8453 - EXPOSURE CONTROL PLAN FOR HANDLING AND DISPOSING OF BODY FLUIDS

Perry Local School District

Administrative Guidelines

8453 - EXPOSURE CONTROL PLAN FOR HANDLING AND DISPOSING OF BODY FLUIDS

All school staff should be aware of the risks involved when exposed to and dealing with body fluids. It must be assumed that all body fluids are potentially infectious and by following procedures for universal infection control the risks can be greatly reduced and the possibility of accidental infection can be minimized or prevented. A surface should be considered contaminated if blood or the reasonably anticipated presence of blood or other potentially infectious body fluids occur, even if the contaminates have dried. Certain pathogens (e.g. HCV) remain viable for extended periods in dried blood.

Sources of Infectious Organisms in Body Fluids

Source		Organism	Transmission

Blood		HBV	Contact with broken skin or membrane
- cuts/abrasions		HCV
- nosebleeds		HIV/AIDS
- menses		Cytomegalovirus
- needles
- human bites

Feces		HAV	Oral inoculation from hands or food
		Salmonella bacteria
		Shigella bacteria
		Rotavirus

Urine		Cytomegalovirus	Bloodstream, oral, and mucus membrane inoculation from hands



Respiratory Secretions	HBV		Bloodstream, oral, and mucous membrane
- saliva	Tuberculosis
- nasal discharge	Mononucleosis V
	Influenza V
	Common cold V
	Meningitis

Source		Organism	Transmission

Vomitus	Gastrointestinal V		Oral from contaminated hands (see "blood")
- may contain blood	(Rotavirus)
	See "blood"

Semen		HBV	Sexual contact
		HIV/AIDS	(unprotected)
		Venereal Disease

Materials and equipment required and made available to dispose of body fluids include:


	Antibacterial soap
	Potable water
	Paper towels
	Latex and non-allergenic gloves
	Hazardous material bags (red) and labels
	Hazardous material (sharps) container (puncture proof and leak proof)
	Buckets and mops
	Disinfectant solutions from the following list:

	A.	Sodium hypochlorite solution (household liquid bleach), one (1) part bleach to ten (10) parts water (1-1/2 cups bleach to one (1) gallon of water, freshly prepared)
	B.	Phenolic germicidal detergent in a one percent (1%) aqueous solution (Lysol)
	C.	Quaternary ammonium germicidal detergent in two percent (2%) aqueous solution (Tri-quat, Mytar, Sage)
	D.	Iodophor germicidal detergent with 500ppm available iodine (Wescodyne)
	E.	Sanitary absorbing agent (Chlora Sorb, X-O Odor Away)

Universal Infection Control Procedures

GENERAL

		1.	Wear disposable latex or non-allergenic gloves before making contact with body fluids during care, treatment, and all cleaning procedures.
		2.	Dispose of gloves and disposable cleaning materials in hazardous materials container (bag).
		3.	Wash hands with an antibacterial soap-even if gloves are worn.
		4.	Discard disposable items including tampons, sanitary napkins, used bandages, dressings in a hazardous materials container. (Rest rooms should have waste receptacles lined with hazardous waste bags.)
		5.	Close and label hazardous waste containers (bags) and dispose of in accordance with public health guidelines as provided by the Stark County Public Health Office. Note: be sure your waste disposal carrier is authorized to dispose of hazardous waste materials.
		6.	Use disposable items to handle body fluids whenever possible. Discard items in accordance with Item 5 above. If handling vomitus or feces, use a second barrier (i.e. plastic bag) in addition to gloves.

HANDWASHING

		1.	Use anti-bacterial soap and warm running water.
		2.	Rub hands together to work up a lather-scrub between fingers, knuckles, backs of hands, under fingernails.
		3.	Rinse thoroughly.
		4.	Dry with paper towel or hot air. If paper towels are used, dispose of in an appropriate container.

WASHABLE SURFACES

Tables, desks (wear gloves)

			a.	Use household bleach solution of one (1) part bleach to ten (10) parts water-freshly mixed.
			b.	Rinse with fresh water.
			c.	Repeat "a"
			d.	Repeat "b"
			e.	Allow to air dry.
			f.	Dispose of gloves and wiping materials in a hazardous waste container.

Floors (wear gloves)

			a.	Use household bleach solution as previously described.
			b.	Use a mop and two buckets- one for bleach solution and one for rinse water (with bleach or Lysol solution).

				1)	in bucket #1, dip, wring, mop up vomitus, blood
				2)	dip, wring, and mop until body fluids are cleaned up
				3)	dip mop into bucket #2, wring, re-mop (rinse) area
				4)	continue cycle until all spills are cleaned up � using fresh solutions as necessary

			c.	Soak mop in disinfectant solution after use.
			d.	Disposal cleaning materials should be placed in a hazardous waste container.
			e.	Pour solutions down a drain pipe � flush thoroughly.
			f.	Rinse non-disposable cleaning equipment in disinfectant.
			g.	Dispose of gloves in a hazardous waste container.
			h.	Wash hands as described in B.

Non-washable surfaces (rugs, upholstery)

		1.	Apply sanitary absorbing agent, dry, vacuum.
		2.	Remove solid materials with broom and dustpan � use second barrier if necessary to use hands.
		3.	Apply rug or upholstery shampoo as directed - vacuum according to directions.
		4.	Clean dustpan and broom (if used) in disinfectant solution - air.
		5.	Dispose of gloves in a hazardous materials container.
		6.	Wash hands as described in B.

Washable Materials (clothing, towels, etc.)

		1.	Rinse item under running water.
		2.	Place item in a hazardous materials bag and seal until item is ready to be washed. Bags containing soiled, washable material must be clearly identified as "Hazardous Material" if an outside laundry service is used. Contact-sports uniforms should be closely inspected for blood and handled in an appropriate manner.
		3.	Rinse and wipe sink with paper towels � dispose of towels in a hazardous waste container.
		4.	Wash potentially contaminated materials separate from others � dry as usual. If material is color-fast add one-half (1/2) cup bleach to the wash cycle. Otherwise, add one-half (1/2) cup non-chlorine bleach (Clorox II, Borateem) to the wash cycle.
		5.	Dispose of gloves in a hazardous waste container.
		6.	Wash hands as described in B.

Accessibility of equipment and materials

	A.	Latex and/or non-allergenic gloves shall be available at all work stations in all buildings and outdoor facilities.
	B.	Cleaning equipment and solutions as described in the Materials and Equipment section shall be made readily available to all work stations.
	C.	A hazardous material container (biohazard container, sharps container) with a cover which is puncture proof and leak proof shall be kept in a central location (central office, nurse's station) for proper disposal of needles and lancets used for medicinal purposes. Periodically, this container shall be disposed of and replaced in accordance with public health guidelines.
	D.	Hazardous waste (red) trash can liners shall be used in all rest rooms and shall be properly labeled and disposed of in a timely manner and in accordance with public health guidelines.
	E.	Broken glass, plastics, or other small materials which have been contaminated with body fluids shall be placed in a puncture-proof, leak-proof container with a lid, labeled as hazardous material and disposed of in accordance with public health guidelines.

This guideline is not meant as an all-inclusive list of infectious organisms that may be contained in body fluids. Additionally, the use of brand name cleaning agents or other products in this guideline are meant as examples only and are not endorsements of the specific products mentioned herein.

Approved 11/03
Revised 5/04