There are a number of illnesses and infections present in the general community to which staff, clients and pupils may be exposed.  Fortunately, most of these are not serious, however, it is important that precautions are taken to minimise the risk of contracting them and limiting their spread if a case arises.  Such infections or illnesses can include impetigo, gastro enteritis, threadworms, conjunctivitis, measles, meningitis, mumps, scabies etc.

There are also a number of more serious infections which can be contracted as a result of a person’s work activities.  Most of these are fortunately rare, however, it is important that precautions are taken to minimise the risk.   In addition to Council employees, volunteers working on countryside projects and members of the public on Council sites may be at risk of these diseases.

Below are listed some of the diseases which may potentially be contracted within the work environment of the Council.  Further information on these diseases is provided in Appendix 1:

• Anthrax*
• Hantavirus Disease
• Hepatitis A*
• Lyme Disease*
• Orf
• Psittacosis
• Tetanus (Lockjaw)*
• Weils Disease (Leptospirosis)*
• Rabies*
• Legionnaires’ Disease

* These infections are reportable to HSE under RIDDOR. 

Hepatitis B, C and HIV/Aids are covered in more detail in Health and Safety Policies and Procedures Section 8.2 Blood Borne Diseases.

For up to date information on COVID-19 protocols and guidance please see the government guidance on working safely at: https://www.gov.uk/guidance/working-safely-during-covid-19

Risk Assessment:

Some people who work with animals, or provide care for people, or who clean up or handle waste materials, can be exposed to harmful micro-organisms.  Micro-organisms are bacteria and viruses (more commonly known as germs), fungi or parasites. In most workplaces, the risk of catching an infection, such as a cold or flu, is no higher than in any other public place and under normal circumstances you do not have to take any action.

These micro-organism's can cause an infection if they are breathed in, swallowed, or if they penetrate the skin, and can include some very serious illnesses. Some may in turn cause an allergic reaction or are toxic.  Micro-organism's which are hazardous to human health such as those listed in Appendix 1 are included as substances hazardous to health in the Control of Substances Hazardous to Health Regulations 2002 (COSHH), see Health and Safety Policies and Procedures – COSHH (Section 4.1).

COSHH requires employers to:

• Assess the risks to health from any work activities which involve a hazardous substance (e.g. a micro-organism)

• Prevent or, where this is not reasonably practicable, adequately control exposure to the hazardous substances

• Introduce and maintain control measures

• Provide suitable and sufficient information, instruction and training to employees about the risks and precautions to be taken

• Regularly review risk assessments and the effectiveness of control measures

Examples of Occupations and the Micro-organisms which could be encountered

Emergency Workers 
Tetanus, Leptospirosis, Hepatitis A

Conservation, Forestry, Park and Landscape Workers
Leptospirosis, Tetanus, Hantavirus disease, Lyme disease, Orf

Architects & Surveyors
Psittacosis, Tetanus, Anthrax

Building Maintenance Workers
Tetanus, Psittacosis, Leptospirosis

Engineers
Tetanus, Leptospirosis

Health Care and Social Workers
Hepatitis B, Hepatitis A, TB

Animal Health Officers
Rabies

Street Marshals/Car Park Attendants
Hepatitis A, Tetanus

Manager Responsibilities:

• Identify whether any employee or group of employees (or volunteers or agency workers working under the direction of the Council) is at risk from any of the micro-organisms listed above (or any other microorganism, zoonosis* or any other disease such as Hepatitis B).

• Identify the activities which give rise to that risk.

• Carry out an assessment of the risk to employees (and volunteers, agency workers, pupils and clients) when carrying out particular activities. Guidance on how to do this is given in the COSHH Policy which is available on The Source (Health & Safety Policies & Procedures – COSHH [Section 4.1]).

• Take steps to prevent or control the risk by preventing rodent or bird contamination in areas under Council control by notifying Facilities or the Estates Team to any potential issues as required.

• Develop safe systems of work for activities involving exposure, issue water proof clothing and first aid equipment as required, encourage good housekeeping and hygiene practices and encourage staff and volunteers to be immunised where available.

• Give staff and volunteers information about the risks to their health, the symptoms and what precautions are required through induction and training and issue warning cards if necessary.

• Make the COSHH assessment available.

• Ensure that reporting procedures are in place for monitoring the occurrence of infectious diseases and, if required escalate any concerns or issues initially to Line Management and then Occupational Health and the Health & Safety team as needed.

*Zoonosis – a disease which can be transmitted from animals to humans.

Risk Assessment:

As these diseases are always present in the community there is usually no requirement to carry out a risk assessment. However, Managers can still take steps to minimise the risk of infections occurring and to limit their spread if they do occur and in particular consider the effects of diseases on vulnerable groups, e.g. pregnant women and those with suppressed immunity.

Manager Responsibilities:

• Make themselves aware of any diseases which may present a special risk

• Ensure that procedures are in place to deal with any outbreak of disease including communicating rapidly with staff who may be affected

• Ensure safe systems of work are followed for activities involving potential for exposure such as first aid e.g. use of protective gloves

• Encourage good hygiene practice such as thorough hand washing and the use of handkerchiefs when coughing and sneezing

• Encourage good food hygiene practice

• Encourage staff to be immunised where appropriate

There is normally no requirement to report the occurrence of minor infections which are common in the community such as colds, bronchitis or stomach upsets the Health and Safety Executive under RIDDOR unless there is reasonable circumstantial evidence that the infection has been contracted at work from a client, pupil or member of the public.  A written diagnosis from a GP would normally be expected.

However, it is important to note that certain infectious diseases are reportable under RIDDOR including:

• Anthrax*
• Hepatitis A*
• Tetanus (Lockjaw)*
• Weils Disease (Leptospirosis)*
• Rabies*

In relation to COVID, it should be noted, that a RIDDOR report should only be made where there is reasonable evidence that a work-related exposure is the likely cause of the disease and when one of the following circumstances applies:

• An accident or incident at work has, or could have, led to the release or escape of coronavirus (SARS-CoV-2). This must be reported as a dangerous occurrence

• A person at work (an employee) has been diagnosed as having COVID-19 attributed to an occupational exposure to coronavirus. This must be reported as a case of disease

• A worker dies as a result of occupational exposure to coronavirus. This must be reported as a work-related death due to exposure to a biological agent

Further guidance on COVID RIDDOR report requirements is available at:  RIDDOR reporting of COVID-19 (hse.gov.uk

To report an Incident/Accident please refer to Health & Safety Procedures – Incident Reporting Policy 

Advice on employee occupational health issues is available through the Council’s Occupational Health Provider.  For more information or referrals contact HR via Servicenow or through the Source.

Further advice and guidance is also available from the Council’s Health & Safety team who can be contacted on 01296 674412 or via email at healthandsafety@buckinghamshire.gov.uk

Further Sources of Information:

Further information about common illnesses and infections including exclusions periods, advice for vulnerable groups and general disease prevention is available from: Health protection in schools and other childcare facilities - GOV.UK (www.gov.uk)  An Exclusion Table and Checklists are available. It is recommended that this is available for reference in all school and childcare settings.

For more in-depth information and the latest guidance about individual diseases (and for advice on immunisation and good practice such as hand washing), please refer to the Public Health England website available at ‘Health protection: Infectious diseases - detailed information - GOV.UK (www.gov.uk)’ or www.gov.uk/phe.

Further specific advice and support is available from the local public health protection team Thames Valley Public Health England on 0344 225 3861 or via Contacts: PHE health protection teams - GOV.UK (www.gov.uk)

Specific advice is also available for care homes and similar settings from the Department of Health: Infection Control Guidance for Care Homes available to download from their website www.dh.gov.uk

APPENDIX 1 – SPECIFIED INFECTIOUS DISEASE INFORMATION

 

ANTHRAX

A life threatening but rare bacterial infection acquired from infected animals and animal products particularly imported hair, wool, skins or bone meal. The spores may contaminate land for many years presenting a risk to construction workers.

Infection can be acquired through broken skin, inhalation of spores or person to person infection.

Prevention

Prevention is through certification and disinfection of imported animal materials, high standards of personal hygiene and covering cuts with waterproof dressings.

A vaccination is available for those in regular contact with potentially infected material.

Further information is available at:  Anthrax info - hse.gov.uk and Anthrax from contaminated land and buildings - Harmful micro-organisms - Controlling hazardous substances - Managing occupational health risks in construction (hse.gov.uk)

HANTAVIRUS DISEASE (HVD)

Hantavirus Disease is spread by infected wild rodents in their saliva, urine and faeces.  The way the virus enters the body is not clear, but it is thought that it is inhaled from aerosols of the virus.

Anyone exposed to wild rodents is at risk particularly water sports enthusiasts; farm and sewage workers and those involved in nature conservancy.

Prevention

The main method of prevention is the control of wild rodents.

Further information available at:  Anthrax info - hse.gov.uk

HEPATITIS A

Hepatitis A is caused by a virus, it has a long, infectious incubation period (2-6 weeks), and it may cause no symptoms or it may cause flu like symptoms and sometimes jaundice.  It is not generally as serious as other types of Hepatitis.  It is spread through contaminated food and water due to poor hygiene and sanitation.

Prevention

Through good hygiene precautions, washing hands and raw food before eating.  A vaccination is available and may be recommended for certain care workers and those working with young children.

Further information available at: Hepatitis A: guidance, data and analysis - GOV.UK (www.gov.uk)

LYME DISEASE

Lyme disease is a tick borne infection caused by a bacterium.  The disease is transmitted to humans from infected tick bites and usually begins with a reddened ring on the skin around the bite, flu like symptoms may also occur, followed weeks or months later by heart, nerve or arthritis problems.  The ticks which are thought to use deer as hosts are found in ground vegetation, in wood and grassland and are therefore a potential hazard to agricultural, forestry and leisure land management workers in these areas.

Prevention

Lyme disease can be prevented by covering exposed skin especially legs e.g. by closing trouser bottoms and by inspection of clothing and skin when working in wood and grassland where ticks may be present.

Further information available on HSE's infectious diseases page.

ORF

ORF is a virus which causes a painless ulcer on the skin and these usually occur on the hands, face or arms.  These will heal in 6-8 weeks without treatment.

It is transmitted by direct skin contact with the lesions on animals, infected hides and wood or by contact with infected hedges and fences where the virus may remain latent indefinitely.

Prevention

ORF is not a serious condition and can be prevented by covering cuts and scratches on the hands and arms with a waterproof dressing and by washing thoroughly before eating, drinking etc. and after finishing work.

Further information available on HSE's infectious diseases page.

PSITTACOSIS

Psittacosis is a serious disease caused by a micro-organism and it is caught by inhaling dust or aerosol contamination by infected bird faeces.  The organism can survive many months in dry dust.

Those involved in entering roof spaces or in roof demolition and repair where there has been bird contamination are at risk, particularly where contaminated dust is disturbed.

Prevention

Prevention includes ensuring good standards of cleanliness to reduce dust levels, using work techniques which do not create dust, avoiding contaminated areas, the use of personal protective equipment where contaminated areas must be entered and good standards of personal hygiene and thorough washing after contact with contaminated areas.

Further information available on HSE's infectious diseases page and Psittacosis and other diseases from work involving bird droppings - Harmful micro-organisms - Controlling hazardous substances - Managing occupational health risks in construction (hse.gov.uk)

RABIES

Usually fatal but very rare infection of the central nervous system resulting from the bite of a rabid animal usually dogs, cats or foxes. Animal health inspectors and dog wardens are at risk.

Prevention

Strict control of at risk animals into the Country. A vaccination is available to those who may be at special risk.

Further information available on HSE's infectious diseases page.

TETANUS (LOCKJAW)

Tetanus is caused by a micro-organism which is found in the soil and street dust.  It is contracted when contaminated soil, clothing or tools come into contact with broken skin.  Anyone at risk of accidental cuts or wounds in a dirty environment may be exposed to the tetanus micro-organism.

Prevention

Anyone at risk should have an up-to-date tetanus inoculation.  Re-inoculation is required every 10 years.

Further information is available at:  Tetanus - Harmful micro-organisms - Controlling hazardous substances - Managing occupational health risks in construction (hse.gov.uk)

WEILS DISEASE (LEPTOSPIROSIS)

Weils Disease is caused by a micro-organism spread by animals (mainly rats, but also pigs and cattle), either directly or indirectly through their urine, which contaminates water and the banks of canals, ponds, rivers and ditches.

The micro-organism enters the body through breaks in the skin and mucous-membranes (eyes, nose etc.) or from animal bites.  The micro-organism can live in soil, vegetation or fresh water for several weeks particularly during summer months and is a potential hazard for anyone working or pursuing leisure activities (swimming, water sports) in and around contaminated water.

The disease can be serious but in its early stages may be mistaken for flu, it is therefore important that anyone suffering from any flu like illness within three weeks of being exposed to the risk of Weils Disease should inform their GP of this.

A pocket sized card is available from HSE Books, reference no. IND E/G 84 or via https://books.hse.gov.uk/bookstore.asp?ACTION=BOOK&PRODUCTID=9780717664559 . 

Prevention

• Clean and cover all cuts and breaks in the skin immediately with a waterproof dressing and keep them covered whilst at work until they are fully healed.

• Wear appropriate waterproof protective clothing, wellingtons, jackets, trousers, gloves etc., when working in potentially contaminated areas.

• Wash thoroughly before eating, drinking etc. and after finishing work.

• Where possible get rid of any rats or discourage their presence.

Further information is available from:  Leptospirosis / Weil's Disease from rats - Harmful micro-organisms - Controlling hazardous substances - Managing occupational health risks in construction (hse.gov.uk)