4.2 Outline potential risks of infection within the workplace

Infection control is an essential component of workplace safety in all sectors. An infection is the invasion of the body by pathogens, sometimes referred to as 'biological agents'. The presence of such agents in a given environment, where there is an obvious route for them to enter the body, can pose a potential risk of illness to employees, service users, and visitors.

Each of these potential risks is fully explored in the following sections.

1. Types of Infectious Agents (The Pathogens)

The chance of infection starts with microorganisms, and they are classified into several types:

Bacteria: They are single-celled organisms. Diseases associated with bacteria include tuberculosis (TB), MRSA, and diarrhoeal diseases such as C. difficile. They may be spread by contact, direct or indirect, or via airborne routes.

Viruses: They are infectious agents. Their size is minimal, and replication cannot take place without a host cell. Common workplace risks include influenza (flu), the common cold, gastroenteritis, and COVID-19. Main modes of transmission: through respiratory droplets and contaminated surfaces.

Fungi: Organisms that may cause local infections, like athlete's foot, which can be spread in damp shared environments such as changing rooms or washrooms if hygiene is inadequate.

Parasites: Organisms such as lice or scabies that depend on a living host. These typically require direct, sustained contact for transmission and can be a risk in communal or close-contact settings.

2. Modes of Transmission (How Infections Spread)

Infections need a route to take from a source, such as an infected person or contaminated environment, to a susceptible host. The most significant hazards of spread at work include:

Direct Contact Transmission: Direct physical contact with the infected person, such as touching, hugging, or handshaking. This also encompasses exposure to body fluids (blood, saliva, urine, faeces) through any cut/open skin or mucous membranes.

Indirect Contact (Fomites): Fomites are spread through indirect contact by touching an infected object or surface, such as a shared keyboard, phone, door handle, light switch, or breakroom equipment, and then touching the mouth, nose, or eyes.

Droplet Transmission: Droplet transmission involves the inhalation of droplets or deposition on the mucous membranes. Large droplets are produced during coughing, sneezing, and talking by an infected person and usually land on the ground or another surface a short distance away, normally one to two metres.

Airborne Transmission: Airborne transmission is the inhalation of very small particles, such as aerosols and droplet nuclei, which contain pathogens that remain suspended in the air for longer periods, thus often travelling greater distances, especially in poorly ventilated or crowded indoor settings.

Vector-Borne Transmission: This is not common in the average indoor workplace but includes organisms (vectors) like mosquitoes or ticks that transmit disease-causing pathogens to humans. In this case, workers who work outdoors or in the field are the ones who may be at risk.

3. Factors Increasing Infection Risk

Several environmental and behavioural failures can increase the overall risk of infection within any workplace:

Poor Hygiene Practices: The most important single factor promoting indirect contact transmission is a lack of robust personal hygiene, especially poor timing, technique, or frequency of handwashing.

Inadequate Cleaning and Disinfection: Not establishing or following a strict cleaning schedule for high-touch surfaces, restrooms, and shared equipment enables pathogens to survive and build up.

Insufficient Ventilation: Poor airflow and a low ACH make the air full of fumes, particles, and respiratory droplets; this greatly enhances the chances of acquiring airborne illnesses.

Lack of Training and Protective Equipment (PPE): Personnel not trained in infection control practices or who do not have the appropriate PPE for high-risk activities, such as gloves, masks, and aprons, are much more likely to be exposed and infected.

4. High-Risk Settings and Susceptible Groups

Severity of risk is context-based on the work environment and population served:

High-Risk Settings:

Healthcare and Care Homes: The risk is higher because of constant exposure to infectious patients and a large number of vulnerable individuals, service users, who may have compromised immune systems.

Childcare Facilities: High turnover of respiratory and gastrointestinal diseases owing to close contact and shared toys/surfaces between children and child caretakers.

Laboratories: Risk of exposure from intentionally cultured or concentrated biological agents via spills, improper handling, or aerosol generation.

Susceptible Groups:

Service Users/Patients: These are usually people with affected immune systems or with certain conditions that make them more prone to infections.

Employees: Employees are exposed to colleagues, visitors, and service users daily and should take collective responsibility to minimise the risk of illness spread within shared spaces.

Service Users/Patients: Visitors can introduce community infections into the workplace or vice versa, acquiring workplace-specific infections and spreading them upon exit.

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