FILE:  GAMFB

GUIDELINES FOR HANDLING BODY FLUIDS IN SCHOOL

The Bossier Parish School Board shall require all personnel to follow specific guidelines in the handling of body fluids in the school setting.  While the risk of infection may be low, contact with body fluids shall be minimized.  Employees who fail to use the precautions outlined in the guidelines for handling body fluids may be subject to disciplinary action.

The body fluids of all persons should be considered to contain potentially infectious agents (germs).  The term "body fluids" includes:  blood, semen, drainage from scrapes and cuts, feces, urine, vomitus, respiratory secretions (e.g., nasal discharge) and saliva. Contact with body fluids presents a risk of infection with a variety of germs.  In general, however, the risk is very low and dependent on a variety of factors including the type of fluid with which contact is made and the type of contact made with it.

The following table provides examples of particular germs that may occur in body fluids of children and the respective transmission concerns.  The body fluids with which one may come in contact usually contain many organisms, some of which may cause disease.  Furthermore, many germs may be carried by individuals who have no symptoms of illness.  These individuals may be at various stages of infection: incubating disease, mildly infected without symptoms, or chronic carriers of certain infectious agents including the AIDS and hepatitis viruses.  In fact, transmission of communicable diseases is more likely to occur from contact with infected body fluids of unrecognized carriers than from contact with fluids from recognized individuals because precautions are not always carried out.

TRANSMISSION CONCERNS IN THE SCHOOL SETTING

BODY FLUID SOURCE OF INFECTIOUS AGENTS

 * Possible transmission of AIDS and Hepatitis B is of little concern from these sources.  There is no evidence at this time to suggest that the AIDS virus is present in these fluids.

1. Contact With Body Fluids
   
   When possible, direct skin contact with body fluids should be avoided.  Disposable gloves should at least be available in the office of the custodians, nurses, or principal.  It is recommended that gloves be available in every classroom, and convenient to teachers on playground duty.  Gloves are recommended when direct hand contact with body fluids is anticipated (e.g., treating bloody noses, handling clothes soiled by incontinence, cleaning small spills by hand).  Gloves used for this purpose should be put in a plastic bag, and disposed in a lined trash can, secured, and disposed of daily.

2. Direct Skin Contact
   
   In many instances, unanticipated skin contact with body fluids may occur in situations where gloves may be immediately unavailable (e.g., when wiping a runny nose, applying pressure to a bleeding injury outside the classroom, helping a child in the bathroom).  In these instances, hands and other affected skin areas of all exposed persons should be routinely washed with disinfectant soap and water for a full three (3) minutes after direct contact has ceased.  Clothing and other non-disposable items (e.g., towels used to wipe up body fluid) that are soaked through with body fluids should be rinsed and placed in plastic bags.  If presoaking is required to remove stains, (e.g., blood, feces), use gloves to rinse or soak the item in cold water prior to bagging.  Clothing should be sent home for washing with appropriate directions to parents/teachers.  Contaminated disposable items (e.g., tissues, paper towels, diapers), should be handled as with disposable gloves.

3. Removing Spilled Body Fluids From The Environment
   
   Most schools have standard procedures already in place for removing body fluids (e.g., vomitus).  These procedures should be reviewed to determine whether appropriate cleaning and disinfection steps have been included.  Many schools stock sanitary, absorbent agents specifically intended for cleaning body fluid spills.  Disposable gloves should be worn when using these agents.  The dry material is applied to the area, left for a few minutes to absorb the fluid, and then vacuumed or swept up.  The vacuum bag or sweepings should be disposed of in a plastic bag.  Broom and dustpan should be rinsed in a disinfectant.  No special handling is required for vacuuming equipment.
   
   

4. Handwashing Procedures
   
   Proper handwashing requires the use of soap and water and vigorous washing under a stream of running water for approximately one minute.
   
   Soap suspends easily removable soil and microorganisms allowing them to be washed off.  Running water is necessary to carry away dirt and debris.  Rinse under running water.  Use paper towels to thoroughly dry hands.
   
   Should an ungloved person have any contact with bodily fluids, the person having contact should wash his/her hands for a full three (3) minutes using disinfectant soap and water.

5. Disinfectants
   
   An intermediate level disinfectant should be used to clean surfaces contaminated with body fluids.  Such disinfectants will kill vegetative bacteria, fungi, tuberculosis bacillus and viruses.  The disinfectant should be registered by the U. S. Environmental Protection Agency (EPA) for use as a disinfectant in medical facilities and hospitals.
   
   Various classes of disinfectants are listed below.  Hypochlorite solution (bleach) is preferred for objects that may be put in the mouth.

1. 1. One-step disinfectant, a broad spectrum of kill claims including:  Athlete’s  Foot, HIV-1 (associated with the AIDS Virus), HBV (Hepatitis B Virus), HCV (Hepatitis C. Virus) Influenze A/Brazil, Human Coronavirus and Vaccinia. (e.g. Terminator)
      
      

   2. Ethyl or isopropyl alcohol (70%)
      
      

   3. Phenolic germicidal detergent in a 1 per cent aqueous solution (e.g., Lysol*)
      
      

   4. Sodium Hypochlorite with at least 100 ppm available chlorine (2 cup household bleach in 1 gallon water, needs to be freshly prepared each time it is used)
      
      

   5. Quaternary ammonium germicidal detergent in 2 per cent aqueous solution (e.g., Tri-quat*, Mytar* or Sage*)
      
      

   6. Iodophor germicidal detergent with 500 ppm available iodine (e.g., Wescodyne*)

*Brand names used only for examples of each type of germicidal solution, and should not be considered an endorsement of a specific product.

6. Disinfection Of Hard Surfaces And Care Of Equipment
   
   After removing the soil, a disinfectant is applied.  Mops should be soaked in the disinfectant after use and rinsed thoroughly or washed in a hot water cycle before rinse.  Disposable cleaning equipment and water should be placed in a toilet or plastic bag as appropriate.  Non-disposable cleaning equipment (dust pans, buckets) should be thoroughly rinsed in the disinfectant.  The disinfectant solution should be promptly disposed down a drain pipe.  Remove gloves and discard in appropriate receptacles.

7. Disinfection Of Rugs
   
   Apply sanitary absorbent agent, let dry and vacuum.  If necessary, mechanically remove with dust pan and broom in disinfectant.  If necessary, wash brush with soap and water.  Dispose of nonreusable cleaning equipment as noted above.

8. Laundry Instructions For Clothing Soiled With Body Fluids
   
   The most important factor in laundering clothing contaminated in the school setting is elimination of potentially infectious agents.  Clothing soaked with body fluids should be washed separately from other items.  Presoaking may be required for heavily soiled clothing.  Otherwise, wash and dry as usual.  If the material is bleachable, add 2 cup household bleach to the wash cycle.  If the material is not colorfast, add 2 cup of non-hypochlorite solution to the wash cycle.

Ref:     Information and Guidelines: Prevention of Disease Transmission in Schools, Acquired Immune Deficiency Syndrome (AIDS), State of Connecticut, Department of Education and Department of Health Services, March 1985

Health and Safety, Bulletin 135

Louisiana Handbook for School Administrators, Bulletin 741, Louisiana Department of Education

Bossier Parish School Board