1. Janitors, Custodians, and Housekeepers Module 3: Biological Hazards

2. This module: Will demonstrate that janitors, custodians, and housekeepers may complete many different tasks Is one in a series of modules that will discuss hazards janitors, custodians, and housekeepers may encounter Will cover exposure to biological hazards and provide tips for prevention –Module 1 will cover chemical hazards from cleaning products –Module 2 will cover physical hazards –Module 4 will cover musculoskeletal hazards –Module 5 will cover removing graffiti –A stand alone module entitled “Working Alone in Safety” may also be of interest Provide sources of additional information

3. Janitors may have a large variety of tasks: Vacuuming Sweeping and Mopping Waxing floors Cleaning bathrooms Dusting furniture Moving furniture Emptying trash Restocking supplies Wiping counters Scrubbing Unstopping drains/ repairing faucets Mowing lawns Removing stains Heating/Air conditioning Ventilation Pest control Maintaining and cleaning doors and windows Delivery/Pick up of items Extra security Weather emergencies Lab spills Helping with disabled cars Minor repairs Painting and carpentry

4. Janitors work in a variety of buildings: Hospitals Schools Universities Laboratories Factories Offices Restaurants Stores Nursing Homes Clinics

5. Biological hazards janitors may encounter: Blood and body fluids Pathogens –Viruses –Bacteria –Fungi –Parasites Rodents and rodent droppings Insects

6. Focus of this module This module will focus on contact with blood or other potentially infectious material (OPIM) such as pathogens. They are most likely to be encountered by workers in: –Hospitals –Nursing Homes –Clinics –Laboratories

7. Focus of this module You will learn: What pathogens are and what kinds of diseases they cause How you may be exposed What to do if you are exposed Methods for preventing exposure in your job –Universal precautions –Hand washing and protective clothing –Cleaning contaminated areas –Working in the laundry area

8. What is a Pathogen? PATHOGEN: a microorganism that can cause disease Examples Viruses very small, packages of genetic material; need living hosts to reproduce HIV, influenza Bacteria one-celled living organisms; do not need living hosts to reproduce E. coli, salmonella Fungi includes yeasts and molds; plants that live by decomposing and absorbing the organic material in which they grow Aspergillis, Stachybotris Parasites plants or animals that live upon, or within, other living hosts from which they obtain some advantage, like nutrients Giardia, trichinella Four main groups of microorganisms:

9. What kinds of disease can pathogens cause? VirusesAIDS, Hepatitis B, colds, flu, Herpes Bacteria Intestinal diseases, Tuberculosis, Gonorrhea Fungi Athlete’s foot, Farmer’s lung, Asthma/allergies ParasitesGiardiasis, Malaria, Trichinosis

10. How can you get these diseases? Contact Bloodborne Ingestion Food, water Inhalation Air The first step in preventing disease is to keep the organism from entering the body. There are three primary routes of entry: Infected person coughs or sneezes and spreads the pathogen through the air to others Infected person doesn’t wash hands properly (virus in the feces), handles or prepares food/water and contaminates it Infected person transmits pathogen through a route that involves blood/mucous membrane/ sexual contact

11. What are the main bloodborne pathogens? Bloodborne Pathogen Diseases Hepatitis B Virus (HBV)Hepatitis B Virus (HBV) – Hepatitis B Hepatitis C Virus (HCV)Hepatitis C Virus (HCV) – Hepatitis C Human Immunodeficiency Virus (HIV)Human Immunodeficiency Virus (HIV) – AIDS (Note: A person can have co-infections - two or more infections in the body at the same time. For example,a person having HIV/HCV co- infection has both HIV and HCV.)

12. Means reasonably anticipated skin, eye, mucous membrane, or parenteral (piercing of the skin) contact with blood or other potentially infectious material (OPIM) that may result from the performance of an employee's duties Occupational Exposure How can you be exposed in your work? Is a specific contact with blood or other potentially infectious material that is capable of transmitting a bloodborne disease Exposure Incident

13. How can bloodborne pathogens enter your body? Bloodborne pathogens can enter your body through A break in the skin (cut, burn, lesion, etc.) Mucus membranes (eyes, nose, mouth) Sexual contact Other modes

14. Getting a disease from exposure to a bloodborne pathogen  The pathogen involved  The type/route of exposure  The amount of virus in the infected blood at the time of exposure  The amount of infected blood involved in the exposure  Whether post-exposure treatment was taken  Specific immune response of the infected individual Risk of infection depends on several factors:

15. What should you do if you are exposed? If you are stuck by a needle or other sharp or get blood in your eyes, nose, mouth, or on broken skin: –Immediately flood the exposed area with water and clean any wound with soap and water or a skin disinfectant if available. –Report this immediately to your employer. –Seek immediate medical attention.

16. Preventing exposure to bloodborne pathogens: universal precautions Implement Universal Precautions according to the Bloodborne Pathogens Standard: Treat all blood and other potentially infectious materials with appropriate precautions such as: –Use gloves, masks, and gowns if blood or OPIM exposure is anticipated. Use engineering and work practice controls to limit exposure

17. Preventing exposure to bloodborne pathogens : Employers must: –Provide readily accessible hand washing facilities. –Ensure that employees wash their hands and any other skin with soap and water after contact with blood or OPIM. –Ensure that employees flush mucous membranes with water as soon as feasible after contact with blood or other potentially infectious materials. Protective clothing must: –Be removed before leaving the room –Disposed of in an appropriately designated area or container for storage, washing, decontamination or disposal. Hand washing and protective clothing

18. Preventing exposure to bloodborne pathogens: Cleaning and decontamination of affected areas Determine and implement an appropriate written schedule for cleaning and methods of decontamination. This written schedule must be based on the: –Location within the facility. –Type of surfaces to be cleaned. –Type of soil present. –The tasks or procedures to be performed in the area. Cleaning

19. Preventing exposure to bloodborne pathogens: Use appropriate or approved disinfectants as determined by the EPA (U.S. Environmental Protection Agency). http://www.epa.gov/oppad001/chemregindex.htm http://www.epa.gov/oppad001/chemregindex.htm Fresh solutions of diluted household bleach made up every 24 hours are also considered appropriate for disinfection. Contact time for bleach is generally considered to be the time it takes the product to air dry. All equipment and environmental and working surfaces need to be cleaned and decontaminated after contact with blood or other potentially infectious materials. Cleaning

20. Preventing exposure to bloodborne pathogens: Cleaning and decontamination of affected areas All bins, pails, cans, and similar receptacles intended for reuse which may have become contaminated: –cleaned and decontaminated immediately or as soon as feasible upon visible contamination –need to be inspected and decontaminated on a regularly scheduled basis and Reusable sharps containers must not be opened, emptied or cleaned manually or in any other manner that would expose employees to the risk of percutaneous injury. Cleaning

21. Preventing exposure to bloodborne pathogens: Bagging and handling of contaminated laundry, with a minimal amount of agitation, at the location where it was used Contaminated laundry shall not be sorted or rinsed in the location of use and must be transported to the laundry for decontamination in bags or containers labeled or color-coded When universal precautions are used in the handling of all soiled laundry alternative labeling or color-coding is sufficient if it permits all employees to recognize the containers as requiring compliance with universal precautions. Laundry Area

22. Preventing exposure to bloodborne pathogens: Other Recommended Good Practices: Melt away bags that can be thrown directly into washers without having to unload or remove contaminated laundry from bags. Rinsing soiled laundry in utility rooms is acceptable, if it is not contaminated with blood, OPIM, or does not contain sharps. Do not hold contaminated laundry bags close to the body or squeeze when transporting Laundry Area

23. References used for this overview: OSHA Hospital eTool http://www.osha.gov/SLTC/etools/hospital/index.html What Are Bloodborne Pathogens? http://wishatraining.lni.wa.gov/training/presentations/BBP _ROCDD.ppt International Labor Organization - International Hazard Datasheets on Occupation http://www.ilo.org/public/english/protection/safework/cis/ products/hdo/htm/cleaner.htm

24. Additional Resources WISHA Bloodborne Pathogens Information and Links Page http://www.lni.wa.gov/Safety/Topics/AtoZ/BBPathogens/default.a sp http://www.lni.wa.gov/Safety/Topics/AtoZ/BBPathogens/default.a sp OSHA Bloodborne Pathogens Information and Links Page http://www.osha.gov/SLTC/bloodbornepathogens/index.html http://www.osha.gov/SLTC/bloodbornepathogens/index.html National Institute of Occupational Safety and Health (NIOSH) Bloodborne Pathogens Information and Links Page http://www.cdc.gov/niosh/topics/bbp/ http://www.cdc.gov/niosh/topics/bbp/ EPA's Registered Antimicrobial Products Effective Against Certain Bloodborne/Body Fluid Pathogens http://www.epa.gov/oppad001/chemregindex.htm

25. Additional Resources WISHA Core Safety Rules (WAC 296-800) http://www.lni.wa.gov/wisha/rules/corerules/default.htm (Basic safety and health rules needed by most employers in Washington State) Workplace Safety and Health http://www.lni.wa.gov/Safety/default.asp

26. WISHA Consultation Services Safety & Health program review and worksite evaluation By employer invitation only Free Confidential No citations or penalties Letter explains findings Follow-up all serious hazards For additional assistance, you can call one of our consultants. Click below for local L&I office locations: http://www.lni.wa.gov/Safety/Basics/Assistance/Consultation/consult ants.asp

27. Thank you for taking the time to learn about safety and health and how to prevent injuries and illnesses.