Control of Biological Agents

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

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

Agenda

Agenda (continued)

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

• 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

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

Definitions

• Bloodborne Diseases• Bloodborne pathogens such as:

• Hepatitis B and C (HBV, HCV)• Other WorkSafeBC specified biohazardous

materials

Definitions

• Occupational Exposure• Reasonably anticipated exposure as a

result of employment

Definitions

• 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

• 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

• Hepatitis B Virus (HBV)• Short or long term liver swelling• Permanent liver damage and scarring

(cirrhosis)• Liver cancer in some

Symptoms and Effects

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

• 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

Symptoms and Effects

• Hepatitis C Virus – continued

• Often no symptoms initially• 90% become chronically infected• 1 – 2 % of population in BC is affected

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

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

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

Method of Transmission

• The Exposure Control Plan must:• Be in writing• List responsibilities• Include:

• Risk assessment• Training• Written work procedures• Hygiene and decontamination facilities

Exposure Control Plan

Exposure Control Plan

• The Exposure Control Plan – continued

• Health monitoring• Documentation

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

Exposure Control Plan

• Risk Assessment• A systematic approach to quantify a risk• Components include:

• Likelihood• Frequency• Consequence

Risk Assessment

• Identify at risk jobs/tasks. Examples include:

Risk Assessment

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

1. Elimination• Must be the 1st option

• Is it necessary to do the task?• Can it be done another way?

Risk Controls

2. Substitution• Substitute the process with a less

hazardous procedure• Substitute the process with an alternate

procedure

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

Risk Controls

4. Work Practice Controls• Reduce the likelihood of exposure by

altering the way a task is performed

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

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)

Risk Controls

• Work Practice Controls include:• Safe Work Procedures

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

Risk Controls

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

Risk Controls

Risk Controls

• Safe Work Procedures

• General Rules• Wash hands and remove protective

clothing before eating, drinking, smoking, handling contact lenses, applying lip balm or cosmetics

Risk Controls

Risk Controls

• General Rules - continued

• Keep hands away from eyes, nose, and mouth

• Frequent hand washing is best defense against spreading infection

• 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

• 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

• 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

Risk Controls – Removing Disposable Gloves

• 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

• 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

• 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

• 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

Proper hand washing

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

Questions