If Exposed (2)
• Sharp Injury or Bite
• Let the wound bleed freely
• Promote bleeding
• Wash the affected area
• Seek medical attention immediately

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Exposure Response

• What To Do If Exposed (3)
• Contact With Intact Skin
• Immediately wash exposed area
• Do not use bleach or caustic disinfectant
• Vehicles should carry waterless hand cleaner
• Remember intact skin is a barrier to
  transmission of diseases

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Exposure Response

• What To Do If Exposed (4)
• Contact With Non-Intact Skin or Mucous Membranes
• Immediately flush the affected area with large
  amounts of water
• Seek medical attention immediately (treat as a
  medical emergency)

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Exposure Response

• Medical Evaluation
• Type of fluid or material
• Type of exposure
• Status of the source
• Status of the worker
• All medical information is confidential

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Exposure Response

• Reporting the Exposure
• Report all exposures/injuries where
• injury penetrates through intact skin or mucous
  membrane
• there is an exposure to non-intact skin (healing
  wound, dermatitis, chapped or scraped skin)

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Vaccinations

• If a vaccine is available for a known
  occupational hazard (as per WorkSafeBC
  Regulation) the employer will make it available
  to workers free of charge.

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Review

• Protect yourself on and off the job know what
  you are working with
• Practice good personal hygiene
• Follow procedures. Use gloves and protective
  clothing
• Wash your hands often
• Keep areas clean - report problems immediately to
  supervisors

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Summary

• Todays discussion included
• WorkSafeBC Regulations
• Definitions
• Symptoms and Effects
• Method of Transmission
• Exposure Control Plan
• Risk Assessments and Controls
• Exposure Response, and
• Vaccinations

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Questions