In accordance with the Health and Safety at Work Act 1974 and the Control of Substances Hazardous to Health Regulations 2002, employers carry a legal obligation to safeguard the health and safety of both employees and any individuals present on the premises.

The responsibility for addressing biohazard incidents falls upon the individual in charge of the property. If these issues are left unattended, bodily fluids like blood, urine, and vomit often infiltrate porous materials and concealed areas, imperceptible to the untrained eye. This renders cleanup considerably challenging and heightens the risk of infection exposure.

Our main concern when dealing with raw sewage lies in the presence of pathogens, which are living organisms that have the capacity to transmit diseases, leading to severe health issues. The three most common categories of pathogens discovered in raw sewage are bacteria, parasites, and viruses.

Pathogens have the potential to induce various acute illnesses, encompassing symptoms like nausea, diarrhea, and infections. While these ailments can be discomforting and aggressive, they typically subside over a span of days or weeks with appropriate treatment and without causing long-term effects. However, in certain situations, pathogens may lead to severe, persistent illnesses, or even fatal outcomes.

Some of the diseases that can be contracted from exposure to raw sewage include:

1. Cryptosporidium and Giardia
2. Gram Negative Bacteria
3. Hepatitis A
4. Leptospirosis
5. Tetanus

The primary concern associated with cuts or wounds caused by sharp objects is the potential exposure to infections, particularly blood-borne viruses (BBV). The risk of contracting an infection depends on various factors, including an individual’s natural immune system. The most significant blood-borne viruses of concern include:

1. Hepatitis B

Hepatitis B is an infectious disease caused by the Hepatitis B virus (HBV), which infects the human liver, leading to inflammation known as hepatitis. Hepatitis B is one of the most prevalent infectious diseases globally and is transmitted from one person to another through bodily fluids. Hepatitis B infections can be classified as either acute or chronic.

Acute infections can last for a few weeks to several months. Some individuals can naturally recover from acute hepatitis B, remaining asymptomatic while the virus clears from their body. In some cases, individuals might not even be aware of their infection. However, as long as the virus is present in the body, it can be transmitted to others. Chronic hepatitis B is more severe, persisting throughout a person’s life, and it carries the risk of permanent liver scarring (cirrhosis) and potential development of liver cancer.

Common Symptoms:

• Flu-like symptoms: fatigue, aches, pains, headaches, and fever
• Loss of appetite
• Weight loss
• Nausea or vomiting
• Diarrhea
• Abdominal pain
• Jaundice

Treatment options for chronic hepatitis B include interferon and antiviral drugs. Interferon, a natural protein produced in response to viral infections, can help prevent further liver damage but may have side effects. Antiviral drugs like Lamivudine, Tenofovir, Entecavir, and Adefovir can inhibit the virus’s replication.

2. Hepatitis C

Hepatitis C is a liver infection caused by the hepatitis C virus. It can lead to liver inflammation, fibrosis, and, in severe cases, significant liver damage, including liver failure and cancer.

Many individuals may not realise they’ve been infected with the virus as initial symptoms are often absent or non-specific. Common symptoms, if present, include fatigue, weight loss, loss of appetite, joint pain, nausea, flu-like symptoms, anxiety, and discomfort in the liver area. Unlike Hepatitis A and B, Hepatitis C rarely causes jaundice.

Around 20-30% of people can clear the virus naturally, but for 75% of those infected, it becomes a chronic condition, potentially leading to cirrhosis. Treatment for chronic Hepatitis C often involves antiviral drugs, typically a combination of Interferon and Ribavirin.

3. HIV (Human Immunodeficiency Virus) 

HIV is a lentivirus responsible for causing AIDS, a condition that weakens the immune system, making individuals susceptible to life-threatening infections and cancers. HIV can be transmitted through contact with blood, semen, vaginal fluid, pre-ejaculate, or breast milk.

The primary stage of HIV infection, known as primary HIV infection, is characterised by symptoms like a blotchy rash, fever, joint pain, muscle pain, sore throat, swollen glands, and fatigue. These symptoms can be mild and are sometimes mistaken for a common cold or glandular fever.

Following the initial symptoms, HIV may remain asymptomatic for many years but continues to damage the immune system. There is no cure or vaccine for HIV, but combination therapy, involving multiple medications, can slow the virus’s progression and extend a patient’s lifespan.

In addition, there is a risk of spreading blood-borne pathogens through injuries from contaminated sharp objects. Proper management and disposal of sharps waste are crucial to prevent the spread of disease. If an injury occurs from a contaminated sharp object, it is essential to:

• Encourage the wound to gently bleed, preferably under running water
• Clean the wound with running water and soap (avoid scrubbing)
• Refrain from sucking the wound
• Dry the wound and cover it with a waterproof plaster or dressing
• Seek immediate medical advice, as prophylactic medications can be effective
• Report the injury to your employer if necessary.

Swift management of the situation is of utmost importance when it comes to trauma emergencies, as they entail substantial health risks.

Stringent guidelines and legal provisions govern the cleaning of crime and trauma scenes, primarily to safeguard the well-being of individuals within the affected property or vicinity. These regulations also encompass precise protocols for the safe disposal of potentially hazardous waste.

Diseases like Hepatitis B, Hepatitis C, and HIV, which are transmitted through bodily fluids, elevate the risk factor. Engaging specialized technicians for the decontamination of affected areas stands as the preferred course of action.

Hoarding cleanup encompasses tasks beyond mere item removal. It entails comprehensive cleaning, sanitisation, and, when necessary, structural enhancements to guarantee the safety and habitability of the space.