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20 December 2016 | Simon Biggs
Simon Biggs looks at the risks to health that have prompted the strict legislation and regulations governing the biohazard cleaning process, and the difficulties faced by management and operatives.
Biohazard and trauma cleaning services are in increasing demand by industry. Partly because of the stringent regulatory control and health and safety guidelines and possibly because of the fear of litigation, many bodies are outsourcing the task.
Category 1 and 2 incidents would be classed as trauma cleans, and category 3 and 4 would be biohazard cleans. From an operational perspective, they are treated similarly, although the number of staff required would be significantly higher for a trauma clean. The biggest difference lies in the management of the personnel.
Keeping everyone safe
The aim of a biohazard or trauma clean is to remove the source of a public health risk, either by cleaning or safe disposal. To do this, the situation is assessed, categorised, and decisions are made as to what will be disposed of and what will be treated and cleaned. The job will then be risk-assessed - for operatives carrying out the work and the public - during and after the clean. A plan of action will be decided in accordance with safe systems of work. The four key stages of clean-up are: neutralisation, disinfection, removal and incineration. Infection control is paramount. Cleaning takes place in a methodical format to eliminate scope for cross-contamination. It is most practical to have safe systems of work for different scenarios prepared, but it is imperative that qualified staff review these before work starts.
Personal Protective Equipment (PPE) must be supplied to operatives: gloves, overshoes, coverall, mask, face shield and goggles. Everything must be either disposable or sterilised after use.
Under the Health & Safety at Work Act 1974 and the Control of Substances Hazardous to Health Regulations 2002 employers have a legal duty to protect anyone on the premises. Outside the workplace, if an incident occurs on private property, the property owner is responsible for a biohazard clean-up, even if the emergency services attended.
From a management system standards perspective, ISO 9001, ISO 14001, and OHSAS 18001 cover quality, environmental and occupational health and safety respectively.
If biohazard cleaning is done wrongly, it can be dangerous, and costly, both financially, and to an organisation's reputation. Done correctly, it is a systematic process, eliminating pathogens and controlling infection in a safe environment.
When does a biohazard clean become a trauma clean?
Biohazard situations are categorised into four groups, according to their severity and impact.
Category 1 incidents include train crashes, plane crashes, bomb blasts and large-scale road traffic accidents. Significant resources are required to eliminate any visible or bacterial remnants of the event and must be attended by a bioengineer with a primary qualification.
Category 2 incidents include decomposition, falls from height, suicides on railways, and road traffic accidents. The incidents affect a more confined area and will require fewer resources than a category 1 incident, although the expertise needed to address the challenges for decontamination are the same and a bioengineer with a primary qualification must be present.
Category 3 incidents include acts of violence, minor industrial accidents, flesh wounds and presence of sharps. They usually result from a minor incident involving a single person and are primarily required for the clean-up of bodily fluids. A bio first-aider with a secondary qualification can attend category 3 incidents without the supervision of a bioengineer.
Category 4 incidents include domestic incidents, minor injuries and occupier purges. A bio first-aider with a secondary qualification can attend category 4 incidents without the supervision of a bioengineer.
The risks to health include viruses such as hepatitis B, hepatitis C and HIV, which bodily fluids and faces can carry. Pathogens can come in the form of bacteria, viruses, mould spores, or protozoans. They can cause disease and often have a significant presence in sewage waste. Infection can take place though the mouth, nose, eyes, broken skin, open sores or wounds, or by absorption.