Hygiene control in schools

Advice on the appropriate hygiene procedures for schools to help prevent the spread of blood-borne viruses such as HIV and hepatitis, and conditions such as dysentery 

Whose responsibility is school hygiene? 

The overall responsibility for the health and safety of pupils and staff in schools rests with the employer who should recommend hygiene procedures for schools to follow. They should also provide further information and training to head teachers, who are responsible for day-to-day management of health and safety in the school. 

Although teachers have a duty of care towards the health and safety of pupils in their care, they cannot be obliged to assist with cleaning-up procedures or administer first aid or medicines. The NEU does not favour teachers becoming involved in such matters. Procedures should be in place whereby they may notify another member of staff to deal with these tasks. 

Hygiene and blood-borne viruses 

HIV and AIDS 

HIV and AIDS can only be transmitted by the introduction of infected blood or blood products into the bloodstream, through sexual intercourse, and from a mother to her baby either during pregnancy or by breast feeding. There will be children in all schools carrying the HIV virus. It is important that the issues surrounding HIV are understood by staff to ensure that any children with a diagnosis do not receive detrimental treatment. 

Hepatitis A 

Hepatitis A virus, or infective hepatitis, is a common infection that mainly affects children and young adults. The illness is caused by an infection in the faeces and may be passed from one person to another by contamination of the hands with infected faeces, which may lead to the germ being introduced into the mouth. Although symptoms can sometimes be severe, in most cases they are so mild as not to be apparent. The infection can be difficult to control but its spread can usually be reduced by simple hygienic measures. 

Hepatitis B 

Hepatitis B virus is much more serious, resulting in a permanent carrier state and with a risk of permanent liver damage. The virus may be transmitted through spittle or blood contact. High-risk groups are people requiring blood transfusions, long-term hospital patients or institution residents, and those with natural or acquired immune deficiency. Down’s syndrome children are known to have a higher carrier rate because of a deficiency in their immune system. 

School staff can be at risk through contact with children with high-risk groups. An effective vaccine is available and the NEU believes that the vaccine should be offered to any staff who feel they may be at particular risk. 

Hepatitis C 

The hepatitis C virus was discovered in 1989 and still very little is known about it. Like hepatitis B, it is spread by blood contact and can cause long-term liver damage. There is currently no vaccine against hepatitis C because the virus comes in many forms and can transmute. 

Diarrhoea and vomiting illnesses 

There are a range of illnesses which can cause vomiting and diarrhoea including dysentery, salmonella and E coli infection. They vary considerably in severity but in all cases effective hygiene control procedures in schools can substantially reduce the risk of infection and transmission. 

Hygiene control guidelines 

Basic hygiene procedures for schools are recommended by Public Health England (PHE) in Guidance on Infection Control in Schools and Other Childcare Settings and should be followed by all schools to effectively control the risk of infection. 

Personal hygiene 

The PHE guidance contains the following advice: 

  • Effective hand washing is an important method of controlling the spread of infections, especially those that cause diarrhoea and vomiting. 

  • Always wash hands after using the toilet and before eating or handling food. Use warm, running water and a mild, preferably liquid, soap. Toilets must be kept clean. 

  • Discard disposable towels in a bin. Bins with foot-pedal operated lids are preferable. 

  • Encourage use of handkerchiefs when coughing and sneezing. 

The NEU recommends that schools also adopt the following additional procedures: 

  • Razors, toothbrushes or other implements which could become contaminated with blood must not be shared. 

  • Minor cuts, open or weeping skin lesions, and abrasions should be covered with waterproof or other suitable dressings. 

  • Nappies and sanitary towels must be burnt in an incinerator or securely bagged and sealed, and disposed of according to local guidance. 

  • It is advisable to dispose of tampons in the same way as sanitary towels. Local guidance should be followed. 

Cleaning up body fluid spills 

The PHE guidance contains the following advice: 

  • Spills of body fluids – blood, faeces, nasal and eye discharges, saliva and vomit – must be cleaned up immediately. 

  • Wear disposable gloves. Be careful not to get any of the fluid you are cleaning up in your eyes, nose, mouth or any open sores. 

  • Clean and disinfect any surfaces on which body fluids have been spilled. Use a product which combines a detergent and a disinfectant. 

  • Discard fluid-contaminated material in a plastic bag along with the disposable gloves. The bag must be securely sealed and disposed of according to local guidance. 

  • Use paper towels to clean up blood and body fluid spillages, not mops. 

  • Ensure contaminated clothing is laundered at the hottest wash the fabric will tolerate. 

Injuries 

The NEU recommends that the following procedures be adopted to deal with injuries in schools: 

  • A senior member of staff should be responsible for receiving reports of accidents involving staff and children, even the most minor incidents. 

  • Normal first aid procedures should be followed, which should include the use of disposable gloves and, where appropriate, suitable eye protection and a disposable plastic apron. 

  • All wounds should be washed immediately in copious amounts of soap and water, treated with a disposable disinfectant tissue and covered with an appropriate adhesive dressing. If the accident involves the eye or mouth, wash them thoroughly with water. 

  • Splashes of blood, saliva or other body fluids on the skin should be washed off with soap and water. If these enter the eye or mouth, wash them copiously with water. 

  • Where there is a risk of contracting a blood-borne virus, the employer should provide adequate information and training on the potential risk as well as protective clothing and equipment, eg disposable gloves, aprons, medical tissues and disinfectant. 

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