1. OCCUPATIONAL INFECTIONS DISEASES AND OTHER DISEASES OF BIOLOGICAL ORIGIN Tartu 10.-11.3
OCCUPATIONAL HAZARDS
physical
chemical
biological
psycho-social
Markku Seuri, FIOH, 2004

2. BIOLOGICAL OCCUPATIONAL HAZARDS
= occup. biohazards
infectious
allergic
toxic
carcinogenic
Markku Seuri, FIOH, 2004

3. BIOLOGICAL AGENTS viruses bacteria fungi plant substances
invertebrate animals
substances derived from vertebrate animals
(hazards of accidental)
Markku Seuri, FIOH, 2004

4. 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

5. 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

6. 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

7. 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

8. bacterial and fungal spores 264 TBC 16
THE INCIDENCE OF WORK-RELATED DISEASES OF BIOLOGICAL ORIGIN IN FINLAND IN
bacterial and fungal spores 264
TBC 16
bacteria, virus, fungi and protozoa 134
all biological agents (not including allegens of biological origin) (8,5 % of the total number)
Markku Seuri, FIOH, 2004

9. bacterial and fungal spores 264
THE INCIDENCE OF WORK-RELATED DISEASES OF BIOLOGICAL ORIGIN IN FINLAND IN
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

10. OCCUPATIONAL GROUPS THREATEND BY INFECTIOUS AGENTS - 1
Agriculture
epidemic nephritis
mycosis, tularemia
Forestry
Lyme disease
Fishermen
Skin infections
Waste management
Hepatitis A and C
intestinal parasites
Markku Seuri, FIOH, 2004

11. OCCUPATIONAL GROUPS THREATEND BY INFECTIOUS AGENTS - 2
Veterinarians
Zoonotic microbes, toxoplasma, listeria
Slaugherhouse workers
dermatomycosis, erysipelothrix
Fishermen
Skin infections
Health care workers
blood borne diseases, TBC, MRSA
Markku Seuri, FIOH, 2004

12. OCCUPATIONAL GROUPS THREATEND BY INFECTIOUS AGENTS – 3
Security professions
blood borne diseases
Laboratory workers
what ever handled in the laboratory
Teachers, day care workers
viruses causing epidemics among children
Personal care workers (cosmeticians, hairdressers)
dermatophytic fungi
Markku Seuri, FIOH, 2004

13. EU DIRECTIVE 2000/54/EC 18th of Sept
EU DIRECTIVE 2000/54/EC 18th of Sept On the protection of workers from risks related to exposure to biological agents at work
Tartu
Markku Seuri, FIOH, 2004

14. 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

15. DEFINITION OF BIOLOGICAL AGENTS
micro-organisms, which may be able to provoke any
infection
allergy
toxicity
Markku Seuri, FIOH, 2004

16. DEFINITION OF MICRO-ORGANISM
microbiological entity, cellular or non-cellular and
capable of replication or of transferring genetic material
Markku Seuri, FIOH, 2004

17. 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

18. 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

19. 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
may present a high risk of spreading
usually no effective prophylaxis or treatment
Markku Seuri, FIOH, 2004

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. containment measures according to the agent (levels 2,3 and 4)
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

39. 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

40. 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

41. 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

42. GROUP 4 only viruses 11 viruses rare like Ebola Marburg Lassa Junin
Markku Seuri, FIOH, 2004

43. GROUP 3 27 bacteria, like 52 viruses, like 16 parasites, 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

44. NB! Direktiiv on tõlgitud eesti keelde:
Group 2
120 bacteria
66 viruses
60 parasites
20 fungi
NB! Direktiiv on tõlgitud eesti keelde:
lex/et/dd/docs/2000/32000L0054-ET.doc
Markku Seuri, FIOH, 2004