This section covers highlights of Communicable Disease Exposure
Plan. For more information please refer to the Plan directly.
Slide 3
Application The City of Joplin has an obligation to the public
and to its own staff to increase awareness and promote procedures
which prevent exposure of its employees to communicable diseases on
the job
Slide 4
Relevance Communicable diseases are dangerous. If you dont take
precautions to protect yourself, one incident could result in
acquiring a disease you must deal with for the rest of your life.
You cant UN-contract a disease!
Slide 5
Goals & Objectives Provide the employee with the processes
to follow in the event of an occupational exposure incident.
Provide revised and updated information on procedures which affect
occupational exposure through annual review of the Communicable
Disease Plan This plan has been developed with the assistance of
employees who are responsible for those who have potential exposure
to source individuals or contaminated items, chemicals and
substances due to the nature of their jobs Inform all employees of
information included in Communicable disease plan Employees will
sign an acknowledgement of this plan Employees in certain
classifications, will have additional training provided Certificate
of completion shall be awarded upon having completed the training
and this certificate shall be retained in the employees file in
Human Resources.
Slide 6
Personnel at Risk for Exposure Police Department High Risk
Police Officers Police Corporals Police Sergeants Detention Officer
Jail Cooks Jail Shift Supervisors Tasks that put these individuals
at high risk: Assisting the public on medical related calls
Physical confrontations while making arrests Crime scene
investigations Other Police Department personnel may have some risk
associate with job
Slide 7
Personnel at Risk for Exposure Fire Department High Risk
Firefighter/EMT Fire Driver/Engineer Fire Captain These positions
require tasks that put the individuals at high risk for contact
with blood or other bodily fluids Other Fire Department personnel
may have some risk associated with job
Slide 8
Personnel at Risk for Exposure Health Department High Risk RN,
LPN WIC Certifier WIC Nutritionist Epidemiology Specialist Animal
Control Officer Tasks that put these individuals at high risk:
Testing for diseases which involves puncturing the skin
Immunizations Treatment of allergic reactions Investigation of
communicable disease incidents Performance of animal control
activities Other Health Department Personnel may have some risk
associated with job
Slide 9
Personnel at Risk for Exposure Wastewater Treatment Plant/Sewer
Maintenance High Risk Waste Water Plant Operator, Technician,
Supervisor Waste Water Pre-Treatment Inspector, Relief Operator
Equipment Operator Laborer Relief Laborer Infrastructure
Maintenance Supervisor Heavy Equipment Operator Utility Locator
Tasks that put these individuals at high risk: Wastewater sampling
and testing Facility and equipment maintenance Clean up of raw
sewage spills and overflows Other Waste Water Treatment Personnel
may have some risk associated with job
Slide 10
Personnel at Risk for Exposure Parks / Cemeteries, Athletic
Complex, Fields and Facilities Departments High Risk Lifeguards
Tasks that put these individuals at high risk: Cleaning pool areas
throughout the day Performing first aid Providing swimming rescues
Other Parks Department Personnel may have some risk associated with
job
Slide 11
Personnel at Risk for Exposure Recycling Department Personnel
High Risk Recycling Laborer Tasks that put these individuals at
high risk: Separation and handling of the used recyclable items
which may include needles, lancets or other OPIM in trash brought
to the center Picking up of litter inside and outside fenced area
of the Recycling Center Other Recycling Department Personnel may
have some risk associated with job
Slide 12
Other Personnel at Risk for Exposure All other employees Any
employee that has an occupational contact with blood or body
fluids, wastewater, infectious materials, and airborne contaminates
arising out of and in the course of City of Joplin employment would
be assessed on a post-exposure basis and administered any
applicable testing or vaccination on an as needed basis.
Slide 13
Methods of Compliance All body fluids or OPIM should be
considered potentially infectious and precautions should be taken
to prevent exposure to them The following list of precautions that
can be used to reduce exposures to communicable diseases in the
workplace:
Slide 14
Methods of Compliance 4.1 4.1 Universal precautions It is
important prevent contact with blood or other potentially
infectious materials Under circumstances in which identification
between body fluid types is difficult or impossible, all body
fluids should be considered potentially infectious materials
Slide 15
Methods of Compliance 4.2 Hand Washing The City will provide
hand-washing facilities, which are readily accessible to employees
in each facility. If hand washing facilities are not feasible,
antiseptic hand cleaners/towelettes will be provided; however,
hands must be washed with soap and running water as soon as
possible. If personal protective equipment is worn, hands should be
washed immediately after removal of such gloves or equipment
Employees should wash hands and any other skin with soap and water,
or flush mucous membranes with water immediately following contact
with blood or other potentially infectious materials
Slide 16
Methods of Compliance 4.3 4.3 Needles and Other Sharps
Contaminated needles and other sharps shall not be bent, recapped,
or removed except when there is no other alternative If a
contaminated sharp is found on the premises of a facility belonging
to the City of Joplin, an employee is to stay with the item until
it is properly disposed of to prevent any further exposure If a
contaminated sharp is found, an employee should contact the
authorized employee from their department who may remove the item
and place it into a sharps container When the container is full it
shall be taken to a proper disposal site located at the Health
Department
Slide 17
Methods of Compliance 4.4 4.4 Eating, drinking, smoking,
applying cosmetics or lip balm, and handling contact lenses are
prohibited in work areas where there is a reasonable likelihood of
occupational exposure Food and drink should not be kept in
refrigerators, freezers, shelves, cabinets or on countertops or
bench tops where blood or other potentially infectious materials
are present Mouth pipetting/suctioning of blood or other
potentially infectious material should never be performed
Slide 18
Methods of Compliance 4.5 4.5 Equipment which may become
contaminated with blood or other potentially infectious materials
should be examined prior to use and should be decontaminated as
necessary, unless the decontamination of the equipment is
demonstrated to be unfeasible
Slide 19
Methods of Compliance 4.6 4.6 Personal Protective Equipment
Protective equipment will be made available to general City of
Joplin employees as necessary for tasks. Each facility must have
equipment in an easily accessible area. Gloves must be worn when an
employee may have hand contact with: blood other potentially
infectious materials mucous membranes non-intact skin when handling
or touching contaminated items or surfaces
Slide 20
Methods of Compliance Single use gloves should not be washed or
decontaminated for re- use Utility gloves may be decontaminated for
re-use if the integrity of the glove is not compromised they must
be discarded if they are cracked, peelings, torn, punctured, or
exhibit other signs of deterioration or when their ability to
function as a barrier is compromised Masks, eye protection, and
face shields: to be worn whenever splashes, spray, splatter, or
droplets of blood or other potentially infectious materials may be
generated and eye, nose, or mouth contamination can be
anticipated
Slide 21
Methods of Compliance 4.7 Used Personal Protective Equipment
Must be disposed of correctly, the appropriate receptacles are
located at the Health Department The Community Services Manager or
the designated safety personnel shall perform routine replacement
of depleted personal protection items
Slide 22
Methods of Compliance 4.8 4.8 Warning Labels Must be affixed
to: containers of regulated waste refrigerators and freezers
containing blood or other potentially infectious material other
containers used to store, transport or ship blood or other
potentially infectious materials These labels shall be fluorescent
orange or orange-red or predominantly so, with lettering and
symbols in a contrasting color Labels must be attached to the
container
Slide 23
Pre-Exposure Vaccinations/Baseline Testing The City of Joplin
makes available vaccinations for those diseases in which a vaccine
is available. Certain positions within the City are designated as
having an occupational risk of exposure to those diseases. As part
of the pre-employment physical process, the prospective employee
will be asked by the contracted medical provider if the prospective
employee is current on their vaccinations and determine if
additional vaccinations are needed. If the prospective employee
declines the vaccination, a declination form is available from the
Human Resource Department. The form should be filled out by the
medical provider and the prospective employee, and sent to the City
of Joplin Human Resources Department.
Slide 24
Appendix Information Appendix 1 of this plan includes
Department specific guidelines for the designated departments:
Appendix 1-A - Police Department Appendix 1-B - Fire Department
Appendix 1-C - Health Department Appendix 1-D Wastewater/Sewer
Maintenance Department Appendix 1-E - Parks Department Appendix
1-F- Recycling Center Appendix Two of this plan includes a listing
of the required preventative testing for each Job position listed
Appendix 2-A Required Preventative Vaccination and Testing
List
Slide 25
Baseline Testing Hepatitis A vaccinations are on a schedule of
two shots. The second shot is given 6 months after the first shot.
There is a combined Hepatitis A & B shot given in 3 doses.
Currently, there is no known vaccination for hepatitis C and
hepatitis D. Rabies vaccinations are given as a 3-shot series to
employees determined to be in the frequent-risk category. Mantoux
method for TB skin testing is the recommended method of tuberculin
skin testing by the CDC.
Slide 26
Exposure Procedures, Evaluation and Follow-up Blood Borne /Body
Fluid Exposure - HBV, HIV, HCV 1. When an employee is exposed to
blood or body fluid that individual should provide immediate care
to the wound site by: Washing wound site with soap and water Flush
contamination of nose, mouth, or skin with water Irrigate eyes with
clean water, saline or sterile irrigants 2. Notify employees
supervisor or person in charge of work site.
Slide 27
Exposure Procedures 3. If not already known, obtain information
as to the source individuals name, address and phone number.
Request that they consent to source individual testing for
potential blood or body fluid pathogens. If the source individual
is already known to be infected with a disease, testing for the
source individuals known disease status need not be repeated.
Slide 28
Source Person 4. Consents to Testing 5. Does not Consent to
Testing Have source person fill out Source Individual Occupational
Exposure Testing Consent Form Notify HR they will be taking test,
and go to testing facility City of Joplin will pay for initial
test, but no further follow up testing Exposed Employee should
complete Incident Report and return to HR HR will coordinate
testing/prophylaxis Testing must be initiated 1-3 hours after
exposure Treatment must be initiated 2- 4 hours after exposure
Slide 29
Exposure Procedures 6. Employee testing and prophylaxis is
voluntary, but strongly recommended. If an employee decides not to
obtain follow-up testing and/or prophylaxis the employee will be
required to sign an Occupational Exposure to Blood/Body Fluids
Testing/Prophylaxis Declination Form 7. Results of testing will
remain confidential, only the exposed employee and source
individual will be given results Information will only be released
via written consent of patient Should the exposed employee contract
a communicable disease through the reported exposure incident, the
City would be notified at that time so that medical treatment can
be authorized The Health Department will be notified by healthcare
provider for necessary investigation
Slide 30
Air Borne Exposure TB and other droplet- spread or airborne
diseases Tuberculosis exposure results from saliva inhaled in
droplet form from a cough or sneeze from a person identified or
highly suspected of having TB or other airborne disease When an
employee has a known exposure to Active TB, they should notify
their supervisor or person in charge, who will notify the Health
Department. Obtain an employee Incident Report form and fill out
completely. Notify HR Dept.
Slide 31
Fecal Exposure-HAV Exposure would result from accidental
ingestion of fecal material Employees working with wastewater,
parks, sewer maintenance, fire, police or in health department
would be most at risk of this exposure To alleviate this risk all
employees identified at risk will be offered the HAV
vaccination
Slide 32
Animal Bite Exposure Rabies A rabies exposure results from
contact with saliva from an animal capable of carrying rabies
through a bite or scratch which breaks the skin If rabies from
exposure is a possibility you should: Capture the animal for
quarantine and observation Wash exposed area with soap and water,
flush nose, mouth, eyes and skin with water and appropriate
irrigants Notify employees supervisor or person in charge If animal
was not captured, contact the Animal Control Officer at the Health
Department so an attempt can be made to capture the animal for
quarantine and/or testing Contact Human Resources to arrange
testing/prophylaxis and fill out Incident Report
Slide 33
Other Exposures Any other potential communicable disease
exposure not otherwise identified in this plan will be handled on a
case by case basis
Slide 34
Information and Training All training will be provided by the
City of Joplin during working hours at no cost to the employee
Department training officers are to ensure all new employees
receive instruction on communicable diseases before their first
assignment Annual refreshers may be mandatory
Slide 35
Training The person conducting the training should be
knowledgeable in the subject matter covered by the elements
contained in the training program as it relates to the workplace
that the training will address. For that reason, the following
positions are to be responsible for providing the training
materials, maintaining training records, scheduling training
sessions, and providing knowledgeable trainers: Police Department -
Training Sergeant Fire Department - Fire Training Officer Health
Department - Environmental Health/Epidemiology Coordinator All
other departments - Administrator
Slide 36
Recordkeeping The City of Joplin will establish and maintain an
accurate record for each Employee with occupational exposure. The
record must include: name social security number copy of the
employees vaccination status including the dates of all the
vaccinations and any medical records relative to the employees
ability to receive vaccination
Slide 37
Compliance Violations of this plan, or portions thereof, may
result in disciplinary action as described in the City of Joplins
Personnel Rules. This plan shall become effective on
____________________________, based on the City Managers
approval.
Slide 38
Slide 39
Overview Each department has a Communicable Disease Exposure
book with a red cover sheet which is to be located in a particular
spot which is accessible by all employees at all times and that is
labeled with laminated sign There is slight variance between each
departments book, as department-specific protocol is required in
certain places. Referring to the Table of Contents is critical to
finding the information you are seeking
Slide 40
Contents Each books includes: Communicable Disease Exposure
Plan Emergency Contacts for that department Emergency procedures
Baseline Testing Requirements Recordkeeping forms
Slide 41
Communicable Disease Exposure Plan A copy of the Plan is in
each departments book and may be referenced at any time
Slide 42
Emergency Contacts Emergency Contacts specific to each
department are located immediately after the Red Tab The contacts
are to be called in the order they are listed on the page
Additional numbers and information are on the page
Slide 43
Emergency Procedures After the Red Tab and emergency contacts,
emergency procedures are listed Some departments have general
procedures and some have department specific procedures
Slide 44
Baseline Testing Requirements A list of what test are required
of particular jobs can be found in this book
Slide 45
Recordkeeping Forms These forms are located after the Blue Tab
Included are: Occupational Exposure Risk Stratification Form
Occupational Exposure to Blood/Body Fluid Testing or Prophylaxis
Declination Form Source Patient Occupational Exposure Testing
Consent Form Hepatitis A, Hepatitis B, and Rabies Vaccine
Declination