Safe Work Practices Picking Up Sharps

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Safe Work Practices Picking Up Sharps
Dealing with Biohazard Waste
75323
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WHAT IS A SHARP

• What is a Sharps
• Sharps are defined in the "National Guidelines
  for the Management of Clinical and related
  Wastes" published by the National Health and
  Medical Research Council as "objects or devices
  having acute rigid corners, or edge points
  capable of cutting or penetrating the skin".
  Hypodermic needles, razor blades and broken glass
  all fit this definition.
• All sharps have the potential to cause injury
• Sharps cause injury through cuts or puncture
  wounds. In addition, many sharps could be
  contaminated with blood or body fluids,
  microbiological materials, toxic chemicals or
  radioactive substances, posing a risk of
  infection or illness if they penetrate the skin.

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WHAT IS BIOHAZARD WASTE

• Human blood and blood products
• All human blood, blood products (such as serum,
  plasma, and other blood components) in liquid or
  semi-liquid form.
• Human Body Fluids
• Human body fluids in a liquid or semi-liquid
  state, including semen, vaginal secretions,
  cerebral spinal fluid, synovial fluid, pleural
  fluid, pericardial fluid, peritoneal fluid,
  amniotic fluid, and saliva from dental
  procedures. Also includes any other human body
  fluids visibly contaminated with blood, and all
  body fluids in situations where it is difficult
  or impossible to differentiate between body
  fluids.
• Pathological waste
• All human tissues, organs, and body parts.
• Animal waste
• All animal carcasses, body parts, and any bedding
  material from animals known to be infected with,
  or that have been inoculated with human
  pathogenic microorganisms infectious to humans.

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WHAT ARE THE DANGERS

• Sharps and Biohazard waste may carry HIV and the
  Hepatitis B C viruses.
• The hepatitis B and C virus can permanently
  damage your liver, and is the biggest cause of
  liver cancer worldwide. Hepatitis B C is
  transmitted through sexual contact, blood or
  bodily fluids.
• Other waste, such as feces, can contain Hepatitis
  A, bacteria (ex. salmonella) and viruses (ex.
  norvirus).
• Where can Sharps and Biohazard waste be found?
• Sharps and Biohazard waste are often thrown away
  in streets, public washrooms, regular garbage,
  parks, alleys, vacant lots, and on beaches. They
  have also been found under mattresses and
  pillows, in garbage cans, and behind toilets.

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CONTACT TRANSMISION

• Contact transmission are infectious diseases
  transmitted through direct or indirect contact
  with bacteria or viruses.
• Direct contact Involves skin-to-skin contact,
  such as patient care, first aid or emergency
  response activity that requires direct personal
  contact. First Aid Attendants or Fire Department
  first responders could be exposed by direct
  contact.
• Indirect contact involves a person touching a
  contaminated intermediate object such as a table,
  doorknob, telephone, photocopiers, tools and then
  touching the eyes, nose, or mouth. (Some Viruses
  can live on hard surfaces for 24-48hrs and on
  non-porous surfaces as cloth, paper for 8-12hrs).
  

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TRANSMISION

• Routes of Entry
• Respiratory tract Inhalation
• GI Tract Ingestion
• Skin Injection
• Eyes
• Biological agents are not absorbed through the
  skin but they can be passed from skin to eyes,
  mouth and nose.

• Method of Entry
• Inhalation
• Ingestion
• Absorption
• Injection

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PRECAUTIONS

• Universal Precautions should be followed whenever
  workers are exposed to
• Blood
• Semen
• Vaginal fluid
• Synovial fluid
• Cerebral spinal fluid
• Pleural fluid
• Peritoneal fluid
• Pericardial fluid
• Amniotic fluid
• Universal Precautions means assume infectious

• Universal Precautions do not apply to the
  handling of (except when visibly contaminated
  with blood)
• Feces
• Nasal secretions
• Sputum
• Sweat
• Tears
• Urine
• Vomitus
• Saliva

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SAFE WORK PROCEDURES

• The City of Langley strives to provide a safe
  workplace for all employees. The purpose of Safe
  Work Procedures (SWP) in regards to sharps and
  biohazard waste is to provide a safe way for
  finding, and removing Sharps and Biohazard Waste
  to minimize health risks.
• PPE, Personal Protective Equipment
• Employees trained in the handling and disposal of
  Sharps and Biohazard Waste will use appropriate
  PPE (personal protective equipment) which are
  puncture resistant gloves, tongs, a proper
  portable sharps disposal containers, and if
  splashes are a potential then goggles.
• Disposal of Sharps and biohazard waste
• Once the portable sharps disposal containers are
  ¾ full, tell your supervisor. The supervisor
  will ensure the container is brought to the
  Operations Centre and placed in the main
  Biohazards container.
• Any gross contaminations of biohazard waste will
  also be disposed of at the main Biohazard
  Container (grossly saturated products used to
  clean blood or body fluid ).

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PRECAUTIONS

• Do not pick up sharps and other biohazard waste
  unless you have been trained, and you have the
  proper equipment and PPE.
• Do not pick up anything with the intention of
  discarding it later.
• For example, dont put a used needle in your
  pocket or in something that isnt a proper
  container. You could injure yourself before you
  discard it.
• Do not place needles in regular garbage under any
  circumstances you may create a hazard for
  others.
• Do not reach into objects you can not see.
• Empty all containers, backpacks, and purses onto
  a hard surface and use a long object such as
  tongs to look through.
• Do not reach into areas you can not see.
• Dont use your hands to feel or reach into any
  area, for example shrubbery. Use a long-handled
  stick or other object not your hands to
  explore hidden spots. A flashlight could be used
  to move objects and to shed light on hard-to-see
  objects.

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HANDLING SHARPS

• Wear disposable puncture resistant waterproof
  gloves and have a proper authorized sharps
  container ready.
• Put the gloves on. Place the sharps container
  next to the needle or other item. Do not hold the
  container in your hand, or you might accidentally
  jab yourself.
• If you are comfortable using tongs or pliers, use
  them to pick up the sharp and place it into the
  sharps container. If you are not comfortable
  using the tongs or pliers, pick up the sharp by
  its shaft (if it is a needle). In both cases,
  place the needle into the sharps container,
  pointed end first, away from you.
• Do not insert your fingers into the opening of
  the container, and keep your free hand out of the
  way.
• Remove and discard the gloves. Wash your hands
  with soap and water immediately.
• Dont fill the sharps container to the brim. When
  it is about three-quarters full, replace it with
  a new one and properly dispose of the old one.

Use tongs or pliers to pick up place the
sharp pointed end first into the container.
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HANDLING GARBAGE

1. Wear disposable puncture resistant gloves. Do not
   use bare hands.
2. Handle garbage as little as possible.
3. Be alert. If possible, look for sharps sticking
   out of the bags. Listen for broken glass when you
   move the bag.
4. Dont compress garbage or reach into garbage
   containers with your bare hands.
5. Dont let garbage bags get too full. Leave enough
   free space at the top of the bag, so that when
   you grab it, you grab the top of the bag only
   not any of the contents.
6. Hold garbage bags by the top of the bag, away
   from your body. Dont hold garbage bags against
   your body.
7. Dont place one hand under the bag to support it.
8. Dispose of wastes according to federal,
   provincial, and local regulations.
9. When finished, dispose of gloves and immediately
   wash hands.

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INCIDENTS

• A restaurant worker was cleaning the washroom.
  When emptying the garbage can, she reached into
  it and was poked with a discarded needle.
• A worker picked up a bag of garbage and held it
  close to his body. His thigh was stuck with a
  needle.
• A worker found a lost backpack and reached in to
  see the content they were stuck with a needle.

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HOW TO CLEAN UP BIOHAZRD SPILLS

1. This could be blood, vomit, feces, body fluids,
   etc.
2. Restrict access to the area.
3. Make sure plastic bags are available for removal
   of contaminated items from the spill site. Have
   fresh, dilute bleach or a germicide ready.
4. Dispose of any sharps first according to the
   procedure
5. Wear disposable, waterproof gloves (such as
   natural rubber latex, neoprene, nitrile, and
   vinyl). If necessary, wear other PPE, such as a
   face shield and a gown, to act as a barrier
   against contact with blood and certain body
   fluids and the dilute household bleach. If using
   a germicide, check the material safety data sheet
   (MSDS) to find out what type of glove to use.
6. Cover your shoes or boots with disposable,
   waterproof covers if they could become
   contaminated during clean-up. If you do not have
   shoe or boot covers ensure you decontaminate them
   with germicide or diluted bleach solution.
7. Wipe up visible material first with disposable
   towels (or in another way that prevents direct
   contact with blood and certain body fluids).
   Dispose of the material and paper towels in
   waterproof garbage bags.
8. After you have carefully removed all the obvious
   material, it may be necessary to change gloves.
   Then decontaminate the area by carefully pouring
   over the spill site a germicide approved for use
   as a hospital disinfectant, or a fresh solution
   of household bleach and water (next slide). Leave
   the solution on for 10 minutes, then wipe it up
   with disposable towels. Discard the towels in the
   waterproof garbage bags

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DISINFECTANT

• Disinfect the area with a fresh bleach solution.
  A solution of 1 part of common household bleach
  to 100 parts of water (1100 ratio) will kill HIV
  and the hepatitis B and C viruses except with
  spills involving a large amount of blood.
• With spills involving a large amount of blood,
  apply a solution of 1 part common household
  bleach to 10 parts of water (110 ratio).
• In both cases, leave the solution on for about 10
  minutes.You can also use a germicide that is
  approved for use as a health care disinfectant.
• Caution Do not mix cleaning chemicals such as
  bleach and ammonia.

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WHEN TO REMOVE GLOVES

• Remove disposable gloves as soon as become
  damaged or contaminated.
• Remove them after you have completed the task
  that required gloves.
• Gloves should also be removed before leaving the
  work area.
• Do not wash and reuse your gloves. Use new gloves
  for each new task.

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HOW TO REMOVE GLOVES

• With both hands gloved
• Grasp the outside of one glove at the top of the
  wrist. (See drawing top right.)
• Peel off this glove from wrist to fingertips
  while turning it inside out, as you pull the
  glove off your hand and away from you.
• Hold the glove you just removed in your gloved
  hand. (See drawing below right.)
• With the ungloved hand
• Peel off the second glove by inserting your
  fingers on the inside of the glove at the top of
  your wrist. (See drawing to right.)
• Turn the glove inside out while pulling it away
  from you, leaving the first glove inside the
  second. (See drawing on the right.)
• Dispose of the entire bundle promptly in a
  waterproof garbage bag.
• Wash your hands thoroughly with soap and water as
  soon as possible after removing gloves and before
  touching non-contaminated objects and surfaces.

Grasp the outside of one glove.
Hold the glove with your gloved hand.
Insert your fingers on the inside of the glove.
Turn the glove inside out over the first glove.
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WHEN TO WASH HANDS

• When should you wash your hands?
• Always!
• Wash your hands when you tear a glove, or you
  think a glove is leaking. Remove the gloves and
  wash your hands immediately. If you have
  punctured your skin with a contaminated sharp,
  follow the procedure for exposure incidents.
• Wash your hands after removing gloves at the end
  of a task even if the gloves appear to be
  intact. Because you may contaminate your hands if
  you remove your gloves improperly, make sure you
  follow the correct procedure.
• Wash your hands immediately after accidental
  contact with blood, body fluids, and/or feces.
• Wash your hands before leaving a work area. Wash
  your hands before eating, drinking, smoking,
  biting your nails, handling contact lenses, and
  applying personal care products (such as lip balm
  or make-up).
• If a hand washing facility isnt available, use a
  waterless hand cleanser. Follow the
  manufacturers directions on how to use the
  cleanser. Thoroughly wash your hands with soap
  and water in a proper facility as soon as
  possible after using the cleanser.

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HOW TO WASH HANDS

• Hand washing is one of the best defenses against
  spreading infections. It stops you from
  transferring infectious material from your hands
  to other areas of your body or other surfaces you
  may touch, and vice versa. Wash your hands
  thoroughly, in a suitable facility such as a rest
  room or utility sink, using warm running water
  and non-abrasive soap.

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WHAT IS AN EXPOSURE

• The following exposure incidents are potentially
  harmful
• Skin is punctured with a contaminated sharp.
• A mucous membrane (the eyes, nose, or mouth) is
  splashed with blood or certain body fluids.
• Non-intact skin is splashed with blood or certain
  body fluids.
• Blood and body fluid contact with intact skin is
  not considered to be a risk for the spread of
  blood borne pathogens. You should, however,
  thoroughly wash your hands and other affected
  areas immediately. If you have any further
  concerns, contact your family physician or
  nearest health unit office (see the blue pages of
  the telephone directory).

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What to do if you are Exposed

• Get first aid immediately, report the incident
  immediately to your supervisor and first aid
  attendant.
• If the mucous membranes of the eyes, nose, or
  mouth are affected, flush with lots of clean
  water at a sink or eyewash station.
• If there is a sharps injury, allow the wound to
  bleed freely. Then wash the area thoroughly with
  non-abrasive soap and water.
• If an area of non-intact skin is affected, wash
  the area thoroughly with nonabrasive soap and
  water.
• Seek medical attention immediately if you have
  been injured by a sharp.
• Seek medical attention immediately preferably
  within two hours at the closest hospital
  emergency room, or at a health care facility if
  theres no hospital emergency room in the
  vicinity. Immunizations or medications may be
  necessary. These may prevent infection or
  favorably alter the course of the disease if you
  do become infected. Blood tests should also be
  done at that time. You may need to see your
  family doctor within the next five days for
  follow-up, such as counseling and medications.

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Questions to Ask Yourself

• Do you know where the sharps container and PPE
  is?
• If no, ask your supervisor
• Do you know where to fill out a sharps form?
• In the OHS Binder, if you dont know where that
  is, ask your supervisor to show you
• Do you know where the Hazard Report Forms are if
  you need to report an unsafe condition,
  equipment, or practice?
• In the OHS Binder, if you dont know where that
  is, ask your supervisor to show you
• Do you know you have the right to refuse unsafe
  work?
• Please ensure you take the Sharps Review Test and
  submit to your Supervisor (Doc. 75170)
• (this is an open book test)