Notes for Infection Control

Infection Control: Principles & Practice
- regulatory agencies & governmental departments of health require any business that serves public must follow prescribed sanitary precautions

Bacteria (Germs or Microbes)
- one-celled microorganism with both plant and animal characteristics
- can exist almost anywhere
-- on skin
-- in water, air, decayed matter
-- secretions of body openings
-- on clothing
-- beneath nails
- only be seen with aid of microscope
- 1500 rod-shaped bacteria will fit comfortably on head of a pin

Types of Bacteria
- there are hundreds of different kinds of bacteria
- 2 main types: nonpathogentic and pathogenic
- Nonpathogenic:
-- most bacteria are nonpathogentic organisms
-- helpful or harmless; not disease producing
-- perform many useful functions
--- decomposing garbage
--- improving soil fertility
--- in humans: help metabolize food, protect against infectious microorganisms, and stimulate immune response
-- some bacteria cultures are used to produce penicillin, acidophilus yogourt, and a special type of milk used for gastrointestinal disorders
-- Saprophytes: a type of nonpathogenic bacteria lives on dead matter
- Pathogenic bacteria (microbes or germs):
-- harmful
-- in the minority
-- cause disease when they invade plant or animal tissue
-- Parasites: require living matter for their growth

Classification of Pathogenic Bacteria
- bacteria have distinct shapes that help to identify them
1. Cocci:
-- round-shaped bacteria appear singly (alone) or in the following groups
-- Staphylococci:
--- pus-forming bacteria that grows in clusters like a bunch of grapes
--- cause abscesses, pustules, and boils
-- Streptococci:
--- pus-forming bacteria arranged in curved lines resembling a string of beads
--- cause infections such as strep throat and blood poisoning
-- Diplococci:
--- spherical bacteria that grow in pairs and cause diseases such as pneumonia
2. Bacilli:
-- short, rod-shaped bacteria
-- most common bacteria and produce disease such as tetanus (lockjaw), typhoid fever, tuberculosis, and diphtheria
3. Spirilla:
-- spiral or corkscrew-shaped bacteria
-- subdivided into subgroups such as Treponema pallida (causes syphilis) or Borrelia burgdoferi (causes Lyme disease)

Movement of Bacteria
- cocci rarely show active Motility (self-movement)
-- transmitted in air, dust, or within substance where they settle
- bacilli and spirilla are both motile and use slender, hairlike extensions, known as Flagella (singular: flagellum) or Cilia for locomotion
-- a whiplike motion of these hairs move bacteria in liquid

Definition Relation to Causes of Disease

Bacteria (singular: Bacterium) Microbes or Germs
- one-celled microorganism with both plant and animal characteristics
- some are harmful, some harmless

Bacteriology
- science of microorganisms called bacteria

Infectious
- communicable by infection from one person to another person or from one infected body part to another

Microbes/Germs
- synonyms for disease-producing bacteria

Microbiology
- science of microorganisms and their effects on other forms of lie

Microorganism
- microscopic plant or animal cell

-Ology
- suffix meaning "scientific study of" (i.e. microbiology)

Parasite
- a vegetable or animal organism that lives on or in another organism and draws its nourishment from that organism

Virology
- study of viruses & viral diseases

Virus (plural: viruses)
- a submicroscopic structure capable of infesting almost all plants and animals including bacteria
- infectious agent that lives only by penetrating cells and becoming part of them

Singular - Plural
coccus - cocci
bacillus - bacilli
spirillum - spirilla
staphylococcus - staphylococci
streptococcus - streptococci
diplococcus - diplococci

Bacterial Growth and Reproduction
- bacteria generally consist of an outer cell wall and internal protoplasm
- they manufacture own food from surrounding environment, give off waste products, and grow and reproduce
- life cycle of bacteria => 2 distinct phases
-- active or vegetative stage
-- inactive or spore-forming stage

Active or Vegetative Stage
- bacteria grow and reproduce
- multiply best in warm, dark, damp, or dirty places where sufficient food is available
- when conditions are favourable, bacteria grow and reproduce
- when they reach largest size, they divide into 2 new cells (Mitosis)
- Daughter Cells: cells that are formed
- when conditions become unfavourable, bacteria die or become inactive

Inactive or Spore-forming Stage
- certain bacteria (anthrax and tetanus bacilli) form spherical spores with tough outer coverings during inactive stage
-- purpose to withstand periods of famine, dryness, and unsuitable temperatures
-- spores can be blown about and not harmed by disinfectants, heat or cold
- when favourable conditions are restored, spores change into active or vegetative form, then grow and reproduce

Bacterial Infections
- Infection: occurs when body tissues are invaded by disease-causing or pathogenic bacteria
- Pus: a fluid product of inflammation and contains white blood cells and debris of dead cells, tissue elements, and bacteria
-- presence of pus sign of infection
- Staphylococci ("staph") among most common human bacteria
-- carried about by 1/3 of population
-- can be picked up on doorknobs, countertops, and other surfaces, more frequently through skin-to-skin contact
--- shaking hands or using unclean implements
-- antibiotics once controlled these bacteria, but certain strains of staph are now resistant to drugs

Local Infection:
- such as pimple or abscess is confined to a particular part of body and indicated by a lesion containing pus

General Infection:
- results when bloodstream carries bacteria or virus and their toxins (poisons) to all parts of body
- i.e. syphilis

Contagious or Communicable:
- when a disease spreads from one person to another person by contact
- some common contagious disease preventing cosmetology from servicing clients:
-- tuberculosis, common cold, ringworm, scabies, and viral infections
- chief source of contagion are unclean hands and implements, open sores, pus, mouth and nose discharges, and shared drinking cups and towels
- uncovered coughing or sneezing and spitting in public also spread germs


General Terms Relating to Disease
Acute disease
- disease having a rapid onset, severe symptoms, and a short course or duration
Allergy
- reaction due to extreme sensitivity to certain foods, chemicals, or other normally harmless substances
Chronic Disease
- disease of long duration, usually mild but recurring
Congenital Disease
- disease that exists at birth
Contagious Disease
- disease that is communicable or transmittable by contact
Contraindication
- any condition or disease that makes an indicated treatment or medication inadvisable
Diagnosis
- determination of the nature of a disease from its symptoms
Disease
- abnormal condition of all or part of the body, organ, or mind that makes it incapable of carrying on normal function
Epidemic
- appearance of a disease that simultaneously attacks a large number of persons living in a particular locality
Etiology
- study of causes of disease and their mode of operation
Infectious disease
- disease caused by pathogenic microorganisms or viruses tat are easily spread
Inflammation
- condition of some part of the body as a protective response to injury, irritation, or infection, characterized by redness, heat, pain, and swelling
Objective symptoms
- symptoms that are visible, such as pimples, pustules, or inflammation
Occupational Disease
- illness resulting from conditions associated with employment, such as coming in contact with certain chemicals or tints
Parasitic Disease
- Disease caused by vegetable of animal parasites, such as pediculosis and ringworm
Pathogenic Disease
- disease produced by disease-causing bacteria, such as staphylococcus and streptococcus (pus-forming bacteria), or viruses
Pathology
- science that investigates modifications of functions and changes in structure caused by disease
Prognosis
- foretelling of probably course of a disease
Seasonal Disease
- disease influenced by weather
Subjective Symptoms
- symptoms that can be felt, such as itching, burning, or pain
Systemic Disease
- disease that affects body generally, often due to under or overfunctioning of the internal glands
Venereal Disease
- contagious disease commonly acquired by contact with an infected person during sexual intercourse, characterized by sores and rashes on skin

Viruses
- a submicroscopic structure capable of infesting almost all plants and animals, including bacteria
- so small they can even pass through pores of a porcelain filter
- cause common colds and other respiratory and gastrointestinal (digestive tract) infections
- other viruses that plague humans are measles, mumps, chicken pox, smallpox, rabies, yellow fever, hepatitis, polio, influenza, and HIV which causes (AIDS)
- difference between viruses and bacteria:
-- virus live only by penetrating cells and becoming part of them
-- bacteria are organisms that can live on their own
-- bacterial infections treated with specific antibiotics while viruses are hard to kill without harming body in process
-- viruses are generally resistant to antibiotics
- vaccination prevents viruses from penetrating cells, but vaccinations are not available for all viruses

Hepatitis
- a disease marked by inflammation of liver
- caused by bloodborne virus similar to HIV in transmission
- more easily contracted than HIV
- present in all body fluids
- 3 types of concern to cosmetologist
1. Hepatitis A
-- illness usually lasts about 3 weeks
-- symptoms are similar to flu
-- adults have yellowing of skin or eyes
-- spread through close household contact
--- bathroom use, poor sanitation, poor personal hygiene,
--- contaminated food, milk, water, and shellfish
--- infected food handlers and sexual contact
-- vaccine is available
2. Hepatitis B (HBV) Standard
-- can cause long-term hepatitis, cirrhosis, and/or liver cancer
-- about half people with disease do not have symptoms
-- disease can mirror flu
-- primarily transferred through sexual contact or parenteral exposure (piercing mucous membranes or skin barrier) to blood or blood products
-- vaccine is available
3. Hepatitis C (HCV)
- illness can progress slowly, and about 1/3 of those with illness do not have symptoms
- symptoms can include fatigue and stomach pain
- disease is transferred through parenteral contact and sexual activity with infected partners
- no vaccine available

HIV/AIDS
- HIV (Human Immunodeficiency Virus) causes AIDS (Acquired Immune Deficiency Syndrome)
- AIDS, the disease, breaks down body's immune system
- HIV is passed from person to person through blood and other body fluids, such as semen and vaginal secretions- a person can be infected with HIV for up to 11 years without having symptoms
- some HIV-positive people have never been tested and not know they are infecting other people
- HIV virus is transmitted through unprotected sexual contact, sharing of needles by intravenous (IV) drug users, and accidents with needles in health-care settings
- can enter bloodstream through cuts and sores and can be transmitted in salon by sharp implement
- NOT transmitted by holding hands, hugging, kissing, sharing food or household items like the telephone, or toilet seats
- no documented cases of virus being transmitted by food handlers, insects, or casual contact

How Pathogens Enter the Body
- a break in skin (cut, pimple, or scratch)
- mouth (contaminated water or food)
- nose (air)
- eyes or ears
- unprotected sex

The body fights infection by means of:
- unbroken skin, which is the body's first line of defence
- body secretions, such as perspiration and digestive juices
- white cells within blood that destroy bacteria
- antitoxins that counteract toxins produced by bacteria and viruses

Bloodborne Pathogens
- disease-causing bacteria or viruses that are carried through body in blood or body fluids, such as hepatitis and HIV
- if you accidentally cut a client who is HIV-positive or is infected with hepatitis and you continue to use the implement without cleaning and disinfecting it, you risk puncturing your skin or cutting another client with a contaminated tool
- if you shave a client's face or neck with a razor or clipper blades and pick up body fluid from a blemish or open sore, transmission is possible
- risks are also present when waxing and tweezing

Parasites
- vegetable or animal organisms that live in or on another living organism and draw their nourishment from them (host)
- not capable of sustaining their own life without a host
- vegetable (plant) parasites or Fungi (moulds, mildews, yeasts) can produce contagious diseases such as ringworm and favus, both skin disease
- nail fungus can be contracted through implements that have not been disinfected properly or by moisture trapped under nail enhancements
-- is chronic and usually localized but can spread to other nails and from client to client if imlements are not disinfected before and after each client
-- treatment is generally applied directly to affected area
-- in serious cases, physician's care is required
- animal parasites, such as head lice, are responsible for contagious diseases and conditions
- Pediculosis Capitis: a skin disease caused by an infestation of head lice
- Scabies: contagious skin disease caused by the itch mite, which burrows under skin
- clients should be referred to a physician for contagious diseases and conditions caused by parasites
- contaminated countertops should be cleaned with a pesticide or insecticide according to manufacturer's directions

Immunity
- the ability of the body to destroy bacteria that have gained entrance and to resist infection in general
- immunity against disease can be natural or acquired and is a sign of good health
- Natural Immunity: partially inherited, partly developed through hygienic living
- Acquired Immunity: immunity that body develops after overcoming a disease, or through inoculation (vaccination)

Principles of Prevention

Decontamination
- Contaminants:
-- any substances that can cause contamination
-- hair left in comb
-- makeup on towel or brush
-- nail dust on file
- tools and other surfaces in salon can be contaminated with bacteria, viruses, and fungi
- Decontamination:
-- involves use of physical or chemical means to remove, inactivate, or destroy pathogens so that the object is rendered safe for handling, use, or disposal
- 3 main levels of decontamination: sterilization, disinfection, and sanitation
-- only disinfection and sanitation are required in salon

Sterilization
- highest level of decontamination
- completely destroys every organism on surface, whether beneficial or harmful
- even kills bacterial spores, most resistant form of life on Earth
- methods of sterilization include steam autoclave and dry heat (form of extreme heat)
- a process used by dentists and surgeons, whose tools are designed to break and penetrate skin barrier
- estheticians also use needles and probes that lance skin => follow sterilization procedures
-- presterilized disposable lancets or needles are a simpler solution to the issue of sterilization
- "sterilize" is often used incorrectly, i.e. "sterilizing nail plate or skin"
-- means kill skin and destroy nail plate
- can only sterilize surfaces that are not Porous
- metal implements are nonporous and can be sterilized, but wood surfaces cannot
- sterilization is impractical and unnecessary in salons

Disinfection
- higher level of decontamination than sanitation
- 2nd only to sterilization
- controls microorganisms on hard, nonporous surfaces such as cuticle nippers and other salon implements
- provides level of protection required by salon to kill most organism, with one exception
- does NOT kill bacterial spores
- lancets and other metal implements used in advanced facial treatments should be sterilized, or disposable implements should be used
- Disinfectants:
-- chemical agents used to destroy most bacteria and some viruses
-- disinfect implements and surfaces
-- are NOT used on human skin, hair, or nails
-- never use as hand cleaners
--- any substance powerful enough to quickly & efficiently destroy pathogens can also damage skin

Read Carefully Before Using
- any professional salon product can be dangerous if used incorrectly
- all disinfectants must be approved by Environmental Protection Agency (EPA) and each individual state
- disinfectant label must also have EPA registration number
-- look for this number when choosing disinfectant
-- product label also tell you exactly which organisms the disinfectant has been tested for (i.e. HIV1 or Hepatitis B virus)
- federal law requires manufacturers to provide Material Safety Data Sheet (MSDS), directions for proper use, safety precautions, and a list of active ingredients
-- MSDS provides all pertinent info on products, ranging from content and associated hazards to combustion levels and storage requirements
--- these sheets should be available for every product used in salon and obtained from product's distributor / manufacturer
-- operating without MSDS poses health risk t anyone in salon who comes to contact with hazardous materials
- read all vital information

OSHA (Occupational Safety and Health Administration)
- created as part of US department of labour to regulate and enforce safety and health standards in workplace
- regulating employee exposure to toxic substances and informing employees about dangers of materials used in workplace are key points of Occupational Safety and Health Act of 1970
-- act established Hazard Communication Rule
--- requires chemical manufacturers and importers assess hazards associated with their products
-- Material Safety Data Sheets and product labelling are 2 important results of this law
- standards set by OSHA are particularly relevant to cosmetology industry because of nature of chemicals used
- issues having to do with mixing, storing, and disposal of chemicals; general safety of workplace; and right of cosmetologist to know what is contained in products used are all regulated by OSHA standards

Choosing Disinfectant
- disinfectants are chemicals
- read & follow manufacturer's instructions
- mixing precautions and exposure times demand particular attention
- product label explain what disinfectant has been tested for
- to meet salon requirements, a disinfectant must have correct Efficacy (effectiveness) to be used against bacteria, fungi, and viruses
- disinfectants formulated for hospitals & health care facilities must be Pseudomonacidal (effective against bacteria Pseudomonas), in addition to being Bactericidal, Fungicidal, and Virucidal
- if disinfectant tested for i.e. HIV-1, it will be stated on label
- check for label number and efficacy standard on label
- for bloodborne pathogens, OSHA issued a policy in 1997 stating that, in order to comply with OSHA's Bloodborne Pathogens Standard, the use of an EPA-registered Tuberculocidal disinfectant or an EPA-registered disinfectant labelled as effective against HIV and HBV is required
- when salon implements accidentally come into contact with blood or body fluids, they should be cleaned and completely immersed in EPA-registered disinfectant that kills HIV-1 and Hepatitis B virus, or in a tuberculocidal disinfectant
- National Interstate Council of State Cosmetology Boards (NICS) follows this standard for examinations

Proper Use of Disinfectants
- any item used on client must be disinfected or discarded after each use
-- combs, brushes, scissors, razors, clipper blades, nippers, electrodes, and other commonly used, nonporous tools must be disinfected
- all implements should be thoroughly cleaned before soaking to avoid contaminating disinfecting solution
- implements must be completely submerged for proper disinfection
- ultrasonic cleaners useful addition to your disinfection process, but not required
- many systems disinfect with great effectiveness without replying on such devices
- some salons feel this added cleansing benefit is well worth extra expense
- also saves time by eliminating cleaning by hand


Quats (Quaternary Ammonium Compounds)


- type of disinfectant considered non-toxic, odourless, and fast-acting
- older formulas were not very effective
- newer products, called Dual Quat formulas => more effective
- disinfect implements in 10-15 minutes
- leaving some tools in solution too long may damage them
- long-term exposure to any water solution or disinfectant may damage fine steel
- corrosion of metal surfaces can be easily avoided => separate implements while disinfecting
- metal implements such as scissors and nail clippers should be oiled regularly
- quats very effective for cleaning tables and countertops

Phenols (Phenolic Disinfectants)
- like quats, used reliably over years to disinfect implements
- Phenol is a caustic poison, but safe and effective if used according to instructions
- disadvantage, most rubber and plastic materials may be softened or discoloured by phenols
- phenols in 5% solution used mostly for metal implements
- avoid sin contact with phenols
-- cause skin irritation or in concentrated amounts, seriously burn skin and eyes
- some are poisonous if accidentally ingested

Alcohol & Bleach
- methyl alcohol (methanol), ethyl alcohol (ethanol or grain alcohol), and isopropyl alcohol (rubbing alcohol)
- in salon, ethyl and isopropyl alcohol are used to disinfect implements
- strength of ethyl alcohol must be no less than 70%
- strength of isopropyl alcohol must be 99%
- since alcohol is NOT an EPA-registered disinfectant => NOT permitted for use with implements in states requiring hospital disinfection
- disadvantages to using alcohol:
-- extremely flammable, evaporate quickly, slow-acting and less effective compared to other disinfectants
-- alcohol corrode tools and cause sharp edges to dull
-- discolour and damage surface of floors and countertops
-- vapour formed on evaporation can cause headaches and nausea when inhaled in high concentrations or after prolonged exposure
- Household Bleach (Sodium Hypochlorite):
-- effective disinfectant
-- shares drawbacks as alcohol
-- not professionally designed and tested for disinfection of salon implements
-- effective laundering additive
-- bleach & alcohol used extensively in past, but have been replaced by more advanced effective technologies
- although quarts suitable for cleaning any surface, you can clean floors, bathrooms, sinks, and waste receptacles with commercial cleaner
-- Lysol or Pine-sol
--- should not be used on salon implements

Disinfectant Safety
- always wear gloves & safety glasses when mixing chemicals with water
- always dd disinfectant to water, not water to disinfectant
- use tongs, gloves, or a draining basket to remove implements from disinfectants
- always keep disinfectants away from children
- never pour quats, phenols, formalin, alcohol (not legal in most states), or other disinfectant over hands
-- cause skin irritation and increase chance of infection
-- wash hands with soap and warm water and dry thoroughly
- carefully weight and measure all products to ensure they perform at peak efficiency
- never place an disinfectant or other product in unmarked container
-- disinfectants come in different forms (ready-to-use sprays for surface cleaning, liquid concentrate, and powders)
-- some disinfectant appear clear while others are a little cloudy
- always follow manufacturer's recommendations for mixing and using, and check efficacy to make sure you are using right disinfectant
- avoid overexposure
-- disinfectants are chemicals and overuse is detrimental to environment

- jars or containers used to disinfect implements are often incorrectly called wet sanitizers
-- purpose of containers to disinfect
- disinfecting soak solution must be changed daily and kept free from debris unless otherwise directed by manufacturer's instructions
- strict adherence to principles of good hygiene and disinfection must be maintained

Disinfection Procedures
- always disinfect your tools or other implements according to guidelines listed for EPA wet disinfectants
- complete immersion for required amount of time

Disinfecting Implements
- most tools and implements can be disinfected
- combs, brushes, rollers, picks, styling tools, scissors, tweezers, nail clippers, and some nail files
1. pre-clean to remove hair, filings, and other such loose matter by scrubbing with soap and water
2. rinse thoroughly and pat dry with clean towel
3. put on gloves, goggles, or safety glasses
4. mix disinfectant according to manufacturer's directions, always adding disinfectant to water
5. using gloves or tongs, completely immerse implements or tools and leave for required amount of time, as per manufacturer's instructions
6. remove implements with tongs, basket, or gloves so as not to contaminate disinfectant
7. rinse thoroughly and dry
8. place disinfected implements in a clean, closed, dry, disinfected container (such as a plastic container with lid)


CAUTION: in past, formalin, solution of formaldehyde in water, was recommended as disinfectant and fumigant in dry cabinet sanitizers
- formalin not safe for salon
- formaldehyde, a pungent gas, can cause cancer
-- poisonous when inhaled and can irritate eyes, nose, throat, and lungs
-- cause skin allergies, irritation, dryness, and rash
-- long-term use cause symptoms similar to chronic bronchitis or asthma
--- worsen over time with continued exposure

Disinfecting Linens & Capes
- all linens should be used once then laundered with bleach according to label directions
- capes or drapes that come into contact with client's skin should be laundered in same manner

Disinfecting Electrical Equipment
- contact points of equipment that cannot be immersed in liquid, such as hair clippers, electrotherapy tools, and nail drills, should be wiped or sprayed with EPA-registered, hospital-grade disinfectant created especially for electrical equipment
- electrical equipment must be kept in good repair

CAUTION: electric or bead "sterilizers" do NOT sterilize implements
- they do NOT even properly disinfect tools
- only tip of implement can be inserted into the hot glass beads, and the handles remain contaminated
- they only give users a false sense of security
- these devices represent a dangerous gamble with your client's health

Disinfecting Work Surfaces
- before and after each client, EPA-registered, hospital-grade disinfectant should be used on work surface (manicure table, workstation, aesthetic bed, etc.)
- disinfectant should be left on surface the full amount of time prescribed by manufacturer's directions
- remember to disinfect all surfaces
-- doorknobs, handles, etc.
- shampoo bowl should be cleaned and drain cleared of all hair after each client
- neck of bowl should be disinfected the same as other work surfaces

Disinfecting Whirlpool Pedicure Foot Spas
- read manufacturer's cleaning instructions and ask for demonstration
- improperly disinfected equipment can harbour bacteria that may spread disease or infection to clients, cosmetologist, or nail technicians

CAUTION: ultraviolet (UV) sanitizers are useful storage containers
- they will not disinfect salon implements
- never use these devices to disinfect

Blood Spill Disinfection
- blood spills occur when you are or a client are accidentally cut with a sharp instrument
1. if cut is sustained, stop service and clean injured area
2. use finger guard or gloves as appropriate
3. apply antiseptic and/or liquid or spray styptic without contaminating container
4. cover injury with Band-Aid or other appropriate dressing
5. clean client and workstation as necessary
6. discard all disposable contaminated objects such as wipes or cotton balls by double-bagging (place waste in plastic bag then in a trash bag)
- use biohazard sticker (red or orange) or a container for contaminated waste
- deposit sharp disposables in sharps box
7. remove gloves
- wash hands with soap and warm water before returning to service
8. all tools and implements that have come into contact with blood or body fluids must be disinfected by complete immersion in EPA-registered, hospital-grade disinfectant that kills HIV-1 and Hepatitis B Virus or in a tuberculocidal disinfectant
- be sure to mix and use disinfectant according to manufacturer's directions

- because blood can carry many pathogens, never touch client's open sore or wound

Dispensary
- must be kept clean and orderly, with all containers marked clearly as to content
- an MSDS on every chemical in stock should be kept readily available to all those working in salon or school
- MSDS should indicate appropriate disinfectant to be used with each chemical

Handling Disposable Supplies
- to prevent spread of disease, all disposable supplies, such as orangewood sticks, emery boards, cotton, gauze, neck strips, and the like, should be thrown away
- anything exposed to blood, including microdermabrasion debris, must be double-bagged and marked with biohazard sticker or marked and disposed of according to feeral, state, and local regulation)
- puncture-proof containers should be used in disposal of all sharps
- remember: disinfect or discard

Sanitation (Sanitizing)
- 3rd and lowest level of decontamination
- to sanitize: to significantly reduce the number of pathogens or disease-producing organisms found on a surface
- cleaning with soap or detergents will sanitize salon tools and other surfaces
- sanitized surfaces may still harbour pathogens or other organisms
- removing hair from a brush and washing with detergent is sanitation
- putting antiseptics designed for hands or feet on your skin or washing your hands is another example of sanitation
- hands may appear very clean but harbour pathogens found in tap water and on towel

Mould
- a fungus growth that usually grows in dark, damp place
- mould spores carry Toxins => allergic reactions and sickness
- spores present in outdoor and indoor air and on most furnishings and construction materials
- dirt on surfaces provides nutrients for mould
- practising proper sanitation provides protection against growth of mildew and mold in salon

Mildew
- moldy coating produced by fungi that can appear on walls, fabrics, etc. and in damp areas

Washing Hands
- most important action to prevent transfer of microorganisms from one person to another
- removes microorganisms from folds and grooves of skin by lifting and rinsing them from skin surface
- in salon, hands should be thoroughly washed before and after each service
- avoid touching items such as bar soap, towel dispenser, or a doorknob after washing and before leaving restroom
-- use paper towel to turn doorknob
- wash hands at end of the day preventing contamination outside salon
- soap and warm water sufficient for hand-washing
- antibacterial soaps can kill microorganisms in deeper layers of skin
-- when overused, the relatively harsh drying action of antibacterial soaps may actually leave skin vulnerable to skin problems such as eczema
- alcohol-based no-rinse products designed for use without water are also very drying to skin

Proper Hand Washing Procedure
1. wet hands with warm water
2. using liquid soap, scrub hands together and work up lather for 15-20 seconds
- give particular attention to areas between fingers, nails, both sides of hands, and exposed portions of arms
3. rinse hands well with warm water
4. dry hands using disposable paper towel or air blower
- do not use cloth towels unless they are dispensed one to a person

CAUTION: avoid bar soaps in salon
- can grow bacteria- better practice to provide pup-type liquid soaps

Antiseptics
- can kill, retard, or prevent growth of bacteria
- NOT classified as disinfectants
- i.e. 3% solution of hydrogen peroxide are weaker than disinfectants and are safe for application to skin (usually used prior to manicure or pedicure)
- considered sanitizers and are not adequate for use on instruments and surfaces

Universal Precautions
- same infection control practices should be used with all clients
- OSHA sets standards that must be used in industry for dealing with bloodborne pathogens
- standard prescribes use of Universal Precautions as approach
- Universal Precautions: set of guidelines and controls, published by Centers for Disease Control and Prevention (CDC), that require employer and the employee to assume all human blood and specified human body fluids are infectious for HIV, HBV, and other bloodborne pathogens
- precautions include hand-washing, personal protective equipment (goggles), injury prevention, proper handling and disposal of needles, other sharp instruments and products contaminated by blood or body fluids
- most cases, clients infected with Hepatitis B Virus or other bloodborne pathogens are Asymptomatic => show no symptoms or signs of infection
- many individuals who have minor, nonspecific symptom may not even know they are infected
- exposure to blood in salon setting resents risk of exposure to various diseases including hepatitis and AIDS

Infection Prevention Guidlines
1. lancets or other facial tools and implements used to puncture or break skin, or anything that comes into contact with pus or oozing
- level of decontamination: steralization
- procedure: steam autoclave (high pressure and heat) and dry heat
-- dispose of all sharps in a puncture-proof container

2. nonporous tools and implements such as combs, bushes, razors, haircutting shears, clipper attachments, picks, bobby pins, rollers, Velcro rollers, nippers, tweezers, immersible nail files, attachments, and so on, that have NOT come in contact with body fluids or blood
- level of decontamination: disinfection
- procedure: complete immersion in EPA-registered, hospital-grade, bactericidal, pseudo-monacidal, fungicidal, and virucidal disinfectant for amount of time specified by manufacturer

3. nonporous hair-care tools and implements that have come in contact with parasites such as head lice
- level of decontamination: disinfection
- procedure: complete immersion in a Lysol solution (2 tablespoons in 1 quart of water) for 1 hour

4. nonporous tools and implements such as nippers, razors, or haircutting shears that have accidentally come in contact with blood or body fluids
- level of decontamination: disinfection
- procedure: complete immersion in a EPA-registered, disinfectant with demonstrated efficacy against HIV-1/HBV or tuberculosis for the amount of time specified by manufacturer

5. electrotherapy tools, electric clippers, electric files
- level of decontamination: disinfection
- procedure: spraying or wiping with EPA-registered, hospital-grade disinfectant specifically made for electrical equipment

6. countertops, shampoo bowls, sinks, floor, toilets, doorknobs, mirrors, magnifying lamps, dispensary
- level of decontamination: sanitation
- procedure: use EPA-registered cleaning product designed for surfaces
-- efficacy label states what is appropriate for such surfaces as floors, countertops, toilets, towels, sinks, and the like

7. towels, linens, capes, headbands
- level of decontamination: sanitation
- procedure: laundering in hot water and detergent, with bleach or Lysol added to rinse water

8. your hands prior to each service
- level of decontamination: sanitation
- procedure: washing with liquid soap and warm water

9. your hands, client's hands, and/or feet before each manicure or pedicure service
- level of decontamination: sanitation
- procedure: soap and warm water or antiseptic designed for use on hands and/or feet

The Professional Image
- overall health, safety, and cleanliness an integral part of normal routine
1. sweep floors clean after each client service, especially after every haircut
2. deposit all wast materials in waste receptacle with self-closing lid
3. mop floors and vacuum carpets daily
4. control all types of dust
5. keep windows, screens, and curtains clean
6. regularly clean fans, ventilation systems, and humidifiers
7. keep all work areas well lit
8. keep rest rooms clean and tidy
- remember to clean bathroom door handles
9. provide toilet tissue, paper towels, and pump-type liquid soap in rest room
10. clean sinks and drinking fountains regularly
11. provide disposable drinking cups
12. keep salon free from insects and rodents
13. do not allow salon to be used for cooking or living quarters
14. never place food in refrigerators used to store salon products
15. prohibit eating, drinking, and smoking in areas where services are performed
16. empty waste receptacles regularly throughout the day
17. wear clean, freshly laundered clothing
18. make sure all containers are properly marked, tightly closed, and properly stored
19. keep outside of all containers clean
20. do not place any tools, combs, rollers, or hairpins in your mouth or pockets
21. if you drop an implement on floor, disinfect it before using it again
- properly clean and disinfect all tools and implements after each use and store in clean, covered container
22. avoid touching your face, mouth, or eye areas during services
23. do not allow any pets or animals in salon except for trained service animals
24. clean and disinfect all work surfaces, including manicure tables, aesthetic beds, workstations, and chairs, between client services
- clean shampoo bowls and disinfect neck of bowl after each client
25. use only freshly laundered or new disposable linen on clients
- use separate closed containers for soiled linens
- use disposable towels or tissues whenever possible
- use neck strips or towels to ensure that no skin contact with cutting or shampoo capes
- disinfect all linens during wash cycle with detergent and bleach
26. monitor air quality in salon
- 4-10 air changes per hour are recommended for public buildings
- air changes remove suspended particles such as hair spray, nail filings, and microscopic particles loosened when brushing scalp- an air purification system or EPA-registered air cleaner are effective in removing particles

- contact local state board or cosmetology or health department for complete list of regulations


Procedure 1 - Disinfecting Foot Spas

After each customer:
1. drain all water and remove all foreign matter from foot spa
2. clean surfaces and walls of foot spa with soap or detergent and rinse with clean, clean water
3. disinfect with an EPA registered disinfectant with bactericidal, fungicidal, virucidal (and in some states tuberculocidal) efficacy, according to manufacturer's instructions
4. rinse and wipe dry with clean towel

At end of day:
1. remove screen and clean all debris trapped behind screen of each foot spa
2. wash screen and inlet with soap or detergent and a chlorine solution (5% chlorine bleach to 1 gallon of water), or wash screen with soap or detergent and clean, clear water
- totally immerse in EPA-registered disinfectant with bactericidal, fungicidal, virucidal (and in some states tuberculocidal) efficacy, according to manufacturer's instructions
3. flush system with low-sudsing soap and warm water for 10 minutes
- rinse, drain, and let air-dry

Every 2 weeks:
1. after following recommended daily cleaning procedure described above, fill foot spa tub (5 gallons) with water and 4 teaspoons of 5% bleach solution (a dose of 50 parts per thousand)
2. circulate solution through foot spa system for 5-10 minutes
3. let solution sit overnight (at least 6-10 hours)
4. following morning, in advance of first customer, drain and flush system