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
BODY FLUID SOURCE |
ORGANISM OF CONCERN |
TRANSMISSION CONCERN |
Blood -cuts/abrasions -nosebleeds
|
Hepatitis B virus AIDS virus Cytomegalo virus |
Bloodstream inoculation through cuts and abrasions on hands |
*Feces -incontinence |
Salmonella bacteria Shigella bacteria Rotavirus Hepatitis A virus
|
Oral inoculation from contaminated hands |
*Urine -incontinence |
Cytomegalovirus |
Bloodstream and oral inoculation from contaminated hands
|
Respiratory Secretions -saliva |
Mononucleosis Common cold virus Influenza virus
|
Oral inoculation from contaminated hands |
-nasal discharge |
Hepatitis B virus |
Bloodstream inoculation through cuts and abrasions on hands; bites
|
*Vomitus |
Gastrointestinal viruses, e.g., (Norwalk agent Rotavirus)
|
Oral inoculation from contaminated hands
|
Semen |
Hepatitis B AIDS virus Gonorrhea |
Sexual contact (intercourse) |
* 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.
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.
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.
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.
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.
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.
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)
Ethyl or isopropyl alcohol (70%)
Phenolic germicidal detergent in a 1 per
cent aqueous solution (e.g., Lysol*)
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)
Quaternary ammonium germicidal detergent
in 2 per cent aqueous solution (e.g., Tri-quat*, Mytar* or Sage*)
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.
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.
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.
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