1. Control of Biological Agents

2. 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

3. WorkSafeBC Regulation Requirements Definitions Symptoms and Effects Method of Transmission Exposure Control Plan Agenda

4. Agenda (continued) Risk Identification & Assessment Controls Hepatitis B Vaccine Response Procedures Labeling and Identification

5. 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 WorkSafeBC OHS Regulation

6. Biological Agents include: Viruses Bacterium Prion Fungus Some other biological agents Definitions

7. Bloodborne Diseases Bloodborne pathogens such as: Hepatitis B and C (HBV, HCV) Other WorkSafeBC specified biohazardous materials Definitions

8. Occupational Exposure Reasonably anticipated exposure as a result of employment Definitions

9. 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 Symptoms and Effects

10. HIV Causes AIDS (Acquired Immune Deficiency Syndrome) May take many years before AIDS develops HIV attacks the body’s immune system AIDS is a fatal disease Symptoms and Effects

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

12. 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

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

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

15. Transmitted through contact with infected human blood and other body fluids such as: Method of Transmission Semen Vaginal fluids Cerebrospinal fluid Synovial fluid Pleural fluid Peritoneal fluid Amniotic fluid Saliva – HBV only

16. 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 Method of Transmission

17. 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 Method of Transmission

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

19. The Exposure Control Plan – continued Health monitoring Documentation

20. The Plan is based on: Statistical information History at similar workplaces Known exposures and/or near misses Input from workers Exposure Control Plan

21. Risk Assessment A systematic approach to quantify a risk Components include: Likelihood Frequency Consequence Risk Assessment

22. Identify at risk jobs/tasks. Examples include: Risk Assessment Police Firefighters Parks workers Solid waste disposal workers Cleaning Staff Sewage workers Recreation staff Plumbers Road Crews First Aid Attendants

23. 1.Elimination 2.Substitution 3.Engineering Controls 4.Work Practice Controls, which may include Standard Infection Control Precautions Good housekeeping practices Safe work procedures 5.Personal Protective Equipment Risk Controls

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

25. 2. Substitution Substitute the process with a less hazardous procedure Substitute the process with an alternate procedure Risk Controls

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

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

28. 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 Risk Controls

29. 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) Risk Controls

30. Work Practice Controls include: Safe Work Procedures Risk Controls

31. 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 Risk Controls

32. PPE may include: Face shields Gloves Aprons, gowns, shoe covers Risk Controls

33. 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

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

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

36. 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 Risk Controls

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

38. 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 Risk Controls

39. Risk Controls – Removing Disposable Gloves

40. 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 Risk Controls

41. 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 Risk Controls

42. 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 Risk Controls

43. 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 Risk Controls

44. Proper hand washing

45. Spill Cleanup and Decontamination Use proper PPE Spills must be cleaned up immediately Use a freshly mixed 1:10 bleach solution or an approved germicide / disinfectant Refer to written safe work procedures Risk Controls

46. 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 Exposure Response

47. 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 Exposure Response

48. 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 Exposure Response

49. 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) Exposure Response

50. Medical Evaluation Type of fluid or material Type of exposure Status of the source Status of the worker All medical information is confidential Exposure Response

51. 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) Exposure Response

52. 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. Vaccinations

53. 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 Review

54. Today’s discussion included: WorkSafeBC Regulations Definitions Symptoms and Effects Method of Transmission Exposure Control Plan Risk Assessments and Controls Exposure Response, and Vaccinations Summary

55. Questions