INTRODUCTION iv

ORIENTATION AND TRAINING 1

USE OF HEALTH CONSULTANTS 17

HEALTH APPRAISALS AND ASSESSMENTS 20

IMMUNIZATIONS 23

OCCUPATIONAL HAZARDS 25

GENERAL 25

EXPOSURE TO BODY FLUIDS 26

EXPOSURE TO TOXIC SUBSTANCES 29

INFECTIOUS DISEASES 34

HAEMOPHILUS INFLUENZAE TYPE B (Hib) 34

STREPTOCOCCUS PNEUMONIAE 36

NEISSERIA MENINGITIDIS (MENINGOCOCCUS) 37

PERTUSSIS 38

GROUP A STREPTOCOCCAL (GAS) INFECTION 39

TUBERCULOSIS 40

PARVOVIRUS B19 42

UNSPECIFIED RESPIRATORY TRACT INFECTION 42

HERPES VIRUSES 43

HERPES SIMPLEX 43

VARICELLA-ZOSTER (CHICKENPOX) VIRUS 44

CYTOMEGALOVIRUS (CMV) 45

ENTERIC (DIARRHEAL) AND HEPATITIS A VIRUS (HAV) INFECTIONS 46

BLOODBORNE INFECTIONS 50

HEPATITIS B VIRUS (HBV) 50

HYGIENE FOR HEPATITIS B VIRUS (HBV) INFECTION 52

HEPATITIS C VIRUS (HCV) 53

HUMAN IMMUNODEFICIENCY VIRUS (HIV) 53

ADMINISTRATIVE POLICIES ON HIV INFECTIONS 53

PREVENTING TRANSMISSION OF HIV INFECTION 55

SKIN INFECTIONS 55

SCABIES 55

PEDICULOSIS CAPITIS (HEAD LICE) 56

RINGWORM 56

INJURIES 57

NOISE LEVELS 58

STRESS 59

EXCLUSION DUE TO ILLNESS 60

PROHIBITED BEHAVIORS 63

PERSONNEL POLICIES AND RECORDS 65

APPENDIX B: MAJOR OCCUPATIONAL HEALTH HAZARDS 77

APPENDIX D: GLOVING 78

APPENDIX E: CHILD CARE STAFF HEALTH ASSESSMENT 79

APPENDIX BB: CONTACT INFORMATION 80

INDEX 83