communicable disease exposure training. this section covers highlights of communicable disease...

Communicable Disease Exposure Training

This section covers highlights of Communicable Disease Exposure Plan. For more information please refer to the Plan directly.

Application The City of Joplin has an obligation to the public and to its own staff to increase awareness and promote procedures which prevent exposure of its employees to communicable diseases on the job

Relevance Communicable diseases are dangerous. If you dont take precautions to protect yourself, one incident could result in acquiring a disease you must deal with for the rest of your life. You cant UN-contract a disease!

Goals & Objectives Provide the employee with the processes to follow in the event of an occupational exposure incident. Provide revised and updated information on procedures which affect occupational exposure through annual review of the Communicable Disease Plan This plan has been developed with the assistance of employees who are responsible for those who have potential exposure to source individuals or contaminated items, chemicals and substances due to the nature of their jobs Inform all employees of information included in Communicable disease plan Employees will sign an acknowledgement of this plan Employees in certain classifications, will have additional training provided Certificate of completion shall be awarded upon having completed the training and this certificate shall be retained in the employees file in Human Resources.

Personnel at Risk for Exposure Police Department High Risk Police Officers Police Corporals Police Sergeants Detention Officer Jail Cooks Jail Shift Supervisors Tasks that put these individuals at high risk: Assisting the public on medical related calls Physical confrontations while making arrests Crime scene investigations Other Police Department personnel may have some risk associate with job

Personnel at Risk for Exposure Fire Department High Risk Firefighter/EMT Fire Driver/Engineer Fire Captain These positions require tasks that put the individuals at high risk for contact with blood or other bodily fluids Other Fire Department personnel may have some risk associated with job

Personnel at Risk for Exposure Health Department High Risk RN, LPN WIC Certifier WIC Nutritionist Epidemiology Specialist Animal Control Officer Tasks that put these individuals at high risk: Testing for diseases which involves puncturing the skin Immunizations Treatment of allergic reactions Investigation of communicable disease incidents Performance of animal control activities Other Health Department Personnel may have some risk associated with job

Personnel at Risk for Exposure Wastewater Treatment Plant/Sewer Maintenance High Risk Waste Water Plant Operator, Technician, Supervisor Waste Water Pre-Treatment Inspector, Relief Operator Equipment Operator Laborer Relief Laborer Infrastructure Maintenance Supervisor Heavy Equipment Operator Utility Locator Tasks that put these individuals at high risk: Wastewater sampling and testing Facility and equipment maintenance Clean up of raw sewage spills and overflows Other Waste Water Treatment Personnel may have some risk associated with job

Personnel at Risk for Exposure Parks / Cemeteries, Athletic Complex, Fields and Facilities Departments High Risk Lifeguards Tasks that put these individuals at high risk: Cleaning pool areas throughout the day Performing first aid Providing swimming rescues Other Parks Department Personnel may have some risk associated with job

Personnel at Risk for Exposure Recycling Department Personnel High Risk Recycling Laborer Tasks that put these individuals at high risk: Separation and handling of the used recyclable items which may include needles, lancets or other OPIM in trash brought to the center Picking up of litter inside and outside fenced area of the Recycling Center Other Recycling Department Personnel may have some risk associated with job

Other Personnel at Risk for Exposure All other employees Any employee that has an occupational contact with blood or body fluids, wastewater, infectious materials, and airborne contaminates arising out of and in the course of City of Joplin employment would be assessed on a post-exposure basis and administered any applicable testing or vaccination on an as needed basis.

Methods of Compliance All body fluids or OPIM should be considered potentially infectious and precautions should be taken to prevent exposure to them The following list of precautions that can be used to reduce exposures to communicable diseases in the workplace:

Methods of Compliance 4.1 4.1 Universal precautions It is important prevent contact with blood or other potentially infectious materials Under circumstances in which identification between body fluid types is difficult or impossible, all body fluids should be considered potentially infectious materials

Methods of Compliance 4.2 Hand Washing The City will provide hand-washing facilities, which are readily accessible to employees in each facility. If hand washing facilities are not feasible, antiseptic hand cleaners/towelettes will be provided; however, hands must be washed with soap and running water as soon as possible. If personal protective equipment is worn, hands should be washed immediately after removal of such gloves or equipment Employees should wash hands and any other skin with soap and water, or flush mucous membranes with water immediately following contact with blood or other potentially infectious materials

Methods of Compliance 4.3 4.3 Needles and Other Sharps Contaminated needles and other sharps shall not be bent, recapped, or removed except when there is no other alternative If a contaminated sharp is found on the premises of a facility belonging to the City of Joplin, an employee is to stay with the item until it is properly disposed of to prevent any further exposure If a contaminated sharp is found, an employee should contact the authorized employee from their department who may remove the item and place it into a sharps container When the container is full it shall be taken to a proper disposal site located at the Health Department

Methods of Compliance 4.4 4.4 Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of occupational exposure Food and drink should not be kept in refrigerators, freezers, shelves, cabinets or on countertops or bench tops where blood or other potentially infectious materials are present Mouth pipetting/suctioning of blood or other potentially infectious material should never be performed

Methods of Compliance 4.5 4.5 Equipment which may become contaminated with blood or other potentially infectious materials should be examined prior to use and should be decontaminated as necessary, unless the decontamination of the equipment is demonstrated to be unfeasible

Methods of Compliance 4.6 4.6 Personal Protective Equipment Protective equipment will be made available to general City of Joplin employees as necessary for tasks. Each facility must have equipment in an easily accessible area. Gloves must be worn when an employee may have hand contact with: blood other potentially infectious materials mucous membranes non-intact skin when handling or touching contaminated items or surfaces

Methods of Compliance Single use gloves should not be washed or decontaminated for re- use Utility gloves may be decontaminated for re-use if the integrity of the glove is not compromised they must be discarded if they are cracked, peelings, torn, punctured, or exhibit other signs of deterioration or when their ability to function as a barrier is compromised Masks, eye protection, and face shields: to be worn whenever splashes, spray, splatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can be anticipated

Methods of Compliance 4.7 Used Personal Protective Equipment Must be disposed of correctly, the appropriate receptacles are located at the Health Department The Community Services Manager or the designated safety personnel shall perform routine replacement of depleted personal protection items

Methods of Compliance 4.8 4.8 Warning Labels Must be affixed to: containers of regulated waste refrigerators and freezers containing blood or other potentially infectious material other containers used to store, transport or ship blood or other potentially infectious materials These labels shall be fluorescent orange or orange-red or predominantly so, with lettering and symbols in a contrasting color Labels must be attached to the container

Pre-Exposure Vaccinations/Baseline Testing The City of Joplin makes available vaccinations for those diseases in which a vaccine is available. Certain positions within the City are designated as having an occupational risk of exposure to those diseases. As part of the pre-employment physical process, the prospective employee will be asked by the contracted medical provider if the prospective employee is current on their vaccinations and determine if additional vaccinations are needed. If the prospective employee declines the vaccination, a declination form is available from the Human Resource Department. The form should be filled out by the medical provider and the prospective employee, and sent to the City of Joplin Human Resources Department.

Appendix Information Appendix 1 of this plan includes Department specific guidelines for the designated departments: Appendix 1-A - Police Department Appendix 1-B - Fire Department Appendix 1-C - Health Department Appendix 1-D Wastewater/Sewer Maintenance Department Appendix 1-E - Parks Department Appendix 1-F- Recycling Center Appendix Two of this plan includes a listing of the required preventative testing for each Job position listed Appendix 2-A Required Preventative Vaccination and Testing List

Baseline Testing Hepatitis A vaccinations are on a schedule of two shots. The second shot is given 6 months after the first shot. There is a combined Hepatitis A & B shot given in 3 doses. Currently, there is no known vaccination for hepatitis C and hepatitis D. Rabies vaccinations are given as a 3-shot series to employees determined to be in the frequent-risk category. Mantoux method for TB skin testing is the recommended method of tuberculin skin testing by the CDC.

Exposure Procedures, Evaluation and Follow-up Blood Borne /Body Fluid Exposure - HBV, HIV, HCV 1. When an employee is exposed to blood or body fluid that individual should provide immediate care to the wound site by: Washing wound site with soap and water Flush contamination of nose, mouth, or skin with water Irrigate eyes with clean water, saline or sterile irrigants 2. Notify employees supervisor or person in charge of work site.

Exposure Procedures 3. If not already known, obtain information as to the source individuals name, address and phone number. Request that they consent to source individual testing for potential blood or body fluid pathogens. If the source individual is already known to be infected with a disease, testing for the source individuals known disease status need not be repeated.

Source Person 4. Consents to Testing 5. Does not Consent to Testing Have source person fill out Source Individual Occupational Exposure Testing Consent Form Notify HR they will be taking test, and go to testing facility City of Joplin will pay for initial test, but no further follow up testing Exposed Employee should complete Incident Report and return to HR HR will coordinate testing/prophylaxis Testing must be initiated 1-3 hours after exposure Treatment must be initiated 2- 4 hours after exposure

Exposure Procedures 6. Employee testing and prophylaxis is voluntary, but strongly recommended. If an employee decides not to obtain follow-up testing and/or prophylaxis the employee will be required to sign an Occupational Exposure to Blood/Body Fluids Testing/Prophylaxis Declination Form 7. Results of testing will remain confidential, only the exposed employee and source individual will be given results Information will only be released via written consent of patient Should the exposed employee contract a communicable disease through the reported exposure incident, the City would be notified at that time so that medical treatment can be authorized The Health Department will be notified by healthcare provider for necessary investigation

Air Borne Exposure TB and other droplet- spread or airborne diseases Tuberculosis exposure results from saliva inhaled in droplet form from a cough or sneeze from a person identified or highly suspected of having TB or other airborne disease When an employee has a known exposure to Active TB, they should notify their supervisor or person in charge, who will notify the Health Department. Obtain an employee Incident Report form and fill out completely. Notify HR Dept.

Fecal Exposure-HAV Exposure would result from accidental ingestion of fecal material Employees working with wastewater, parks, sewer maintenance, fire, police or in health department would be most at risk of this exposure To alleviate this risk all employees identified at risk will be offered the HAV vaccination

Animal Bite Exposure Rabies A rabies exposure results from contact with saliva from an animal capable of carrying rabies through a bite or scratch which breaks the skin If rabies from exposure is a possibility you should: Capture the animal for quarantine and observation Wash exposed area with soap and water, flush nose, mouth, eyes and skin with water and appropriate irrigants Notify employees supervisor or person in charge If animal was not captured, contact the Animal Control Officer at the Health Department so an attempt can be made to capture the animal for quarantine and/or testing Contact Human Resources to arrange testing/prophylaxis and fill out Incident Report

Other Exposures Any other potential communicable disease exposure not otherwise identified in this plan will be handled on a case by case basis

Information and Training All training will be provided by the City of Joplin during working hours at no cost to the employee Department training officers are to ensure all new employees receive instruction on communicable diseases before their first assignment Annual refreshers may be mandatory

Training The person conducting the training should be knowledgeable in the subject matter covered by the elements contained in the training program as it relates to the workplace that the training will address. For that reason, the following positions are to be responsible for providing the training materials, maintaining training records, scheduling training sessions, and providing knowledgeable trainers: Police Department - Training Sergeant Fire Department - Fire Training Officer Health Department - Environmental Health/Epidemiology Coordinator All other departments - Administrator

Recordkeeping The City of Joplin will establish and maintain an accurate record for each Employee with occupational exposure. The record must include: name social security number copy of the employees vaccination status including the dates of all the vaccinations and any medical records relative to the employees ability to receive vaccination

Compliance Violations of this plan, or portions thereof, may result in disciplinary action as described in the City of Joplins Personnel Rules. This plan shall become effective on ____________________________, based on the City Managers approval.

Overview Each department has a Communicable Disease Exposure book with a red cover sheet which is to be located in a particular spot which is accessible by all employees at all times and that is labeled with laminated sign There is slight variance between each departments book, as department-specific protocol is required in certain places. Referring to the Table of Contents is critical to finding the information you are seeking

Contents Each books includes: Communicable Disease Exposure Plan Emergency Contacts for that department Emergency procedures Baseline Testing Requirements Recordkeeping forms

Communicable Disease Exposure Plan A copy of the Plan is in each departments book and may be referenced at any time

Emergency Contacts Emergency Contacts specific to each department are located immediately after the Red Tab The contacts are to be called in the order they are listed on the page Additional numbers and information are on the page

Emergency Procedures After the Red Tab and emergency contacts, emergency procedures are listed Some departments have general procedures and some have department specific procedures

Baseline Testing Requirements A list of what test are required of particular jobs can be found in this book

Recordkeeping Forms These forms are located after the Blue Tab Included are: Occupational Exposure Risk Stratification Form Occupational Exposure to Blood/Body Fluid Testing or Prophylaxis Declination Form Source Patient Occupational Exposure Testing Consent Form Hepatitis A, Hepatitis B, and Rabies Vaccine Declination

communicable disease exposure training. this section covers highlights of communicable disease...

Documents

risk associate

job slide

police department personnel

potential exposure

health department personnel

occupational exposure

employees of information

employees file