Infectin Cntrl Guidelines fr Cabin Crew Members n Cmmercial Aircraft PURPOSE These guidelines prvide cabin crew members (flight attendants) with practical measures t prtect themselves, passengers, and ther crew members when smene nbard is ill with a pssible cntagius infectin. The practical measures fr prtecting yurselves and thers include persnal prtectin, management f an ill traveler, targeted clean-up measures, and pstflight measures. Since whether an illness is cntagius is usually nt knwn at the time, any bdy fluid (such as phlegm, diarrhea, vmit, r bld) must be treated as ptentially infectius. This guideline prvides infrmatin n general infectin cntrl measures, as well as specific measures accrding t three infectin categries: respiratry, gastrintestinal, and bldbrne. ILLNESS CATEGORIES Respiratry infectins: Symptms: Viruses r bacteria in the respiratry system (such as measles, tuberculsis, influenza, whping cugh, r sme pneumnia) can cause symptms including cughing, sneezing, fever, rash, and difficulty breathing. Similar symptms may als be caused by nninfectius cnditins, such as asthma, allergic reactins, r reactins t irritating substances. Hw infectin spreads: Cughing, sneezing, r even singing r talking may spread respiratry infectius agents. Depending n what is causing the infectin, germs may be spread when anther persn inhales them frm drplets r aersls expelled int the air by a cugh r sneeze.
Anther way f spreading these germs is by tuching cntaminated surfaces with yur hands, then tuching yur muth, eyes, r nse, befre washing yur hands. Sme infectins, such as tuberculsis (TB), d nt spread easily withut clse and prlnged cntact, while thers, such as measles, can be transmitted after brief cntact. Gastrintestinal infectins: Symptms: Germs in the stmach r intestines, such as nrvirus, can cause symptms including nausea, abdminal pain, vmiting, diarrhea, r fever. Similar symptms may als be triggered by a sensitivity r allergy t a fd r fd additive. Hw infectin spreads: Vmiting r diarrhea may spread germs t surfaces that ther peple may tuch and then tuch their muth with cntaminated hands. Infectin may als be spread thrugh cntaminated fd r liquids, fr example, if an ill persn prepares fd r drink fr ther peple. Bld-brne infectins: Symptms: Certain infectins, such as HIV/AIDS, hepatitis B and C, and viral hemrrhagic fevers (Ebla), are carried in the bldstreams f infected peple. A persn with ne f these infectins may have symptms such as jaundice (a yellw appearance f the skin r white parts f the eyes) in the case f hepatitis B r C; r, in the case f hemrrhagic fevers, unexplained bleeding f the skin, eyes, r gums. A persn with sme f these diseases may nt have any symptms at all, yet still be cntagius. Ebla patients, hwever, are generally nt cntagius until symptms present. Hw infectin spreads: Sme f these infectins can be spread when bdy surfaces that can Easily absrb bld-brne pathgens, such as pen cuts, scrapes, r mucus membranes (lining f muth, eyes, r nse) cme int direct cntact with infectius bdily fluids. INFECTION CONTROL MEASURES Persnal prtectin Treat any bdy fluid as thugh it is infectius Hand hygiene is the single mst imprtant infectin cntrl measure Wash hands with sap and water fr at least 20 secnds after assisting ill travelers r cming in cntact with bdy fluids r surfaces that may be cntaminated. Infectin Cntrl Guidelines n Cmmercial Aircraft Internatinal Brtherhd f Teamsters Safety and Health Department, Page 2 f 5
An alchl-based hand cleaner is an alternative t hand-washing but will nt be effective if hands are visibly siled. Avid tuching yur muth, eyes, and nse with unwashed r glved hands. Dispsable glves (glves d nt replace prper hand hygiene) Wear impermeable, dispsable glves when: physically tending t an ill traveler cming in cntact with bdy fluids (such as used tissues, bld, vmit, r diarrhea), ptentially cntaminated surfaces r lavatries Remve glves carefully t avid cntaminating yurself r yur clthing. Prperly dispse f siled glves after use int a plastic bag, and d nt re-use. Wash yur hands with sap and water r with an alchl-based hand cleaner after remving glves. Face masks Surgical-type face masks wrn by an ill persn may help reduce the spread f respiratry germs frm cughing, sneezing r talking; hwever, surgical facemasks are nt recmmended fr use by a persn wh is nt ill. MANAGEMENT OF ILL PERSONS Minimize the number f persns directly expsed t the ill traveler, keep interactins with the ill traveler as brief as pssible. Respiratry infectins* Ask the ill traveler t cver his r her muth with a tissue when cughing r sneezing. Prvide tissues, if necessary. Prvide a plastic bag fr dispsing f used tissues. Ask the ill traveler t wear a face mask particularly fr persistent cugh, if it can be tlerated and ne is available. Encurage the ill traveler t wash hands and/r use alchl-based hand cleaner (if available). Separate the ill traveler frm thers by 6 feet, if pssible, and withut cmprmising flight safety r expsing additinal passengers. Fllw the instructins in Targeted Clean-Up belw, as necessary. Infectin Cntrl Guidelines n Cmmercial Aircraft Internatinal Brtherhd f Teamsters Safety and Health Department, Page 3 f 5
*Nte: measles and rubella (German measles) are caused by respiratry viruses with rash and fever being prminent signs. Therefre, fllw the abve respiratry illness infectin cntrl measures if the ill traveler has a fever and rash Gastrintestinal infectins Seat the ill traveler(s) clse t a lavatry, if pssible. If pssible, restrict the use f that lavatry t nly the ill traveler(s). If traveler is vmiting, prvide air-sickness bags. Prvide a plastic bag fr dispsing f used air-sickness bags. Encurage the ill traveler t wash hands and/r use alchl-based hand cleaner (if available). Fllw the instructins in Targeted Clean-Up belw as necessary. Bld-brne infectins If the ill traveler is actively bleeding, such as frm an injury r nsebleed, prvide first aid accrding t yur airline s guidelines. Separate the ill traveler frm thers far enugh t reduce the likelihd f bld splattering n ther peple, if pssible. Prvide a plastic bag fr dispsing siled tissues r twels. Fllw the instructins in Targeted Clean-Up belw as necessary. TARGETED CLEAN-UP Hard (nnprus) surfaces, such as tray tables, TV mnitrs, seat arms, windws and walls that are visibly siled: remve visible cntaminatins, then clean with a cleaning r disinfectant agent apprved by yur airline. Sft (prus) surfaces, such as carpeted flr r seat cushins that are bviusly siled, such as with vmit r diarrhea: first remve as much f the cntaminant as pssible, then cver the area with an absrbent substance, fllwed by an impermeable material, such as plastic, t reduce the risk f spread beynd the immediate area r int the air. If a cntaminated item can be easily remved, is small enugh t fit inside a plastic bag (such as a pillw, blanket r small cushin), and will nt cause significant disruptin t passengers by remving it (such as in a full flight), carefully place it inside a bihazard bag r plastic bag with a manually applied bihazard label and tie r tape the bag shut securely t avid leaking. Infectin Cntrl Guidelines n Cmmercial Aircraft Internatinal Brtherhd f Teamsters Safety and Health Department, Page 4 f 5
Dispse f used cleaning materials in a bihazard bag r plastic bag with a manually applied bihazard label, immediately after use.*nte: actins shuld be cnsistent with cmpany plicy. POST-FLIGHT MEASURES Prperly dispse f cntaminated items Place all receptacles that have been used by the ill traveler, as well as all bags cntaining materials used t clean up, in a bihazard bag r plastic bag with a manually applied bihazard label and tie it securely. Ntify cleaning crew f areas that have been cntaminated (specify respiratry, gastrintestinal, and/r bld-brne bdy fluids) which may need mre than rutine cleaning r pssible remval such as: visibly siled sft materials (e.g., seat cushin) hard surfaces like arm rests and tray tables lavatry used by ill traveler(s) Remind cleaning crew that this may require additinal persnal prtective equipment and that they shuld fllw cmpany plicy fr such situatins Nte: If ill traveler(s) changed seats, ensure that bth areas are adequately cleaned. When t see a health care prvider after expsure t ill travelers Cabin crew members wh have been expsed t travelers with knwn r suspected cntagius infectins shuld cnsult their health care prviders shrtly after the flight in questin if they develp symptms that cncern them (such as fever, rash, persistent cugh, vmiting, r diarrhea). Risk f infectin depends n many factrs, including the type f disease, flight duratin, level f expsure, and level f immunity. REFERENCES: Centers fr Disease Cntrl and Preventin http://www.cdc.gv/quarantine/air/managing-sick-travelers/cmmercial-aircraft/infectincntrl-cabin-crew.html Infectin Cntrl Guidelines n Cmmercial Aircraft Internatinal Brtherhd f Teamsters Safety and Health Department, Page 5 f 5