Janitors, Custodians, and Housekeepers Module 3: Biological Hazards

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

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

Janitors work in a variety of buildings:

Hospitals Schools Universities Laboratories Factories Offices Restaurants Stores Nursing Homes Clinics

Biological hazards janitors may encounter:

Blood and body fluids Pathogens
Viruses Bacteria Fungi Parasites

Rodents and rodent droppings Insects

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

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

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

Fungi

Aspergillis, Stachybotris

Parasites

Giardia, trichinella

What kinds of disease can pathogens cause?

Viruses Bacteria

AIDS, Hepatitis B, colds, flu, Herpes Intestinal diseases, Tuberculosis, Gonorrhea

Fungi
Parasites

Athletes foot, Farmers lung, Asthma/allergies

Giardiasis, Malaria, Trichinosis

How can you get these diseases?

The first step in preventing disease is to keep the organism from entering the body. There are three primary routes of entry:

Inhalation
Air

Ingestion

Contact
Bloodborne

Food, water

Infected person coughs or sneezes and spreads the pathogen through the air to others

Infected person doesnt 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

What are the main bloodborne pathogens?

Bloodborne Pathogen Diseases
Hepatitis B Virus (HBV) Hepatitis C Virus (HCV) Hepatitis B Hepatitis C

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 coinfection has both HIV and HCV.)

How can you be exposed in your work?

Occupational Exposure
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

Exposure Incident
Is a specific contact with blood or other potentially infectious material that is capable of transmitting a bloodborne disease

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

Getting a disease from exposure to a bloodborne pathogen

Risk of infection depends on several factors:
The pathogen involved The type/route of exposure The amount of virus in the

infected blood at the time of exposure blood involved in the exposure treatment was taken

The amount of infected

Whether post-exposure Specific immune response

of the infected individual

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.

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

Preventing exposure to bloodborne pathogens: Hand washing and protective clothing

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.

Preventing exposure to bloodborne pathogens:

Cleaning
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.

Preventing exposure to bloodborne pathogens:

Cleaning
Use appropriate or approved disinfectants as determined by the EPA (U.S. Environmental Protection Agency).
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.

Preventing exposure to bloodborne pathogens:

Cleaning
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.

Preventing exposure to bloodborne pathogens:

Laundry Area
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.

Preventing exposure to bloodborne pathogens:

Laundry Area
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

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

Additional Resources
WISHA Bloodborne Pathogens Information and Links Page
http://www.lni.wa.gov/Safety/Topics/AtoZ/BBPathogens/default.a sp http://www.osha.gov/SLTC/bloodbornepathogens/index.html

OSHA Bloodborne Pathogens Information and Links Page National Institute of Occupational Safety and Health (NIOSH) Bloodborne Pathogens Information and Links Page
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

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

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

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