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Transcript
OSHA
Occupational Safety
and Health
Administration
OSHA

Establishes and enforces standards that
protect workers from job-related illness and
injuries.
OSHA STANDARDS

The Occupational Exposure to Hazardous
Chemicals Standard

The Blood borne Pathogen Standard
The Occupational Exposure to
Hazardous Chemicals Standards

Requires the employers to inform employees
of all chemicals and hazards in the
workplace

Must provide the MSDSs (Material Safety
Data Sheets)
MSDSs provide





Product identification information about the
chemical
Protection or precautions that should be
used while handling the chemical
Instructions for safe use of the chemical
Procedures for handling spills, clean-up, and
disposal
Emergency first-aid procedures
Mandated training for MSDSs
proper procedure and policies





Identifying the types of chemicals
Locating and using the MSDS manual
Reading and interpreting chemical labels and
signs
Locating cleaning equipment and use of PPE
(personal protective equipment) goggles,
mask, gowns
Reporting accidents and exposures
BLOODBORNE PATHOGEN
STANDARD
Protects health care providers from diseases
caused by exposure to body fluids (i.e.. stool,
urine, semen, salvia, mucus)
Bloodborne Pathogens

Pathogenic microorganisms present
in human blood that
can lead to diseases
Human immunodeficiency virus (HIV)
Hepatitis B (HBV)

Hepatitis C (HCV)


Other Bloodborne Pathogens

Syphilis
 Malaria
 Brucellosis
 Babesiosis
 Leptospirosis
 Arborviral Infections
 Relapsing Fever
 Creutzfeld-Jacobs Disease--Mad-cow
 Viral Hemorrhagic Fever--Ebola
Potentially Infectious Materials –All Can
Transmit Hepatitis B, C, and HIV

Blood

Semen
Vaginal secretions
Cerebrospinal fluid
Pleural fluid
Pericardial fluid
Peritoneal fluid
Amniotic fluid
Saliva in dental proc.











Any visibly
contaminated body
fluid
Any body fluid where
differentiation is difficult
Any unfixed tissue or
organ
Aqueous and vitreous
humors in the eyes
Other Body Fluids

These body fluids do NOT have enough virus in
them to transmit disease UNLESS they are
contaminated with blood
–
–
–
–
–
–
Urine
Feces
Tears
Sweat
Vomitus
Spit
Modes of Transmission



Stick or Cut
Splash to mucous membranes of the eyes,
nose, mouth
Non-intact skin exposure
Universal Precautions



Must be observed
All blood and body fluids are treated as if
known to be infected with HIV, HBV, HCV,
etc.
Do not come into contact with another
person's blood or body fluids
Exposure Control Plan






Employer's plan describing how compliance with
the standard is achieved
Describes what employees are covered
Describes tasks that are covered
Describes post-exposure follow-up procedures
Must be reviewed and updated annually
Must be accessible to employees
– Every employee should know the procedure to
follow to obtain a copy
Exposure Control Plan

Safer Medical Devices
–
–
–
The Exposure Control Plan must be updated every
12 months to reflect evaluation, consideration, and
selection of appropriate devices
Document in the plan the devises evaluated and
those currently used
Front line employees must be involved in the
selection of devices
Handwashing




The single most important aspect of
infection control
Wash hands when contaminated with
blood or body fluids and after removing
personal protective equipment
Use antiseptic hand cleaner clean
paper/cloth towels or antiseptic towelettes
when "in the field"
Wash hands with soap and water asap
Needles/Sharp Objects







Use sharps with sharps injury prevention or needleless systems for
all procedures involving sharps
Place in puncture resistant, labeled, leak-proof containers for
transport, storage, and/or disposal
Keep the container closed
Do not bend, break, recap, or remove needles
Do not pick up contaminated broken glass directly with the hands
Do not reach by hand into containers where contaminated sharps
are placed
Do not overall sharps containers
Eating/Drinking


Do not eat or drink in
areas where there is
exposure to blood or
body fluids
Do not store food in
refrigerators, freezers,
cabinets, on shelves
or countertops where
blood or other body
fluids are present
Personal Protective Equipment
(PPE)




Wear PPE to prevent blood or body fluids
from getting on your clothes, skin,
underclothes, etc.
Must be provided at no cost to the employee
Employer must enforce the use
Must be removed prior to leaving the work
area and placed in designated area
PPE

Parental exposure
–

Mucous membrane
–

stick or cut
splash
Non-intact skin
–
spill or splash






gloves
gowns
glasses/ goggles
masks
pocket masks
shoe covers
Decontamination


Clean and decontaminate all equipment and
environmental and working surfaces after
contact with blood and/or body fluids
Decontaminate with appropriate disinfectant
–
–
–
EPA registered tuberculocidal disinfectant
EPA registered disinfectant with label stating it is
effective against HIV and HBV
Household bleach, diluted 1:10-1:100, made fresh
daily
Contaminated Laundry



Remove contaminated clothing when it
becomes contaminated
Place immediately in bag or container that is
labeled
Prevent leakage
Regulated Waste

Sharps containers
–
–
–

Needles
Blades
Broken glass
Red bags
–
–
–
–
–
Liquid or semi-liquid blood or
OPIM
Items caked with dried blood or
OPIM
Items that could release blood or
OPIM
Pathological waste
Microbiological waste
HEPATITIS

Hepatitis A HAV most common transmitted by feces,
salvia, and contaminated food. Vaccine available

Hepatitis B “serum hepatitis” is caused by HBV and
is transmitted by blood, serum, and other body
secretions. It affects the liver and cause scarring and
destruction of liver cells. Infectious for life and
vaccination available. Can cause liver cancer. Some
people never have any sign and symptoms but are
infectious.


Hepatitis C caused by hepatitis C virus or
HCV and is transmitted in blood and blood
containing body fluids. 50% of people
infected develop chronic hepatitis. Maybe
present for years before patient is aware of it
while destroying the liver. Leading cause for
liver transplant.
Hepatitis D is like A but not prevalent in this
country
Signs and Symptoms










May mimic the flu
Fatigue
Malaise
Headache
Sore throat
Sensitivity to light
Cough
Nausea
Vomiting
Jaundice stage dark color urine, clay colored stool, and skin is
yellow
PREVENTION FOR HEALTHCARE
WORKERS





Vaccination for A and B
Use standard precautions
Pay close attention to sharps
Do not use illegal drugs
Practice safe sex
Hepatitis B Vaccination

the HBV vaccination must be offered after the employee has
received training and within 10 working days of job assignment
– At no cost
– Provided by PLHCP
– According to US Public Health Service most current
recommendations
 “Immunization of Health Care Workers:
Recommendations of ACIP and HICPAC,” MMWR, Vol.
46, No. RR-18
HBV Vaccination






Employees who do not take the shots must sign a
declination statement
Highly recommended
Few contraindications
Three-shot series—titer 1-2 months after last shot
No booster currently recommended
Each person must have a health care professional's
written opinion
–
–
A copy must be provided to the employee within 15 days of
completion of the evaluation
An employee can decline now, take the shots later
Written Opinion

Each person must have a health care
professional's written opinion for hepatitis B
vaccination
–
A copy must be provided to the employee within
15 days of completion of the evaluation
AIDS

Acquired immunodeficiency syndrome is a worldwide epidemic
caused by human immunodeficiency virus (HIV). Must have an
HIV blood test performed to know if HIV positive.

Attacks the immune system
Spread thru :sexual secretions, blood, or from mother to fetus
during pregnancy, sharing intravenous needles.
CANNOT GET thru: casual contact, sharing toilet, telephones,
closed mouth kissing, mosquitoes, or tattooing.


Not everyone who comes in contact with will become infected.
Disease progression
Determined by the effect of the virus on the
protective white cells known as CD4 (T cells).
When number drops below 200cells/mm3
person diagnosed with AIDS

Symptoms: acute flulike, fever, night sweats,
fatigue, swollen lymph nodes, sore throat
Post-Exposure Follow-up

After exposure incident
–
–
–



Stick or cut
Splash
Non-intact skin exposure
At no cost
Begin ASAP after exposure incident
Report exposure incident to your supervisor
or designated personnel immediately
Post-Exposure Follow-up




Investigation of the incident
ID source individual, obtain consent, and test
their blood to determine HBV, HCV, and HIV
infectivity ASAP
Results of source individual's test given to
exposed person
Obtain and test exposed person's blood for
HBV, HCV, and HIV serological status
Labels


Containers with
contaminated items
Can substitute red
Training



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


For all employees listed in the Exposure
Determination
At no cost to employees
During working hours
At the time of initial assignment
Annually--within 1 year of last training date
Must be opportunity for interactive questions and
answers
Train employees on adopted safer needle devices
before implementation
Training

Five Easy Questions
–
–
What is universal precautions?
What do you do when there is a blood spill?



–
–
–
Personal protection
Clean-up and disposal procedures
Disinfection (hazard communication applies)
What do you do with contaminated sharps and
laundry?
Have you been offered the HBV vaccination free
of charge?
Where is the Exposure Control Plan?
Additional Training







Copy of the BBP standard, 29 CFR 1910.1030, must be
accessible to you
Explanation of methods of recognizing tasks that may
involve exposure to blood and/or body fluids
Information on types, use, location, removal, handling,
decontamination, and disposal of ppe
Basis of selection of ppe
Actions to take and persons to contact in a bloodborne
emergency that you do not know how to handle
Procedure to follow if exposure incident occurs
Opportunity for interactive Q & A
Records

Medical records
–
–
–
–
–
–
Name and social security number
HBV vaccination status
Results of exposure incident follow-up
Health care professional's written opinions
Info provided to health care professional
Confidential
Records

Training
–
–
–
–
Dates
Contents
Names and qualifications of trainers
Names and titles of persons attending
Records

Sharps Injury Log
–
–
Per the Tennessee Sharps Injury
Prevention law
Keep a log of all sharps injuries with
 Type
and brand of device involved in the
incident
 Department or work area where the incident
occurred
 Explanation of how the incident occurred
Resources
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www.osha.gov
www.tennessee.gov/labor-wfd/tosha
www.cdc.gov
www.cdc.gov/niosh
Memphis Office
901-543-7259
Jackson Office
701-423-5641
Nashville Office
615-741-2793
1-800-249-8510
Knoxville Office
865-594-6180
Kingsport Office
423-224-2042
Chattanooga
423-634-6424
Consultative Services
1-800-325-9901