Infection Prevention and Control

• Issued: October 2011
• Content last reviewed: October 2011

Overview

Over the past decade, infectious diseases have gained prominence in Ontario health care facilities due to a number of outbreaks such as norovirus, clostridium difficile (commonly known as C. difficile) and influenza.

In Ontario, a large number of people – more than 500,000 – work in the health care sector. This includes more than 6,000 hospitals, long-term care homes, retirement homes, community care and other workplaces.

Healthcare workers are potentially at risk from exposure to infections in the workplace. Employers have a responsibility to control hazards in the workplace, and these hazards may include infectious agents.

Infection prevention and control will be the focus of a province-wide blitz in Ontario's health care sector during November 2011. The blitz will include hospitals, long-term care facilities, retirement homes and community health centres.

The stepped-up enforcement is part of the Ministry of Labour's Safe At Work Ontario strategy.

Compliance

Inspectors will focus on the following key priorities:

Employer duties

• Employers must take all reasonable precautions to protect the health and safety of workers from infection hazards. As well, employers must report occupational illnesses to the Ministry of Labour, trade union (if any), and the workplace's Joint Health and Safety Committee (JHSC) or health and safety representative (HSR).

Safe work practices

• Employers must have practices in place to protect workers from infectious agents, such as respirator fit-testing, safe use and disposal of sharps, maintenance of ventilation systems, and proper cleaning and disinfection.
• Supervisors must ensure workers follow safe work practices and use the required personal protective equipment provided by the employer.
• Employers, supervisors and workers must inspect the workplace for infection hazards.

Personal protective equipment and safety devices

• Personal protective equipment (for example: gloves, eye protection and respirators) must be properly used and maintained, as prescribed.
• Workers must have access to appropriate hygiene facilities such as access to hand-washing supplies and alcohol-based hand rub.
• Safety-engineered needles (SENs) must be used and handled in a safe manner.
• Safety devices must be activated on the SENs before being disposed of in appropriate puncture resistant containers.

Worker information, education and training

• Workers must be made aware of infection hazards in the workplace and the safe handling, storage, use, disposal and transport of biological agent.
• Workers must be provided with appropriate information, instruction and supervision to protect their health and safety. Worker training may include instruction on routes of transmission of infectious agents, proper hand hygiene practices, safe routine practices and additional precautions.

Health care workplaces regulated by the Health Care and Residential Facilities Regulation (HCRF)

The employer must develop written measures and procedures for the health and safety of workers [HCRF Section 8 and 9(1)].

These health and safety measures and procedures must be developed in consultation with the joint health and safety committee (JHSC) or health and safety representative (HSR)

The measures and procedures may deal with, but are not limited to:

• Safe work practices
• Safe working conditions
• Proper hygiene practices and the use of hygiene facilities
• Control of infections
• Immunization and inoculation against infectious diseases
• Use of appropriate antiseptics, disinfectants and decontaminants
• Use, wearing and care of personal protective equipment and its limitations (such as gloves, gowns, facial protection and respirators).

An employer, in consultation with the JHSC or health and safety representative, must develop, establish and provide training and education programs in health and safety measures and procedures to protect workers from exposure to infectious agents [HCRF subsection 9(4)].

Needle Safety Regulation O. Reg. 474/07

The Needle Safety Regulation applies in each of the following circumstances:

• Where a worker is to do work requiring the use of a hollow-bore needle on a person for a therapeutic, preventative, palliative, diagnostic or cosmetic purpose, in any workplace.
• Where a worker is to do any work requiring the use of a hollow-bore needle, in: hospitals, private hospitals, Homewood Health Centre Inc., long-term care homes, laboratories and specimen collection centres, and designated psychiatric facilities.

More information

Ministry of Labour – Health and Community Care

Health & Safety Ontario

Public Services Health & Safety Association

Occupational Health Clinic for Ontario Workers

Workers Health & Safety Centre

Public Health Ontario – Infectious Disease Prevention and Control

Regional Infection Control Networks of Ontario

Ontario Regulation 474/07 – Needle Safety

Ontario Regulation 67/93 – Health Care and Residential Facilities

Call toll-free

Call 1-877-202-0008 anytime to report workplace health and safety incidents. For general inquiries about workplace health and safety, call 8:30 a.m. – 5 p.m., Monday to Friday. In an emergency, always call 911 immediately.