regulator view: managing common biological hazards … · regulator view: managing common...
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Regulator view: managing common biological hazards at work
Patricia Coward
Principal Adviser (Occupational Health)
Asbestos and Occupational Hygiene and Health Unit
BSc (Hons) Nursing Studies
MAppSc (OHS)
Diploma OHN
Grad Cert Infection Control
RN
• WHS legislation and biological hazards
• Risk management of biological hazards.
– infectious diseases.
Overview
WHS legislation
• WHS legislation for biological hazards for sites that are not on a mining lease.
• WHS Act 2011– primary duty of care– further duties– duty to consult– management of risks– incident notification– workers’ duties.
• WHS Regulation 2011– risk management– information, training and
instruction – general workplace facilities– adequate and accessible
facilities– first aid– emergency plans– PPE.
Chain of infection
• Source of infectious agent
– bacteria, viruses, fungi, parasites
– reservoir of infection.
• Mode of transmission– contact transmission – droplet transmission – airborne transmission – vector-borne (insect) transmission– food-borne transmission – water-borne transmission.
• Susceptible person
– workers may be more susceptible to infection if they• are not immune to a vaccine-preventable disease at work
• have an impaired immune system because of a medical condition or treatment.
Dept. of Health 2010
Identify biological hazards
• Identify infectious diseases that workers and other persons may be exposed to
• invisible hazard
• seek expert advice as needed.
• Contact with people, blood and body substances and used needles and syringes– examples of at-risk workers
• cleaning services
• emergency services
• first aid services
• healthcare services and paramedics
• laundry services
• landscaping services
• maintenance services
• security services
• sewage, plumbing and water treatment services
• waste management services.
– examples of infection risks• hepatitis A
• blood-borne viruses (hepatitis B, hepatitis C and HIV)
• gastrointestinal infections.
Identify biological hazards
• Contact with animals, animal products and animal waste– examples of at-risk workers
• animal rescue and welfare services
• construction services
• environmental and ecology services
• exploration services
• geoscience and surveying services
– examples of infection risks• Australian bat lyssavirus
• gastrointestinal infections
• histoplasmosis
• leptospirosis
• Q fever.
Identify biological hazards
• Contact with the environment, soil, vegetation and water – examples of at-risk workers
• blast crews
• construction services
• drilling services
• emergency services
• engineering services
• environmental technology and rehabilitation services
• exploration services
• geoscience and surveying services
• maintenance services
• other outdoors work
• plumbers
• industrial users of non-potable and recycled water
• ventilation engineers
• water treatment and maintenance services
• work or recreational users of man-made water systems (e.g. bath houses, swimming and spa pools)
– examples of infection risks• gastrointestinal infections
• legionellosis
• leptospirosis
• melioidosis
• mosquito-borne diseases
• skin infections
• tetanus
• tick-borne diseases.
Identify biological hazards
• Shared work accommodation and amenities
– examples of at-risk workers• cleaning services
• laundry services
• live-in workers
• security services
• users of communal amenities
• waste management services
– examples of infection risks• gastrointestinal infections
• influenza
• skin infections and infestations (e.g. scabies, impetigo (school sores),Staphylococcus aureus infections (‘golden staph’, MRSA), tinea, plantar warts).
Identify biological hazards
• Work at locations where there is a higher prevalence of a infectious disease– offshore
– remote locations.
• Lifestyle infection risks associated with working away from home– blood-borne viruses
– sexually transmissible infection
– contact with wildlife (e.g. hunting).
Assess the risk
• Risk assessment
– risk = likelihood x consequences.
• What is the likelihood of the infectious disease occurring? – task
• source of infection
– exposure
• frequency, duration and level of exposure
• number and type of people exposed
• whether the exposure is routine, occasional or unpredictable
– workplace• environmental and climatic conditions
• design and layout
• facilities
• standards of hygiene and cleanliness
• ability to control or influence the workplace
Assess the risk
– infectious agent
• how infectious it is
• how it is spread
• infectious period
• survival in the environment
– workers• knowledge, skills and experience
• level of compliance and supervision
• risk factors for acquiring infection
– existing control measures.
Assess the risk
• What are the consequences if the infectious disease occurs?
– death, illness (acute or chronic), adverse reproductive outcomes,
psychological effects, spread of infection to vulnerable groups, cost
– some workers may have risk factors for developing more severe
infection.
Assess the risk
• Challenges
– only considering the likelihood of the infectious disease occurring and
not the consequencs
• low likelihood, high consequence risks
– only considering the more common consequences associated with the
infectious disease.
Control the risk
• Control measures should be appropriate to– the outcome of an informed risk assessment
– the hierarchy of risk control
– the mode of transmission
– whether or not it is vaccine-preventable.
HIGHER ORDER CONTROLS CONTROL THE PROCESS
Elimination
Substitution
Isolation
Engineering
LOWER ORDER CONTROLS CONTROL THE PERSON
Administrative controls
Personal protective equipment
Control the risk
• Contact transmission– prevent contact with and contain
sources of infection– protect the hands, skin, mucous
membranes of the eyes, nose and mouth, clothing, etc. from contamination and prevent skin penetrating injuries.
• Droplet transmission– prevent and contain the
generation of infectious droplets
– protect the mucous membranes of the eyes, nose and mouth from infectious droplets.
• Airborne transmission– prevent and contain the
generation of infectious aerosols and dust
– protect against inhaling infectious aerosols and dust.
• Vector-borne transmission– prevent insect breeding sites and
insect bites.
• Food-borne transmission– prevent food contamination and
promote food safety.
• Water-borne transmission– prevent water contamination and
contain or treat sources of contaminated water
– protect against exposure to contaminated water and associated droplets and aerosols.
Vaccine-preventable diseases
• Occupational vaccination program.
• Hepatitis A– plumbers
– waste water workers
– workers who make frequent visits to rural and remote Indigenous communities.
• Hepatitis B– healthcare workers and
paramedics
– first aiders, cleaners, waste industry workers and others who are regularly exposed to human blood and body substances and used needles and syringes.
• Influenza– encourage annual influenza
vaccination.
• Q fever– fauna spotter-catchers and
others who have contact with native wildlife, camels, cattle, sheep and goats and animal products and waste.
• Rabies
– fauna spotter-catchers and others who may have contact with bats.
• Tetanus– those at risk of tetanus prone
wounds.