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Safe Work Practices Picking Up Sharps & Dealing with Biohazard Waste #75323 WHAT IS A SHARP What is a Sharps Sharps are defined in the "National Guidelines for the Management of Clinical and related Wastes" published by the National Health and Medical Research Council as "objects or devices having acute rigid corners, or edge points capable of cutting or penetrating the skin". Hypodermic needles, razor blades and broken glass all fit this definition. All sharps have the potential to cause injury Sharps cause injury through cuts or puncture wounds. In addition, many sharps could be contaminated with blood or body fluids, microbiological materials, toxic chemicals or radioactive substances, posing a risk of infection or illness if they penetrate the skin. WHAT IS BIOHAZARD WASTE Human blood and blood products: Human Body Fluids: Human body fluids in a liquid or semi-liquid state, including: semen, vaginal secretions, cerebral spinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, and saliva from dental procedures. Also includes any other human body fluids visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids. Pathological waste: All human blood, blood products (such as serum, plasma, and other blood components) in liquid or semi-liquid form. All human tissues, organs, and body parts. Animal waste: All animal carcasses, body parts, and any bedding material from animals known to be infected with, or that have been inoculated with human pathogenic microorganisms infectious to humans. WHAT ARE THE DANGERS Sharps and Biohazard waste may carry HIV and the Hepatitis B & C viruses. The hepatitis B and C virus can permanently damage your liver, and is the biggest cause of liver cancer worldwide. Hepatitis B & C is transmitted through sexual contact, blood or bodily fluids. Other waste, such as feces, can contain Hepatitis A, bacteria (ex. salmonella) and viruses (ex. norvirus). Where can Sharps and Biohazard waste be found? Sharps and Biohazard waste are often thrown away in streets, public washrooms, regular garbage, parks, alleys, vacant lots, and on beaches. They have also been found under mattresses and pillows, in garbage cans, and behind toilets. CONTACT TRANSMISION Contact transmission are infectious diseases transmitted through direct or indirect contact with bacteria or viruses. Direct contact: Involves skin-to-skin contact, such as patient care, first aid or emergency response activity that requires direct personal contact. First Aid Attendants or Fire Department first responders could be exposed by direct contact. Indirect contact involves a person touching a contaminated intermediate object such as a table, doorknob, telephone, photocopiers, tools and then touching the eyes, nose, or mouth. (Some Viruses can live on hard surfaces for 24-48hrs and on non-porous surfaces as cloth, paper for 8-12hrs). TRANSMISION Method of Entry: Routes of Entry • Respiratory tract – Inhalation • Inhalation • Ingestion • GI Tract – Ingestion • Absorption • Skin – Injection • Injection • Eyes • Biological agents are not absorbed through the skin but they can be passed from skin to eyes, mouth and nose. PRECAUTIONS Universal Precautions should be followed whenever workers are exposed to: Blood Semen Vaginal fluid Synovial fluid Cerebral spinal fluid Pleural fluid Peritoneal fluid Pericardial fluid Amniotic fluid Universal Precautions means ~ assume infectious Universal Precautions do not apply to the handling of: (except when visibly contaminated with blood) Feces Nasal secretions Sputum Sweat Tears Urine Vomitus Saliva SAFE WORK PROCEDURES The City of Langley strives to provide a safe workplace for all employees. PPE, Personal Protective Equipment The purpose of Safe Work Procedures (SWP) in regards to sharps and biohazard waste is to provide a safe way for finding, and removing Sharps and Biohazard Waste to minimize health risks. Employees trained in the handling and disposal of Sharps and Biohazard Waste will use appropriate PPE (personal protective equipment) which are; puncture resistant gloves, tongs, a proper portable sharps disposal containers, and if splashes are a potential then goggles. Disposal of Sharps and biohazard waste Once the portable sharps disposal containers are ¾ full, tell your supervisor. The supervisor will ensure the container is brought to the Operations Centre and placed in the main Biohazards container. Any gross contaminations of biohazard waste will also be disposed of at the main Biohazard Container (grossly saturated products used to clean blood or body fluid ). PRECAUTIONS Do not pick up sharps and other biohazard waste unless you have been trained, and you have the proper equipment and PPE. Do not pick up anything with the intention of discarding it later. Do not place needles in regular garbage under any circumstances — you may create a hazard for others. Do not reach into objects you can not see. For example, don’t put a used needle in your pocket or in something that isn’t a proper container. You could injure yourself before you discard it. Empty all containers, backpacks, and purses onto a hard surface and use a long object such as tongs to look through. Do not reach into areas you can not see. Don’t use your hands to feel or reach into any area, for example shrubbery. Use a longhandled stick or other object — not your hands— to explore hidden spots. A flashlight could be used to move objects and to shed light on hard-to-see objects. HANDLING SHARPS 1. 2. 3. 4. 5. 6. Wear disposable puncture resistant waterproof gloves and have a proper authorized sharps container ready. Put the gloves on. Place the sharps container next to the needle or other item. Do not hold the container in your hand, or you might accidentally jab yourself. If you are comfortable using tongs or pliers, use them to pick up the sharp and place it into the sharps container. If you are not comfortable using the tongs or pliers, pick up the sharp by its shaft (if it is a needle). In both cases, place the needle into the sharps container, pointed end first, away from you. Do not insert your fingers into the opening of the container, and keep your free hand out of the way. Remove and discard the gloves. Wash your hands with soap and water immediately. Don’t fill the sharps container to the brim. When it is about three-quarters full, replace it with a new one and properly dispose of the old one. Use tongs or pliers to pick up & place the sharp – pointed end first – into the container. HANDLING GARBAGE 1. Wear disposable puncture resistant gloves. Do not use bare hands. 2. Handle garbage as little as possible. 3. 4. 5. 6. Be alert. If possible, look for sharps sticking out of the bags. Listen for broken glass when you move the bag. Don’t compress garbage or reach into garbage containers with your bare hands. Don’t let garbage bags get too full. Leave enough free space at the top of the bag, so that when you grab it, you grab the top of the bag only — not any of the contents. Hold garbage bags by the top of the bag, away from your body. Don’t hold garbage bags against your body. 7. Don’t place one hand under the bag to support it. 8. Dispose of wastes according to federal, provincial, and local regulations. 9. When finished, dispose of gloves and immediately wash hands. INCIDENTS A restaurant worker was cleaning the washroom. When emptying the garbage can, she reached into it and was poked with a discarded needle. A worker picked up a bag of garbage and held it close to his body. His thigh was stuck with a needle. A worker found a lost backpack and reached in to see the content; they were stuck with a needle. HOW TO CLEAN UP BIOHAZRD SPILLS 1. This could be blood, vomit, feces, body fluids, etc. 2. Restrict access to the area. 3. 4. 5. 6. 7. 8. Make sure plastic bags are available for removal of contaminated items from the spill site. Have fresh, dilute bleach or a germicide ready. Dispose of any sharps first according to the procedure Wear disposable, waterproof gloves (such as natural rubber latex, neoprene, nitrile, and vinyl). If necessary, wear other PPE, such as a face shield and a gown, to act as a barrier against contact with blood and certain body fluids and the dilute household bleach. If using a germicide, check the material safety data sheet (MSDS) to find out what type of glove to use. Cover your shoes or boots with disposable, waterproof covers if they could become contaminated during clean-up. If you do not have shoe or boot covers ensure you decontaminate them with germicide or diluted bleach solution. Wipe up visible material first with disposable towels (or in another way that prevents direct contact with blood and certain body fluids). Dispose of the material and paper towels in waterproof garbage bags. After you have carefully removed all the obvious material, it may be necessary to change gloves. Then decontaminate the area by carefully pouring over the spill site a germicide approved for use as a hospital disinfectant, or a fresh solution of household bleach and water (next slide). Leave the solution on for 10 minutes, then wipe it up with disposable towels. Discard the towels in the waterproof garbage bags DISINFECTANT Disinfect the area with a fresh bleach solution. A solution of 1 part of common household bleach to 100 parts of water (1:100 ratio) will kill HIV and the hepatitis B and C viruses except with spills involving a large amount of blood. With spills involving a large amount of blood, apply a solution of 1 part common household bleach to 10 parts of water (1:10 ratio). In both cases, leave the solution on for about 10 minutes.You can also use a germicide that is approved for use as a health care disinfectant. Caution: Do not mix cleaning chemicals such as bleach and ammonia. WHEN TO REMOVE GLOVES Remove disposable gloves as soon as become damaged or contaminated. Remove them after you have completed the task that required gloves. Gloves should also be removed before leaving the work area. Do not wash and reuse your gloves. Use new gloves for each new task. HOW TO REMOVE GLOVES With both hands gloved: Grasp the outside of one glove at the top of the wrist. (See drawing top right.) Peel off this glove from wrist to fingertips while turning it inside out, as you pull the glove off your hand and away from you. Grasp the outside of one glove. Hold the glove you just removed in your gloved hand. (See drawing below right.) With the ungloved hand: Peel off the second glove by inserting your fingers on the inside of the glove at the top of your wrist. (See drawing to right.) Hold the glove with your gloved hand. Turn the glove inside out while pulling it away from you, leaving the first glove inside the second. (See drawing on the right.) Insert your fingers on the inside of the glove. Dispose of the entire bundle promptly in a waterproof garbage bag. Wash your hands thoroughly with soap and water as soon as possible after removing gloves and before touching noncontaminated objects and surfaces. Turn the glove inside out over the first glove. WHEN TO WASH HANDS When should you wash your hands? Always! Wash your hands when you tear a glove, or you think a glove is leaking. Remove the gloves and wash your hands immediately. If you have punctured your skin with a contaminated sharp, follow the procedure for exposure incidents. Wash your hands after removing gloves at the end of a task — even if the gloves appear to be intact. Because you may contaminate your hands if you remove your gloves improperly, make sure you follow the correct procedure. Wash your hands immediately after accidental contact with blood, body fluids, and/or feces. Wash your hands before leaving a work area. Wash your hands before eating, drinking, smoking, biting your nails, handling contact lenses, and applying personal care products (such as lip balm or makeup). If a hand washing facility isn’t available, use a waterless hand cleanser. Follow the manufacturer’s directions on how to use the cleanser. Thoroughly wash your hands with soap and water in a proper facility as soon as possible after using the cleanser. HOW TO WASH HANDS Hand washing is one of the best defenses against spreading infections. It stops you from transferring infectious material from your hands to other areas of your body or other surfaces you may touch, and vice versa. Wash your hands thoroughly, in a suitable facility such as a rest room or utility sink, using warm running water and non-abrasive soap. WHAT IS AN EXPOSURE The following exposure incidents are potentially harmful: Skin is punctured with a contaminated sharp. A mucous membrane (the eyes, nose, or mouth) is splashed with blood or certain body fluids. Non-intact skin is splashed with blood or certain body fluids. Blood and body fluid contact with intact skin is not considered to be a risk for the spread of blood borne pathogens. You should, however, thoroughly wash your hands and other affected areas immediately. If you have any further concerns, contact your family physician or nearest health unit office (see the blue pages of the telephone directory). What to do if you are Exposed 1. Get first aid immediately, report the incident immediately to your supervisor and first aid attendant. 2. If the mucous membranes of the eyes, nose, or mouth are affected, flush with lots of clean water at a sink or eyewash station. If there is a sharps injury, allow the wound to bleed freely. Then wash the area thoroughly with non-abrasive soap and water. If an area of non-intact skin is affected, wash the area thoroughly with nonabrasive soap and water. Seek medical attention immediately if you have been injured by a sharp. Seek medical attention immediately —preferably within two hours — at the closest hospital emergency room, or at a health care facility if there’s no hospital emergency room in the vicinity. Immunizations or medications may be necessary. These may prevent infection or favorably alter the course of the disease if you do become infected. Blood tests should also be done at that time. You may need to see your family doctor within the next five days for follow-up, such as counseling and medications. Questions to Ask Yourself Do you know where the sharps container and PPE is? Do you know where to fill out a sharps form? In the OH&S Binder, if you don’t know where that is, ask your supervisor to show you Do you know where the Hazard Report Forms are if you need to report an unsafe condition, equipment, or practice? If no, ask your supervisor In the OH&S Binder, if you don’t know where that is, ask your supervisor to show you Do you know you have the right to refuse unsafe work? Please ensure you take the Sharps Review Test and submit to your Supervisor (this is an open book test) (Doc. #75170)