Public Administrator / Public Guardian

Occupational Exposure Awareness

Presented by Anna Levina, Department of Mental Health

Developed by Gevork Kazanchyan, MS, REHS, CP-FSCHIEF EXECUTIVE OFFICE

LOSS CONTROL AND PREVENTION SECTION

Field OperationsHealth & Safety Mantra

DO wash hands afterwardDO keep wounds covered

Do NOT touch eyes, nose, ears & mouthDo NOT contact what will touch eyes, nose &

mouth Do NOT stand where you can’t see ground

Do NOT reach into where you can’t seeDo NOT touch what you question as safe

Exposure: Routes of Entry

Inhalation

Ingestion

Absorption/Dermal

Mucous Membranes

Injection

Exposure: Routes of Entry

“Active”Employee action

creates hazard◦Slips, Trips & Falls◦Probes & Piercings◦Over-exertions◦Strains/Sprains◦Contact Infections & Irritations

◦Some Infestations◦Etc., etc., etc…

Exposure: Routes of Entry“Passive”

Employee presence creates hazardSome Insect

Infestations/BitesSome Allergens/

Respiratory Irritants

Vulnerable Populations

Immuno-compromised

Asthma

Respiratory Sensitivity

2-Legged

4-Legged

More-Legged

No-Legged

“Squatting” Populations

X

4-Legged

Raccoons:Aggressive if corneredCarnivores: large caninesCommunal latrinesBaylisascaris procyonis

◦Hardy & nasty roundworm◦Primary host◦Accidental ingestion of eggs

Female produces 800,000/day Raccoon sheds 45,000,000/day

◦Serious illness; No cure

4-LeggedOpossums:Are NOT aggressive“All hiss, no bite”Unique defenseInfested with cat flea

◦Flea-borne typhus in LAC◦Person’s scratch, not bite

4-Legged

Feral Cats:“Community Cats”Infested with cat fleaToxoplasma gondii

◦Nasty parasite◦Primary host◦Accidental ingestion of cat feces

Excrete cysts in feces◦2 risk factors for Toxoplasmosis are:

Infants born to mothers infected upon pregnancy Severely Immuno-compromised

◦Behavioral change; acute Toxo = > psychotic

4-Legged

Rodents:

Roof Rats: Suburban

House Mice: Suburban & Rural

Deer Mice: Rural/Natural Areas

Norway Rats: “Downtown” L.A.

Legged & Winged

Bats:Rabies

◦Primary reservoir in SoCalFecal pellets

◦Look like mouse droppings◦Adhere vertically

Extremely sharp teeth

More-Legged

Spiders:Widow family

◦Venomous, sharp fangs◦Characteristic “snare” web

Black Widow◦Female

Twice size of male Larger venom glands

Brown Widow◦More potent but:

Less injected Localized

More-Legged

Spiders:Brown Recluse

◦Rarely aggressive◦Potentially deadly venom

Hemotoxic◦Not established in CA

Common Concerns

Human Remains & Body Fluids:

• Clear property with authorities• Ventilate if feasible• Lingering waste/fluids

• Odor; unpleasant=>unbearable• Simply avoid all contact• Inhalatory Health Risk; N/A

• Decomposition• Odor; unpleasant=>unbearable• Inhalatory Health Risk; N/A

Animal Remains & Body Fluids:

• Clear property with authorities• Ventilate if feasible• Distancing for “critters” • Lingering waste/fluids

• Odor; unpleasant=>unbearable• Simply avoid all contact• Inhalatory Health Risk; Negligible

• Decomposition• Odor; unpleasant=>unbearable• Inhalatory Health Risk; N/A

Hepatitis B & C:• Bloodborne Pathogen

• Sex• IV Drug Use• Needlesticks

Viable week+ outside bodyTransmission & Prevention:

HIV

Dust & Dirt:Discomfort or threat?Unsightly or unsafe?

Chemicals & Solvents:

Is it stable?◦Simply leave it be

Health Haz-Mat (LA County Fire) Emergency Response Unit (323)890-4317◦Unidentified chemicals?◦Hazmat of any concern?◦Disposal of chemicals?

Unstable/Off-gassing?->911

Medications & SyringesAvoid interaction if possibleMed’s

◦No bare hand contact (.)Sharps

◦Appropriate attire ◦Constant awareness◦Proper handling & disposal

Disposal: Follow County Protocol

Structural & Footing Hazards:• Is stability questionable?• Is footing questionable?• Is “trash-out” an option?• Adhere to fundamentals:

• Be conservative• Slow & sure

• Safety first• Don’t be a hero

Parvovirus◦No members of the genus Parvovirus are currently known to infect humans

Meningitis◦Acquired via direct contact with infected person (kissing, sneeze, sharing food & utensils, etc.)

Gastrointestinal Infections◦Consuming contaminated food/water or indirect oral contact after touching tainted surfaces

Non-Fac tors

Diptheria◦Direct physical contact or breathing aerosolized secretions of infected individuals

Tapeworm and Roundworm Infections◦Consumption of infected foods/fluids or bathing in contaminated waters

SARS◦No U.S. deaths, 8 confirmed cases, ALL contracted the virus abroad

Non-Fac tors

Scabies◦Mites usually survive off the host for 1-2 days, but no longer than 1 week (max)

Tuberculosis◦Bacteria (Tubercle) immediately inactivate once off living tissue/on non-living surfaces

Lice: Head & Body◦Head Louse dies off host within 1 day◦Body Louse survive less than 1 week

Non-Fac tors

Hepatitis A:• Food & Water-borne

Live shellfish

Fecal-oral contamination of ANY food

Prevention:o Vaccineo Good personal hygieneo Sanitation

Non-Fac to rs

Mold/MildewThe “M” WordRelative exposure timeFrom the CDC (re: removal):

◦ “We do not believe that one needs to take any different precautions with Stachy than with other molds.”

Recent study:◦ Inefficiency of inhaling mycotoxins◦ Requires extremely high airborne

spore levels for extended periods◦ Mycotoxicoses implausible by

inhalation in moldy indoor areas

N e g l i g i b l e Fa c t o r s

There is no evidence in the medical literature to

suggest that any one species of mold is more

poisonous than another, when present on surfaces in an indoor environment.

N e g l i g i b l e Fa c t o r s

“SuperDeadlyKillerToxicBlack” Mold?

Mold…In GeneralHealth effects of mold exposure are generally confined to mild respiratory irritation and potential triggering of symptoms in individuals with asthma and certain allergies.

N e g l i g i b l e Fa c t o r s

Asbestos◦Simply “Do Not Disturb”

“Airborne” Diseases◦No ill host to generate and transmit

Lead-Based Paint◦Dust: ingested as hands/food place in mouth◦Chips: consumed by children◦Fumes: inhaled during “hot-work” tasks

N e g l i g i b l e Fa c t o r s

N e g l i g i b l e Fa c t o r s

MRSA (“Superbug”):• Antibiotic-resistant Staph

Transmission: contact with infected person (or their belongings) at wound site

• Prevention: o Wash handso Don’t share personal itemso Keep wounds covered

N e g l i g i b l e Fa c t o r s

Psittacosis:• Inhalation of bacteria from

dried bird droppings

Mostly involves pet, Parrot-like caged birds o Pigeons occasionally

Less than 50 confimed cases in the U.S. since 1996

N e g l i g i b l e Fa c t o r s

Hanta Virus:• Deer mice

◦West U.S.Rural SettingsContact with:

◦Urine◦Droppings◦Saliva

• Fresh viral loads• Extremely rare in LA County

N e g l i g i b l e Fa c t o r s

Plague:• Infected flea bite (Ground squirrels)• 3 cases in LA County since 1979• High elevations/Mountains

N e g l i g i b l e Fa c t o r s

“Bed Bugs”:• Come out to feed weekly

• Need textured surfaces

• 3 months without meal• Nocturnal (Practically)• “Hitch-hikers”• 1/8”

Cockroaches:

• Extraordinarily prolific creatures

• Hide in dark, warm, moist environments

• Nest inside wall/ceiling spaces and appliances

• Indicators of unsanitary conditions

• About 50 pathogens have been isolated

• NO scientific proof of direct transmission

• Definite “mechanical vector”

N e g l i g i b l e Fa c t o r s

N e g l i g i b l e Fa c t o r s

“Third-Hand Smoke”:• Lingering aged smoke

deposited on indoor surfaces• Potential hazard from irritant

aerosols and carcinogenic adsorbed compounds

• Higher asthma hazard index than parent compounds

• No data on exposure doses• No guidelines to mitigate

exposure

N e g l i g i b l e Fa c t o r s

Field Pack Considerations

Field Pack Considerations

Footwear: ◦Shoes/Boots

Sturdy Slip-resistant Puncture-resistant

◦BootiesHand:

◦Single-use gloves Latex*, Nitrile, etc.

◦Reusable heavy work gloves

Field Pack Considerations

Properly Removing Gloves

Field Pack Considerations

Respiratory:◦“Where respirator use is not required”◦Section 5144 (c)(2)(B)

“Employers not required to include in written program those EE’s whose only use involves voluntary use of filtering facepieces (dust masks)”

◦N-95◦Activated-charcoal embedded

Field Pack Considerations

Body: ◦Single-use

“Tyvek” ◦Coveralls◦Pants

Field Pack Considerations

Eye Protection: Safety Eyewear◦Sensitivity to airborne agents

◦Application of “pest repellent”

Sanitizing Wipes◦In absence of soap & water

Field Pack Considerations

Insect Repellant◦Flea infestations◦“DEET”

Tape◦Enclosure of seams

Probe ◦Minimize contact:

Bio Hazards Chem Hazards Physical Hazards

Questions?