A308 Environment, Health and Safety

Problem 8: Contagion
6th Presentation

Activity Owner: Linus Mak (Dr) Inputs by: DENV Team Approved by: Soh Thian Ping (Dr) Module Chair: Jayne Loh
Copyright 2011 by Republic Polytechnic, Singapore

Today s problem
In the movie Contagion, doctors raced against time to track people who were infected with a virus that caused many deaths worldwide. In real life, the H1N1 flu hit Singapore and other countries in 2009. It caused some students and staff in Republic Polytechnic to fall ill and disrupted classes. Healthcare workers are vulnerable to virus infection like H1N1 at work. Your task is to examine such hazards in the workplace and their ill-health. You are also to find out what measures can be taken against them.
Copyright 2011 by Republic Polytechnic, Singapore

What do you recognize?

Healthcare workers are exposed to infections at work. It is a biological hazard and causes healthcare workers to fall ill. Other occupations also encounter similar hazards. Control measures can be implemented to minimize the risk of exposure to such hazards.
Copyright 2011 by Republic Polytechnic, Singapore

The approach
What is a biological hazard? What are the ill-health upon exposure to biological hazards? Who are at risk to biological hazards? How are infectious agents transmitted? What are some control measures to minimize exposure to infectious agents?

Copyright 2011 by Republic Polytechnic, Singapore

What is a biological hazard?

Biological hazards, or biohazards, are infectious agents or hazardous biological materials that pose a risk to the health of living things, primarily humans.
Infectious agents include viruses, bacteria, parasites and fungi. Hazardous biological materials include toxins and allergens, some which are from poisonous plants and venomous animals.

Actions of animals can also be biological hazards.

Copyright 2011 by Republic Polytechnic, Singapore

What are the ill-health upon exposure to biological hazards?

Physical injuries
e.g. bites and kicks from animals

Infections of diseases
e.g. HIV and Dengue Fever

Allergic reactions
e.g. asthma, dermatitis, and irritation to eyes and noses

Poisoning
e.g. bites from venomous animals and insects, and food contaminated with harmful bacteria

Copyright 2011 by Republic Polytechnic, Singapore

Who are at risk to biological hazards?

Industries at risk include
Cleaning services Food production Waste Management Agriculture, forestry, horticulture Recycling plants (paper, glass, synthetic materials etc) Animal handlers and trainers, farm workers, veterinarians Raw material processing industry (cotton, clay, wood and straw) Healthcare (hospitals, clinics, nursing homes etc) Biotechnology companies and microbiology laboratories Working areas with air conditioning systems and high humidity (e.g. textile industry and print industry)

Copyright 2011 by Republic Polytechnic, Singapore

Who are at risk to biological hazards?

Occupations Animal trainers (dog trainers, performers in theme parks) Description of hazards y y Ill-health y Abrasion, cuts y Infection of vectorAnimal attacks, kicks or bites borne diseases Inhale or direct contact animal proteins y Infection from wounds found in fur, secretions and excretions of y Asthma or dermatitis animals y Irritation of eyes and nose Direct contact with bacteria from raw food or indirect contact with bacteria due to cuts when using contaminated sharp objects y Bacterial infection Inhale or direct contact vegetable y Asthma or dermatitis. proteins Exposed to animal proteins when handling fish and meats in food preparation

Kitchen helpers in restaurants

y y

Copyright 2011 by Republic Polytechnic, Singapore

Who are at risk to biological hazards?

Description of hazards y Bites from venomous wildlife y Insect stings (ticks, mosquitoes, wasps) Forestry and park y Damaged leaves of poisonous plants workers come in contact with the skin. y Inhale toxic burnt poisonous plants Occupations y Fishmongers y Handling crustacean seafood with bacteria Contact with bacteria when cut by shells Ill-health y y y y y y y y y Infection of vectorborne diseases Allergic reaction on skin Poisoning Bacterial infection Allergic reaction on skin Cuts and punctured holes Asthma or dermatitis. Irritation of eyes and nose Bronchitis

Production Inhale or direct contact with cotton dust workers in a cotton processing plant Healthcare Contact with harmful microbiological agents workers, cleaning (bacteria, parasite, virus etc) workers

Infections resulting in diseases

Copyright 2011 by Republic Polytechnic, Singapore

How are infectious agents transmitted?

Industries at risk include healthcare, clinical research, biologics manufacturing, cleaning services and waste management. Ways of contacting infectious agents
Direct contact on contaminated surfaces Indirect contact through contaminated materials Ingestion of contaminated food and fluids Inhalation of aerosolized agents

Copyright 2011 by Republic Polytechnic, Singapore

How are infectious agents transmitted?

Mode of Transmission Airborne Method of transmission Dust particles or evaporated droplets (5mm or smaller in size) containing microorganisms travel considerable distances through the air, and are inhaled by susceptible hosts. Direct contact with blood or body fluids or indirect contact via items contaminated with blood or body fluids Bite of infected animals and insects such as mosquitoes, ticks and sandflies. Examples of diseases SARS (rare cases) Tuberculosis Legionnaires disease Hepatitis B and C HIV Dengue Fever Malaria

Bloodborne Vector-borne

Droplet

Infectious droplets generated during coughing, sneezing SARS and talking or through procedures such as bronchoscopy Tuberculosis and suctioning are propelled a short distance through Influenza the air and deposited on a host's mouth, nose or eyes. Direct body surface to body surface contact and physical transfer of bacteria or indirect contact with contaminated objects such as food, medical instruments and dressings.
Copyright 2011 by Republic Polytechnic, Singapore

Contact (including foodborne)

Hepatitis A Typhoidal salmonella (typhoid fever) Hookworm

How are infectious agents transmitted?

Examples in such biohazards in healthcare
Contact with blood and other body fluids during surgeries and housekeeping (bed sheets, patient wear) Contact with patients respiratory secretions through the air Contact with patients while bathing them Contact with contaminated biomedical equipment Contact with patients during resuscitation Treating patients with open bleeding wounds Spill and splashes of contaminated liquids Pricks when handling needles contaminated with blood or other body fluids Disposal of biohazard waste Clinical and laboratorial testing Post-mortem procedures
Copyright 2011 by Republic Polytechnic, Singapore

Some measures to minimize exposure to infectious agents in healthcare

Engineering controls
Safety engineered room for isolating the affected patients Safety engineered mouthpieces and resuscitation masks with one-way valves for resuscitation Safety engineered microbiological safety cabinets for laboratory work

Administrative controls
Separate infectious patients in a separate enclosed section away from others Put on personal protective equipment (PPE) when entering rooms of patients Follow the proper sequence of PPE removal Proper containment and disposal of contaminated waste and PPE Education and training on hazards, effects and safe work practices

Personal protective equipment

Appropriate gloves, safety goggles, face masks, N95 respirator Rubber boots or plastic overshoes if the ground can be contaminated

Copyright 2011 by Republic Polytechnic, Singapore

Legislation and Guidelines in Singapore

Legislation
Infectious Disease Act Biological Agents and Toxins Act Environmental Public Health (Cooling Towers and Water Fountains) Regulations

Other Guidelines
Workplace safety and health guidelines by WSH Council Singapore Biosafety Guidelines for Research on Genetically Modified Organisms (GMOs)
(http://www.gmac.gov.sg/Index_Singapore_Biosafety_Guidelines_for_Research_on_GMOs.html)

School Science Laboratory Safety Regulations

(http://www.silingpri.moe.edu.sg/index2.php?option=com_docman&task=doc_view&gid=75&Itemid=95)

Copyright 2011 by Republic Polytechnic, Singapore

What you have learnt?

Understand what a biological hazard is Understand that some industries are susceptible to biological hazards Identify biological agents that contribute to biological hazards Know the ill-health when exposed to biological hazards Apply appropriate control measures to minimize exposures to biological hazards
Copyright 2011 by Republic Polytechnic, Singapore

Post-Reading Materials
Outdoor Work Health Hazard, pages 1-4
http://www.state.nj.us/health/eoh/peoshweb/Outdoor.pdf

Workplace Safety and Health Guidelines (Healthcare), page 35-55

https://www.wshc.sg/wps/themes/html/upload/cms/file/WSHCouncil%20 Healthcare%20Guideline.pdf

Workplace Safety and Health Guidelines (Cleaning and Custodial Services), Section 4.7, pages 27-28
https://www.wshc.sg/wps/themes/html/upload/cms/file/WSH_GuidelinesCleaning_&_Custodial_Services.pdf

Copyright 2011 by Republic Polytechnic, Singapore