HEALTHCARE HAZARD CONTROL

HEALTHCARE HAZARD CONTROL.

General and Hazardous Health Care Waste and Diseases.

Types of waste. Infectious waste Pathological waste Sharps waste Chemical waste Pharmaceutical waste Cytotoxic waste Radioactive waste Non-hazardous or general waste.

Infectious waste: waste contaminated with blood and other bodily fluids (e.g. from discarded diagnostic samples), cultures and stocks of infectious agents from laboratory work (e.g. waste from autopsies and infected animals from laboratories), or waste from patients with infections (e.g. swabs, bandages and disposable medical devices).

Pathological waste: human tissues, organs or fluids, body parts and contaminated animal carcasses; Sharps waste: syringes, needles, disposable scalpels and blades, etc.; Chemical waste: for example solvents and reagents used for laboratory preparations, disinfectants, sterilants and heavy metals contained in medical devices (e.g. mercury in broken thermometers) and batteries. Non-hazardous or general waste: waste that does not pose any particular biological, chemical, radioactive or physical hazard.

Pharmaceutical waste: expired, unused and contaminated drugs and vaccines; Cytotoxic waste: waste containing substances with genotoxic properties (i.e. highly hazardous substances that are, mutagenic, teratogenic or carcinogenic), such as cytotoxic drugs used in cancer treatment and their metabolites. Radioactive waste: such as products contaminated by radionuclides including radioactive diagnostic material or radiotherapeutic materials.

The major sources of health-care waste are. hospitals and other health facilities laboratories and research centres mortuary and autopsy centres animal research and testing laboratories blood banks and collection services nursing homes for the elderly High-income countries generate on average up to 0.5 kg of hazardous waste per hospital bed per day. In 2010, unsafe injections were still responsible for as many as 33 800 new HIV infections, 1.7 million hepatitis B infections and 315 000 hepatitis C infections.

Environmental Impact. Treatment and disposal of healthcare waste may pose health risks indirectly through the release of pathogens and toxic pollutants into the environment. It can lead to the contamination of drinking, surface, and ground waters if those landfills are not properly constructed. chemical disinfectants can result in the release of chemical substances into the environment. Incineration of unsuitable materials results in the release of pollutants into the air and in the generation of ash residue..

Only modern incinerators operating at 850-1100 °C and fitted with special gas-cleaning equipment are able to comply with the international emission standards for dioxins and furans..

Waste management: reasons for failure. Lack of awareness about the health hazards related to health-care waste. Inadequate training in proper waste management. Absence of waste management and disposal systems. Insufficient financial and human resources and the low priority given to the topic..

Key elements in improving health-care waste management.

WHO developed the first global and comprehensive guidance document, Safe management of wastes from health-care activities. WHO/UNICEF Joint Monitoring Programme will regularly report on safe management of health care waste as part of wider monitoring efforts on water and sanitation in health care facilities. United Nations Children's Fund.

WHO guidance. A monitoring tool; A cost assessment tool; A rapid assessment tool; A policy paper; Guidance to develop national plans; Management of waste from injection activities; Management of waste at primary health care centres; Management of waste from mass immunization activities; and Management of waste in emergencies..

Healthcare Hazard Control System. The Healthcare Hazard Control System (HCS) is a comprehensive framework developed by the Centers for Disease Control and Prevention (CDC) in the United States. It is designed to address the unique hazards and risks present in healthcare settings and to assist healthcare facilities in effectively managing those hazards to ensure the safety of patients, healthcare workers, and visitors..

Identification of Hazards: The first step is to identify the potential hazards within the healthcare facility. These hazards can include infectious agents, chemical substances, physical hazards, ergonomic challenges, and more. Risk Assessment: Once hazards are identified, a risk assessment is conducted to determine the likelihood and severity of potential harm associated with each hazard. This helps prioritize hazards for further action..

Hierarchy of Controls: The HCS employs a hierarchy of controls, which categorizes control measures based on their effectiveness in reducing or eliminating hazards. Elimination/Substitution: Removing the hazard or substituting it with a less hazardous alternative. Engineering Controls: Implementing physical changes or engineering solutions to minimize exposure. Administrative Controls: Implementing policies, procedures, and training to control hazards. Personal Protective Equipment (PPE): Providing appropriate PPE to protect workers from hazards that cannot be eliminated through other means..

Control Implementation: Based on the risk assessment and hierarchy of controls, specific control measures are implemented to minimize or eliminate hazards. Monitoring and Evaluation: The effectiveness of control measures is continuously monitored and evaluated to ensure that they are achieving the intended outcomes. Training and Education: Healthcare workers are provided with appropriate training and education on hazard recognition, control measures, and safe practices to minimize risks..

Emergency Preparedness: The HCS also includes plans for responding to emergencies and incidents related to hazards. Documentation: Keeping detailed records of hazard assessments, control measures, training sessions, and incidents is essential for maintaining accountability and compliance. Communication: Effective communication among healthcare workers, management, and other stakeholders is crucial for creating awareness about hazards, control measures, and changes in protocols..

Continuous Improvement: The HCS promotes a culture of continuous improvement by encouraging regular review and updates of hazard control strategies based on new information, technologies, and best practices..

Hazard Management. Hazard management is a systematic approach to identifying, assessing, and controlling potential hazards in order to prevent or minimize their impact on people, the environment, and assets. Hazard Identification: The first step is to identify all potential hazards that could exist in a particular context. This involves recognizing conditions or situations that could lead to harm, injury, damage, or adverse effects. Risk Assessment: Once hazards are identified, a risk assessment is conducted to determine the likelihood and severity of the potential consequences of each hazard..

Risk Evaluation: Based on the results of the risk assessment, hazards are evaluated to determine which one pose the highest risks and require immediate attention. Implementation of Controls: Control measures are implemented to reduce or eliminate the potential for harm. For example, if a hazard is identified as a slippery floor in a workplace, control measures might include installing anti-slip mats, providing proper footwear, and implementing regular cleaning procedures. Monitoring and Review: Hazard management is an ongoing process that requires continuous monitoring and review. Control measures need to be regularly evaluated to ensure their effectiveness and to identify any changes in hazards or circumstances..

Training and Communication: Effective hazard management involves training employees and stakeholders on hazard recognition, control measures, and emergency procedures. Emergency Preparedness: Hazard management includes preparing for potential emergencies and incidents related to hazards. This involves developing plans and procedures to respond to unexpected situations effectively. Documentation: Keeping thorough records of hazard assessments, risk evaluations, control measures, and incidents is essential for accountability, compliance, and future reference..

Continuous Improvement: Hazard management is an iterative process that encourages continuous improvement. Regularly reassessing hazards, reviewing control measures, and updating strategies based on new information and best practices are important aspects of continuous improvement..

Hazard Analysis. Hazard analysis is a systematic process of identifying, assessing, and understanding potential hazards in order to determine their characteristics, causes, and potential consequences. Hazard analysis is commonly used in various fields, including safety management, risk assessment, environmental management, and engineering..

Hazard Correction. Hazard correction refers to the process of taking action to eliminate, minimize, or control identified hazards in order to reduce the associated risks. Hazard correction is an essential step in ensuring the safety of people, the environment, and assets..

Steps to correct the Hazards. Identifying Hazard Causes Selecting Control Measures Engineering Controls Administrative Controls Personal Protective Equipment (PPE) Implementing Corrective Actions Testing and Validation Monitoring and Follow-Up Documentation and Communication Continuous Improvement.

Identifying Hazard Causes: Before implementing hazard correction measures, it's important to understand the underlying causes of the hazards. This involves analyzing the factors that contribute to the existence of the hazard. Selecting Control Measures: Depending on the nature of the hazard and its causes, appropriate control measures are selected. Control measures can include various approaches, such as engineering controls, administrative controls, and personal protective equipment (PPE).

Engineering Controls: Engineering controls involve modifying the physical environment or systems to prevent the hazard from occurring. Administrative Controls: Administrative controls involve changing work procedures, policies, and practices to reduce the risk associated with the hazard. This could involve implementing training programs, work rotation, signage, and standard operating procedures. Personal Protective Equipment (PPE): PPE is used when hazards cannot be eliminated through other means. This includes providing workers with appropriate gear such as helmets, gloves, masks, and safety goggles to protect them from potential harm..

Implementing Corrective Actions: Once control measures are identified, they are implemented to address the hazard and its causes. This involves putting the chosen measures into practice to prevent or minimize the risk. Testing and Validation: After implementing corrective actions, it's important to validate their effectiveness. This may involve testing the new controls under simulated conditions or monitoring their impact in real-world situations. Monitoring and Follow-Up: Continuous monitoring is necessary to ensure that the hazard remains effectively controlled and that the corrective actions are sustaining the desired outcomes over time..

Documentation and Communication: Thorough documentation of the hazard correction process, including the actions taken and their outcomes, is essential for accountability and regulatory compliance. Effective communication ensures that employees, stakeholders, and relevant parties are aware of the hazard correction efforts. Continuous Improvement: The hazard correction process is iterative and should be part of a broader culture of continuous improvement. Organizations should regularly review and update their hazard correction measures to ensure they remain effective and aligned with changing circumstances..

Personal Protective Equipment. Personal Protective Equipment (PPE) refers to specialized clothing, equipment, or gear designed to protect individuals from potential hazards, risks, and safety threats in various environments. PPE is used to minimize the risk of injury, illness, or exposure to harmful substances by creating a barrier between the wearer and the hazardous elements..

Types of PPE. Head Protection: Helmets, hard hats. Eye and Face Protection: Safety goggles, face shields. Hearing Protection: Earplugs, earmuffs. Respiratory Protection: Respirators, masks. Hand Protection: Gloves, gauntlets. Body Protection: Coveralls, aprons, vests. Foot Protection: Safety boots, shoes. Fall Protection: Harnesses, lanyards..

Selection of PPE: Choosing the appropriate PPE depends on the specific hazards and risks present. Fit and Comfort: Proper fit and comfort are essential for the effective use of PPE. Training and Proper Use: Workers need proper training on how to use PPE correctly. Maintenance and Inspection: PPE should be regularly inspected for damage or wear and tear. Hierarchy of Controls: PPE is often considered the last line of defense in a hierarchy of controls for managing hazards. Respiratory Protection: Respiratory protection is a critical aspect of PPE, particularly in environments where exposure to airborne contaminants or pathogens is a concern..

Hazardous Environments: PPE is especially important in hazardous environments, such as those with chemicals, biological agents, radiation, or physical hazards. Emergency Situations: PPE is crucial during emergency situations, such as fire, chemical spills, or natural disasters. Regulations and Compliance: PPE is often regulated by government agencies to ensure workplace safety. COVID-19 Pandemic: During the COVID-19 pandemic, PPE gained significant attention as an essential means of preventing the spread of the virus. Face masks, gloves, and other protective gear became widely used to protect against infection..

Hazard Control Committee. Also known as a Safety Committee or Health and Safety Committee, is a group within an organization that is responsible for identifying, assessing, and managing workplace hazards to ensure the health and safety of employees, visitors, and stakeholders. The committee plays a critical role in promoting a safe and healthy work environment.

Purpose and Objectives. Identifying potential hazards and assessing their risks. Developing and implementing control measures to mitigate identified hazards. Promoting a safety culture and raising awareness about workplace safety. Reviewing incidents, accidents, and near-misses to prevent recurrence. Ensuring compliance with relevant laws, regulations, and standards. Educating employees about safety practices and providing training. Monitoring and evaluating the effectiveness of hazard control measures. Regularly reviewing safety policies, procedures, and protocols..

Composition. Management representatives. Safety officers or coordinators. Employee representatives from various departments. Health professionals or experts, if required. Environmental experts, if relevant..

Roles and Responsibilities. Hazard Identification Risk Assessment Control Measure Development Communication Training and Education Incident Review Policy Development Emergency Preparedness Compliance Continuous Improvement Meetings and Reporting.

Accident Causation. Accident causation refers to the process of identifying the underlying factors and events that lead to an accident or incident in a workplace or any other setting. Understanding the causes of accidents is crucial for preventing future incidents, improving safety measures, and creating a safer environment for individuals..

Heinrich's Domino Theory:. Heinrich's model suggests that accidents result from a sequence of events, often represented as dominoes falling in a chain reaction. Social Environment Fault of Person Unsafe Act or Condition Accident Injury.

Bird's Triangle Theory: Bird's model illustrates the relationship between the three factors involved in accidents: Host (the person) Agent (the object or substance causing harm) Environment (the circumstances).

Human Factors Models: These models focus on human error and the psychological, physiological, and cognitive factors that contribute to accidents. Swiss Cheese Model: Also known as the cumulative act effect, this model depicts multiple layers of defense in a system as slices of Swiss cheese. Accidents occur when the holes in different layers align, allowing a hazard to pass through. Multiple Causation Model: This model considers that accidents result from a combination of factors, including unsafe conditions, unsafe acts, and management failures..

Systems Approach: The systems approach views accidents as the result of failures in the overall system, including design, processes, procedures, management, and individual behaviors. Root Cause Analysis: Root cause analysis seeks to identify the fundamental cause or causes of an accident by exploring factors such as direct causes, contributing factors, and underlying causes. It aims to prevent recurrence by addressing the core issues..

Human Performance Model: This model focuses on human performance as a key factor in accidents. It considers the individual's capabilities, limitations, and interactions with the environment to understand how errors occur. Accident Iceberg Theory: This theory suggests that the accidents we observe are just the visible "tip of the iceberg." Below the surface, there are many near-miss incidents, unsafe conditions, and minor errors that contribute to accidents..

Accident Reporting. Accident reporting is the process of documenting and communicating information about workplace accidents, incidents, injuries, near-misses, and other safety-related events. Injury and Illness Prevention: Reporting accidents allows organizations to address the root causes of incidents and implement measures to prevent similar occurrences. Legal and Regulatory Compliance: Many jurisdictions require employers to report workplace accidents to comply with labor and occupational health and safety regulations..

Insurance and Workers' Compensation: Accurate reporting ensures that workers' compensation claims are processed promptly and fairly. Data Analysis: Data from accident reports can help identify trends, patterns, and high-risk areas, enabling organizations to focus their safety efforts effectively. Continuous Improvement: Reporting incidents provides an opportunity to evaluate the effectiveness of existing safety measures and make necessary adjustments for improvement..

Steps in Accident Reporting. Immediate Response Secure the Area Notify Management Gather Information Injury Assessment Document the Incident Notification to Authorities Medical Treatment Workers' Compensation Investigation Corrective Actions Data Analysis.

Reporting Tools:. Accident Report Forms: Pre-designed forms that guide the collection of essential information about the incident. Digital Platforms: Many organizations use software or apps to streamline accident reporting and data analysis. Safety Management Systems: Integrated systems that track accidents, incidents, investigations, and corrective actions..

Workers' compensation. Workers' compensation, also known as workers' comp, is a form of insurance that provides benefits to employees who suffer job-related injuries or illnesses. It is designed to cover medical expenses, lost wages, and rehabilitation costs for employees who are injured or become ill while performing their job duties..

Key Aspects of Workers' Compensation. Coverage: Workers' compensation covers injuries and illnesses that occur in the course of employment. This can include accidents, repetitive strain injuries, occupational diseases, and more. Benefits: Medical Expenses Lost Wages Disability Benefits Vocational Rehabilitation Death Benefits.