Occupational Health Policy on Communicable Diseases

1 2 3. Introduction............................................................................................................ Responsibilities ................................................................................................... 2 General information ............................................................................................. 4

APPENDIX A: Basic Standard Precautions ................................................................ 5 APPENDIX B: Specific Infections ............................................................................... 7 APPENDIX C: General Risk Assessment For MRSA ............................................... 10 APPENDIX D: Sharps Injury Questionnaire.............................................................. 12
Author and contact: Personnel & Training/Occupational Health and Safety, Reviewed 10/2009

Good personal hygiene precautions are crucial to prevent the spread of all infections, and hand washing is the single most important intervention in the control of crossinfection. A risk assessment approach will be taken to manage the hazards associated with exposure to foreseeable communicable diseases, to determine the appropriate control measures required which will include educating, informing, instructing, and where necessary, training staff in the appropriate safe working practices.

Key points
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This Policy has been introduced to ensure that the required standards are met to protect staff who may be at risk from communicable diseases at work. Managers and staff must ensure that the appropriate personal hygiene precautions are observed, particularly in the provision of direct personal care. Responsibilities fall on Chief Officers, Managers and employees Detailed information and guidance on specific communicable diseases is given in Appendix B Copies of all the Health and Safety Policies can be found on the Intranet:

Health and Safety Team

paths@eastsusssex.gov.uk

Autumn 2009

Page 1 of 12

etc and the infectious/communicable diseases to which they may be exposed specifically as a result of their work.2 LMG and other Line Managers must ensure that: 2.2.1 this Policy is implemented in their departments.1 Responsibilities Chief Officers must ensure that: 2.gov.2. eg in Adults and Children’s Services.3 safe and appropriate waste disposal procedures must be implemented 2. code of practice. 2.2.uk Autumn 2009 Page 2 of 12 . 2. • implement the appropriate control measures. leaflets. are identified in order to:• confirm who may be harmed and how. 2.2. and note that additionally some diseases that could result from these injuries may be reportable under The Reporting of Injuries. Specific risk assessments must be carried out sensitively. have their health safeguarded.2.Occupational Health Policy on Communicable Diseases 1. 2. issue and application of specific departmental procedures. including procedures for dealing with laundry 2. volunteers. The County Council cannot assume responsibility for action on diseases to which the community at large is at risk and which are not work-related. to be appropriately advised and encouraged.5 records are kept of those service users known to have MRSA. • determine the level of risk. etc appropriate to implement this Policy.2. including safe methods of work.6 the Occupational Health Adviser and the Personnel and Training (PAT) Safety Advisers are notified of any needlestick injury. by virtue of their job and working environment.1. and arrange for the production. Diseases and Dangerous Occurrences Regulations Health and Safety Team paths@eastsusssex. recorded in their individual care plans.1 their staff. and • emphasise that on a generic risk assessment approach. Introduction This Policy describes the arrangements to ensure that those employees who. and the necessary control measures. or otherwise their refusal recorded on their personal file. 2 2.2 any employee who refuses immunisation recommended by the County Council. may be exposed to a small risk of contracting certain infectious and communicable diseases. effective hand washing/disinfecting is the most effective control measure to protect (care) staff against foreseeable communicable diseases. including agency staff. or any other communicable diseases.4 appropriate and effective cleaning procedures must be implemented. and informing and instructing all their staff (potentially) affected.

2.7 thoroughly decontaminate their hands with an approved hand disinfectant after visiting any service user in their own home. 2. in a proprietary sharps container. Sussex Local Health Protection Unit (01273 403597).7 a PAT Safety Adviser is informed of any infection.2 attend their GP surgery or Hospital Minor injuries Unit (or out of hours their nearest Accident and Emergency Department) for appropriate treatment and advice. which could be attributable to their work. Hepatitis B.4 Employees must: 2. 2.1 report all sharps incidents to their manager and attend their nearest Accident and Emergency Department for appropriate treatment and advice as soon as possible.3. contaminated waste. 2.2. human and animal body fluids as well as sharps.4. 2. 2.g. Health and Safety Team paths@eastsusssex.2. Norovirus and sharps. 2.4 safely dispose of discovered/discarded sharps. spitting or scratching by a third party. which should then be dealt with as clinical waste.4.9 refer to Appendix B containing information specific to Tuberculosis.4.8 an outbreak of infection is managed effectively and advice is sought on specific safe working practices and/or potential diseases from the Occupational Health Unit. eg needles and syringes.4. contracted by a staff member. eg from biting. 2.4. 2. MRSA.Occupational Health Policy on Communicable Diseases 1995 (RIDDOR). 2.uk Autumn 2009 Page 3 of 12 . 2.4.4. whenever they suspect they may have contracted an infectious disease at work. District/Borough Council Environmental Health Officers and/or the Consultant in Communicable Diseases Control.8 adopt the agreed safe methods of work for dealing with biological agents e.4.6 adhere to the basic standard personal hygiene precautions detailed in Appendix A. Clostridium Difficile.3 ensure that incident reports are completed in relation to the above incident types. 2.3 The Occupational Health Adviser will ensure that: 2.1 advice and support is available to managers and staff around issues concerning communicable diseases.4.gov. taking the completed Sharps Injury Questionnaire (page 11) with them.5 use any personal protective clothing provided.

must ensure.4. as they may need to refrain from work until they have recovered. LS23 7LN) or on the D of H’s website using the following internet address: http://www.dh. 3. that effective hand washing protocols are followed.gov.Occupational Health Policy on Communicable Diseases 2. Reference Appendix A Reference should also be made to the “Guidelines on the Control of Infection in Residential and Nursing Homes” (obtainable from the Department of Health. PO Box 410.pdf Those who work in the countryside can obtain a copy of the County Council document Health Information for Countryside Workers on the intranet. General information Staff who do not provide personal care to Service Users e. Wetherby.g. to minimise the risk of cross infection.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/docu ments/digitalasset/dh_4136384. food poisoning. which gives similar guidance in respect of specific diseases which may be encountered in the natural environment.uk Autumn 2009 Page 4 of 12 .10 report to their manager if they are suffering from any communicable disease e.g. Visiting Officers and Social Workers. Health and Safety Team paths@eastsusssex. such as Leptospirosis.

Effective hand washing should be performed as follows: • • wet the hands up to the wrist before applying liquid hand cleanser. before using an approved hand disinfectant. • • Effective use of hand disinfectant: • Where the specific hand washing facilities above are not always available or suitable.gov. hands should be free of dirt and organic material. paying particular attention to the tips of the fingers. disposable paper towels in all care. until the solution has evaporated and the hands are dry. the thumbs and the areas between the fingers. cracking of the skin.uk Autumn 2009 Page 5 of 12 . rubbing vigorously. drinking or handling food When they are obviously soiled. Effective hand washing is the single most important intervention in the control of cross-infection. lather well. If the approved hand disinfectant causes a rash. When decontaminating hands. eg home care.Occupational Health Policy on Communicable Diseases APPENDIX A: Basic Standard Precautions Good personal hygiene precautions are crucial to preventing the spread of all infections. an approved hand disinfectant must be provided and used. easy access to hot and cold running water and an adjacent (ideally foot-operated) waste bin. Hand washing facilities should include liquid soap dispensers (bar soap is prohibited for use by care staff). and in between the fingers. • • Health and Safety Team paths@eastsusssex. smooth the liquid hand cleanser evenly over the hands. The hands must be rubbed together vigorously. However. the approved hand rub solution (2mls) must come into contact with all surfaces of the hands. and After cleaning of any kind. including the thumbs. rinse hands under running water and dry thoroughly with paper towels. and staff must always wash their hands: • • • • • • • Before and at the end of each working period Before and after direct physical contact with service users After using the toilet Before and after removing protective clothing such as disposable aprons and gloves Before eating. etc the Occupational Health Adviser must be contacted as soon as practicable.

etc. handling laundry. • Changed between service users. • Changed between tasks.g. must never be shared with others. clinical waste etc.Occupational Health Policy on Communicable Diseases APPENDIX A (continued) Protective Clothing: • Disposable aprons and gloves must be worn whenever there is a risk of splashing or contamination with blood. They should be: • Single use. eg. clippers. latex gloves should only be used in exceptional circumstances and only following a risk assessment.gov. non latex gloves e. Therefore. saliva) or chemicals. faeces. scissors.g. urine. vomit.uk Autumn 2009 Page 6 of 12 . razors. and when cleaning. Blood and body fluid spills must be dealt with immediately in accordance with the “Don’t spread infection” leaflet obtainable electronically (link below). on the same person. Personal grooming items. Disposable Gloves: To ensure latex allergies are minimised. vinyl or nitrile. Additional Information: • • • Staff must cover cuts or breaks in skin on exposed parts of the body with a waterproof plaster or dressing whilst at work. Please note that hands must be washed after carefully removing gloves. and not re-used. • Health and Safety Team paths@eastsusssex. other body fluids (e. nail files. must be available for use at all times. or anything that may have come in contact with blood. Additional information can be found in the “Don’t Spread Infection” Guidance which is located on the intranet.

staff suffer from a needlestick injury. following an incident involving a person known. It most commonly affects elderly people with other underlying diseases. The HSE publication INDG342 “Blood-borne Viruses in the Workplace” gives more guidance on Hepatitis B and associated risk assessments. If the GP is unable to assist with such a service. Any employee who refuses immunisation recommended by the County Council. they should consult their GP who may refer them to a Chest Clinic for a skin test to confirm whether they have any immunity. etc they must report to their GP or to an Accident and Emergency Unit as soon as possible. The spread of infection is a greater risk in hospitals and care homes where there are many people in close contact with each other and touching equipment or surfaces that are contaminated with the bacteria. spitting. either directly or through a third party. eg service users with severe learning difficulties. in exceptional circumstances and as a result of a specific risk assessment. Clostridium Difficile (C.gov. or suspected. if staff have any doubts. or believe they may not have been previously immunised.Difficile) C. The elderly and the ill are particularly vulnerable in particular if they are taking broad spectrum antibiotics for one or more conditions.uk Autumn 2009 Page 7 of 12 .Occupational Health Policy on Communicable Diseases Appendix B: Specific Infections Tuberculosis: The possibility of contracting TB is low unless staff are providing direct prolonged personal care in the same room to the “at risk groups” in a social care setting. and who may have direct exposure to contaminated sharps. Health and Safety Team paths@eastsusssex. or otherwise their refusal recorded on their personal file. bite. Hepatitis B immunisation is considered appropriate. Difficile is a bacterium that lives in the large bowel. the relevant staff should approach their GP for advice in the first instance. Where staff have previously been immunised against TB this should give long term protection. It is the major cause of antibiotic associated diarrhoea. and widespread immunisation is not necessary. However. of being a Hepatitis B carrier. they should contact Occupational Health for advice on alternative arrangements . If. However. Hepatitis B: Current medical advice is that Hepatitis B is generally not a significant occupational risk. and whether BCG immunisation is appropriate. to be appropriately advised and encouraged. should be made on the basis of a local risk assessment. ie older people. and asylum seekers and their children. If. decisions on immunisation for staff who work with particular at risk groups. infected blood or other bodily fluids contaminated with infected blood.

Occupational Health Policy on Communicable Diseases APPENDIX B (continued) The bacterium is spread by touch therefore if you work or visit in a care home or hospital it is very important that you take care to minimise the risk and spread of possible infection by: • washing your hands after any contact with a patient/service user: • maintaining good hygiene practices through thorough cleaning of the environment: • wearing disposable gloves and aprons when giving care to patients who have C Difficile or when cleaning equipment that could be contaminated. Some service users who have been discharged from hospital may have developed MRSA. commodes. It is easily spread among people who are already ill. e. or result in serious disease such as blood poisoning or bronchopneumonia. and before preparing food: disinfecting any surfaces or objects that could be contaminated with a norovirus using a bleach based household cleaner and following the product instructions: flushing away faeces and vomit in the toilet. by touching contaminated surfaces/objects or person to person contact (unwashed hand to mouth).gov. In recent years some strains have become resistant to many of the antibiotics used in the treatment of infections. Norovirus (Winter Vomiting Disease) Outbreaks often occur in establishments such as hospitals and care homes where there are many people in close contact with each other. The most effective way to control the spread of norovirus is by: • • • • washing your hands frequently and thoroughly particularly after using the toilet. and these are called Methicillin Resistant Staphylococcus Aureus (MRSA).g. There is a difference between numerous people in the general population who are asymptomatically colonised with MRSA (eg carry it on their skin or in their nose) harmlessly without any associated problems. Health and Safety Team paths@eastsusssex.uk Autumn 2009 Page 8 of 12 . Infected people should not prepare food until 48 hours after symptoms have ceased. Methicillin Resistant Staphylococcus Aureus (MRSA) Staphylococcus Aureus (SA) is a common bacterium. keeping the toilet area clean and hygienic: washing contaminated clothing and linen in hot soapy water to help ensure the virus is killed. The virus is spread by the faecal/oral route (unwashed hand to mouth). and those who have a specific MRSA infection. Such infection can slow down recovery.

practice the highest standards of hygiene precautions to prevent contracting MRSA or spreading it (or any other organism) to other people (Appendix A).gov. Sharps Incidents In the event of any “sharps” incident involving the risk of blood-borne infections. taking the Introductory Letter (attached) with them. and it is therefore essential that staff who provide personal care to service users and come into direct APPENDIX B (continued) physical contact with them. personal care for service users with MRSA. eg needlestick injuries. e. it should be washed with liquid soap and running water. should be dealt with as follows: • • • • • the wound should be encouraged to bleed freely. a specific risk assessment must be sensitively carried out using the generic risk assessment (Appendix C) given below which must be tailored by establishment managers. All discovered (discarded) needles and syringes must be safely disposed of in a proprietary sharps container. dermatitis and psoriasis. . the wound should then be covered with an appropriate dressing. human scratches. which should then be dealt with as clinical waste. employees should report to an Accident and Emergency Unit as soon as possible. Health and Safety Team paths@eastsusssex.Occupational Health Policy on Communicable Diseases MRSA is passed on by human contact. commonly by the hands. contamination of cuts and abrasions with blood-borne fluids. Where service users are known to have MRSA. the incident should be reported on a Health and Safety Incident Report form and the incident investigated. etc to reflect the specific service provision. For more information on MRSA please log onto the ‘NHS Direct’ or the ‘Department of Health’ website. or continuing to provide. Staff with skin problems on their hands. must seek occupational health advice before providing.g. eczema.uk Autumn 2009 Page 9 of 12 .

eg by direct physical contact with the broken skin. Hand Care – cuts or breaks in the skin must be covered with an impermeable dressing. open wounds etc. Record Keeping – identify and record those service users known to have MRSA and stipulate the necessary control measures in their care plans.Occupational Health Policy on Communicable Diseases APPENDIX C: Generic Risk Assessment For MRSA HAZARD MRSA bacteria WHO MIGHT BE AFFECTED? Service users. REQUIRED (CURRENT) CONTROL MEASURES Policy on Communicable Diseases at Work – communicated to all relevant staff. Information/Instruction – all relevant staff must be provided with suitable information on the prevention and control of MRSA in the workplace. HOW MIGHT THEY BE AFFECTED? Describe work activity involved and potential source(s) of infection.uk Autumn 2009 Page 10 of 12 . Staff with skin conditions affecting their hands should avoid physical contact with service users (and seek advice from the Occupational Health Unit).gov. by transfer between service users. Waste – Safe and appropriate waste disposal procedures must be implemented. RISK LEVEL RISK = LOW (ie Likely Frequency .2 × Likely Severity – 4 = Risk Rating – 8) • This calculation had been undertaken using the format contained in ESCC’s Risk Assessment Policy. the use of protective clothing and sharps and body fluid management. Hand Disinfectant – All staff who visit service users in the community must thoroughly decontaminate their hands with an approved hand disinfectant after visiting every service user in their own home. care staff and other staff who may visit or come into direct physical contact with service users in residential. including effective hand washing. Cleaning – Appropriate and effective cleaning procedures must be implemented including procedures for dealing with laundry. Basic Standard Hygiene Precautions – to be applied when working with all service users. of infected service users. day or home care services. Health and Safety Team paths@eastsusssex.

Occupational Health Policy on Communicable Diseases Further Recommendations Maintain (current) control measures above and inform and supervise staff involved. Assessed by: Date: Health and Safety Team paths@eastsusssex.gov.uk Autumn 2009 Page 11 of 12 .

gov. In addition to any treatment given. From: East Sussex County Council . if any. if available: Health and Safety Team paths@eastsusssex. did damaged skin come into contact with another person’s blood or blood stained body fluid c) Was there contact from body fluid with your eye or mouth? Any other relevant details: YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO 3. would you please advise what future action. go to Part (b). eg a diabetic pen? a bite? b) Was your skin broken or damaged before the incident? If Yes.Occupational Health Policy on Communicable Diseases APPENDIX D: Sharps Injury Questionnaire To: A&E Department The person presenting this completed form is an East Sussex County Council employee who has been exposed to a sharps injury and/or possible contaminated body fluids at work. About others: YES/NO Was another person involved? If Yes. If Yes. About the incident: DATE and TIME: a) Were you injured by something sharp? If No. NAME About the person affected: JOB TITLE Date (if known): Have you been immunised against Hepatitis B? Yes/No 2. was it: a recently used hypodermic needle? a discarded hypodermic needle? some other sharp object.Occupational Health Service 1. may be appropriate. their Name: Contact address or number.uk Autumn 2009 Page 12 of 12 .

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