HAAD Standard for CBRNE Contaminated Material Management and Disposal Document Ref. Number: HAAD/CBRNECMMD/0.9 Version: 0.9

Transcription

1 Document Title: HAAD Standard for CBRNE Contaminated Material Management and Disposal Document Ref. Number: HAAD/CBRNECMMD/0.9 Version: 0.9 Approval Date: 26/03/2017 Document Owner: Applies to: Classification: Effective Date: 26/03/2017 Emergency & Disaster Management, IPC Division EDM Department Designated Healthcare Disaster Readiness Centers (HDRC s) Public 1. Purpose 1.1 To ensure the safety of the citizens of the Emirate of Abu Dhabi along with the staff, patients, and visitors of healthcare facilities during an emergency or a disaster (CBRNE incident). 1.2 To define how health care facilities address hazardous waste generated as a part of a Hazardous Materials or Chemical, Biologic, Radiologic, Nuclear, Explosive (CBRNE) incident. 2. Scope 2.1 This standard applies to HAAD Designated HDRCs. 2.2 The standard specifically addresses material created in or related to a Hazardous Materials or Chemical, Biologic, Radiologic, Nuclear, Explosive (CBRNE) incident. It does not address general blood borne pathogen and traditional hospital biohazard waste. 3. Definitions and Abbreviations CBRNE: Chemical, Biological, Radiological, Nuclear, Explosive HDRC: Healthcare Disaster Readiness Centre PPE: Personal Protective Equipment OSHAD: Abu Dhabi Occupational Safety and Health Center OSHA: United States Occupational Health and Safety Administration Page 1 of 6

2 4. Duties for Healthcare Disaster Readiness Centers 4.1 HDRCs shall: Develop and maintain policies and procedures to address the handling of hazardous materials generated from a disaster Educate all staff and patients, as appropriate, to the procedures around the recognition, isolation, avoidance, and proper notification regarding hazardous materials Review and evaluate the overall effectiveness of the containment and disposal policies and procedures via the organization s policy review procedure All healthcare providers, including healthcare facilities and professionals, licensed by HAAD must: Provide services in accordance with the requirements of this Standard, and where relevant HAAD Clinical Care Standards and ensure that their practices reflect internationally recognised evidence based clinical care pathways; When required by HAAD report and submit e-claims data in accordance with the Data Management Policy, Chapter VI, Healthcare Regulator Manual Version 1.0 and as set out in The HAAD Data Standards and Procedures ( Document and monitor quality and safety of services and make these available to HAAD for auditing, as and when requested to do so; Comply with relevant HAAD policies and standards Comply with HAAD requests to inspect and audit records and cooperate with HAAD authorised auditors, as required for inspections and audits by HAAD. 4.2 HAAD Role: Establishing standards for compliance based on best practice to protect both the facility and the community from exposure to a hazardous material regardless of origin. Standards will address: Storage of contaminated material Disposal of contaminated material Monitor HDRC s compliance with the contaminated materials standard Ensuring standards are in compliance and compliment Environment, Health & Safety Management System developed by Abu Dhabi Occupational Safety and Health-System Framework (OSHAD-SF). Page 2 of 6

3 5. Enforcement and sanctions 5.1 HDRCs must comply with the terms and requirements of this Standard. HAAD may impose sanctions in relation to any breach of requirements under this Standard in accordance with the Complaints, Investigations, Regulatory Action and Sanctions Policy, Chapter IX, Healthcare Regulator Policy Manual Version 1.0 and Healthcare Provider Policy Manual for market entry, Chapter III and Chapter IV. 6. Standard 1. Management of Contaminated Waste 6.1 The HDRC must have a plan and resources to safely capture, store, and manage hazardous material waste generated from a disaster. 6.2 The HDRC will treat any potentially contaminated material from a Hazardous Material and CBRNE incident as a hazardous material This may include, but is not limited to: Hazardous Materials as defined in OSHA 29 CFR ; OSHAD-SF-Code of Practice CoP 1.0- Hazardous Materials Version Patient clothing including shoes Patient valuables Patient belongings Run-off from decontamination operations Decontamination equipment (tents, showers, brushes, buckets, etc.) 6.3 Remediation Capacity: The HDRC should have capability (which may be outsourced) to remediate, remove, and treat generated hazardous waste. HDRCs should actively seek to meet this standard. Currently no capability exists within the UAE and this standard is unenforceable. HAAD will notify the HDRCs in writing if and when this service becomes available within the UAE and provide 90 day notice of enforcing the standard to all HDRCs All activities as a part of remediation must be documented including validation of compliance and a certificate of completion. 6.4 Personal Protective Equipment The HDRC should maintain Personal Protective Equipment (PPE) supplies appropriate to CBRNE risks and any specific hazardous material risks identified within Hazard Vulnerability Analysis PPE should meet, at a minimum the standards set forth in the HAAD Standard for CBRNE Incident Management. Page 3 of 6

4 7. Standard 2. Containment and Storage 7.1The HDRC must be able to contain and temporarily store a reasonable amount of hazardous materials generated from hospital operations related to a disaster response. 7.2The HDRC must plan for and have sufficient resources to contain the run-off of technical decontamination operations with plans to handle the volume of 4 hours of continuous decontamination operations. 7.3The HDRC shall support law enforcement agencies for forensic examination of patient belongings. 7.4 Storage of Generated Waste HDRCs should label all waste with (in both English and Arabic): Classification / Name Any neutralizing agent used Date captured Estimated Volume Location Storage parameters: The facility must have a designated location to store generated waste Containers designed for hazardous materials that are inert in nature Volatile / Flammable Material Should not be within 25 feet (7.5m) of an ignition source Should be in a well-ventilated area Should be a fireproof container A fire extinguisher should be within 25 feet (7.5m). 7.5 Location 8. Standard 3. Identification and Spill Management 8.1 The HDRC must maintain accurate records of all hazardous materials onsite per OSHAD-SF Version 3.0, July Unidentified Substances: The HDRC should make a reasonable effort to identify the substance The HDRC must plan for response to unidentified substances The HDRC shall work with local partners to secure data on contaminants. 8.2 The HDRC must plan to address and contain the spill of hazardous materials Spill response should address Containment Isolation Remediation Evacuation Page 4 of 6

5 Communication Documenting Protective efforts (such as ignition source elimination hazardous gases or vapors transmission through ventilation system, PPE and emergency responder s safety should also be addressed.) The HDRC must develop and maintain a general contingency plan if areas are inaccessible due to a spill, explosion or release of a contaminant. 9. Standard 4. Management of Contaminated Equipment 9.1 Any contaminated equipment must be clearly marked and only accessible by authorised individuals with the appropriate training and PPE. 9.2 The HDRC will have a process to determine the status of contaminated hospital equipment The decision must be made within 24 hours of demobilization to either: Decommission and subsequently dispose of the equipment in question Decontaminate, validate level of readiness, and return to service 9.3 The HDRC must have a plan and capability (which may be outsourced) to safely and compliantly dispose of contaminated equipment The disposal must be validated/certified for both completion and compliance. 10. Standard 5. Education, Documentation, and Compliance 10.1 The HDRC will train staff Sufficient staff will be trained on the following subjects with an annual review: Initial spill response and management Awareness to the risk of hazardous materials in the facility OSHA Hazardous Waste Operations and Emergency Response (HAZWOPR) Awareness level and operations level is recommended Staff responsible for decontamination operations and spill cleanup will receive training with annual refresher on the following subjects (incompliance with the HAAD Standard for CBRNE Incident Management). The training must include hands on training and include a minimum of 8 hours for operations The HDRC will review and evaluate its management of hazardous materials The HDRC will document any incident generating hazardous materials or spill of hazardous materials. Page 5 of 6

6 Reference Documentation must be maintained for a minimum of 5 years Documentation must include: Date Time of Day Duration Location Hazardous Materials Involved Actions taken for remediation Staff member in charge Names of any individuals exposed regardless of affiliation 10.3 All policies and procedures must be reviewed annually by both internal and external stakeholders. The review must include revisions for any noted improvements found during incidents or exercises. 1. Abu Dhabi Occupational Safety and Health-System Framework (OSHAD-SF) Version US EPA 40 CFR, Subchapter 1 EHS Regulatory Instrument Code of Practice EHS RI CoP 1.0 Hazardous Materials, Version OSHA 29 CFR Fire Protection and Prevention: Flammable Liquids 4. OSHA 29 CFR Hazardous Materials: Hazardous waste operations and emergency response 5. OSHAD-SF- Cod of Practice CoP 54.0 Waste Management, Version Federal regulation for handling hazardous material, hazardous waste, and medical waste issued by Cabinet Decree No. 37 of Law no 21 of 2005 concerning waste management of Abu Dhabi 8. NFPA 472: Standard for Competence of Responders to Hazardous Materials/Weapons of Mass Destruction Incidents 2013 Edition Page 6 of 6