Biological Hazards for the Construction Industry



Biological Hazards for the Construction Industry

Introduction

Biological hazards are hazards from plants, animals, insects and microorganisms, or their waste products that may be infectious, toxic or allergenic. Sources of biological hazards include bacteria, viruses, insects, plants, birds, animals including reptiles and humans. Exposure to these sources can lead to a variety of health effects ranging from skin irritations, to allergies, infections and severe injury.

Plants

The most common exposures to poisonous plants in the United States involve poison ivy, poison oak and poison sumac. There are five types of poison Ivy, sumac & oak in the United States, and all of the plants contain the exact same substance that leads to the rash as a result of contact.

[pic]

|Poison Ivy | |

|A climbing vine with three serrated-edge, pointed leaves grows in the East, Midwest and South. In the northern and western | |

|states, poison ivy grows as a non-climbing shrub. | |

|Poison Oak | |

|Poison oak also has three leaves. It grows in the sandy soil of the Southeast as a small shrub. In the western United States | |

|poison oak is a very large plant, which grows as a standing shrub or climbing vine. | |

|Poison Sumac |

|A shrub or bush with two rows of 7 - 13 leaflets, most common in the peat bogs of the Northern United States and in swampy |

|Southern regions of the country. |

Symptoms

Signs and symptoms of exposure vary depending on the sensitivity of the individual exposed, the duration of exposure and the season. The first symptom of poisoning is a severe itching of the skin. Later, a red inflammation and a blistering of the skin occurs. In severe cases, oozing sores develop. The rash spreads by the poisonous sap, not as the result of contamination from sores. The rash will continue to spread through repeated contact with the sap which may remain on clothes, shoe laces and other surfaces that have been in contact with the plant. Although extremely irritating, most cases disappear in a week or 10 days.

Treatment

Relief may be found through the application of medication available in most drugstores. A physician should examine severe rashes, especially those covering large areas or accompanied by fever. Medical treatment is most effective if applied before the oozing sores appear.

Wash infected skin as soon as possible with cold water to minimize the severity of the rash and prevent the spread of the sap to uninfected parts of the body. Skin absorbs the active compounds in the sap within the first 3 minutes, and dermatitis cannot be prevented in most cases without medical treatment. Soap and water is more effective than just water in removing the sap, but may temporarily remove a natural protective layer that helps keep the active compounds from being absorbed through the skin.

Clothing can be decontaminated by laundering with soap or detergent. Protective gloves are recommended before handling contaminated clothing.

Microorganisms

Microorganisms include viral, bacterial and fungal exposures. These diseases may be spread through the air in dust or droplet form, through skin contact or by animal vectors such as ticks.

Hanta Virus

Viral hazards are uncommon in the construction industry. The most significant viral exposure in the industry is Hanta Virus. The virus is transmitted through the air when rodent droppings are disturbed, creating dust that is inhaled by the worker, or through exposure to rodent saliva if rodents are handled. The deer mouse and western chipmunk are two species that are known to carry the virus. In the United States, cases have been largely restricted to the Southwestern region of the country, in the Four Corners area.

Exposure

Insufficient information is available at this time to allow general recommendations regarding risks or precautions for persons in the affected areas who work in occupations with unpredictable or incidental contact with rodents. Occupations that may have exposures include:

□ telephone installers;

□ maintenance workers;

□ plumbers;

□ electricians;

□ construction workers.

Workers in these jobs may have to enter various buildings, crawl spaces, or other sites that may be rodent infested. Recommendations for such circumstances must be made on a case-by-case basis after the specific working environment has been assessed and state or local health departments have been consulted.

Symptoms

Initial symptoms are flu-like with fever and muscle aches. These symptoms can appear from one to six weeks after exposure, followed by shortness of breath and coughing. The disease can progress rapidly and may require hospitalization.

Histoplasmosis

Histoplasmosis is an infectious disease of the lungs caused by a fungus found in the droppings of chickens, pigeons, starlings, blackbirds, and bats. The infection sometimes can spread to other parts of the body.

This fungus thrives in moderate temperatures and moist environments. Birds are not infected with it because of their high body temperatures, but they do carry it on their feathers. Bats can be infected because they have a lower body temperature than birds and can excrete the organism in their droppings.

When the spores from the fungus are inhaled, they are small enough that they enter the lungs and start an infection. Many of these infections are easily overlooked because they either produce mild symptoms or none at all. However, histoplasmosis can be severe and produce an illness similar to tuberculosis.

Exposure

Workers in occupations that involve contact with the soil, in particular soil enriched with bird and bat droppings are at high risk of acquiring infection. They include:

□ farmers and poultry keepers, especially when cleaning silos, chicken coops, pigeon roosts and bat-infested lofts;

□ gardeners and horticulturists using poultry manure as fertilizer;

□ construction and other workers in earth-moving operations;

□ workers in road construction, tree-clearing or landscaping;

□ workers clearing or dismantling contaminated buildings;

□ construction workers in road and bridge construction activities.

Symptoms

The symptoms of the infection appear within 5 to 18 days after exposure, most commonly in 10 days. Symptoms can range from mild to chronic lung and pulmonary infections.

Workers who will be performing construction activities in areas with noticeable amounts of bird and/or bat droppings should take precautions to avoid breathing in the spores that can become airborne when the waste material is disturbed. Dust suppression techniques such as wetting material before scraping or shoveling can minimize the risk of creating dust and reduce inhalation hazards. Good hygiene practices, including washing hands and storing lunches away from the work area will help to minimize exposure. Respiratory protection may be required in some cases to provide adequate protection for workers.

Lyme Disease

Two species of ticks carry the bacteria that cause Lyme disease. The disease is spread when the tick bites a human, however the disease is not spread from person to person. Since it is a bacterial infection the same person can become infected more than once.

The ticks that carry the disease are the deer tick, found mainly in the eastern regions of the United States, and the California blacklegged tick found in the Western and Pacific regions of the country.

Exposure

Most victims of Lyme disease were in situations where being bitten by a tick could be expected. Many people who develop the disease, however, do not remember seeing ticks or being bitten. Tick bites may cause small red irritations, but they often go unnoticed, especially those from small, immature ticks.

Tick bites commonly occur from May to September, although this varies from year to year and from region to region. Ticks sometimes move around on the body but they usually attach themselves to the skin and stay in one place. Before feeding, ticks look like small, brown scabs or freckles. After feeding, ticks may swell considerably, and, according to some people, look like a raisin or blood blister with legs. Soon after receiving a tick bite, some victims of Lyme disease experience a brief flu-like illness.

Symptoms

Lyme disease is sometimes difficult to recognize, and it has occasionally been confused with other diseases. It is important to consult with a doctor if you think it is possible that you have Lyme disease.

The disease has three major features: a history of tick bites, a slowly expanding rash, and complications from nerve disease, heart disease, or arthritis. The following symptoms have been recorded by the Centers for Disease Control (CDC):

Rash - In about 75 % of reported cases of Lyme disease, the victims develop a rash around or near the tick bite usually within one week. In some cases, a peculiar, bright red, circular rash develops. It soon expands to form a ring-shaped "bull's-eye" that can grow to the size of a dinner plate. Often, however, a more mild, general rash appears anywhere on the body. The rashes fade after several weeks. Some victims, however, never develop a rash, yet experience more advanced symptoms of the disease.

Nerve disease, heart disease, arthritis - About 15 % of untreated victims develop temporary nerve problems from a few weeks to several months after a tick bite. The most common problem is meningitis (inflammation of the covering of the brain) with fever, headache and stiff neck. Some victims experience neuritis (nerve inflammation) with pain and other disturbances such as deafness. These nerve problems are usually temporary and disappear with proper treatment.

Heart disease occurs in about 5 % of untreated victims often with no symptoms of infection. The most common problem is a heart block that affects the rhythm of the heartbeat. This problem is also temporary and disappears permanently with proper treatment.

Lyme disease causes arthritis in about 25 % of studied cases and occurs several months to two years after receiving a tick bite. This arthritis most often affects the knees, although it also occurs in the shoulders, wrists, elbows, hips, and ankles. Prompt treatment usually solves this problem. Without treatment, however, this arthritis can lead to permanent disability.

In rare cases, people who have the disease for several months or years, and do not receive treatment, develop serious changes in the nervous system. These changes result in loss of feeling in the limbs, loss of memory, and extreme tiredness.

Rocky Mountain Spotted Fever

The name Rocky Mountain spotted fever is misleading as this disease is broadly distributed throughout the continental United States, as well as southern Canada, Central America, Mexico, and parts of South America.  Between 1981 and 1996, Rocky Mountain Spotted Fever was reported from every U.S. state except Hawaii, Vermont, Maine, and Alaska.

The disease is spread by the wood tick and the dog tick. Wood ticks are found in the Western and Pacific regions of North America, and the dog tick is primarily found in the Eastern U.S. and California.

Symptoms

Rocky Mountain Spotted Fever is caused by a parasite called Rickettsia, which is transmitted to the victim when they are bitten. Symptoms can include fever, headache, muscle pain and a characteristic rash. The rash appears several days after the other symptoms and starts on the wrists and ankles before spreading to the palms and soles of the feet.

In most cases Rickettsia can be treated successfully with antibiotics.

Prevention

With all tick borne diseases prevention consists of checking for ticks when working in an area where they are prevalent. Ticks live in grassy areas, and forested or brushy areas including willows near streams. The tick resides on a branch or grass stalk with the front legs extended. When a host brushes by the tick latches on and finds a place to bite the victim. They prefer protected areas such as creases in the skin, and under the hairline at the nape of the neck. By checking for ticks regularly they can be detected and removed before they bite.

Snakes

There are approximately 20 species of venomous snakes are in the USA. Most are rattlesnakes, cottonmouths (water moccasins), coral snakes and copperheads. All of these snakes with the exception of coral snakes are called "pit vipers" because they have deep pits lined with heat receptors in the cheeks between the eyes and nostrils. These receptors are thought to detect the presence of prey and guide the direction of the strike.

Pit vipers are widely distributed throughout the USA, but most bites occur in southern and southwestern states between the months of April and October. Rattlesnake bites are the most serious; copperhead bites are usually not severe, and cottonmouth bites are usually considered moderately severe.

Coral snakes are found in southern states as far west as Texas. The copperhead is found in most of the eastern and mid-western states. The cottonmouth Moccasin occupies waterways and wetlands throughout the south as far west as Texas. Rattlesnakes are the most widely dispersed with different varieties that can be found throughout most of the US.

Statistics

• 7000 venomous snakebites are reported annually in the United States.

• 85% of the natural bites are below the knee.

• 50% are dry. Squeezing the venom glands to inject is a voluntary reflex. In that strikes against humans are generally defensive actions, it is estimated that no venom is purposely injected about half the time. This holds true with the pit vipers. With the Coral Snake the amount of venom injected is directly related to the size of the snake and the length of time it holds on to the victim.

First Aid Therapy

The stabbing strike of a pit viper can be recognized by one or two definite puncture wounds, and if venom is injected there will be intense, burning pain and swelling around the holes. The following lists some of the Do’s and Don’ts when treating a snakebite injury:

Do

• Remain calm - Remember that there is an excellent chance for survival, and in most cases there is plenty of time.

• Suction – remove as much venom as possible directly from the wound. A snakebite kit generally provides a suction cup for this purpose. Do not attempt to suck venom from the wound by mouth.

• Remove jewelry - Swelling can progress rapidly, so rings, watches and bracelets can be a real problem.

• Mark the time - The progress of symptoms (swelling) is the most obvious indicator of the amount of venom.

• Keep the stricken limb below the heart.

• Apply a cool compress, not ice.

• Get to a hospital as quickly as possible - Anti-venom serum is the only sure cure for venomous snakebite. Anti-venom should only be administered in a fully equipped medical facility.

• In case of a Coral bite, do pull the snake off immediately – Coral snake fangs are relatively small, and they have to work at getting venom into the wound. Therefore, the faster the snake is removed the less venom is injected.

• Attempt to identify the offending snake - Positive identification in the form of a dead snake is helpful, if convenient, but no time or safety should be wasted since the symptoms will give medical personnel an accurate diagnosis.

• Get a tetanus shot.

Don't

• Don't cut the wound - This almost always causes more damage than it's worth.

• Don't use a tourniquet - This isolates the venom in a small area and causes the digestive enzymes in the venom to concentrate the damage.

• Don't use alcohol orally - it speeds the heart and blood flow and reduces the body's counter-acting ability.

• Don't use ice - Freezing the stricken limb has been found to be a major factor leading to amputation.

Insects [pic]

Wasps and Bees

Wasp and Bee stings are common in the construction industry. Many species of stinging insects build nests in the ground, or in piles of brush and debris. Clearing operations may disturb the nest causing the insects to attack aggressively. Heavy equipment operators may be stung when they uncover a ground nest during clearing operations. At the end of the season wasps may scavenge for food and will be drawn to areas where workers eat lunch or dispose trash.

Symptoms

Painful red bumps appear almost immediately after being stung. Localized swelling may increase for up to 24 hours. If swelling continues or spreads to other areas, medical treatment should be provided.

Stingers can continue to inject venom even if they are no longer attached to the bee or wasp. Do not squeeze the sting area to remove a stinger as this may inject more venom into the sting site. Remove stingers by scraping over the sting site with a flat object like a credit card. Wash the area with soap and water and apply ice to reduce swelling.

On rare occasions, children or adults can have an allergic reaction called anaphylaxis. The reaction, which involves the whole body, can be deadly. Symptoms include the following:

▪ Rash over many parts of the body

▪ Shortness of breath and tightness in the chest

▪ Wheezing

▪ Dizziness

▪ Swollen tongue or face

If these symptoms occur, call 911 immediately for emergency medical care. Multiple stings can also be dangerous. The amount of venom from ten or more stings can cause vomiting, diarrhea, headache, and fever. This is not anaphylaxis, but it is serious enough to call your doctor immediately.

Mosquitoes [pic]

West Nile Virus

What Is West Nile Virus

West Nile virus (WNV) is a potentially serious illness. Experts believe WNV is established as a seasonal epidemic in North America that flares up in the summer and continues into the fall. This fact sheet contains important information that can help you recognize and prevent West Nile virus.

What Are the Symptoms of WNV?

WNV affects the central nervous system. Symptoms vary.

• No Symptoms in Most People. Approximately 80 percent of people who are infected with WNV will not show any symptoms at all.

• Mild Symptoms in Some People. Up to 20 percent of the people who become infected will display mild symptoms, including fever, headache, and body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. Symptoms typically last a few days.

• Serious Symptoms in a Few People. About one in 150 people infected with WNV will develop severe illness. The severe symptoms can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. These symptoms may last several weeks, and neurological effects may be permanent.

How Does It Spread?

• Infected Mosquitoes. Generally, WNV is spread by the bite of an infected mosquito. Mosquitoes are WNV carriers that become infected when they feed on infected birds. Infected mosquitoes can then spread WNV to humans and other animals when they bite.

• Transfusions, Transplants, and Mother-to-Child. In a very small number of cases, WNV also has spread through blood transfusions, organ transplants, breastfeeding and even during pregnancy from mother to baby.

• Not through touching. WNV is not spread through casual contact such as touching or kissing a person with the virus.

How Soon Do Infected People Get Sick?

People typically develop symptoms between 3 and 14 days after they are bitten by the infected mosquito.

How Is WNV Infection Treated?

There is no specific treatment for WNV infection. In cases with mild symptoms, people experience symptoms such as fever and aches that pass on their own. In more severe cases, people usually need to go to the hospital where they can receive supportive treatment including intravenous fluids, help with breathing and nursing care.

What Should I Do if I Think I Have WNV?

Mild WNV illness improves on its own, and people do not necessarily need to seek medical attention for this infection. If you develop symptoms of severe WNV illness, such as unusually severe headaches or confusion, seek medical attention immediately. Severe WNV illness usually requires hospitalization. Pregnant women and nursing mothers are encouraged to talk to their doctor if they develop symptoms that could be WNV.

What Is the Risk of Catching WNV?

For most, risk is low. Less than 1 percent of people who are bitten by mosquitoes develop any symptoms of the disease and relatively few mosquitoes actually carry WNV.

Greater risk for those outdoors a lot. People who spend a lot of time outdoors are more likely to be bitten by an infected mosquito. They should take special care to avoid mosquito bites.

People over 50 can get sicker. People over the age of 50 are more likely to develop serious symptoms of WNV if they do get sick and should take special care to avoid mosquito bites.

Risk through medical procedures is low. The risk of getting WNV through blood transfusions and organ transplants is very small, and should not prevent people who need surgery from having it. If you have concerns, talk to your doctor before surgery.

Pregnancy and nursing do not increase risk of becoming infected with WNV.

What Can I Do to Prevent WNV?

The easiest and best way to avoid WNV is to prevent mosquito bites.

• When you are outdoors, use insect repellents containing DEET (N, N-diethyl-meta-toluamide). Follow the directions on the package.

• Many mosquitoes are most active at dusk and dawn. Consider staying indoors during these times or use insect repellent and wear long sleeves and pants. Light-colored clothing can help you see mosquitoes that land on you.

• Make sure you have good screens on your windows and doors to keep mosquitoes out.

• Get rid of mosquito breeding sites by emptying standing water from flower pots, buckets and barrels. Change the water in pet dishes and replace the water in bird baths weekly. Drill drainage holes in tire swings so water drains out. Keep children's wading pools empty and on their sides when they aren't being used.

What Is the CDC Doing About WNV?

CDC is working with state and local health departments, the Food and Drug Administration and other government agencies, as well as private industry, to prepare for and prevent new cases of WNV.

Some things CDC is doing include:

• Coordinating a nation-wide electronic database where states share information about WNV

• Helping states develop and carry out improved mosquito prevention and control programs

• Developing better, faster tests to detect and diagnose WNV

• Creating new education tools and programs for the media, the public, and health professionals

• Opening new testing laboratories for WNV

What Else Should I Know?

If you find a dead bird: Don't handle the body with your bare hands. Contact your local health department for instructions on reporting and disposing of the body.

Spiders

Brown Recluse

[pic]

Brown recluse spiders are typically found in sheltered corners, debris, woodpiles, under loose bark and stones, in old barns, storage sheds and garages. The spider is found mainly in Midwestern states, especially Arkansas, Oklahoma and Missouri.

Bite Symptoms

The severity of a person's reaction to the bite depends on the amount of venom injected and individual sensitivity to it. Bite effects may be nothing at all, immediate or delayed. Some may not be aware of the bite for 2 to 8 hours, whereas others feel a stinging sensation usually followed by intense pain if there is a severe reaction. A small white blister usually rises at the bite site surrounded by a large congested and swollen area. Within 24 to 36 hours, a systemic reaction may occur with the victim characterized by restlessness, fever, chills, nausea, weakness and joint pain. The affected area enlarges, becomes inflamed and the tissue is hard to the touch. The spider's venom contains an enzyme that destroys cell membranes in the wound area with affected tissue gradually sloughing away, exposing underlying tissues. Within 24 hours, the bite site can erupt into a "volcano lesion" (a hole in the flesh due to damaged, gangrenous tissue).

The open wound may range from the size of an adult's thumbnail to the span of a hand. The sunken, ulcerating sore may heal slowly up to 6 to 8 weeks. Full recovery may take several months and scarring may remain. Plastic surgery and skin grafts are sometimes required.

First Aid

If bitten, remain calm, collect the spider, if possible, for positive identification and get medical attention immediately (contact your physician, hospital and/or Poison Information Center). Apply antiseptic solution to prevent infection and ice packs to relieve local swelling and pain directly to the bite area. Effective anti-venom is not generally available. The physician will usually administer high doses of cortisone-type hormones to combat hemolysis and other systemic complications.

Black Widow

[pic]

Adult black widow spiders have shiny, jet black, rounded, globular abdomens with two reddish or yellowish triangles on the underside, which form a characteristic hourglass marking. Adult female northern widow spiders are shiny black or brown-black with two reddish triangles on the underside, resembling a split hourglass. These spiders are about 1/2-inch long, not including the legs (about 1-1/2 inches when legs are spread). Adult males are harmless, about half the female's size, with smaller bodies, longer legs and usually have yellow and red bands and spots over the back, as do the immature stages.

These spiders spin tangled webs of coarse silk in dark places, usually outdoors. Webs are usually built near the ground (occasionally within dwellings) normally in trash, rubble piles, under or around houses and outbuildings such as out houses, sheds and garages. Many are associated with dry, undisturbed piles of firewood, old limbs, rock piles, and bales of hay.

Bite Symptoms

The venom of the black widow spider is 15 times as toxic as the venom of the prairie rattlesnake. However, only a minute amount of the toxin is injected with a single bite by the spider. The severity of a person's reaction to the bite depends on the area of the body bitten, amount of venom injected, depth of bite, seasonal changes and temperature.

The bite feels like a pinprick or is not even felt. At first, there may be only slight local swelling and two faint red spots surrounded by local redness at the bite. Pain becomes intense in one to three hours and may continue up to 48 hours. Pain usually progresses from the bitten member up or down the arm or leg, finally localizing in the abdomen and back. The abdominal muscles may become rigid and board-like with severe cramps (resembles appendicitis). There may be pain in the muscles and soles of the feet, and eyelids may become swollen.

Other symptoms may be nausea, profuse perspiration, tremors, labored breathing and speech, and vomiting. During this time, a feeble pulse, cold clammy skin, unconsciousness, convulsions and even death may result if the victim does not receive medical attention immediately. Additional complications may occur due to the infection of the bite. However, with some untreated individuals, symptoms may diminish in several hours and be gone in several days after agony. Bites are uncommon and serious long-term complications or death is rare. Only four deaths were officially attributed to black widow bites in the United States from 1960-69.

First Aid

If bitten, remain calm, collect the spider, if possible, for positive identification and get medical attention immediately. (Contact your physician, hospital and/or Poison Control Center.) First aid is of limited help. Application of a mild antiseptic such as iodine or hydrogen peroxide prevents infection. A physician can give specific anti-venom or calcium gluconate to relieve pain. Healthy people recover rapidly in two to five days.

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