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Hazards found in the Storage Room Reusable Container Contaminated IV Pole Disposal of Containers Clean and Sanitary work environments Disinfectant Brush/Dustpan Barricades Barricades Cleaning Chemicals Cleaning Chemicals Cleaning Chemicals

Common safety and health topics: 

 

Contaminated Work Environments

Hazard

Exposure of housekeeping staff to bloodborne pathogens through contaminated work environments.

Example Controls

OSHA requires:

 Provide clean and sanitary work environments.

In order to prevent contact with bloodborne pathogens and other potentially infectious materials, workplaces must be kept clean and sanitary. Bloodborne Pathogens Standard [1910.1030(d)(4)(i)].

The employer must:

  • Develop and implement a cleaning schedule that includes appropriate methods of decontamination and tasks or procedures to be performed
  • This written schedule must be based on the:
    • Location within the facility.
    • Type of surfaces to be cleaned.
    • Type of contamination present.
    • The tasks or procedures to be performed.

 

 

Appropriate Disinfectants

The CDC states that Hepatitis B Virus can survive for at least one week in dried blood on environmental surfaces or contaminated needles and instruments.

Hazard

Exposure of housekeeping staff to bloodborne pathogens by not using an appropriate or approved disinfectant.

Example Controls

Who determines which disinfectants are appropriate? Appropriate or approved disinfectants are determined by the EPA (U.S. Environmental Protection Agency), who oversees the registration of anti-microbial products. A list is provided by the National Anti-Microbial Network that provides the most recent information available from the EPA on registered anti-microbials. In categories such as: Sterilants, Tuberculocides, (anti) HIV, and (anti) HIB & HIV. The employer must then decide which approved disinfectant to use for it's particular situation.
  • Fresh solutions of diluted household bleach made up every 24 hours are also considered appropriate for disinfection of environmental surfaces and for decontamination of sites. Contact time for bleach is generally considered to be the time it takes the product to air dry.
  • NOTE: Products registered by the EPA as HIV effective are not necessarily effective against tuberculosis (tuberculocidal) or against the Hepatitis B Virus (HBV).
What disinfectants does OSHA recommend?
  • OSHA requires that work surfaces be cleaned with an "appropriate disinfectant". Appropriate disinfectants include a diluted bleach solution, and EPA-registered tuberculocides (List B) or sterilants (List A), or products registered against HIV/HBV (List D). 
    CPL 2-2.44D
    paragraph (d)(4)(ii). 
  • Also see OSHA's FAQs for bloodborne Pathogens.

"The particular disinfectant used, as well as the frequency with which it is used, will depend upon the circumstances in which the housekeeping task occurs." [OSHA Directive CPL 2.2-44D].

 

Contaminated Equipment

Hazard

Exposure to bloodborne pathogens through contact with contaminated: 

Example Controls

OSHA requires:

Equipment and working surfaces: All equipment and environmental and working surfaces shall be cleaned and decontaminated after contact with blood or other potentially infectious materials [1910.1030(d)(4)(ii)].

  • Contaminated equipment, such as IV poles require labels or tags in accordance with 1910.1030(g)(1)(i)(H). The labels must also identify which portions of the equipment are contaminated.
    • Some equipment, if grossly contaminated, must be cleaned prior to decontamination, as some anti-microbial products will not work in the presence of blood, which interferes with the sterilizing process.

Protective Coverings:

  • Contaminated protective coverings such as plastic wrap or foil, shall be removed and replaced as soon as possible, or at the end of a workshift [1910.1030(d)(4)(ii)(B)].

Reusable Containers:

  • All bins, pails, cans, and similar receptacles intended for reuse which have a reasonable likelihood for becoming contaminated with blood or other potentially infectious material shall be inspected and decontaminated on a regularly scheduled basis and cleaned and decontaminated immediately or as soon as feasible upon visible contamination [1910.1030(d)(4)(ii)(C)].
Glassware:
  • Broken glassware may be contaminated, and must not be picked up directly with hands; use a brush and dustpan or tongs [1910.1030(d)(4)(ii)(D)].

Note: Some care facilities who rent or lease medical equipment or devices from third parties or other institutions, need to be aware that these devices may not be properly cleaned, disinfected and/or sterilized prior to delivery to the health care facility. 

 

 

 Contaminated Laundry

Hazard

Exposure to bloodborne pathogens and other infectious agents from handling contaminated laundry, during rinsing practices of contaminated laundry in utility rooms. Some facilities allow employees to rinse contaminated laundry (i.e., laundry contaminated with blood or (OPIM), Other Potentially Infectious Materials definition 1901.1030(b) in dirty utility "hopper" rooms, instead of simply containerizing it and then transporting it to the laundry. 


Example Controls

The Bloodborne Pathogen Standard requires:
  • bagging and handling of contaminated laundry, with a minimal amount of agitation, at the location where it occurred [1910.1030(d)(4)(iv)(A)(2)]. 
  • contaminated laundry shall not be sorted or rinsed in the location of use [1910.1030(d)(4)(iv)(A)(1)], and must be transported to the laundry for decontamination. 

Other Recommended Good Practices:

  • Meltaway bags for the bagging process. Meltaway bags can be thrown directly into washers without having to unload or remove contaminated laundry from bags. 

For soiled laundry, not contaminated with blood or OPIM, rinsing in utility rooms is acceptable.

  • The ergonomic hazards that can occur with hopper room rinsing, (i.e., lifting, reaching, rinsing, and transporting wet heavy laundry) must also be addressed. An extra lift or transfer device for the lifting of these materials is likely.

The Laundry module area addresses additional information for the handling and bagging of contaminated laundry.

 

 

Sharps and Containers

Hazard

Exposure of housekeeping staff to contaminated sharps and containers from:

Example Controls

Implement work practice and engineering controls to help prevent exposure to sharps. 

OSHA requires:

Sharps handling:

  • Sharps must be properly disposed of immediately or as soon as feasible into appropriate containers [1910.1030(d)(4)(iii)(A)(1)].
  • Engineering and work practice controls are mentioned in the Bloodborne Pathogens Module sections: Safer Needle Devices, and Other Sharps.
Handling sharps containers:
  • Contaminated sharps must be properly disposed of immediately or as soon as feasible in containers that are closable, puncture resistant, leak-proof and labeled with the biohazard symbol or color coded in accordance with [1910.1030(g)(1)(i)].
    • Containers must be examined and replaced on a regular schedule, so they do not become overfilled [1910.1030(d)(2)(ii)], [1910.1030(d)(4)(iii)(A)(2)].
Disposal of Sharps Containers: Employees should be trained in proper handling/disposal of sharps and containers, such as:

When moving containers of contaminated sharps or Other Regulated Wastes, from the area of use, the containers shall be [1910.1030(d)(4)(iii)(A)(3)]:

  • Closable, and closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.
  • Placed in a secondary container, if primary container is contaminated or if leakage is possible.
  • Disposed of  in accordance with the EPA, and state and local regulations.
Reusable sharps containers:
  • Must meet the same requirements as containers for disposable sharps, with the exception that they are not required to be closable. CPL 2-2.44D
  • Shall not be opened, emptied or cleaned manually or in any other manner that would expose employee to the risk of percutaneous injury.

 

 

 Hazardous Chemicals

Hazard

Exposure to hazardous chemicals used in cleaning.


Example Controls

Hazardous Chemicals Implement a written program which meet the requirements of the Hazard Communication Standard (HCS) to provide for worker training, warning labels, and access to Material Safety Data Sheets (MSDS).

The Hazard Communication Standard ensures employee awareness of the hazardous chemicals they are exposed to in the workplace.

  • Agents with any of the following characteristics are considered hazardous: carcinogens, corrosives, toxic or highly toxic, irritants, sensitizers, or target organ effectors Hazard Communication Standard Appendix A and chemicals listed in 1910.1000 Table 2.
    • Both human and animal data are to be used in this determination. The Hazard Communication Standard Appendix B lists sources of toxicity information. 
  • There are exceptions to some of the requirements of the HCS for consumer products that are subjected to the labeling requirements of the terms as defined in the Consumer Product Safety Act and the Federal Hazardous Substances Act [1910.1200(b)(5)(v)].
Provide readily available Material Safety Data Sheets (MSDS) for all hazardous chemicals.

Workers must be trained in potential chemical hazards and controls (engineering controls, work practices, PPE) necessary to prevent hazards in the work area [1910.1200(h)(3)].

All hazardous chemicals must be clearly labeled [1910.1200(f)].

Provide appropriate PPE 1910.132 such as gloves, goggles, splash aprons as appropriate when handling hazardous cleaning chemicals. 

Medical Services and First Aid 1910.151(c) Where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within the work area for immediate emergency use. 

Employers could consider substituting non hazardous cleaning chemicals for hazardous products.

The Laundry, Dietary, Pharmacy, and Maintenance, Modules also address Hazardous Chemicals. 

 

 

Slips/Falls

Hazard 

Exposure to wet floors, possible slips/falls.

Example Controls

OSHA requires:

  • Floors shall be maintained in a clean and dry condition, and mats provided where practicable. Walking/Working Surfaces Standard [1910.22(a)(2)].

Other Recommended Good Practices:

  • Implementing a program to provide safe, immediate, clean-up of floor spills.
  • Provide appropriate warning and barricades for wet floor areas.

See Dietary slips/falls module for more information.

Additional Information

 

 


 

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