3. Hazard Control - Midterm

7/29/2019 3. Hazard Control - Midterm

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HAZARD CONTROL


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GOVERNMENT REGULATORY

AGENCIESAffecting the dental

office with regards toprotection of employeesand patients frompotential hazardsassociated with tx


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1. Occupational Safety and

Health Administration (OSHA)Requires employers, including those in

the healthcare profession: 1. to establish and carry out a wide

range of procedures designed to protectemployees,

2. implement and maintain employeeexposure-incident records for the

duration of employment plus 30 years,and 3. provide specific protective equipment

(PPE) to protect staff from infectiousdiseases & other potential hazards


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Set specific guidelines for infectioncontrol & disease containment.

Does not have enforcement powerover dental practices but the OSHA

is charged with investigation andenforcement of the CDCsguidelines.

2. Centers for Disease Control

& Prevention (CDC)


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3. Environmental Protection

Agency (EPA) Regulates and registers certain

products used in dental practices,

including surface disinfectants.

It requires products to undergo

and pass specific testingrequirements prior to approval forregistration.


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4. Food and Drug

Administration (FDA) Regulates marketing of medical

devices that include equipment

and disposables items.

It reviews product labels for false

or misleading information andsufficient directions for use.


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Examples of chemicalgermicides regulated by FDA:

1.Antiseptics

2. Disinfectants3. Drugs

4.

Sterilizers


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5. Organization for Safety and

Asepsis Procedure (OSAP) National organization of teachers

practitioners, dental healthcareworkers, and manufacturers, anddistributors of dental equipment andproducts.

Develops and communicates standards

and information on aseptic techniqueto dental practices and educationalinstitutions to assist them in theefficacy of their infection controlprogram


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HAZARD COMMUNICATION

STANDARD EMPLOYEE RIGHT TO KNOW

LAW

-addresses the right of everyemployee to know the possibledangers associated with hazardous

chemicals & other related hazardsin the workplace.

- it requires employers to provide

methods for corrective action.


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Requisites to comply w/ HCS1. The dentist must develop &

implement a written compliance

program which include:a. exposure control plan

b. written hazard communication

programc. waste and sharp handlingmanagement

d. injury & illness prevention


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2. The dentist must also ensure thathazardous chemicals used in theoffice are properly labeled andhazardous substances havecorresponding MSDS available forstaff training and review.

3. The dentist must designate aprogram coordinator to providestaff training to new employees &once annually thereafter.


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Common hazardous materials

used in the dental office1. Mercury- used in silver filling

material to create amalgam2. Nitrous oxide sedation gases-

used for conscious sedation

3. Chemicals for dental x-rayprocessing- developer & fixer


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If mercury spill occurs, ADA

recommends the ff:1. If the spill occurs on carpeted floors, do

not use a vacuum cleaner to pick upthe droplets.

2. Pick up all visible droplets with anarrow bore tubing connected by awash-bottle trap to a low volume

aspirator on the dental unit. The trapbottle connections keep the mercuryin the bottle and prevent it from beingsucked back into the dental unit.


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3. Use adhesive tape to cleanup small spills.

4. If the spilled mercurydroplets cannot be reached,

dust sulfur powder on themto form a film coating ontop of the droplets


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5. Keep a commercialmercury spill kit on

hand. Follow themanufacturersdirections & documentthe circumstances of

the spill with the dateand the cleanupprocedure used.


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* Warning labelsmust beattached tocontainers,products andotherhazardousmaterials usedin the dentaloffice


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Label of these products mustinclude:

1. Identity of the chemical

2. Appropriate hazard warning

( including route of entry &target

organ)3. Name & address of themanufacturer


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Members of the dental healthteam should familiarize

themselves with the labels ofhazardous substances & beaware of how to clean up spills

or handle other emergenciesthat may arise when handlingthese products.


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Hazardous spill kit includes:

A. Absorbent material - to soak upthe liquid

B. Scooping device- for a no-touchmethod to pick up the material

C. Hazardous waste bag with abiohazard warning label


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MSDS-(Material Safety DataSheets)

- provides written information about thecontent & potential hazard of specificproducts

- Each potentially hazardous productmust have a corresponding MSDS onfile in the office

- Must be provided by the manufacturersor suppliers of products but it is thedentists responsibility to ensure thatthese sheets are obtained & kept up to

date


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OSHA requires each MSDScontain:

1. Identification (chemical andcommon names)

2. Hazardous ingredients3. Physical and chemicalcharacteristics(boiling point, vapor pressure,etc)

4. Fire and explosion data5. Health hazard data6. Reactivity data


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7. Spill and disposal procedures

8. Protection information

9. Handling and storage precautions,including waste disposal

10. Emergency and first aid

procedures11. Date of preparation of the MSDS

12. Name and address of the

manufacturer


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When is this conducted:

A. Provide for new employeesat the beginning ofemployment

B. Whenever a new

hazardous material isintroduced into the office

C. At least annually

thereafter


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Training must include:

a. Hazards of chemical & properhandling

b. The operation where hazardouschemicals are used

c. The availability of MSDSs

d. An explanation of the labeling ofhazardous chemicals

e. An explanation of OSHAguidelines


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Reducing Hazards in theDental Office

1. Keeping the number of hazardousmaterials to a minimum

2. Reading all product labels andfollowing direction for use

3. Storing hazardous chemicals in theiroriginal containers

4. Keeping containers tightly closed orcovered when not in use

5. Avoiding the combination of 2 or more

known hazardous chemicals


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6. Wearing appropriate personalprotective equipment (PPE) when usinghazardous chemicals or when there is

potential for accidental exposure oncontact with body fluids

7. Washing and thoroughly drying hands

before and after wearing gloves8. Keeping the office well ventilated and

avoiding skin contact with knownhazardous substances


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9. Keeping a

functionalfireextinguisher

in the office


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10. Knowing proper cleanupprocedures in the event of a

chemical spill

11. Disposing of all hazardous

chemicals and othersubstances in the accordancewith MSDS instructions or theproduct label


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Blood borne PathogensFinal Standard

- the most significant OSHA regulationaffecting healthcare practices.

- designed to protect dental officeemployees by limiting exposure toblood, saliva & other PIMS (potentiallyinfectious materials)

BBP- producing microorganism thatmay infect human


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Waste Management

Regulated medical waste

- liquid or semi-liquid body fluid

- this includes any items in the dentaloffice contaminated with regulatedwaste (ex. Cotton rolls or gauze) thatreleases bioburden when compressed

- items caked with dried body fluid thathave the potential to release bioburdenduring handling, contaminated sharps,and pathological & microbial wastes

containing body fluid


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Disposable sharps

Ex.- needles, scalpels,

burs, ortho wiresMust be disposed of in

puncture- resistant,

color-coded or labeled,red, closable, leak proofcontainers.


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Needles must berecapped using aone-handedscooping methodor a mechanical

device


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OSHA requires that full sharpscontainers be removed from the

office within 7 days of reaching thefill line on the container

Other regulated waste products,including those items saturated orvisibly caked with blood or saliva,must be disposed of in closable,leak-proof bags or covered

containers.


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The containersmust either be

red or have abiohazardwarning label ortag affixed tothem, readablefrom a distance of5 feet.


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- Contaminated refuse must bekept covered at all times.

- Receptacles must have a

properly fitting lid, preferablyone that can be opened usinga foot pedal


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Types of waste

Basic types:

1. Regulated medicalwaste

2. Non-regulatedmedical waste


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Contaminated waste

Items that have hadcontact with blood or

other body secretions


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Hazardous waste

Waste posing a risk

or peril to humanbeings or theenvironment


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Infectious waste

Waste capable ofcausing an infectious

disease


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Regulated waste

Infectious medical

waste that requiresspecial handling,

neutralization, anddisposal


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HEPATITIS B VACCINE

Required by OSHA to beadministered to all full-time

employees who are potentialrisk for bloodbornepathogens.

Must be made to allemployees at nocost/charge.


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Exposure Incidents

Consists of specific eye,mouth, or other mucous

membranes, non-intact skinor parenteral contact withblood or other PIMS that

directly results from theperformance of anemployees duties


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What to do? 1.Stop immediately

2.If it involves hands, remove the gloves

3.Injury should be treated with scrupulousfirst aid measures including the the ff.

a. if bleeding, squeeze it gently until a small

amount of blood is releasedb. wash hands thoroughly with antimicrobialsoap and water that is comfortably warm tohot


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c. after drying, apply a smallamount of antiseptic and coverwith bandage


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Waterline biofilms- these are film-forming microbes whichexcrete a glue-like substance that

anchors to the metals, plastic, tissue &soil particles.

- they attach themselves to the innersurfaces of plastic tubings used to keephandpieces cool and supply air-watersyringes where they create an idealenvironment for growth

Measures to improve the quality of


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Measures to improve the quality ofwater in their lines and minimize

disease transmission At the start of each day, run and discharge

water from the dental unit waterlines forseveral minutes

Run highspeed handpieces to release air andwater for 20-30 seconds after each patient

Always follow the manufacturers instructionsfor proper maintenance of handpieces and

waterlines Consider the options to improve water quality

such as special filters, chemical therapeutics,and separate water reservoirs


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FIRE AND EMERGENCYEVACUATION PROCEDURES

Employers are required by OSHA to have awritten fire safety policy consisting of training& the use & maintenance of fire extinguishers

Diagram must be provided that clearly marksthe exit routes in the event of fire

Posting of emergency phone #s forpolice,fire, and rescue is also required

Written evacuation & safety proceduresshould be provided in the areas susceptible toweather conditions, including hurricane,tornadoes, floods, and earthquakes


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The dentist has the legal responsibilityof looking after the protection of

employees & patients from potentialhazards associated with dentaltreatment but may delegate it to his

office manager or safety coordinator

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3. Hazard Control - Midterm