Port Macquarie Hastings Council

Biological Hazards

DRAFT - January 2006

Contents Introduction Definitions Responsibilities Procedure Vaccination Programs HEP A, B & Tetanus HIV Aids Dermatitis Infestations and Bites Plants and Plant Products Disposal of BIO Hazardous Waste Counselling POST Exposure Contractors Policy Links Audit Records Further Reading Appendix A B C D E Needle Stick Hazards (Discarded Syringe is Found - General Requirements) Garbage Waste Hazards Contact with Untreated Sewage Procedures for First Aid Personnel Sharps Collection Notification Form

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Introduction
Biological Hazards in the workplace are often overlooked, as they are to a certain extent, unseen by the naked eye. A wide variety of bio-agents encountered in the workplace may cause injury, irritation, sensitisation, infection, discolouration or other changes in the physiology of the exposed worker. In regards to potential contamination, it is human nature to tend to neglect or hope the infection will disappear without seeking medical help as soon as possible. Council will supply appropriate personal protective equipment, and regularly assess work procedures to prevent or minimise biological exposures in the workplace. Should you think that you have been exposed to a biological hazard you should report it to your supervisor as soon as possible and they will ensure the appropriate action is taken.

Definitions
PPE - Personal Protective Equipment Infection - occurs when micro-organisms which are capable of causing disease enter the body in sufficient numbers by a particular route and overcome that body's natural defences. Infectious Waste - any substances containing micro-organisms, helminths (parasites) or viruses which pose a substantial threat to the health of human beings or any other beneficial user of the environment due to their volume or virulence. Potentially Infectious Waste - waste which is contaminated with blood or other body fluids and which is generated during the treatment or investigation of any patient, even though an infection is not known or suspected to be present. Sharps - consist of sharp disposable objects of medical/laboratory equipment which when handled, may accidentally cause a penetrating injury of the skin. The most common sharps encountered are metal needles and broken glass. There are many others, such as disposable scalpel blades, lancets, ampoules, pipettes, tubes and syringes.

Responsibilities
Managers Ensure that necessary resources are available to allow implementation of this procedure. Offer support counselling to exposed or infected employees and their family as necessary.

Supervisors Ensure personnel are trained and supplied with appropriate biological PPE. Ensure first aid facilities are available and quick access to medical services is provided. Investigate all accidents involving blood or body fluids and report appropriately. New employees are competently inducted into working in exposure prone areas, and are familiar with prevention methods. Identify roles that may be at risk of exposure and arrange for their inclusion in vaccination program. Employees Ensure that procedures for prevention of exposure are adhered to at all times. Maintain awareness on job sites at all times, and risk assess for contaminants prior to commencing jobs. Comply with Councils vaccination program if required.

Procedure
If an employee has suffered a possible high-risk exposure to a biological contaminant, the following steps must be carried out as a minimum. 1. If an incident involves blood or body fluids, ensure the area has been washed thoroughly with water, soap or disinfectant where available. 2. Collect any samples of the contaminated source where possible. E.g. Syringe, insect etc. 3. Proceed to nearest Hospital for medical help immediately, and notify Councils Workers Compensation Officer and Safety Coordinator immediately. 4. Have accident report filled out promptly and submitted. 5. Offer counselling where required (consult HR Manager). 6. Review work procedures immediately on site and report recommendations or changes required.

Consequences of Exposure to Biological Hazards

Vaccination Programs HEP A, B & Tetanus
Council has vaccination programs in place to protect specific workers from viral infections. In particular, sewer workers, sewer plant maintenance staff and various inspecting officers that are likely to come in contact with potential infectious work environments, are covered via Councils vaccination program. Vaccination does not replace the requirement for proper work procedures. It is imperative to introduce safe work procedures in conjunction with vaccination to help prevent undue exposure. Generally, vaccinations are offered to staff in the following format (See table following):

Hepatitis A Sewer Workers Electricians (involved in sewer plant/public facility maintenance) Mechanical (involved in sewer plant/public facility maintenance) Communications (involved in sewer plant/public facility maintenance) Laboratory Staff

Hepatitis B Sewer Workers Electricians (involved in sewer plant/public facility maintenance) Mechanical (involved in sewer plant/public facility maintenance) Communications (involved in sewer plant/public facility maintenance) Laboratory Staff Crematorium (Cremator Operators) Rangers Trade Waste Inspector Water Construction Health Inspectors Parks & Gardens (Involved in lawns/garden maintenance) Waste Disposal Facility Attendants / Litter Collectors Community Service Staff First Aid Officers Lifeguards

Tetanus Sewer Workers Electricians (involved in sewer plant/public facility maintenance Mechanical (involved in sewer plant/public facility maintenance) Communications (involved in sewer plant/public facility maintenance) Laboratory Staff Crematorium (Cremator Operators / Grave diggers) Rangers Trade Waste Inspector Water Construction Health Inspectors Parks & Gardens (Involved in lawns/garden maintenance) Waste Disposal Facility Attendants / Litter Collectors

There are a number of different hepatitis viruses: A, B, C, D, E. They are all completely different, cause different illnesses and may require different treatment. Hepatitis C - is spread mainly through blood transfusions and drug injecting equipment. Currently, there is no vaccine for Hep C.

Hepatitis A
Hepatitis A is a viral infection of the liver which is associated with the symptoms of feeling unwell, aches & pains, fever, nausea, lack of appetite, abdominal discomfort & darkening of urine, which is followed by jaundice (yellowing of the eyeballs and skin). Infected people can pass the virus to others. It is usually transmitted when the virus from an infected person is swallowed. The virus can survive in the environment for several weeks in the right conditions e.g. in sewage.

Hepatitis B
Like Hep A, Hep B is a viral infection of the liver with similar symptoms. Hepatitis "B" - is spread by exposure to a virus in an infected person's body fluids. It is passed when a person's mucous membrane or breaks in the skin are exposed to bodily fluids.

Tetanus
Tetanus, sometimes called lock-jaw, is an acute disease caused by a neurotoxic exotoxin of the bacteria, Clostridium tetani. Early symptoms of infection with C. tetani include localised peripheral nerve and muscle spasms. As the organism multiplies at the wound site, toxin spreads via the bloodstream causing generalised spasms and convulsions. In Australia death occurs in about 10 per cent of cases. Spread of infection C. tetani (a bacillus) is a common environmental organism found in soil. Infection with the bacillus may occur after minor incidents (sometimes unnoticed punctures to the skin) or after major injury: compound fractures, any superficial wound obviously contaminated with soil etc. Disinfection of the wound site is important within 4 hours. Tetanus is not directly transmitted from person to person. Although immunity following complete vaccination is long lasting, maintenance of immunity with booster doses at 10 year intervals is recommended.

HIV Aids
Human Immunodeficiency Virus (HIV): a human retrovirus that leads to Acquired Immunodeficiency Syndrome (AIDS). Epidemiological studies throughout the world have demonstrated that the Human Immunodeficiency Virus (HIV) is transmitted three (3) ways: Through sexual intercourse; Through blood (principally through blood transfusions and the use of non-sterile injection equipment; also includes organ and tissue implants); From infected mother to infant (perinatal transmission). The majority of occupations and occupational settings within Local Government work, are not considered a risk of acquiring or transmitting HIV between workers.

Dermatitis
Dermatitis is a general term used to describe any inflammation of the skin. Contact dermatitis describes those conditions that result from direct contact of the skin with external agents. Irritant contact dermatitis defines conditions where only that part of the skin contacted by the external agent becomes inflamed. Allergic contact dermatitis results from skin contact with a sensitising agent which stimulates an allergic response. What causes contact dermatitis? How you develop contact dermatitis depends on: The type of agent you are exposed to, The strength or concentration of the agent How long and how often it touches the skin. Contact with a combination of chemicals, The effectiveness of preventative measures and personal protective equipment (PPE) A persons biological makeup.

What are the symptoms? Areas of irritated skin may be red, swollen, tender, hot, painful or itchy. If the reaction to an irritant is severe, the skin may blister or weep and can become crusty. There may be some scaling as the skin heals. Skin affected for several weeks by dermatitis tends to thicken and change to a deeper colour. If exposure occurs to a sensitising agent, the reaction may spread to involve other areas of the body. Physical, chemical and biological agents can cause dermatitis and other serious occupational skin diseases.

Infestations and Bites

Outbreaks of dermatoses caused by insects occasionally occur in a variety of occupations. Some examples include: Bites from mosquitoes and midges (sandflies), which breed in wet or moist areas in many parts of Australia, and which can cause severe reactions in some workers. Skin eruptions, caused by various mites associated with animal and vegetable products Dog bite victims should be treated for tetanus as soon as possible after an attack. Rats and mice should be eradicated whenever possible, as they harbor various diseases.

Plants and Plant Products

Many plants contain latex, gum or resin (saps), or bristles, which have a corrosive or irritant action on the skin. Some examples include: Gardeners, landscapers and nursery workers are typically exposed to plants, which may initiate allergic skin responses. Several grevillea species are notable examples. Cacti spikes are extremely irritant and may even have a tumour-promoting effect on the skin. Carpenters, joiners, polishers and finishers are all exposed to saps and fine dusts from woods. Timbers known to irritate and occasionally sensitise the skin are western red cedar, acacia, ash, birch, maple, mahogany, pine and spruce.

Disposal of BIO Hazardous Waste

All biological waste products or associate equipment must be handled, cleaned or disposed of properly. Any biological waste generated within Council should be treated as Potentially Infectious Waste. Examples of Bio Waste includes the following: Human tissue (excluding hair, teeth and nails) Bulk body fluids and blood Visibly blood stained disposal material and equipment Sharps Bio waste must be placed in yellow bags and containers identified with the Biohazard symbol marked prominently and permanently in black and yellow. (Symbol below)

Where yellow "Biological Hazard" plastic waste bags are used, double bagging is preferred to protect employees or contractors from spills. The bags should be sealed shut. Larger Sharps discard bins should also be sealed and only accessed by authorised collection persons. Any bio hazardous waste that cannot be safely disposed of (or cannot be disposed of within the requirements of the current guidelines) should be rendered as safe as possible, labelled, segregated, contained / securely stored at the source of generation and reported to the Safety Coordinator. Disposal of Sharps Containers Landfill sites have large 200 litre bins to deposit sharps collected in the smaller yellow field containers. A sharps collection company (SteriCorp NSW Pty Ltd) - collect the 200 litre bins on a monthly basis at all landfill sites. Under no circumstances are syringes to be disposed of in general waste bins. Glove Use: Gloves must be used in situations where the worker is potentially exposed to blood and/or body substances. Medical examination gloves that meet AS/NZS 4011: SingleUse Examination Gloves Specifications, should be used for all procedures that may involve direct skin or mucous membrane contact with blood or fluid capable of transmitting blood borne pathogens Protective Eyewear: Protective eyewear must be worn while performing any procedure where there is a likelihood of splashing or splattering of blood or other body substances.

Counselling POST Exposure

Counselling should be offered to all employees exposed to biological contaminants promptly after initial exposure where necessary. People exposed, tend to start worrying immediately in regard to normal contact with family (and sexual contact with partners). Employees need to be reassured and informed of the appropriate transfer controls available by appropriate professionals within the health / medical industry. Employees concerned that they have contracted a biological health ailment through Council work practices, can request a medical examination / test. Councils Workers Compensation Officer should be contacted for referral to an appropriate Doctor.

Contractors
All Contractors engaged on Council work sites shall be responsible for ensuring that Biological safety is a priority and comply as per regulations and relevant Australian Standard requirements and at their own expense. Failure by contractors to provide approved Biological safety systems in accordance with legislative or Council requirements shall be deemed as non-compliance, and dealt with by the appropriate Contract Manager within Council.

Policy Links
First Aid No.6 Asbestos No.13 PPE & C No.18 Chemicals & Substances No.23 Working Environment No.25 Managing Contractors OH&S Risks No.29

Audit Records
Risk Assessments Conducted Appropriate PPE worn Vaccination Program records Completed Sharps Collection Notification Forms

Further Reading
NSW Health Department website - www.health.nsw.gov.au National Code of Practice for the Control of Work-related Exposure to Hepatitis and HIV (bloodborne) viruses [NOHSC:2010 (2003)] for guidance about the risk management of occupational exposure to blood-borne pathogens. Synopsis of Zoonoses in Australia National Occupational Health and Safety Commission - Diseases Acquired from Animals National Occupational Health and Safety Commission Diseases of the Skin Australian Standards: AS 2243.3 Safety in laboratories - Microbiological aspects and containment facilities AS 3816 Management of Clinical or related Wastes AS 4011 Single-Use Examination Gloves Specifications AS 4031 Non reusable containers for collection of sharp medical items used in health care areas AS 4261 Reusable containers for the collection of sharp items used in human and animal medical applications.

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AS 4815 Office-based health care facilities - Reprocessing of reusable medical and surgical instruments and equipment, and maintenance of the associated environment AS 4939 Non-reusable personal use containers for the collection and disposal of hypodermic needles and syringes NSW WorkCover : Guide - Dermatitis The facts starting from scratch Guide - Notification Requirements for Occupational Exposure to Human Blood -Borne Pathogens. Code of Practice - Blood Borne Viruses

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Needle Stick Hazards

Discarded Syringe is Found - General Requirements
1.

APPENDIX A

Personal hygiene of a high standard is required. If you have any cuts, scratches, sores or broken skin, those areas must be covered by an effectively sealed waterproof dressing. Work boots & normal work clothes must be worn at all times. Beach Inspectors must, as far as is practically possible, wear footwear that will adequately give protection from needle stick injury. When working in the areas of parks and gardens, streets, gutters, drains and beaches, where there is a risk of needle stick injury, leather gloves must be worn. When carrying full plastic garbage bags, hold away from the body. If a syringe is found, do not recap, bend, break or pick up with bare hands: (a) (b) Bring the sharps collection kit to the syringe. Fit a pair of disposable (nitrile) gloves NOTE these ARE NOT needle stick proof gloves, but are to protect against mucous fluid & blood. Open & place the container on the ground beside the syringe (never hold the container) and pick up the syringe by the barrel by placing the sticky paddle on the barrel and place in the Sharps container. Seal lid. Never place hands into any hidden areas where the hands or fingers are not clearly visible.

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(c)

(d)

Note: If the stick paddles are not present, improvise with a pair of pliers or something similar to pick up the syringe.

7.

If the syringe cannot be picked up with the sticky paddles, is broken or has fluid present on the outside, it may, with great care, be picked up by the cylinder end only, with disposable (nitrile) gloves on hand and placed in the Sharps container. Take extreme caution against needle stick injury. Close the lid on the Sharps container. Once the syringe has been placed in the Sharps container, peel the disposable gloves off inside out and place them in a yellow bio waste hazard bag. Wash hands with soap or antiseptic and water. Remember - wash before handling or eating food and smoking. Record the number of syringes collected, the date, address, location etc on the Sharps Collection Notification Form (Appendix E). 12

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Dispose of Sharps containers at appropriately supplied disposal sites. These sites are as follows: Council Landfill sites Wauchope Carpark corner of Bransdon St & Young St. Port Macquarie Base Hospital Council Depots (Port, Wauchope, Laurieton) DO NOT put in normal waste.

13.

If a needle stick occurs, follow the Procedure as per page 4 of this document.

Syringe Collection Kit Councils syringe collection kits will contain the following: One (1) Zip up vinyl case to hold kit items. One (1) Yellow sharps container specifically designed to hold needles. Two (2) Pairs of disposable nitrile gloves. One (1) Pair disposable stick paddles (to pick up syringe) One (1) Antiseptic wipe One (1) Yellow Bio Hazard waste bag & tie Note: Additional supplies are held in stores and should be replaced directly after use.

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Garbage Waste Hazards

Associated Risk:

APPENDIX B

Finding syringes and accidental needle stick injury (refer to General Requirements Appendix A ) Contact with fluids of unknown origin leaking from garbage waste.

1. 2.

Work boots & normal work clothes must be worn at all times. Waterproof gumboots must be worn where there is the likelihood of absorption of unknown waste liquids. Disposable Kleengard overalls must be worn over normal work clothes where there is any risk of being exposed to unknown waste liquids. The hood on the disposable overalls is to be used to advantage when required. Where practicable, leather gloves must be worn. Waterproof gloves are to be worn if there is any risk of being exposed to unknown liquid waste. Safety glasses or goggles are to be worn if there is any likelihood of the eyes being exposed to unknown liquid waste. If machinery is at the tip and cannot be removed away from the garbage area and work has to take place under the plant with the worker reclining, a barrier made out of sheet metal or similar impenetrable material must be put into place. If entry into machinery, e.g. compactor, has to be made where waste cannot be thoroughly removed, a barrier made out of sheet metal or similar impenetrable material must be put in place if practicable. All personnel involved must wash their hands with soap and water as a minimum standard before handling food, eating or smoking.

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Contact with Untreated Sewage

1.

APPENDIX C

Adequate Personal Protective Equipment (PPE) must be worn where contact with untreated sewage takes place. Where necessary, wear a pair of Kleengard disposable overalls over the top of normal work clothes. Where possible, Gauntlet type waterproof gloves are to be worn. Safety glasses or goggles are to be worn if there is a risk of foreign matter being splashed into the eyes. A number of virus infections are present in untreated sewage and may be transmitted by ingestion and may also be introduced through cuts, sores and abrasions. These skin ailments must be suitably dressed with an effectively sealed waterproof bandage. Supervisors should restrict entry of personnel with severe wounds. Persons engaged in sewer main maintenance, clearing sewer chokes, de-sludging pumping stations and the repair of submersible pumping equipment, must take adequate precautions against infection. Before repairs are carried out on any equipment or work area, which has had contact with sewage and where gloves cannot be worn, the equipment should be decontaminated by washing down with high-pressure water jet or steam cleaning. When cleaning up foreign matter or cleaning blockages (chokes), tools are to be used that preclude, as much as is reasonably possible, the use of hands, which may be subject to penetration by syringes or other objects. Clothing should be changed and washed daily and hands washed immediately after handling contaminated material. Remove the protective clothing, dispose of disposable PPE properly and disinfect permanent PPE equipment. All personnel involved must wash hands with soap or antiseptic and water as a minimum standard before handling food, eating or smoking. Employees should not smoke whilst handling contaminated equipment because of the possibility of transferring organisms to the mouth. Rats and mice should be eradicated whenever possible at all sewage worksites, rats in particular are a carrier of Leptospirosis. People usually acquire the disease from the urine of animals infected with Leptospira bacteria.

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Procedures for First Aid Personnel

Note:

APPENDIX D

Your First Aid course has already addressed this matter in some detail, however it is believed that some reinforcement in respect of diseases transferred by body fluids is required.

Associated Risk: If First Aid attendants are exposed to contaminated body fluids. A risk of contracting Hepatitis "B" or other diseases may occur. Precautions 1. If you are a nominated First Aid Officer, ensure your Hepatitis "B" vaccination is current. Personal hygiene of a high standard is required. If you have any cuts, scratches, dermatitis or eczema (any break in the skin), those areas must be covered by a sealed waterproof dressing. If you have any weeping wounds or dermatitis, you are not to undertake first aid official duties. You must nominate another qualified First Aid attendant to carry out treatments. When treating the injured, always wash hands and fit disposable gloves. Wear safety glasses when blood is likely to be sprayed or splashed. Decontaminate surfaces and equipment that have to be re-used, with antiseptic or diluted bleach solution. Practice good housekeeping with all equipment. Where practicable, use disposable equipment. Any bandages etc or disposable equipment must be placed in a yellow Bio Hazard waste bag (Black writing / bio hazard symbol), then sealed and made available for collection by Councils Waste Supervisor. If clothing has been contaminated, remove and wash the garments or dispose of. As a minimum requirement, wash hands thoroughly with soap and water after giving treatment. If giving mouth-to-mouth resuscitation. It is highly recommended that resuscitation masks be used as a matter of precaution.

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If you believe that the body fluids of an injured person may have made contact on an area of your skin that is broken: o o o o Wash affected area with soap and water and antiseptic and water. Proceed to your Doctor or Hospital. Provide your Supervisor with full details and fill in an Accident Report. Appropriate counselling and education will be given to you or your family on request.

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APPENDIX E

Sharps Collection Notification Form

This form is to be used to record the collection and appropriate disposal of sharps that are found in the workplace. Complete and return this form to your Supervisor when sharps are found on a work site.

Date Found

Address where sharps found

Specify Location (toilet, garden bed, playground, drain etc)

Amount Found

Employee Name (reporting):______________________________________________ Supervisor Name:_______________________________________________________ Section Name:__________________________________________________________

Note: Once sharps are found and safely placed in the small plastic sharps
container, dispose of containers properly at the nearest disposal facility. Disposal Facilities are usually placed within the community as 240 litre large specialised disposal bins. If these cannot be located, transport containers back to one of the 3 Council depots and place in large Yellow sharps bin. Councils Waste Supervisor Steve Robb (Contact Mobile 0419 419690) will organise collection and disposal from there.

Forward completed form to Safety Coordinator.

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