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#1 Posted : 09 January 2007 08:36:00(UTC)
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Posted By skooter1
Can you help me with the question please folks.

Our guys who work in M & E – particularly dealing with the unpleasant tasks of unblocking drains and toilets etc.

Are we duty bound by H & S to ensure they are protected against Hepatitis?

hope you can help.

Scott

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#2 Posted : 09 January 2007 08:43:00(UTC)
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Posted By Peter Longworth
If your risk assessment identifies that hepatitis is a foreseeable hazard, then yes you are duty bound to do all that is reasonably practicable to protect your employees. Obviously the bigger the risk the more you have to do.
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#3 Posted : 09 January 2007 08:46:00(UTC)
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Posted By steven bentham
Yep
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#4 Posted : 09 January 2007 09:02:00(UTC)
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Posted By garyh
What is M&E?

If people are exposed to water borne pathogens then you need to cover them as regards to assessing the risk. Also you need to make them aware, consider health surveillance etc. Inoculation is one aspect.

Follow this link to HSE guidance page http://www.hse.gov.uk/pubns/indg198.htm

Essentially you should treat them as sewage workers, the above link will help.
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#5 Posted : 09 January 2007 11:04:00(UTC)
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Posted By Salus
Skooter her is some info I gave to some maintenance employees who work in derelict properties,

Blood born viruses information and procedures if needles or other sharps are discovered while working


The advice given below is instruction and information for all employees.

Blood Borne Viruses = BBV’s

What are blood born viruses?

BBV’s are viruses that some people carry in their blood and which may cause severe disease in certain people and a few or no symptoms in others. The virus can spread to another person whether the carrier of the virus is ill or not.
The main BBV’s of concern are;
• Hepatitis “B” virus
• Hepatitis “C” virus
• Hepatitis “D” virus
• Human immunodeficiency virus, (HIV, which causes acquired immune deficiency syndrome or AIDS)

These viruses can be found in other body fluids other than blood, for example, urine, faeces, saliva, sputum, sweat, tears, and vomit, carry a minimal risk of infection, unless they are contaminated with blood.

Types of occupations and work where there may be contact with BBV’S

Persons at Risk Risk Areas
Maintenance operatives Toilets / urinals
Sewage and cleaning operatives Refuse sacks
Plumbers Litter bins
Void clearance operatives Empty, derelict or disused properties
Carpenters Discarded furniture
Painters & decorators Parks
First aiders Public playgrounds
Area office employees Hostels
Drains

In areas of work where sharps are likely, to be present check for signs of discarded needles or other signs of drug abuse.
• Before moving items or clearing empty properties carry out a visual search for any signs of drug abuse
• Use a torch to check around the back of toilets and inside urinals / plug holes
• Check in between floorboards
• Be very careful if you pull old furniture out, check around, underneath and between cushions with a stick or screwdriver.
• Do not use your fingers or hands to clear blocked plug holes in sinks or baths.
How can BBV’s be spread in the work place
It is very unlikely that you will become infected through everyday social contact with another worker who has BBV. BBV’s are mainly transmitted sexually or by direct exposure to infected blood or other body fluids contaminated with infected blood.
In the work place, direct exposure can happen through accidental contamination by a needle or other sharp instrument. Infected blood may also spread through contamination of open wounds, skin abrasions skin damage due to eczema or through splashes to the eyes, nose, or mouth.

Preventing or controlling the risk
• Do not eat drink or smoke in work areas where there is a risk of contamination.
• Prevent puncture wounds, cuts and abrasions especially in the presence of blood and body fluids.
• Cover all breaks in exposed skin with waterproof dressings.
• Where there may be splashing, use eye protection and a mask or a face shield.
• Use basic good hygiene practices, such as hand washing.
• Clean off all equipment used to retrieve the needle or sharp with a strong bleach or Jeyes fluid,(just pour over the equipment)
• .Use the litter pickers or pliers provided to pick up the needle or sharp
• Drop the needle or sharp into the sharps box provided.

Immunisation
Immunisation is available for Hepatitis blood viruses but not other BBV’s.

Decontamination Procedures

HIV can remain infectious in dried blood and liquid blood for several weeks and HBV’s stay active for even longer. If equipment becomes contaminated then it needs to be decontaminated by applying strong bleach or Jeyes fluid to the equipment.

Disposal of waste
THIS NEEDS TO BE REVEIWED
Certain waste is classified as clinical waste and is collected by the --------- at agreed intervals form the ------ in the form of the sharps box.
The sharps box is kept --------------.

Reporting Incidents

Under the requirements of the Reporting of Injuries, Diseases, and Dangerous Occurrences 1995, all employees have a legal duty of care to report certain incidents and dangerous occurrences.
Incidents such as a puncture wound from a needle known to contain blood contaminated with a BBV should be reported to the Health and Safety Executive as a dangerous occurrence

What do I do as an employee

You have a legal duty to take care of your own health, safety, and that of others who may be affected by your acts or omissions.
Read and follow the procedures for dealing with the discovery of needles or other sharps
Read the risk assessment for the above, see your line manager or supervisor.
Wear and use the protective equipment provided by your employer


Action after possible infection with a blood born virus

If you are contaminated with blood or other body fluids, take the following action,
• Wash any splashes off your skin.
• If the skin is broken, allow the wound to bleed.
• Do not suck the wound.
• Rinse the wound under running water.
• Wash out splashes to the eyes with an eye wash bottle, and rinse out your mouth or nose. with tap water, do not swallow the water.
• Record the source of the contamination by informing your line manager or supervisor.
• Contact your doctor and the accident and emergency department at your nearest Hospital.

Procedure for the Discovery of Hypodermic needles or other Sharps
If when working you discover a sharp or needle

• Do not make any attempt to pick up the object.
• Stop work immediately.
• Contact your line manager or supervisor immediately.
• The line manager or supervisor to contact Health & Safety
• The line manager / supervisor or operative to obtain the litter picker / pliers and sharps box and go to the work area or get an external contractor to carry out the work.
• A nominated person or contractor to pick up the needle or other sharp with the litter picker while wearing gloves and place into the sharps box.
• Return the litter picker and sharps box to the ---- and secure in the sharps cabinet.
• Return the sharps cabinet key to the responsible person.

read through and check facts first to satisfy yourself that it is competent advice, most came from HSE guidance.
You can sometimes get employees GP's surgery to carry immunisation for free, may not be the case now.Just issue all who require it on your companys letterheaded paper.
Up to you whether you go the immunisation route.

HTH


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#6 Posted : 09 January 2007 11:08:00(UTC)
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Posted By Bob Thompson CMIOSH
Dont forget Leptospirosis
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#7 Posted : 09 January 2007 11:15:00(UTC)
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Posted By Scott Fisher
Scott,

I look after teams of jetters that are unblocking sewers and drains on a regular basis. Our risk assessment highlighted the fact that these operatives required HEP A & B and Tetanus.

After talking to our OH dept we decided to run a vaccination program for all of our plumbers (72). For your info we used a vaccination called Twinrix which is a combined Hep A&B jab thuis reducing the amount of jabs required.

But you can not force them to recieve the jabs, as we did have some who rejected the vaccinations. However I have made them sign to state that they have refused them to cover our backs.

Scott
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#8 Posted : 09 January 2007 11:22:00(UTC)
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Posted By John Lewis
I had to look into this last year and found that there is/was some confusion amongst GP's about giving immunisation injections. The BMA were very helpful and sent me a copy of their document outlining the policies to be adhered to by Doctors surgerys. It is all to do with The National Health Service (General Medical Services Contracts) Regulations 2004. These are comparatively new regs' and initially caused a few problems due to misunderstanding.

The confusion seems to have arisen because GP's cannot charge a patient on their list for treatment, which includes immunisation for Hep B. GP's naturally do not want to do expensive immunisations for work purposes out of their own pocket. They can however charge somebody else i.e. the employer and any bill must be made out to the employer, at least, that is how we work it now. On one occasion I was asked for a copy of the RA for the task to prove it was necessary, but when I explained the job it was never followed up.

Check out the BMA website for further info or ring them, they were very, very helpful when I spoke to them.

John
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#9 Posted : 09 January 2007 11:26:00(UTC)
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Posted By John Lewis
Me again
Have a look at the NHS Green Book www.dh.gov.uk/greenbook it has a wealth of information on all kinds of nasty diseases, how and where to contract them, what is the treatment and info' on innoculation. Not necessarily your everyday reference book in H&S but worth knowing about.

John
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#10 Posted : 10 January 2007 10:36:00(UTC)
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Posted By ian milne
Hi,
Previously working in Tank/sewage/waste cleaning: I set up a program for staff to receive Hep A (two jabs one year apart) as a minimum (they would not go for the Hep B). Staff should always wear PPE, especially masks, long gloves and waterproofs.

'Ensure' that they check and cover any cuts or open wounds as there is a rapid deterioration from fit to sick/diarrhoea with water bourne illnesses. Write this into risk assessments.

Provide hygiene station (or small bottles) consisting of anti-bacterial wash, soap and moisturiser and supervise its being done.

Seek to see what can be done without touching; water jets, mirrors, hot water and caustic soda etc.

Hope it helps.
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#11 Posted : 10 January 2007 15:13:00(UTC)
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Posted By Glyn Atkinson
Illnesses can indeed jump out quickly.

Several years ago, in a previous trade employment, we were removing redundant cables from a trench that was occasionally flooded due to high water table problems - near the sea.

We moved a cable and the crusty top of what had looked to be a solid covering turned out to be liquid underneath, with flies inside.

I was bitten on the wrist, became very ill inside two days, and lost nearly two stones in two weeks in an isolation ward in hospital.

The incident took me over six months to pull round from, and ten years on, I still suffer with irritable bowel symptoms and have to constantly watch what I eat, and how close I am to a toilet on occasions.

That incident was one of the reasons that I changed careers into H&S, as the firm at the time completely swilled out the trench to remove any evidence of the incident, and it was glossed over in the accident report.
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#12 Posted : 10 January 2007 17:07:00(UTC)
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Posted By fore!
Great thread, very useful info.

I have a question. I understand that there is a combined vaccination for the two "Heps" but I have been struggling for some time to get any info on a vaccine for Leptospirosis.

Is this because none exists?
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#13 Posted : 11 January 2007 00:53:00(UTC)
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Posted By John Murgatroyd
There is no human vaccine available for leptospirosis, although those at risk can be given doses of doxycycline to cover. There were 41 cases of lepto last year in the uk, hardly high risk.
There is a vaccine for hep A, there is a vaccine for hep B (although it is usually given in 3 stages of treatment and approx 30% of cases will not develop a sufficient degree of immunity. It also takes 6 months to deliver said immunity and needs a blood test to check that immunity HAS been developed) There is no vaccine for hep D, because the B vaccine usually gives immunity to B, and also to D. There is no vaccine for hep C, although there is a treatment for hep C, it is expensive and there is no guarantee that the LHA will authorise payment for it. So you may end-up paying for your employees treatment if he/she develops hep C....it's about £7000.00 / year...for the drug.

Vaccination should not be used instead of good hygiene. Apart from the above diseases, there are several hundred others that can be contracted from, for instance, raw sewage.
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#14 Posted : 19 January 2007 23:36:00(UTC)
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Posted By ian milne
I agree with Johns answer, do your best to protect against it with PPE and hard systems. These viruses really really make people ill. Lepto (weils desease) can make someone so ill they may never become fully fit ever again. No innoculation either and symptoms are akin to flu so would the local doctor know it had been caught eh!

Wear facemasks, gloves and cover all scratches, open cuts etc. Then encourage washing.

Ian
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#15 Posted : 20 January 2007 09:08:00(UTC)
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Posted By John Murgatroyd
I think all this H&S is a waste of time !
Reason ?
Well, watching 4 guys doing a job at a sewage pumping station...ie: changing a pump unit.
[old] unit out, swing clear and removed from lifting gear. No problem. Unit [obviously] covered in the stuff it pumps. Guys then off gloves....(nice coveralls, thick neo-coated gloves)....then the lunch boxes appear and they start eating....
So, what happened to the hand washing after taking the gloves off I'm thinking....

Memorable phrase:
You can lead a horse to water but cannot make it drink.
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