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Posted By David Lennon
I am currently reviewing a risk assessment for Local Authority Highways Inspectors.
The task being assessed is the accessing of culverts and drainage areas for inspection. During floods, it is feasible that these areas may become contaminated with sewage.
The existing assessment (carried out before my time)identified Hepatitis B as a hazard and subsequently those at risk were vaccinated.
I am a little sceptical and feel that the risk of contact from the Hep B Virus under these circumstances is unlikely.
Would anyone care to comment?
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Posted By Paul Maddock
Generally speaking, so long as there are all cuts are covered up, and appropriate PPE is worn in such an environment, the risk of contractng Hepatitis is greatly reduced.
The greatest risk of contracting any illnesses in such an environment would be to inhale aerosol of contaminated water.
Take a look at the CDC web site (sorry don't know URL) for further information.
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Posted By Diane Warne
I agree with you, HepB is blood-borne and though it can be found in very small quantities in sewage, the risk of transmission this way is extremely low as far as I know. The one that is a hazard in water is HepA.
As always with these things, advice should be sought from a medically qualified person.
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Posted By Peter J Harvey
I would say that the risk of infection is greater from other virus/bacteria than Hep B, however;
Approximately 1 person per thousand in the UK population has evidence of previous infection with Hep B.The main risk is through sex or contact with body fluids, in practice however you are unlikely to be infected unless blood to blood contact occurs.
What you have to remember is that this is a very infectious virus which can live for quite a long time outside of the body.
Therefor if your staff are likely to come into contact with body fluids, blood or suffer needle stick injury the risk would required preventative immunisation.
If you require any more information please Email me, I am just completing a powerpoint presentation on the subject of blood borne infection.
Peter Harvey
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Posted By Ken Taylor
I would expect the risks to include Hepatitis A and B, Leptospirosis, Typhoid and Tetanus but as to the need for vaccination, this would depend upon what the employees actually do. The use of adequate and suitable personal protective clothing and equipment seems to present an adequate control together with wound covering, good washing facilities and personal hygiene - but this is a matter for your judgement based upon such considerations as whether the operatives could get the filthy water, etc into their mouths, noses, blood-stream, etc.
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Posted By Ken Taylor
Incidentally, I take it that you have seen the new and free INDG342 'Blood-borne Viruses in the Workplace'
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Posted By Diane Warne
A guidance note from the US on "recommended immunization for sewage workers" is at
http://www.dhs.ca.gov/ps/dcdc/cm/pdf/cm9802pp.pdf
They point out that HepB is not transmitted by the faecal-oral route and that NO cases of hepatitis B have been linked to sewage exposure in the US. It is a good paper, useful for risk assessment as it indicates risk magnitude and explains why some immunizations are NOT needed.
The existence of virus particles (generally in tiny numbers) in sewage does not mean that workers are at risk of catching the disease. For infection to occur, you need to be exposed to the minimum infective dose of the virus, by the correct route.
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Posted By Bryn Maidment
Hep A - theoretical risk - jab available
Hep B - no risk
Typhoid - risk - jab available
Tetanus - risk - jab available, however current government guidance is that if you've had your childhood jabs (5)then you will have sufficient immunity through your adult life
Lepto - risk - no jab but HSE information card, PPE and good personal hygiene should provide protection.
Don't forget Polio - oral faecal risk (from non-immunised, immigrant communities) - jab available
Hope this helps
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Posted By Peter J Harvey
Polio - from non-immunised, immigrant communities - is this a real risk, it is clearly one that I had not considered within the UK. Do we have whole communities of immigrants that would create sufficient risk?
Peter Harvey
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Posted By Tony Overbury
David
As Peter says, you need to assess the risk of contact with bodily fluids. I can't speak for Tunbridge Wells, but around the West End of London we have an increasing problem with with the wastes left behind by drug abusers. This can include syringes, needles, faeces, vomit and blood (in copious quantities). We also regularly find used condoms. The reason this is relevant is that these wastes are often found in the streets, and I have seen syringes chucked into the street drains. I would therefore recommend that anyone likely to come into contact with this type of waste be immunised against Hep B!
Hope this helps.
Tony Overbury
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Posted By Bryn Maidment
Peter
Many immigrants would not have received polio vaccines in their country of origin. The organism is fairly robust and will find end up in foul sewers. It is not a risk to immunised staff but could be to non-immunised immigrant workers who are engaged legally (& illegally)in this line of work. It was not my intention to say what the risk is just that polio is often forgotten during pre-employment screening and needs to be considered.
Regards
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