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
• • • •

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

issue and application of specific departmental procedures. 2. effective hand washing/disinfecting is the most effective control measure to protect (care) staff against foreseeable communicable diseases. 2.1. Specific risk assessments must be carried out sensitively. recorded in their individual care plans. volunteers. • implement the appropriate control measures. Diseases and Dangerous Occurrences Regulations Health and Safety Team paths@eastsusssex. or otherwise their refusal recorded on their personal file.2. and the necessary control measures. leaflets. 2. including procedures for dealing with laundry 2. code of practice.2. including safe methods of work.2. etc and the infectious/communicable diseases to which they may be exposed specifically as a result of their work.2. and • emphasise that on a generic risk assessment approach. Introduction This Policy describes the arrangements to ensure that those employees who.1 Responsibilities Chief Officers must ensure that: 2. and informing and instructing all their staff (potentially) affected.2 LMG and other Line Managers must ensure that: 2.Occupational Health Policy on Communicable Diseases 1.1 their staff.6 the Occupational Health Adviser and the Personnel and Training (PAT) Safety Advisers are notified of any needlestick injury. etc appropriate to implement this Policy. may be exposed to a small risk of contracting certain infectious and communicable diseases.gov. 2 2. are identified in order to:• confirm who may be harmed and how.5 records are kept of those service users known to have MRSA. by virtue of their job and working environment.2 any employee who refuses immunisation recommended by the County Council. and arrange for the production. 2.2.1 this Policy is implemented in their departments. including agency staff. 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.uk Autumn 2009 Page 2 of 12 . or any other communicable diseases. and note that additionally some diseases that could result from these injuries may be reportable under The Reporting of Injuries. have their health safeguarded.3 safe and appropriate waste disposal procedures must be implemented 2.2.4 appropriate and effective cleaning procedures must be implemented. eg in Adults and Children’s Services. • determine the level of risk.

whenever they suspect they may have contracted an infectious disease at work.2. 2.2 attend their GP surgery or Hospital Minor injuries Unit (or out of hours their nearest Accident and Emergency Department) for appropriate treatment and advice. Norovirus and sharps. contracted by a staff member.4. 2.6 adhere to the basic standard personal hygiene precautions detailed in Appendix A.gov.7 thoroughly decontaminate their hands with an approved hand disinfectant after visiting any service user in their own home.7 a PAT Safety Adviser is informed of any infection.8 adopt the agreed safe methods of work for dealing with biological agents e. MRSA. 2.4.9 refer to Appendix B containing information specific to Tuberculosis.3. 2. 2. human and animal body fluids as well as sharps. eg from biting.Occupational Health Policy on Communicable Diseases 1995 (RIDDOR). 2.3 The Occupational Health Adviser will ensure that: 2. spitting or scratching by a third party. taking the completed Sharps Injury Questionnaire (page 11) with them.4.4.uk Autumn 2009 Page 3 of 12 . contaminated waste.5 use any personal protective clothing provided. 2.4 safely dispose of discovered/discarded sharps. which could be attributable to their work.4. which should then be dealt with as clinical waste.3 ensure that incident reports are completed in relation to the above incident types. Clostridium Difficile.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.1 advice and support is available to managers and staff around issues concerning communicable diseases. District/Borough Council Environmental Health Officers and/or the Consultant in Communicable Diseases Control. 2. eg needles and syringes. 2.8 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.4. 2.4.4. 2.g. Hepatitis B. Health and Safety Team paths@eastsusssex. in a proprietary sharps container.4 Employees must: 2. Sussex Local Health Protection Unit (01273 403597). 2.2.4.

Visiting Officers and Social Workers.g. PO Box 410.gov.gov. Wetherby. as they may need to refrain from work until they have recovered.dh.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/docu ments/digitalasset/dh_4136384. such as Leptospirosis. to minimise the risk of cross infection. 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.g. that effective hand washing protocols are followed.pdf Those who work in the countryside can obtain a copy of the County Council document Health Information for Countryside Workers on the intranet. food poisoning.uk Autumn 2009 Page 4 of 12 . General information Staff who do not provide personal care to Service Users e. Health and Safety Team paths@eastsusssex. must ensure. 3. which gives similar guidance in respect of specific diseases which may be encountered in the natural environment.Occupational Health Policy on Communicable Diseases 2. LS23 7LN) or on the D of H’s website using the following internet address: http://www.4.10 report to their manager if they are suffering from any communicable disease e.

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

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

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

gov.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. The virus is spread by the faecal/oral route (unwashed hand to mouth).uk Autumn 2009 Page 8 of 12 . The most effective way to control the spread of norovirus is by: • • • • washing your hands frequently and thoroughly particularly after using the toilet. Methicillin Resistant Staphylococcus Aureus (MRSA) Staphylococcus Aureus (SA) is a common bacterium. 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. 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. 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. and these are called Methicillin Resistant Staphylococcus Aureus (MRSA). Such infection can slow down recovery. and those who have a specific MRSA infection. It is easily spread among people who are already ill. e. commodes. by touching contaminated surfaces/objects or person to person contact (unwashed hand to mouth). Health and Safety Team paths@eastsusssex. keeping the toilet area clean and hygienic: washing contaminated clothing and linen in hot soapy water to help ensure the virus is killed.g. Infected people should not prepare food until 48 hours after symptoms have ceased. In recent years some strains have become resistant to many of the antibiotics used in the treatment of infections. or result in serious disease such as blood poisoning or bronchopneumonia. Some service users who have been discharged from hospital may have developed MRSA.

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

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

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

eg a diabetic pen? a bite? b) Was your skin broken or damaged before the incident? If Yes. About others: YES/NO Was another person involved? If Yes.gov. About the incident: DATE and TIME: a) Were you injured by something sharp? If No.uk Autumn 2009 Page 12 of 12 . In addition to any treatment given. go to Part (b). if available: Health and Safety Team paths@eastsusssex. From: East Sussex County Council .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. would you please advise what future action. was it: a recently used hypodermic needle? a discarded hypodermic needle? some other sharp object.Occupational Health Service 1. If Yes. NAME About the person affected: JOB TITLE Date (if known): Have you been immunised against Hepatitis B? Yes/No 2. may be appropriate. 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. if any. their Name: Contact address or number.

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