ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of August 28, 2018 No. KR DSM-8

About approval of Health regulations "Sanitary and epidemiologic requirements to the organization and carrying out disinfection, disinsection and deratization"

According to Item 6 of article 144 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" PRIKAZYVAYU:

1. Approve the enclosed Health regulations "Sanitary and epidemiologic requirements to the organization and carrying out disinfection, disinsection and deratization" according to appendix 1 to this order.

2. Recognize invalid some orders of the Minister of national economy of the Republic of Kazakhstan according to appendix 2 to this order.

3. To provide to committee of protection of public health of the Ministry of Health of the Republic of Kazakhstan in the procedure established by the legislation of the Republic of Kazakhstan:

1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;

2) within ten calendar days from the date of state registration of this order the direction it the copy in electronic form in the Kazakh and Russian languages in the Republican state company on the right of economic maintaining "The republican center of legal information" for official publication and inclusion in Reference control bank of regulatory legal acts of the Republic of Kazakhstan;

3) placement of this order on Internet resource of the Ministry of Health of the Republic of Kazakhstan after its official publication;

4) within ten working days after state registration of this order submission to Department of legal service of the Ministry of Health of the Republic of Kazakhstan of data on execution of the actions provided by subitems 1), 2) and 3) of this Item.

4. To impose control of execution of this order on the supervising vice-Minister of Health of the Republic of Kazakhstan.

5. This order becomes effective after twenty one calendar days after day of its first official publication.

It is approved Minister of Education and Science of the Republic of Kazakhstan 2018

________________ E.Sagadiyev

It is approved Minister of national economy of the Republic of Kazakhstan 2018

________________ T. Suleymenov

Appendix 1

to the Order of the Minister of Health of the Republic of Kazakhstan of August 28, 2018 No. KR DSM-8

Health regulations "Sanitary and epidemiologic requirements to the organization and carrying out disinfection, disinsection and deratization"

Chapter 1. General provisions

1. These Health regulations "Sanitary and epidemiologic requirements to the organization and carrying out disinfection, disinsection and deratization" (further - Health regulations) establish sanitary and epidemiologic requirements to the organization and carrying out disinfection, disinsection and deratization for all subjects irrespective of pattern of ownership.

2. In these Health regulations the following concepts are used:

1) the current disinfection - disinfection which is carried out with the regularity established for each nosological form so far the patient is in the disease center;

2) midges - the integrated name of group of the blood-sicking flying insects (mosquitoes, gadflies, midges, mokrets, mosquitoes) doing harm to health of the person;

3) field disinsection - extermination of blood-sicking insects and pincers outside the settlement for the purpose of general decrease in their number or creation of protective zones around places of stay of people;

4) field deratization - extermination of rodents for the purpose of decrease in their number and prevention of development of epizooty of diseases, dangerous to people;

5) disinfection - complex of the special events directed to destruction of causative agents of infectious and parasitic diseases in the external environment;

6) the disinfection equipment - the devices and installations intended for carrying out disinfection, presterilizing cleaning, sterilization, disinsection and deratization;

7) disinfectants (further - dezsredstvo) - the chemical and biological means intended for carrying out disinfection (disinfectants), presterilizing cleaning, sterilization (sterilizing means), disinsection (disinsection means), deratization (deratization means) and also repellent means and pedikulitsida;

8) disinsection - complex of preventive and destructive actions for extermination of insects and arthropods for the purpose of protection from them of the person, animals, rooms and the territory;

9) deratization - complex of the preventive and destructive actions directed to destruction or decrease in number of rodents;

10) disinfection of high level - disinfection in case of which all pathogenic and opportunistic microorganisms are destroyed and quantity the dispute decreases;

11) imago - adult (polovozrely) stage of development of arthropods;

12) insecticides (acaricides, insektoakaritsida) - means (medicines), the chemical nature used for extermination of insects and pincers;

13) chamber disinfection - disinfection and disinsection in disinfection cameras;

14) barrier deratization - creation of protective strip at least 200 meters wide around permanent or temporary settlements, and also in vacation spots of the population, improving organizations for extermination of rodents with use of any of the existing methods (physical, chemical, biological) for the purpose of the prevention of migrations of rodents, carriers of infections;

15) settlement disinsection - extermination of harmful insects, pincers and other arthropods within the settlement;

16) settlement deratization - extermination of rodents in premises (buildings), outdoor constructions, livestock, production, storage and other facilities, and also in the open territory within the settlement;

17) the application mode - set of the regulations characterizing use of disinfectant including concentration of active ingredient in the used preparative form, medicine consumption, processing time, frequency rate and the area of processings, use of excipients and methods;

18) final disinfection - disinfection which is carried out in the center after hospitalization, isolation, recovery or the death of the patient;

19) disinfection of the average level - disinfection in case of which there is destruction of bacteria (including tuberculosis mikobakteriya), viruses (including polioviruses), mushrooms, but does not happen destruction dispute;

20) the center - the place of stay of the patient with infectious or parasitic disease with the territory surrounding it in those limits in which the causative agent of infection is capable to be transferred from the patient to susceptible people;

21) focal disinfection - the disinfection which is carried out in the centers for the purpose of prevention and (or) liquidation of infectious and parasitic diseases;

22) preparative form - form of release and (or) use of disinfectants;

23) repellent means - the chemical means which are frightening off arthropods or rodents;

24) rodenticides (ratitsid) - medicines (means) intended for fight against rodents;

25) sterilization - elimination of all types of activators, including dispute, by impact on them physical, chemical, thermal or the mixed methods;

26) disinfection of low level - disinfection in case of which there is destruction of bacteria, some mushrooms, viruses, but not effective concerning such steady bacteria as tuberculosis mikobakteriya.

3. Holding disinfection, disinsection and deratization actions is performed according to article 152 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" (further - the Code).

4. The full age persons which do not have contraindications for health reasons are allowed to work with dezsredstvo. The specialists involved with dezsredstvo (dezinstruktor, the disinfector, deratizator), have each 5 years professional training on disinfection, disinsection, deratization and annually - instructing in questions of safe implementation of works, rendering the first pre-medical aid in case of poisoning with dezsredstvo.

5. Storage and transportation of disinfectants is carried out according to Item 3 of article 156 of the Code.

6. Dezsredstva are stored in container (packaging) of the supplier with indication of the name of means, its appointment, expiration date on the label. The tare label remains during the entire period of storage (use) of dezsredstvo.

7. The means allowed for use in the territory of the Republic of Kazakhstan and the Eurasian Economic Union are applied to carrying out disinfection, disinsection and deratization. Danger of dezsredstvo is established according to classification of danger of means of disinfection, disinsection, the deratization specified in appendix 1 to these Health regulations. Conditions of application of dezsredstvo are determined by degree of their danger:

1) use in the enclosed space of extremely dangerous means (1 class) is not allowed;

2) is not allowed to be used in the organizations of education, the organizations of education for orphan children, children without parental support, the organizations of health care, on objects of public catering and in premises highly hazardous means (the 2nd class). On other objects their application only by the trained personnel in absence of other people with the subsequent obligatory airing and cleaning (the 2nd class) is allowed;

3) moderately dangerous means (3rd class) are allowed for use by the trained personnel in rooms of any type and the population in life, but with obligatory regulation of conditions of application (medicine consumption, the airing mode, cleaning);

4) a little dangerous means (the 4th class) are permitted for use without restriction of scopes of application.

8. In case of expiry date, availability of signs of unfitness (change of color, availability of foreign elements) of dezsredstvo are written off and destroyed.

Chapter 2. Sanitary and epidemiologic requirements to the organization and carrying out disinfection

9. Disinfection in rooms by methods of irrigation, opylivaniye, wiping is carried out by the medicines having irritant action and causing allergic reactions in the absence of other people.

10. The consumption of disinfectants when disinfecting separate objects is calculated according to regulations of planning of disinfectants when disinfecting the separate objects specified in appendix 2 to these Health regulations.

11. The current disinfection in the center of infectious disease is carried out to the period from the moment of identification of the patient before hospitalization, in case of treatment at home - before recovery, at rekonvalestsent and bacillicarriers - before complete sanitation.

12. The current disinfection will be organized by the health worker of the organization of health care and is carried out by person who is looking after the patient, rekonvalestsenty or the bacillicarrier.

13. Final disinfection is carried out by disinfection stations or disinfection departments (departments), the state organizations performing activities in the sphere of sanitary and epidemiologic wellbeing of the population.

14. Final disinfection is performed in the centers of infectious and parasitic diseases within a day from the moment of hospitalization, isolation, recovery or the death of the patient.

15. The application for carrying out final disinfection in the centers of infectious diseases is submitted by phone by the specialist of state body of sanitary and epidemiologic service in the sphere of sanitary and epidemiologic wellbeing of the population to departments (departments) of the state organizations performing activities in the sphere of sanitary and epidemiologic wellbeing of the population, disinfection stations, antiplague organizations after isolation, hospitalization of the patient, change of the diagnosis, death.

16. Calculation of requirement of the organization of health care for disinfectants is carried out according to appendix 3 to these Health regulations.

17. Satisfactory assessment of observance of the modes of disinfection and sterilization is determined by the following indicators:

1) seeding of not pathogenic microflora from objects of control no more than 5 percent (further - %) the selected bacteriological washouts taken not later than 50 minutes after the current disinfection;

2) respect for the concentration of solutions of disinfectants recommended by instructions for application;

3) identification of unsatisfactory express tests on residual amount of disinfecting substances no more than in 5% of number of the delivered tests of each type;

4) compliance of test bacteriological control to the mode of chamber disinfection;

5) lack of positive tests on residual amount of blood;

6) lack of positive tests on residual quantity of alkaline components of the synthetic washing substances and remaining balance of oil medicines;

7) sterilization mode compliance, lack of unsterile material (elimination of vegetative and sporous forms of microorganisms).

18. Quality of the current disinfection in the centers is estimated by specialists of territorial subdivisions of department of state body in the sphere of sanitary and epidemiologic wellbeing of the population using laboratory methods at least at 5% of the centers, fence at least 10 bacteriological washouts from one center, 1 test (solid), 1 test of working solution of disinfectants.

19. Quality of disinfection is considered satisfactory if the number of positive washouts on availability of not pathogenic microflora makes no more than 3% of number of the selected washouts, the number of negative express tests on availability of residual amount of disinfectant makes no more than 5%, the number of unsatisfactory analyses of disinfecting solutions constitutes not higher than 5% of number of the selected tests.

20. When seeding pathogenic microflora after carrying out final disinfection, the last is considered unsatisfactory and is carried out repeatedly with the subsequent quality control of disinfection.

21. The quality evaluation of the organization of work on final disinfection is determined by the following indicators:

1) scope processing of the infectious centers from number of subjects of final disinfection - at least 95%;

2) timeliness of carrying out final disinfection - at least 95% (accomplishment of final disinfection in the infectious centers within a day from the moment of hospitalization or isolation of the patient from organized collective);

3) scope chamber disinfection - at least 95%, from number of the subject centers;

4) scope of the centers quality control of final disinfection:

in case of visual survey - at least 10% of total quantity of the carried-out disinfection. Using laboratory methods - at least in 10% of all centers during from 1 to 3 hours after the end of disinfection.

22. For disinfection quality evaluation on health care facilities are carried out:

1) quality of disinfection is carried out by selection of washouts from objects and the equipment in hospitals from calculation 0, by washout % for one bed, but at least 30 washouts, in the out-patient and polyclinic organizations from calculation of 0,2 of % of washout for one visit;

2) research of tests of disinfectants, working solutions of disinfectants at least 2 tests of different type. When sampling date of selection of test, date of preparation of disinfecting solution, its concentration, the application purpose are celebrated;

3) overall performance of disinfection cameras is performed by bookmark in three planes of the camera till 5-10 of bacterial (chemical) tests depending on its type and amount. The quality evaluation of sterilization is carried out in case of observance of conditions of sterilization, sterility of products of medical appointment and the air circle.

23. Air in rooms of hospitals (departments) of surgical profile is disinfected by the following methods:

1) impact by ultra-violet radiation by means of the opened and combined bactericidal irradiators applied in the absence of people, and the closed irradiators, including the retsirkulyator allowing to carry out disinfecting of air in the presence of people;

2) impact by aerosols of disinfectants in the absence of people by means of the special spraying equipment (generators of aerosols) when carrying out final disinfection;

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