Infectious diseases

Workers in the health and community services industry may be at risk of contracting an infectious disease at work. The consequences can be very serious and infectious diseases can be spread from person to person in many ways, including by:

inhalation of airborne droplets of respiratory secretions being spread by coughing, blowing the nose, sneezing and talking
direct contact with infected blood or bodily fluids when there is broken skin, needle stick type injuries or splashes to mucous membranes
contact with contaminated items or surfaces such as:
- when viruses, bacteria or parasites are present in the faeces of infected people, these may be passed on to others if the infected person doesn't wash their hands properly after going to the toilet
- if hands are not washed properly after changing contaminated nappies or clothes, this contamination can be passed from hands to surfaces and objects such as tap handles, toothbrushes, reusable towels, nappy changing areas, toys or to food that may be eaten by others

Identifying hazards

All work areas and tasks should be regularly assessed to identify all the possible ways workers could be exposed and how many could be exposed to infection. Identifying the hazards could include:

researching which infectious diseases are a risk in the workplace
consulting with workers
completing a workplace inspection
observing and evaluating current existing precautions such as hand washing and food-handling practices
reviewing injury and illness, first aid and workers compensation records.

Reducing the risks

If there is a risk of more than one infectious disease hazard, then control strategies, developed according to the hierarchy of control, need to be developed for each one. However, the following general principals apply when reducing the risk of exposure to infectious diseases:

invasive procedures on patients should only be conducted where essential
isolation of the source of the infection through engineering controls
good engineering design (for example ease of access for maintenance and appropriate construction materials)
development and implementation of clear policies about attendance at facilities including excluding infected workers and excluding or quarantining infected clients
changing the equipment or processes (for example, replacing rotating taps with lever taps, replacing bars of soap with disposable liquid hand-wash dispensers or cloth hand towels with paper towels)
immunisation of workers at significant risk of infection. (for example, vaccinations are available for a number of infectious diseases such as Hepatitis A and B, Q Fever, etc)
informing workers and clients of the need to wash their hands and the correct way to do it
one-use equipment to prevent reuse
protective clothing and equipment (for example rubber gloves, latex gloves, masks, goggles, aprons and tongs)
good housekeeping to establish and maintain hygienic environments
provision of appropriate equipment to dispose all used equipment (for example sharps containers)
regular cleaning and maintenance of air-conditioning equipment
a protocol for the management of incidents such as needle stick injuries or other incidents involving blood or bodily fluids that could lead to exposure to HIV, hepatitis B or hepatitis C
standard (or universal) and additional precautions
development and implementation of safe work practices and procedures, for example:
- proper use and disposal of needles, syringes and sharps
- handling of specimens and samples
- cleaning up and disposal of infectious waste
- cleaning of other contaminated materials.

Additional precautions

Additional precautions should be considered when dealing with infectious diseases transmitted by airborne droplets of respiratory secretions such as tuberculosis, chickenpox, measles, rubella, pertussis and influenza.

In such cases, infected individuals should be quarantined until the period of acute infection has passed.

For residential care providers, the affected individual would need to be isolated in a separate room with a separate toilet and bathroom.

Additional measures are not required for patients with blood borne viruses such as HIV, hepatitis B or hepatitis C.

In the case of outbreaks of a rare infectious disease, such as meningococcal disease, the Infection Control Unit of the Department of Human Services should be contacted for instructions and assistance in coordinating the response.

HIV/AIDS, Hepatitis B and C

The ACT Code of Practice for Human Immuno-deficiency Virus and Hepatitis B provides guidelines for workplaces on assessing and managing hazards associated with HIV infection, Hepatitis B and C.

Healthy workers who test positive for AIDS antibodies generally do not need to be excluded from their normal duties. However, as with others suffering from an infectious disease, these workers should not participate in training for the administration of mouth-to-mouth resuscitation and they should not care for patients who have any disease that affects the immune system.

Hepatitis B and C or HIV/AIDS positive workers should follow some general precautions to prevent the transmission of the disease. This includes:

not donating blood
covering any cuts or abrasions with a waterproof dressing
wearing gloves when dealing with patients if skin is broken
washing hands thoroughly after contact with their own blood or body fluids
not sharing personal items such as razors and toothbrushes
having regular follow-up medical assessments (in the case of HIV/AIDS).

There is no likelihood of catching HIV/AIDS or Hepatitis B or C from casual contact at work. As Hepatitis B and C and HIV/AIDS are blood born diseases, it is not necessary for the person conducting a business or undertaking to be informed that the worker is infected, unless warranted by their particular situation, such as doctors and dentists where the risk of infection is increased due to contact with body fluids.