* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download A Guide To Biological Hazards in the Workplace
Herpes simplex wikipedia , lookup
Ebola virus disease wikipedia , lookup
African trypanosomiasis wikipedia , lookup
Meningococcal disease wikipedia , lookup
Chagas disease wikipedia , lookup
Cross-species transmission wikipedia , lookup
Herpes simplex virus wikipedia , lookup
Onchocerciasis wikipedia , lookup
Tuberculosis wikipedia , lookup
West Nile fever wikipedia , lookup
Sarcocystis wikipedia , lookup
Carbapenem-resistant enterobacteriaceae wikipedia , lookup
Dirofilaria immitis wikipedia , lookup
Trichinosis wikipedia , lookup
Leptospirosis wikipedia , lookup
Henipavirus wikipedia , lookup
Schistosomiasis wikipedia , lookup
Eradication of infectious diseases wikipedia , lookup
Timeline of the SARS outbreak wikipedia , lookup
Sexually transmitted infection wikipedia , lookup
Human cytomegalovirus wikipedia , lookup
Coccidioidomycosis wikipedia , lookup
Oesophagostomum wikipedia , lookup
Neonatal infection wikipedia , lookup
Marburg virus disease wikipedia , lookup
Hepatitis C wikipedia , lookup
Middle East respiratory syndrome wikipedia , lookup
Lymphocytic choriomeningitis wikipedia , lookup
RI Committee on Occupational Safety &Health Emerging Infectious Diseases SARS Marburg (hemorrhagic fevers) Anthrax Avian flu??? SELECTED INFECTIONS HEALTH CARE PERSONNEL AND PATIENTS [] Hepatitis A Hepatitis B Hepatitis C … Human immunodeficiency virus Conjunctivitis Cytomegalovirus Diphtheria Gastrointestinal infections Herpes simplex Staphylococcus aureus infection and Tuberculosis carriage Mumps Measles Meningococcal disease Parvovirus Pertussis Poliomyelitis Rabies Rubella Scabies and pediculosis Streptococcus, group A Varicella Viral respiratory infections a. Influenza b. Respiratory syncytial virus c. SARs 1 []Biological Hazards in the Workplace Block transmission/infection Immunization/prophylactic HCWer Patients Environmental controls Ventilation PPErespirators barriers/isolation Some basic terms: direct contact refers to body surface–to–body surface contact and physical transfer of microorganisms between a susceptible host and an infected or colonized person indirect contact refers to contact of a susceptible host with a contaminated object (e.g., instruments, hands); 2 droplet contact refers to conjunctival, nasal, or oral mucosa contact with droplets containing microorganisms from an infected person (by coughing, sneezing, and talking, or during certain procedures( suctioning and bronchoscopy) that are propelled a short distance; airborne transmission refers to contact with droplet nuclei containing microorganisms that can remain suspended in the air for long periods or to contact with dust particles containing an infectious agent that can be widely disseminated by air currents; common vehicle transmission refers to contact with contaminated items such as food, water, medications, devices, and equipment. Standard precautions: list of hygiene practice to prevent bloodborne/or fluid transmission Isolation precaution: designed to block transmission of highly transmissible/ contagious pathogens or extremely harmful pathogens Droplet large respiratory unit >5micron Airborne smaller respiratory units <5microns 3 Virulence How hard to get How Bad when you get it Host susceptible/immunity/gen phy health subpopulations transmission/infection Infectious agent virus/bacteria/mold Source/People /Places/ Things Persons with acute disease, persons in the incubation period of a disease, persons who are colonized by an infectious agent but have no apparent disease, or persons who are chronic carriers of an infectious agent. (Deliberate releases of biological s (bioterrorism) are a subset of sources. 4 Vectors: air/ blood bodyfluids/ surfaces Transmission/infection Airborne/ droplet Cough 3000 droplet nuclei ;5 mins of talking 40,000 sneeze .02-.3microns viruses 0.3-10 microns bacteria cells/spores 2-5 micron fungal spores 5 Transmission/infection Contaminated items: linen, clothing, utensils, surfaces Percutaneous (into the blood stream) Ingestion Surveillance detection and recordkeeping [] Status of HCW: Eg., “Tuberculosis (TB): Evidence that the health care worker is free of active tuberculosis based upon the results of a negative two-step tuberculin skin test shall be required.” [] Lab work: what tests are effective and turn around time. [] Incubation and evidence of infection 6 Immunization/prophylactic HCWer Patients Vaccine for influenza, measles, rubella, varicella, polio, tetanus, hep A, hep B prophylactic Environmental controls Ventilation PPE respirators barriers/isolation 7 RI Committee on Occupational Safety &Health Generic features of infection control program for a facility: criteria to define a case. cluster, outbreak isolation practices relating to droplet precautions; standard and contact precautions; RI Committee on Occupational Safety &Health (Cont}Generic features of infection control program for a facility: respiratory protection policy (airborne and not just droplet exposures); controls and practices for high risk procedures patient cough etiquette; 8 Generic features of infection control program for a facility: drugs that strict enforcement of hand and surface hygiene; management of staff and visitor traffic role of vaccines and anti-viral meds and related therapies (e.g. interrupt mediators of sepsis). Case Study: WHO Guidelines SARS: Protecting Health Care Workers (03) 1} Recognition of SARS case within one incubation period (about 10days) and no secondary transmission: A} close ward B} isolate patients C] Quarantine hcws and visitors 2} if not recognized within one incubation period A} close hospital B]Hcws work on quarantine If cannot close hospital transfer all exposed patients to a SARS designated hospital Surveillance of HCW Fever check 3 x a day if temp >37.5C not allowed to work If fever for >3days defined as a SARS case and quarantine. 9 {} Occupational H&S Biologic standards OSHA BBP bloodborne pathogens 1910.1030(HIV/HVB/HCB) [] Employers must determine where and when bloodborne pathogen exposure takes place – usually situations and activities when handling blood and blood products and instruments like needles and sharps. [] Universal precautions must be established and observed. (Universal precautions mean you assume that all body fluids are infected and that guidelines to control exposure and transmission – given the situation and the work setting – are established OSHA BBP bloodborne pathogens [] Employees must be educated about risks and the control procedures and supplied with appropriate protective gloves, gowns, and masks. The entire program (called an Exposure Control Plan) must be in writing. And a responsible party to administer the program. [] The facility is responsible to vaccinate all workers at significant risk for hepatitis B. [] Following a significant exposure to blood or tissue products (one that has been shown to produce infection) employees must be tested for infection and treated appropriately. Results must be kept confidential. 10 CDCTB Guidelines (OSHA enforces 1910.134/139 for TB} CDC Infection Control in Health Care Personnel/98[AJIC: American Journal of Infection Control (1998;26:289-354) and Infection Control and Hospital Epidemiology(1998;19:407-63) CDC Isolation precautions in Hospitals WHO Outbreak Communication Guidelines ISI Infection Control in Hospitals RI Committee on Occupational Safety and Health 741 Westminster st. Prov RI 02903 401-751-2015/jobhealth @juno.com 11