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OCCUPATIONAL INFECTIONS DISEASES AND OTHER DISEASES OF BIOLOGICAL ORIGIN Tartu 10.-11.3. OCCUPATIONAL HAZARDS physical chemical biological psycho-social. BIOLOGICAL OCCUPATIONAL HAZARDS. = occup. biohazards infectious allergic toxic carcinogenic. BIOLOGICAL AGENTS . viruses

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occupational infections diseases and other diseases of biological origin tartu 10 11 3
OCCUPATIONAL INFECTIONS DISEASES AND OTHER DISEASES OF BIOLOGICAL ORIGINTartu10.-11.3

OCCUPATIONAL HAZARDS

  • physical
  • chemical
  • biological
  • psycho-social

Markku Seuri, FIOH, 2004

biological occupational hazards
BIOLOGICAL OCCUPATIONAL HAZARDS
  • = occup. biohazards
    • infectious
    • allergic
    • toxic
    • carcinogenic

Markku Seuri, FIOH, 2004

biological agents
BIOLOGICAL AGENTS
  • viruses
  • bacteria
  • fungi
  • plant substances
  • invertebrate animals
  • substances derived from vertebrate animals
  • (hazards of accidental)

Markku Seuri, FIOH, 2004

biohazards vs chemical and physical agents
BIOHAZARDS VS. CHEMICAL AND PHYSICAL AGENTS
  • less well known
  • problems in definition
  • less important in industrialized countries
  • changing nature of the exposure
  • seldom an essential part of the work task
  • difference in prevention: as few exposed as possible

Markku Seuri, FIOH, 2004

spreading
SPREADING
  • by inhalation
  • by ingestion (from hand to mouth)
  • by sharps injuries
  • by blood or other body fluid contact
  • by bites or stings of vectors

Markku Seuri, FIOH, 2004

general measures of prevention 1
GENERAL MEASURES OF PREVENTION -1
  • avoid hazardous agents whenever possible
  • minimize the exposure by proper working practice, technical solutions and personal hygiene
  • minimize the number of exposed

Markku Seuri, FIOH, 2004

general measures of prevention 2
GENERAL MEASURES OF PREVENTION -2
  • inform the workers
  • written guidelines
  • guidance and instructions
  • use signs
  • (health check-ups have a limited role)

Markku Seuri, FIOH, 2004

the incidence of work related diseases of biological origin in finland in 2002 1
THE INCIDENCE OF WORK-RELATED DISEASES OF BIOLOGICAL ORIGIN IN FINLAND IN 2002 - 1
  • bacterial and fungal spores 264
  • TBC 16
  • bacteria, virus, fungi and protozoa 134
  • all biological agents (not including allegens of biological origin) 414 (8,5 % of the total number)

Markku Seuri, FIOH, 2004

the incidence of work related diseases of biological origin in finland in 2002 2
THE INCIDENCE OF WORK-RELATED DISEASES OF BIOLOGICAL ORIGIN IN FINLAND IN 2002 - 2
  • bacterial and fungal spores 264
    • in farming 43
    • public administration 49
    • education 42
    • health care 71
  • damp and mouldy work-places are often found in the public sector

Markku Seuri, FIOH, 2004

slide13

EU DIRECTIVE 2000/54/EC18th of Sept. 2000On the protection of workers from risks related to exposure to biological agents at work

Tartu

10.3.-11.3.

Markku Seuri, FIOH, 2004

objective
OBJECTIVE
  • "protection of workers against risks to their health and safety, including the prevention of such risks, arising or likely to arise from exposure to biological agents at work"

Markku Seuri, FIOH, 2004

definition of biological agents
DEFINITION OF BIOLOGICAL AGENTS
  • micro-organisms, which may be able to provoke any
    • infection
    • allergy
    • toxicity

Markku Seuri, FIOH, 2004

definition of micro organism
DEFINITION OF MICRO-ORGANISM
  • microbiological entity, cellular or non-cellular and
  • capable of replication or of transferring genetic material

Markku Seuri, FIOH, 2004

definition of excludes
DEFINITION OF EXCLUDES
  • microbial toxins if the replicating cell is not present
  • plant substances (allergens)
  • substances derived from vertebrate animals (allergens)
  • => definition is very close to the concept of "occupational infections"

Markku Seuri, FIOH, 2004

classification of biological agents 1
CLASSIFICATION OF BIOLOGICAL AGENTS - 1
  • GROUP 1:
    • unlikely to cause human disease
  • GROUP 2:
    • can cause human disease
    • may be an occupational hazard
    • unlikely to spread to the community
    • usually an effective prophylaxis or treatment

Markku Seuri, FIOH, 2004

classification of biological agents 2
CLASSIFICATION OF BIOLOGICAL AGENTS - 2
  • GROUP 3:
    • can cause human a severe disease
    • serious occupational hazard
    • may spread to the community
    • usually an effective prophylaxis or treatment
  • GROUP 4:
    • causes severe human disease
    • serious occupational hazard
    • may present a high risk of spreading
    • usually no effective prophylaxis or treatment

Markku Seuri, FIOH, 2004

determination and assessment of risks 1
DETERMINATION AND ASSESSMENT OF RISKS - 1
  • where workers are or are potentially exposed to biological agents
    • biological agents are present deliberately in the occupational activity (e.g. laboratories) or
    • workers may be exposed to the agent not essential to the occupational activity (work in forests and Lyme disease)

Markku Seuri, FIOH, 2004

determination and assessment of risks 2
DETERMINATION AND ASSESSMENT OF RISKS - 2
  • if a risk of exposure to biological agent
    • nature,
    • degree and
    • duration of the exposure must be determined
  • for the assessment of the risk and
  • to lay down measures

Markku Seuri, FIOH, 2004

determination and assessment of risks 3
DETERMINATION AND ASSESSMENT OF RISKS - 3
  • for all agents
  • renewed regularly
  • on request authorities must by supplied by information on the assessment process

Markku Seuri, FIOH, 2004

employers obligations
EMPLOYERS´ OBLIGATIONS
  • whenever possible replace the agent
  • if not possible reduce the risks
  • information for the authority
  • hygiene and individual protection
  • information and training of workers
  • list of exposed workers
  • consultation and participation of workers
  • notification of the authority

Markku Seuri, FIOH, 2004

measures to reduce the risk of exposure 1
MEASURES TO REDUCE THE RISK OF EXPOSURE -1
  • minimize the number of workers exposed
  • design of work processes and engeneering control measures
  • collective protection measures and/or individual protection measures
  • hygiene measures to prevent accidental transfer from the workplace

Markku Seuri, FIOH, 2004

measures to reduce the risk of exposure 2
MEASURES TO REDUCE THE RISK OF EXPOSURE -2
  • use warning signs
  • plans to deal with accidents
  • testing the presence of the agent outside the primary physical confinement
  • safe waste handling
  • safe handling and transport within the workplace

Markku Seuri, FIOH, 2004

information for the competent authority
INFORMATION FOR THE COMPETENT AUTHORITY
  • results of the assessment
  • activities where exposed (or potentially)
  • number of exposed
  • name and capabilities of the person responsible for safety and health at work
  • protective and preventive measures taken
  • emergency plan for the loss of physical containment (group 3 and 4)

Markku Seuri, FIOH, 2004

hygiene and individual protection
HYGIENE AND INDIVIDUAL PROTECTION
  • no eating or drinkin in working areas where there is a risk of contamination
  • protective clothing (for free)
  • adequate washing and toilet facilities
  • any necessary protective equipment
  • procedures for taking, handling and processing samples of human or animal origin

Markku Seuri, FIOH, 2004

information of workers
INFORMATION OF WORKERS
  • potential risks to health
  • precautions to be taken to prevent exposure
  • hygiene requirements
  • use of protective equipment and clothing
  • steps to be taken by workers in the case of incidents and to prevent incidents

Markku Seuri, FIOH, 2004

training of workers
TRAINING OF WORKERS
  • at the begining of work involving contact with biological agents
  • new or changed risks
  • repeated periodically if necessary

Markku Seuri, FIOH, 2004

list of exposed workers
LIST OF EXPOSED WORKERS
  • for group 3 and 4 agents
  • the list shal be kept for 10 years (for some agents 40 years)
  • the doctor and/or authority for health and safety shall have access to the list

Markku Seuri, FIOH, 2004

notification of the competent authority
NOTIFICATION OF THE COMPETENT AUTHORITY
  • prior (30 days) notification for group 2, 3 and 4 agents
  • subsequent notification of new group 4 agents (excluding diagnostic laboratories)
  • renotification if substantial changes
  • information content of the notification is defined

Markku Seuri, FIOH, 2004

health surveillance
HEALTH SURVEILLANCE

"The Member State shall establish, in accordance with national laws and practice, arrangements for carrying out relevant health surveillance of workers for whom the results of the assessment referred to in Article 3 reveal a risk to health or safety." (underlined by MS)

Markku Seuri, FIOH, 2004

relevant health surveillance 1
RELEVANT HEALTH SURVEILLANCE - 1
  • principles and practices of occupational medicine
  • in the light of the most recent knowledge available to occupational medicine
  • evidence based medicine

Markku Seuri, FIOH, 2004

relevant health surveillance 2
RELEVANT HEALTH SURVEILLANCE - 2
  • depends on risk assessment not only on the biological agent
  • if a worker is suffering of infection or an illness suspected to be the result of exposure, surveillance should be offered to other workers similarly exposed

Markku Seuri, FIOH, 2004

relevant health surveillance 3
RELEVANT HEALTH SURVEILLANCE - 3
  • can be done prior to exposure and at regular intervals thereafter
  • doctor shall propose protective and preventive measures
  • all cases of diseases and death shall be notified to the comptent authority

Markku Seuri, FIOH, 2004

vaccination
VACCINATION
  • if risk and effective vaccination exist, employers should offer vaccination
  • workers should be informed of the benfits and drawbacks of both vaccination and non-vaccination
  • vaccination must be offered free of charge to workers

Markku Seuri, FIOH, 2004

health and veterinary facilities other than diagnostic laboratories
HEALTH AND VETERINARY FACILITIES OTHER THAN DIAGNOSTIC LABORATORIES
  • in risk assessment consider:
    • uncertanties about the presence of biological agents
    • suspected biological agents
  • in particular decontamination and disinfection procedures
  • special containment measures for group 3 or 4 agents (Annex V)

Markku Seuri, FIOH, 2004

special measures for industrial processes laboratories and animal rooms
SPECIAL MEASURES FOR INDUSTRIAL PROCESSES, LABORATORIES AND ANIMAL ROOMS
  • for group 2, 3 and 4 agents
  • containment measures according to the agent (levels 2,3 and 4)
  • separate containment measures for laboratories and industrial processes

Markku Seuri, FIOH, 2004

classification of biological agents 11
CLASSIFICATION OF BIOLOGICAL AGENTS 1
  • in four groups on the basis of four features:
    • ability to cause diseases
    • ability to cause occupational diseases
    • risk of spreading to the community
    • treatment or prophylaxis

Markku Seuri, FIOH, 2004

classification of biological agents 21
CLASSIFICATION OF BIOLOGICAL AGENTS 2
  • based on healthy adults
  • not considering:
    • pre-existing disease
    • medication
    • compromised immunity
    • pregnancy or breast feeding
  • those agents not listed in groups 2, 3 or 4, are not implicitly group 1 agents

Markku Seuri, FIOH, 2004

classification of biological agents 3
CLASSIFICATION OF BIOLOGICAL AGENTS 3
  • indications:
    • A possible allergic effect
    • D keep the list of exposed workers more than 10 years
    • T toxin production
    • V effective vaccine available

Markku Seuri, FIOH, 2004

group 4
GROUP 4
  • only viruses
  • 11 viruses
  • rare like
    • Ebola
    • Marburg
    • Lassa
    • Junin

Markku Seuri, FIOH, 2004

group 3
GROUP 3
  • 27 bacteria, like
    • Brucella, Bacillus anthracis, Coxiella, several Mycobacteria
  • 52 viruses, like
    • hepatitis viruses, HIV, Creutzfeldt-Jacob, Rabies, Kumlinge
  • 16 parasites, like
    • Echinococcus, Plasmodium falciparum
  • 6 fungi, like
    • Histoplasma capsulatum

Markku Seuri, FIOH, 2004

group 2
Group 2
  • 120 bacteria
  • 66 viruses
  • 60 parasites
  • 20 fungi

NB! Direktiiv on tõlgitud eesti keelde:

http://europa.eu.int/eur-

lex/et/dd/docs/2000/32000L0054-ET.doc

Markku Seuri, FIOH, 2004

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