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Communicable Disease Exposure Training
This section covers highlights of Communicable Disease Exposure
Plan. For more information please refer to the Plan directly.
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 it’s employees to communicable
diseases on the job
Relevance
 Communicable diseases are dangerous. If you don’t take
precautions to protect yourself, one incident could result
in acquiring a disease you must deal with for the rest of
your life.
 You can’t UN-contract a disease!
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 employee’s file in Human Resources.
Personnel at Risk for Exposure
Police Department High Risk
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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
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
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
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
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
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
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.
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:
Methods of Compliance
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
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
Methods of Compliance
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
Methods of Compliance
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
Methods of Compliance
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
Methods of Compliance
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
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
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
Methods of Compliance
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
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.
Appendix Information
 Appendix 1 of this plan includes Department specific guidelines for the
designated departments:
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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
Baseline Testing
 Hepatitis A vaccinations are on a schedule of two shots. The
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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.
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:
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2.
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
Notify employee’s supervisor or person in charge of work
site.
Exposure Procedures
3.
If not already known, obtain information as to the
source individual’s 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 individual’s known disease
status need not be repeated.
Source Person
4. Consents to Testing
5. Does not Consent to Testing
 Have source person fill out
 Exposed Employee should
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
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 24 hours after exposure
Exposure Procedures
Employee testing and prophylaxis is voluntary, but strongly
recommended.
6.
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

Results of testing will remain confidential, only the exposed
employee and source individual will be given results
7.
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
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The Health Department will be notified by healthcare provider for
necessary investigation
Air Borne Exposure – TB and other dropletspread 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.
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
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 employee’s 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
Other Exposures
 Any other potential communicable disease exposure not
otherwise identified in this plan will be handled on a case
by case basis
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
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:
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Police Department - Training Sergeant
Fire Department - Fire Training Officer
Health Department - Environmental Health/Epidemiology Coordinator
All other departments - Administrator
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 employee’s vaccination status
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including the dates of all the vaccinations and any medical
records relative to the employee’s ability to receive vaccination
Compliance
 Violations of this plan, or portions thereof, may result in
disciplinary action as described in the City of Joplin’s
Personnel Rules. This plan shall become effective on
____________________________, based on the City
Manager’s approval.
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 department’s 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
Contents
 Each books includes:
 Communicable Disease Exposure Plan
 Emergency Contacts for that department
 Emergency procedures
 Baseline Testing Requirements
 Recordkeeping forms
Communicable Disease Exposure
Plan
 A copy of the Plan is in each department’s book and may
be referenced at any time
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
Emergency Procedures
 After the Red Tab and emergency contacts, emergency
procedures are listed
 Some departments have general procedures and some
have department specific procedures
Baseline Testing Requirements
 A list of what test are required of particular jobs can be
found in this book
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