British Institute of Cleaning Science Biohazards Awareness

C&G Practical Cleaning Skills

109 Clean & Dispose of bodily fluids, spillages and hazardous items

Biohazards AwarenessAims and ObjectivesBy the end of this course you will be able to:Describe what a biohazard isIdentify places and people at riskHealth and safety relating to sharps and body fluids and contaminated itemsUnderstand what to do in the event of an injuryUnderstand the need for personal protective equipmentDescribe the correct equipment required to deal with sharps and body fluid spillagesThe sharps collection procedure

Biohazards AwarenessAims and ObjectivesYou will also:Identify and deal with simulated spillages and contaminated items (assessed to C&G standards)

Complete the paperwork

Biohazard awarenessWhat are biohazards?

Body fluids NappiesSanitary towelsContraceptivesClothingDressings

Sharps/needlesFood (raw and cooked)DustsHuman/animal tissuesChemicals

Body FluidsAs well as Sharps and Needles you may encounter:BloodUrineVomitFaecesSputum

All of which should be treat as being infected!

Biohazard AwarenessWhat causes the risk?

Pathogenic bacteriaVirusesFungiParasites

Pathogenic bacteriaMost multiply quickly in large numbers and cause illnessNeed time, nutrients, moisture and correct temperature to multiplyProduce toxins, which are poisonous substances that cause illnessMost can be killed with antibiotics

VirusesNeed only one or two viral cells to cause illnessCan only multiply within the living cells of the body it invades Do not survive long outside the host bodyBreaks through the immune systems defencesCannot be killed by antibiotics but immunisation can prevent some viral diseases

Fungi / parasites FungiAppears in the form of moulds and yeastThrush is an example

ParasitesExamples include lice, fleas, scabies and threadworm

Infections common with needle stick injuries / contaminationLock Jaw (Tetanus)Hepatitis AHepatitis BHepatitis C HIV (human immunodeficiency virus)

Lock Jaw (Tetanus)An acute infectious disease of the central nervous system caused by the toxins of the clostridium tetaniCommon in soil, human and animal faeces and digestive tracts of humans and animalsInfection may follow puncture wounds, bites, splinters, burns, lacerations and fracturesSymptoms include muscle spasm, stiffness of facial muscles, difficulty breathing or convulsionsTreatment requires tetanus antitoxin with immunisation and booster shots

HepatitisHepatitis is inflammation of the liverSymptoms include: Tiredness, flu like symptoms, muscle aches, loss of appetite, nausea, jaundice, abdominal pain, aversion to cigarettes and alcohol, cirrhosis and liver failureTreatment involves rest, avoiding alcohol, antiviral drugs and vaccination

HepatitisStrainTransmissionDoes it persist?Hepatitis A & E Poor hygiene, Eating and drinking infected water/foodNoHepatitis BExchange of body fluidsCan cause chronic infectionHepatitis CBy exchanging body fluids or transfusion of contaminated bloodOften causes chronic infectionHepatitis DExchange of body fluidsOften causes chronic infection

HIV (Human immunodeficiency virus)HIV is a virus that infects and can kill certain cells in the immune systemIt is carried in the blood and other body fluids (though rarely saliva or tears)It is spread during sexual intercourse, sharing needles or mother to babySymptoms include: fever, weight loss, swollen glands, white patches in mouthTreatment drugs to fight infection

How could this effect me? Hepatitis A can survive can survive outside the body for several monthsHepatitis B can remain infectious for up to a week outside the bodyHepatitis C can live outside the body for up to 4 daysHIV can only survive a few hours outside the body in wet spillages

How could this effect me? Potential risk of infection following an injury from an infected needle is approximately:

42% for tetanus30% for Hepatitis B3% for Hepatitis C0.3% for HIV

Can I be vaccinated?Hepatitis B vaccine available as 3 injections at monthly intervals followed by a blood testHepatitis A vaccine single injectionTetanus 3 injections at monthly intervals

Hepatitis C no vaccine currently availableHIV no vaccine currently available(all can be done at your local doctor or health centre)

How can I protect myself? Participate in training related to the disposal of sharps and body fluidsHelp you employer select and evaluate devices that reduce the risk of injuryOnly use supplied and recommended PPEDiscuss vaccinations with your Health and safety advisor/officer

How can I protect myself? Avoid trying to recap needlesPlan for safe handling and disposal of needles and/or body fluid spillagesPromptly dispose of all used needles in the appropriate containerReport all needle stick injuries or contamination to ensure you receive appropriate aftercare Tell your manager about any needle stick or body fluid hazards you may seeRemember to fill in the accident book if any incident or injury occurs

How can I protect myself? Risk assessment is a vital step before starting any work procedure. You are required to assess what is needed to protect yourself and others from infection. Make sure these steps are in place before you begin the task.Some risk assessments may be written down already but some may need to be done on the spot to deal with unexpected situations

Where biohazards may be foundDerelict Buildings

Where biohazards may be foundVoid properties

Where biohazards may be foundDisused areas

Where biohazards may be foundLess common but still used:Public toiletsChildrens parks and play areasTrain stationsPark benchesDisused garagesChurch yardsTemporary accommodationCells

Where biohazards may be foundAnd dont forget..General toilet areasFirst aid / treatment roomsEating areas

Emergency action in the event of a needle stick injuryIn the event of a cut, needle stick injury or splash:Wash skin thoroughly with soap under running waterIf bleeding, encourage bleeding before washing. Never suck a wound!

Cover skin with a waterproof dressingReport the incident to your line managerSeek medical adviceIf possible take the needle (sealed in a box) or chemical sample when seeking medical advice

Sharps Collection Equipment & PPE

A Sharps collection kit should consist of the following items: Copy of the Collection Procedures Litter picker or plastic tongs Empty Sharps Containers Sterile Wipes Medical Gloves Approved Sharps Gloves

Sharps Collection ProcedureSafe Recovery ProcedureUse only appropriate PPE & Equipment Keep away from body Place directly into Sharps Container

A Typical Sharps Collection Procedure

Example Collection ProcedureStaff should collect and check the Sharps collection kit If there are any items of equipment missing from the kit You Must report the shortage to your Supervisor immediately When staff reach the location of the Sharp they should proceed with extreme caution

Staff should always use the equipment provided to reduce the possibility of injury Preventing Needle Stick injuries is the best way of protecting yourself from infection

Cleaning Body Fluid SpillagesEquipment Requirements:

'Clean-up' kits can be provided by your Supervisor or Manager which should typically contain:

Latex gloves in perfect condition,A disposable polythene apron,Granules for absorbing spillages,Disinfectant cleanser - spray,Disinfectant hand-wipes, Yellow disposal bag

Body Fluids ProcedureGeneral instructions that apply to all fluid clean ups.Always wear all protective gear provided.Follow instructions carefully on all absorption products.Use only the yellow biohazard bags to dispose of waste.Check with your supervisor for specific disposal instructions.

Principles of the cleaning procedure: ALWAYS assume any body fluids may contain disease causing agents There should be no physical contact between them and the cleaner's body Infection hazards will be destroyed by the disinfectant in a short time e.g. half an hour Body fluid spills and sharps etc must be treated as biohazard/clinical waste. Read all instructions carefully before handling any fluids

Body Fluid and Sharps -Actions

DO NOTHING: initially carefully survey the affected area. DISCOVERY: on discovering any Sharps or Body Fluids, isolate the affected area. Do not clean until adequately stocked 'Clean-up' kit is available. PROTECT YOURSELF: wear the plastic apron and put on disposable latex gloves forthwith. If gloves become damaged in the operation replace them immediately (from the 'Clean-up' kit).

DISCARD SHARPS: solid materials should be removed using the Scoop and Spatula provided in the kit and placed directly into the 'Sharpsafe' container; alternatively and for sharps - needles/glass - use forceps. After use, decontaminate implements by spraying with the disinfectant and leave soaking, do not dry them. BODY FLUID SPILLAGES: follow instructions given in the 'Clean-up' kit:- ABSORB: body fluids with the absorbent granules, REMOVE GRANULES: collect with a Scoop and Spatula or similar and discard into the yellow disposal bag,

Body Fluid and Sharps Actions:DISINFECT: place all contaminated items in the yellow disposal bag, also spray disinfect the contaminated site but leave for a few minutes. Dispose of any non reusable items in the yellow disposal bag. REMOVE APRON and GLOVES: in that order, dump into the yellow disposal bag, CLEAN HANDS with the Disinfectant-wipes, and discard into the yellow disposal bag.

FINAL DISPOSAL: the yellow disposal bag should be sealed up and put in robust container pending disposal. Any spillage en route or into the container, will also need to be cleaned in the same manner as described previously. Ask your Manager to arrange for its disposal. The 'Sharpsafe' container should be transported to and stored in a safe place for future use or ask your Manager to arrange for its disposal.

Additional guidelines for assessmentEquipment used for body fluid spillages should not be used for any other tasksAny action which leads or may lead to risk of personal infection or cross contamination will mean immediate failure of the taskBody fluids include: Blood, Urine, Vomit, Faeces, Sputum etc.Contaminated items include: Nappies, Sanitary towels, Contraceptives, Clothing, Dressings, Needles, Syringes etc.You must show competence in removing one item from 3. and one item from 4.Spillages should be reported to the appropriate person

Practical task The removal of body fluid spillages and contaminated items