INTRODUCTION... -1-1.0 INTRODUCTION TO WHMIS LEGISLATION, LABELLING AND MSDSs........ -2-1.1 Worker responsibilities with respect to WHMIS controlled products........... -2-1.2 Material Safety Data Sheets... -2-1.3 Labelling... -5-1.4 WHMIS Classes and Symbols... -7- SECTION 2: CONSUMER PRODUCTS... -9-2.1 Labels... -9-2.2 Degree of Hazard Borders... -10-2.3 Consumer Symbols... -10-2.4 Worker Responsibility with respect to consumer products... -11- SECTION 3: Health Effects of Hazardous materials and Hazard Control............... -12-3.1 Physical States... -12-3.2 Hazard Control Principles... -13-3.3 Personal Protective Equipment (PPE).................................. -14- SECTION 4: SAFE HANDLING AND DISPOSAL OF HOUSEHOLD HAZARDOUS WASTE... -16-4.1 Sharps... -16-4.2 Biohazardous Waste... -16-4.3. Medications... -16-4.4 TROUBLE SHOOTING... -17- -0-
INTRODUCTION As attendants, there is the potential for you to be exposed to hazardous substances in the work place such as chemicals, blood born pathogens and infectious diseases. Attendants may be exposed through direct consumer care activities and support activities such as housekeeping or laundry. The goal of this guidebook is to reduce or eliminate the incidence of injuries and illnesses resulting from exposure to hazardous materials through the provision of consistent and accurate information designed so that workers can make appropriate decisions regarding the management of hazardous materials. What is a Hazardous Material? Definition of a hazardous material: Any substance or compound that has the capability of producing adverse effects on the health and safety of humans. The Workplace Hazardous Materials Information System (WHMIS) legislation came about in 1988 as a result of labour, government and employer concerns regarding the use, handling and storage of hazardous materials. WHMIS applies only to products which are considered controlled products as defined in the federal Hazardous Products Act. At the ILCWR, attendants are not generally exposed to controlled products which are commonly found in industry. Attendants will however, find themselves working with products on a regular basis that are purchased in retail stores for activities such as housekeeping. These readily available retail products are called consumer products. NOTE: As attendants you are working in a consumer s private home. Consumers are strongly encouraged to maintain a safe environment for their attendants. The ILCWR has no jurisdiction however over a private residence and as a result we cannot guarantee that consumers will have products labelled appropriately and procedures in place for appropriate disposal of hazardous waste or sharps. We can however educate you on appropriate handling so that you can protect yourself at home or work. If you note a hazard to your health and safety in the work place, notify the consumer immediately and if you and the consumer cannot rectify the situation call your supervisor. DO NOT handle dangerous chemicals or hazardous waste in a manner that will compromise your safety. The goal of this training package is: to provide a brief introduction to WHMIS labelling and Material Safety Data Sheets to provide a comprehensive overview of consumer product labelling and safe use to provide a brief education on the health effects of hazardous products and how to minimize the risks to review safe handling procedures for sharps and bio hazardous waste. -1-
1.0 INTRODUCTION TO WHMIS LEGISLATION, LABELLING AND MSDSs Controlled products are materials commonly found in industries or sold in bulk. It is not expected that ILCWR attendants will be working with many controlled substances. Supervisors review on a yearly basis the cleaning supplies and chemicals that are used by attendants in a consumers home. If controlled products are present attendants must know how to recognize them, read the labels and know how to control any hazards they present. Attendants have specific responsibilities under WHMIS as follows: 1.1 Worker responsibilities with respect to WHMIS controlled products participate in WHMIS training programs use the WHMIS information appropriately contact their supervisor immediately if they do not have the required information to handle a hazardous product safely ensure that all labels remain intact and notify the supervisor if labels are altered or removed use personal protective equipment as directed 1.2 Material Safety Data Sheets All controlled products must be sold with a MSDS. This is an information sheet that provides significant amounts of information regarding the hazardous nature of the product and how to control the hazard. This information sheet provides comprehensive information on storage, spill clean up, first aid measures and personal protection wtih respect to the product. A blank MSDS sheet is found on the next two pages. -2-
1.3 Labelling The WHMIS legislation provides rules which determine how products which can be dangerous to human health if not used properly must be labelled. The WHMIS system provides labels which are standard and recognizable throughout Ontario. Controlled products can be recognized by their distinctive labelling system. All controlled products that have been shipped/sold directly from the supplier have a hatched border (see Figure 1) If the product has been transfered to another container in the workplace then it has a workplace label (see Figure 2). Both labels must have refer to MSDS sheet on them When is it required? How do I tell the two apart? Supplier Label A supplier label is affixed to containers of controlled products. If the volume is more that 100 ml it must include all of the following 7 pieces of information. If the volume is less than 100 ml then it must contain the first 4 pieces of information. 1. name of the product 2. name and address of the supplier 3. the statement refer to MSDS 4. hazard symbol 5. a risk phrase explaining the hazards and degree of risk 6. precautionary measures 7. first aid measures has a hatched border always contains symbols information is in French and English Workplace Label Workplace labels are required if: samples arrive in bulk shipment from the supplier without a supplier label affixed the controlled product is produced in the employer s workplace a controlled product is decanted or transferred from the original supplier-labelled container to another container. border is not distinctive no symbols are required information is in the language of the workplace. -5-
Supplier Label Workplace label Figure 1. Figure 2. FORMALDEHYDE FLAMMABLE Keep away from, heat, sparks and flame. POISONOUS Avoid skin and eye contact. Avoid inhaling vapours. Refer to Material Safety Data Sheet (MSDS) before -6-
1.4 WHMIS Classes and Symbols There are 6 classes of controlled substances. As attendants it is unlikely that you will come in contact with many of these substances. However the labels are similar to other classifications. CLASSES RISKS PRECAUTIONS Class A: Compressed Gases Materials which are normally gaseous and kept in a pressurized container. could explode due to pressure could explode if heated or dropped Ensure container is always secured and will not tip or fall over. Do not expose to heat. Class B: Flammable and Combustible Materials Materials which will continue to burn after being exposed to a flame or other ignition source. Store in properly designated areas. Work in well ventilated areas. Do not heat and avoid sparks or flames. Class C: Oxidizing Materials Materials which can cause other materials to burn or support combustion. i.e., hydrogen peroxide. Store in areas away from combustibles. Wear body, hand, face and eye protection. Store in closed containers. Class D: Division 1: Division 2: Poisonous and Infectious Materials Toxic, Immediate and Severe Toxic, Long Term Concealed Divided up into several subclasses. Poisons/potentially fatal materials which cause immediate and severe harm. May be fatal if ingested or inhaled may be absorbed through the skin small volumes have a toxic effect Materials which have harmful effects after repeated exposures or over long periods of time. Avoid breathing dust or vapours. Avoid contact with skin or eyes. Wear appropriate personal protective equipment and work in well ventilated areas. Store in properly designated areas. Work in well ventilated areas. Avoid heating and sources of sparks or flame. -7-
Division 3: Biohazardous Infectious Infectious agents or a biological toxin causing a serious disease or death. May cause anaphylactic shock Includes viruses, yeasts, moulds, bacteria and parasites, fluids containing toxic products and cellular components Special training is required for work in designated biological areas with appropriate engineering controls. Class E: Corrosive Materials Materials which react with metals and living tissue. Can cause eye and skin irritation, burns and tissue damage may cause lung damage if inhaled fumes and vapours can be dangerous to eyes and lungs Wear body, face and eye protection. Use breathing apparatus. Appropriate personal protective equipment must be used to prevent direct body contact. Good ventilation is essential. Class F: Dangerously Reactive Materials Materials which may have unexpected reactions. Handle with care, avoiding vibration, shocks and sudden temperature changes. -8-
SECTION 2: CONSUMER PRODUCTS Consumer products are commonly products which are produced for retail sale such as household cleaners, bleach, paint etc. They may contain substances which can be considered controlled substances when sold in bulk to industry or when sold at higher concentrations. Consumer products require a separate labelling system, from WHMIS labels, which identifies their particular hazard to the consumer. Consumer products are products generally used for personal, family or household purposes. They are not sold with MSDS sheets. To be sold as a consumer product, the product must meet the following two conditions: 1) it must be packaged for the consumer 2) It must be available to the general public through retail systems. Products sold through wholesale outlets are not considered to be available to the consumer. Despite the fact that these products are sold every day and are familiar they can still present a significant hazard if not used and disposed of properly. Attendants should familiarize themselves with any products used in a consumer s home. If any WHMIS controlled products are discovered then a MSDS sheet should be obtained at the attendants request. Attendants should not use a controlled product without access to a MSDS sheet. 2.1 Labels Consumer products have their own unique label form. The labels generally display a border with a specific shape that indicates the degree of hazard and a symbol or pictogram that indicates the type of hazard. As with any hazardous products, labels are important. If a label is defaced or removed or if the product is decanted into other containers then the requirements for a workplace label apply. As with any product, if you are unsure of how to use it safely, ask your supervisor. -9-
2.2 Degree of Hazard Borders WARNING DANGER CAUTION Special Hazard/ Severe Hazard/ Moderate hazard/ Special Requirements immediate harm long-term or hidden harm 2.3 Consumer Symbols FLAMMABLE fire hazard will ignite if exposed to flame or spark store away from heat POISON potentially fatal if inhaled or swallowed. Wear gloves/face mask wash after using EXPLOSIVE handle container with care may explode if heated or dropped may react violently with other materials keep away from heat sources CORROSIVE causes skin/eye burns do not breathe fumes wear gloves and eye protection keep containers sealed may damage metals Symbols are placed inside the borders to indicate the type of hazard and degree of hazard. -10-
If a label on a product becomes damaged or illegible or the product is decanted into another container, then a workplace label similar to the WHMIS workplace label must be put on the container. The label doesn t have to be fancy. It only needs to indicate what the product is and necessary precautions. Example. SQUEAKY CLEAN FLOOR CLEANER Corrosive, Poison Use in well ventilated area. Wear rubber gloves 2.4 Worker Responsibility with respect to consumer products to understand how to read consumer product labels recognize consumer product symbols properly use, handle, store and dispose of the products 2.5 Emergency Response In the event of an emergency involving a consumer product: keep the container if possible, the container label should be brought to the attention of the attending emergency medical personnel as it may provide information pertinent to treatment. Call Fire, Police, Ambulance - 911 if necessary Call Poison Information Centre:1-800-268-9017 if necessary -11-
SECTION 3: Health Effects of Hazardous materials and Hazard Control What is a risk? Risk: The probability that a harmful consequence will likely occur as the result of an action. Then what is toxicity? Toxicity: The degree to which a hazardous material will cause harmful effects in a particular target site in the body when a certain concentration is reached. A substance can be toxic but not pose a health threat if it is unable to enter the body. 3.1 Physical States All materials exist in a physical state such as liquid, gas or solid. Hazardous materials are no different. The physical state of the material dictates how it can enter the body and therefore its risk. The method of entering the body is called a route of entry. There are four main routes. Absorption through the skin, inhalation through the respiratory system, ingestion through the mouth and injection through the skin. Physical Method of Formation Route Example State of Entry Dusts Generated by mechanical action on a solid (e.g., breaking, grinding). Can be found on work surfaces. inhalation ingestion household dust wood dust Smoke Formed when a material containing carbon is burned. Generally contains droplets as well as dry particles. inhalation tobacco smoke Mists Liquid droplets suspended in air that can be created either by the dispersion of a liquid such as with splashing or spraying. inhalation ingestion sneezing coughing Vapour Gaseous state of a substance normally found in a liquid or solid state. Found in many housekeeping operations where cleaning agents are used (i.e., evaporated cleaning solution) inhalation absorption bleach vapour Gases Do not exist as liquids or solids at normal temperature and pressure (e.g., oxygen, carbon dioxide) inhalation gas formed when bleach is mixed with toilet bowl cleaner Liquid Exists as a liquid at room temperature (i.e., bleach, ammonia) ingestion absorption injection poison liquids corrosive liquids needlestick -12-
3.2 Hazard Control Principles There are 3 generally accepted principles applied to hazard control. Recognition Principle Definition Example Assessment of the workplace to determine the hazardous materials present and their associated health and safety risks. You recognize that a consumer s laundry is soiled with body fluids and you know that the consumer has MRSA. Evaluation Control Determination of the degree of exposure and conditions under which the worker is likely to be exposed. Implementation of a procedure to eliminate or reduce the risk to the worker to an acceptable safe, level. You identify that you could be exposed to an infectious agent as you do the laundry. You use gloves to handle the laundry and avoid touching it with unprotected arms by wearing a gown. There are three areas in which to control the hazard: Where How Example At the source eliminate the hazardous product or substitute it with a less hazardous one, modify the process, isolate the hazardous material A family member handles the laundry. Along the path At the worker use of ventilation, barriers such as screens and shields, good housekeeping practices Implemented only after controls at the source and along the path have been considered. Attendant puts the soiled linen into a separate basket labelled for the purpose. Use gloves, gowns or masks. Use good hand washing practices. No eating in work areas. *Universal Precautions* -13-
3.3 Personal Protective Equipment (PPE) Personal protective equipment consists of things such as gloves, gowns, masks, etc. Although PPE should be considered the last line of defence in the control of exposure to hazardous material in health care, it is often one of the main defence strategies, especially with respect to biohazards because of the difficulty in eliminating the hazard in other ways. To be effective: It must be properly fitted. i.e., the right size gloves should be used Workers must be trained properly in use. Workers need to understand why and under what circumstances PPE is used. It is the supervisor s duty to ensure that all workers wear or use all PPE required and provided by the employer. It is each worker s duty to wear all PPE provided by the employer. Use of universal precautions consistently constitutes proper use of Personal Protective Equipment. Infection Control in Community Care Infection control practices demonstrate mutual respect between the attendant and consumer. The objective is to prevent unprotected contact with infectious organisms as well as to prevent consumers from developing infections through cross infections. This system is based on the premise that all body substances are potentially infectious. For the purposes of this manual, body substances shall be deemed to include the following: blood, oral secretions, sputum, urine, semen, faeces, wound drainage, vomitus, mucosal secretions and any other moist body substances. Most of the communicable diseases or conditions that attendants must learn to control are often microbial infections that consumers contract while in hospital. They are also often antibiotic resistant infections that affect individuals with compromised immune systems. Infections such as these do not usually affect attendants but can be transmitted to other consumers by attendants. There is also the possibility of working with consumers who may be HIV/AIDS or Hepatitis A, B, or C positive. It should be noted that the population of people we provide service to are at no more risk of having blood born diseases such as HIV or Hepatitis than the general population. Universal Precautions Universal Precautions, also called standard precautions is the practice of diligent handwashing and glove use when there is the potential for contact with any body fluid. The assumption is made that all fluids are potentially infectious, so a judgement is never necessary as to when gloves or handwashing is required. If universal precautions are always used diligently, it is generally all the protection required for an attendant providing community care. Hand Washing is the most important infection control practice for all attendants. Keep skin on -14-
hands healthy and intact. Skin is an excellent physical barrier. Open areas or cuts in the skin should be covered with a band-aid. If skin breakdown develops on the hands and does not resolve, the attendant should contact a physician. Hand washing is indicated: before performing invasive procedures before and after touching wounds or drainage after touching inanimate sources that are likely to be contaminated with body substances (eg. urine measuring devices, bedpans, soiled linens or waste). before putting gloves on and after removing gloves when common sense dictates Appropriate use of gloves is indicated when there is anticipated contact with: body fluids mentioned above mucous membranes broken skin wiping up surfaces contaminated with body substances especially blood (a household disinfectant should be used to clean up after spills of body substances). handling laundry or linens that have been contaminated with body fluids Wearing gloves will help protect but will only be effective for both consumers and attendants if the following rules are observed: Gloves must be worn for only one consumer contact--not between consumers. Disposable gloves must never be washed or reused. Gloves must be discarded after every procedure and hands washed. Gloves are not necessary if an attendant is providing homemaking tasks or personal care that does not involve contact with surfaces or fluids mentioned above. For example assisting a consumer with a shower that does nto involve peri-care, does not require gloves. Gloves do not have to be worn to comb/brush hair. A final word The best tool in the prevention of communicable disease is common sense. If you are contagious or suspect you may be for any reason, do everything possible to limit the likelihood that anyone else will become infected. Washing your hands frequently, wearing gloves, or calling in sick if necessary. Similarly, if you suspect the consumer you are working with is contagious, take precautions. Wear gloves if you need to, limit contact as much as possible, and wash your hands often. Also, if there is a possibility that you may cross-infect a disease or condition between different consumers, speak to your supervisor. -15-
SECTION 4: SAFE HANDLING AND DISPOSAL OF HOUSEHOLD HAZARDOUS WASTE Household hazardous waste consists of products such as: acids and alkalines, care and household batteries, household chemicals, antifreeze, motor oil, expired medication, lawn/garden chemicals, propane tanks, paint and solvents. Household chemicals and paints should not be disposed of down the drain. In the Waterloo Region there are Household Hazardous Waste Days at various locations throughout the region. Paints and motor oil can be dropped off during regular business hours at the Cambridge and Waterloo Transfer stations. For information on the disposal programs, call 883-5100 for a recorded message. Information can also be obtained from the Internet at www.waterloo.region.on.ca/waste. 4.1 Sharps In the course of providing service to a consumer you may be required to handle syringes or lancets. Any sharps should be promptly disposed of in an appropriate sharps container. Avoid handling syringes with the caps off unless administering medications. Sharps that are on the floor can lead to a risk of puncture injury. Always wear solid shoes. Encourage consumers to use appropriate disposal containers. Specialized sharps containers can be purchased at most drug stores in the Waterloo Region. Once the container is full it can be returned to the drug store and a new one obtained. Sharps can also be collected in any type of puncture proof container and dropped off at a Household Hazardous Waste day free of charge (see Appendix). Never dispose of sharps in the garbage, toilet or sink. 4.2 Biohazardous Waste In the vast majority of cases linens and clothing soiled with blood or body fluid contaminated with an infectious agent can be simply washed with the regular laundry. Hot soapy water is all it takes to disinfect the linens. If gloves or bandages are extremely blood soaked you can dispose of them in a sharps container, otherwise the regular garbage is acceptable. Soiled gloves, gowns and linens must be bagged in plastic bags and disposed of by incineration or autoclaved in very select cases where there is cyto-toxic waste (i.e., cancer fighting drugs). In all other cases gloves and soiled paper products can be disposed of in regular household garbage and linens can be washed with regular household laundry. Follow the consumer s direction with respect to these issues. 4.3. Medications Expired medications should not be thrown in the garbage or down the toilet. Ideally they should be collected and delivered to one of the Household Hazardous Waste days. Although you cannot force these practices on the consumers you work with, you can provide information to them on appropriate waste disposal. Within your own home you can ensure that waste is disposed of properly. -16-
4.4 TROUBLE SHOOTING Situation Risk Solution You are asked to mix household cleaners such as bleach and toilet bowl cleaner A potentially dangerous chemical reaction can occur which will release vapours and gases which can be dangerous. Never mix two household chemicals. You are required to do laundry which is soiled with body fluids. You are in a home where someone has a cold and has left used tissues all over the floor and furniture. You are working for someone who uses syringes and they ask you to dispose of them individually in a plastic garbage bag and then take the garbage to the curb. Absorption of bacteria or viruses through broken skin. Inhalation of body fluids which results if you shake the wet, soiled laundry causing little droplets of fluids to become air born. You can catch the cold from handling the tissues then touching your own face thereby ingesting or inhaling the virus. You could receive a needle stick injury if the syringes are not in a puncture proof container. The garbage collector could receive a needlestick. Always observe universal precautions and wear gloves while handling laundry. Avoid agitating or shaking soiled laundry. Wash your hands. Pick up the soiled tissues with a clean one or using gloves. Wash your hands immediately after you are done. Inform the consumer that if you are to dispose of sharps it must be into an appropriate container. The consumer needs to obtain a puncture proof container. -17-