Biological hazards

Patricia Coward

Principal Adviser (Occupational Health)

Asbestos and Occupational Hygiene and Health Unit

BSc (Hons) Nurs

MApp Sc (OHS)

Dip OHN

Grad Cert Infection Control

RN

• Overview of biological hazards.

• Risk management for biological hazards.

• Role of Workplace Health and Safety Queensland.

Content

Biological hazards

• Biological hazards can cause

– irritation, sensitization (allergy) and toxicity

• organic matter of plant, animal or microbial origin

– infectious diseases

• infectious bacteria, viruses, fungi and parasites.

Work-caused infectious diseases

• About 1300 workers are compensated annually for

infectious diseases

– likely to be an underestimate

– occupational zoonoses underestimated by a factor of at least 10.

• Most commonly compensated workers

– agricultural workers

– meat workers

– livestock workers

– healthcare workers

– childcare workers

– primary school teachers.

WHS legislation

• No specific provisions for biological hazards.

• WHS Act 2011– primary duty of care

– further duties

– duty to consult

– management of risks

– incident notification

– workers’ duties.

• WHS Regulation 2011– risk management

– information, training and instruction

– general workplace facilities

– adequate and accessible facilities

– first aid

– emergency plans

– PPE.

• Worked-caused infectious diseases are notifiable incidents.

Chain of infection

• Source of infectious agent

– bacteria, viruses, fungi, parasites

– reservoir of infection.

• Mode of transmission– contact transmission

– droplet transmission

– airborne transmission

– vector-borne (insect) transmission

– food-borne transmission

– water-borne transmission.

• Susceptible person

– workers may be more susceptible to infection if they• are not immune to a vaccine-preventable disease at work

• have an impaired immune system because of a medical condition or treatment

• skin condition.

Risk management

• Manage biological hazards through risk management.

Identify biological hazards

• Identify infectious diseases that workers and other persons may be

exposed to at work

• seek advice as needed.

At-risk occupations

• Contact with infectious people, blood and body substances and used needles and syringes– accommodation industry

– childcare services

– education services

– cleaning industry

– construction industry

– defence services

– emergency response, rescue services and disaster management

– entertainment industry

– funeral industry

– healthcare, personal care and allied health services

– laundry services

– medical laboratory, research and biotechnology industries

– parks, gardening and landscaping services

– personal appearance services

– security industry

– sewage, plumbing and water treatment services

– sex industry

– waste and recycling industries.

Examples of infection risks

• Cytomegalovirus (CMV)

• Giardiasis

• Hepatitis A

• Hepatitis B

• Hepatitis C

• Herpes simplex

• HIV

• Influenza

• Measles

• Meningococcal disease

• Mumps

• Norovirus

• Parvovirus B19

• Pertussis (whooping cough)

• Rubella (German measles)

• Sexually transmissible infections

• Scabies

• Tuberculosis

• Varicella (chickenpox)..

At-risk occupations

• Contact with animals, animal products and animal waste – agricultural, livestock, farming

and aquaculture industries

– animal care, rescue and welfare services

– environmental and ecology services

– fertiliser production

– fishing industry

– meat, poultry and fish processing and rendering industries

– pest control services

– pet breeding and retail

– pet food manufacturing

– petting zoos

– parks and forestry industries

– tannery industries

– veterinary, para-veterinary, and veterinary laboratory and research industries

– waste industry

– zoos and wildlife exhibits.

Examples of infection risks

• Anthrax

• Australian bat lyssavirus

• Avian influenza

• Brucellosis

• Cat scratch disease

• Campylobacter enteritis

• Dermatophytosis

• Erysipeloid

• Giardiasis

• Hendra virus

• Histoplasmosis

• Hydatid disease (echinococcosis)

• Leptospirosis

• Lymphocytic ChoriomeningitisVirus infection (LCM)

• Methicillin resistant staphylococcus aureus (MRSA)

• Murine typhus

• Mycobacterium avium

• Mycobacterium marinum

• Pasteurella multocida

• Psittacosis

• Q fever

• Rat bite fever

• Salmonellosis

• Streptococcus suis

• Toxoplasmosis.

• About 75% of emerging infectious diseases are of animal origin.

At-risk occupations

• Contact with the environment– agricultural industry

– archaeology services

– construction industry

– eco-tourism industry

– emergency response, rescue and disaster management services

– geology, earth sciences, environmental and surveying services

– horticultural industry

– landscaping and gardening services

– industrial users of non-potable and recycled water

– other outdoors work

– parks and forestry industries

– ventilation/air-conditioning engineering and maintenance services.

Examples of infection risks

Contact with soil,

water and vegetation

Contact with

environments

contaminated with

human or animal

excreta

Contact with insects

(mosquitoes, ticks,

etc)

Cryptococcosis (C. gattii)

Histoplasmosis

Legionellosis (L.

pneumophilia and L.

longbeachae)

Melioidosis

Sporotrichosis

Tetanus

Campylobacter enteritis

Cryptosporidiosis

Leptospirosis

Salmonellosis

Barmah forest virus

Dengue

Murray Valley encephalitis

Ross River virus

Queensland tick typhus

Scrub typhus

Tick typhus

At-risk occupations

• Work at locations where there is a higher prevalence of an infectious

disease

– overseas business travel or offshore work (e.g. travel related infections)

– remote Aboriginal or Torres Strait Islander communities (e.g. hepatitis A,

Japanese encephalitis)

– tropical regions (e.g. melioidosis).

At-risk occupations

• Shared work accommodation

and amenities

– accommodation camps

– communal amenities.

• Examples of at-risk workers– cleaning services

– FIFO/DIDO workers

– laundry services

– live-in workers

– security services

– users of communal amenities

– waste management services.

• Examples of infection risks– gastrointestinal infections (e.g.

norovirus)

– respiratory infections (e.g. influenza)

– skin infections and infestations (e.g. scabies, impetigo, Staphylococcus aureus, tinea, plantar warts).

• Lifestyle infection risks

associated with working away

from home– blood-borne viruses

– STI.

Infection risks for other persons

• Other persons at workplaces may also be exposed to infection risks,

for example:

– aspergillosis risks from construction work at healthcare facilities

– ‘gastro’ risks from animal contact opportunities

– legionellosis risks at healthcare and aged care facilities

– pertussis (whooping cough) risks at healthcare facilities and early

childhood education and care centres.

Industry example

• Construction industry

– soil, vegetation, compost (e.g. tetanus, melioidosis, legionellosis)

– untreated sewage (e.g. ‘gastro’ infections, hepatitis A)

– human waste and discarded needles and syringes (e.g. ‘gastro’ infections, blood-

borne viruses)

– native wildlife (e.g. Australian bat lyssavirus, Q fever)

– livestock (e.g. Q fever)

– rodents (e.g. leptospirosis)

– insects (e.g. mosquito and tick borne infections)

– process water (non-potable water) (e.g. ‘gastro’ infections)

– pigeon or bat excreta (e.g. ‘gastro’ infections, histoplasmosis, cryptococcosis) )

– unhygienic worker facilities (toilets, hand washing, dining, first aid) (e.g. ‘gastro’

infections)

– construction camps (e.g. respiratory infections, skin infections)

– work on medical systems (ventilation systems, vacuum systems).

Assess the risk

• Risk assessment

– risk = likelihood x consequences.

• What is the likelihood of a specific infectious disease occurring? – task

– exposure

– workplace

– infectious agent

– workers

– existing control measures.

• What are the consequences if a specific infectious disease occurs?

– death, illness (acute or chronic), harm to a pregnant woman or her baby,

psychological effects, spread of infection to vulnerable groups, ‘outrage’,

etc.

– some workers may have risk factors for developing more severe

infection.

Control the risk

• Control measures should be appropriate to – the outcome of an informed risk assessment

– the hierarchy of risk control

– the mode of transmission

– whether or not the risk is vaccine-preventable.

HIGHER ORDER CONTROLS CONTROL THE PROCESS

Elimination

Substitution

Isolation

Engineering

LOWER ORDER CONTROLS CONTROL THE PERSON

Administrative controls

Personal protective equipment

Control the risk

• Mode of transmission.

• Contact transmission– prevent contact with or contain

sources of infection– protect the hands, skin, mucous

membranes of the eyes, nose and mouth, clothing, etc. from contamination and prevent skin penetrating injuries.

• Droplet transmission– prevent and contain the

generation of infectious droplets

– protect the mucous membranes of the eyes, nose and mouth from infectious droplets.

• Airborne transmission– prevent and contain the

generation of infectious aerosols and dust

– protect against inhaling infectious aerosols and dust.

• Vector-borne transmission– prevent insect breeding sites and

insect bites.

• Food-borne transmission– prevent food contamination and

promote food safety.

• Water-borne transmission– prevent water contamination and

contain or treat sources of contaminated water

– protect against exposure to contaminated water and associated droplets and aerosols.

Control the risk

• Occupational vaccination

– hepatitis A

– hepatitis B

– influenza

– Japanese encephalitis

– measles-mumps-rubella

– pertussis (whooping cough)

– Q fever

– rabies

– rubella (German measles)

– tetanus

– varicella (chickenpox)

– https://www.qld.gov.au/health/conditions/immunisation/occupational/index.html.

• Animal vaccination

– Hendra virus

– leptospirosis.

https://www.qld.gov.au/health/conditions/immunisation/occupational/index.html

Court case

• WHSQ prosecuted a bat research facility in 2014.

• Workers, volunteers and members of the public had

contact with bats and sustained bites and scratches.

• Workers and volunteers were not immunised against

rabies.

• Workers, volunteers and the public were not informed

about Australian bat lyssavirus risks.

• No warning was given that, if bitten or scratched, to seek

immediate medical attention.

• 12 month good behaviour bond with surety of $10,000,

and costs of $1079.

Court case

• WorkCover Victoria v Galpac 2005.

• Four workers acquired Q fever after processing sheep

placentas for use in cosmetics.

• No risk assessment, Q fever vaccination or RPE.

• Fined $20,000.

Court case

• Hughes v SDN Children’s Services 2002.

• Son born with congenital cytomegalovirus.

• Employer

– failed to advise Hughes about CMV risks during

pregnancy

– relocated Hughes to work with the babies after she

advised of her pregnancy.

• Awarded $4.65 million.

WHSQ and biological hazards

• Role

– targeted audit programs

– injury, illness and complaint

investigation

– standards setting

– information and advice.

• More information

– www.worksafe.qld.gov.au

– biological hazards homepage

– Infoline 1300 362 128.

http://www.worksafe.qld.gov.au/