Download OSHA What are pathogens?

OSHA
Bloodborne Pathogen Standard
Infectious Diseases
Bill Edstrom, Epidemiologist
Spokane Regional Health District
Who is Covered?
• All employees who may
reasonably expect to be
exposed to blood and
OPIM that may contain
pathogens
• Designed to eliminate or
minimize employees’ exposure
to human blood and other
potentially infectious materials
(OPIM) in the workplace
What are pathogens?
Germs transmitted from one person to another
through contact with blood or OPIM
• Anyone whose job
involves handling or
possibly being exposed to
blood or blood products,
or OPIM
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Caution!
You do NOT need to
directly contact someone
carrying a bloodborne
pathogen to be at risk for
exposure!
Risks also come from:
• Clinical specimens
• Biohazardous trash
• Blood- or body fluidsoaked laundry
• Needles or sharps
Exposure Control Plan
• OSHA requirement
• Must describe:
–
–
–
–
Exposure prevention
Engineering and work practice controls
Universal precautions
Personal protective equipment
Annual Training Required:
• How diseases are transmitted and their symptoms
• Protective measures to prevent exposure
• Procedures to be followed if exposed
Infectious Disease Transmission
•
Stages of Disease
Transmission:
1. Someone has an infection
2. The infectious pathogen
leaves the
Infected person’s body
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Serious Bloodborne Pathogens
Infectious Disease Transmission:
3. The infectious pathogen
reaches another person and
enters his or her body.
Transmission:
- Bloodborne
- Airborne
- Vector
- Direct or indirect contact
4. The second person
develops the infection.
Hepatitis A
Hepatitis B
Hepatitis C
Transmission
Person-to-Person
through fecal-oral
Exposure to fecally
contaminated
food/water
Blood/Semen
OPIM
All Body Fluids
Contaminated needles
Unclean
tattoo/piercing tools
Sharing contaminated
items
Signs &
Symptoms
Fever
Fatigue
N/V
ABD pain
Dark Urine
Clay-colored stool
Joint pain
Loss of appetite
Jaundice
Flu-like symptoms
Loss of Appetite
Nausea
Fatigue
Muscle/joint aches
Mild fever
Stomach pain
Jaundice
MOST INFECTED
PEOPLE DO NOT
HAVE SYMPTOMS
Severity
Symptoms last < 2
months, can last up to
6 months
Major liver damage
Cirrhosis
Liver CA
Infection for decades
No Cure –
Prevention is
critical
Prevention
Vaccine
Vaccine
No Vaccine
•Fatigue
•Loss of appetite
•Nausea
•Anxiety
•Weight Loss
•Alcohol Intolerance
•Abdominal pain
•Loss of concentration
•Jaundice
•
Hepatitis B virus (HBV)
•
Hepatitis C virus (HCV)
•
Human immunodeficiency
virus (HIV)
Measures
• Measures you take to
prevent HBV, HCV,
and HIV also help
prevent diseases
caused by other
bloodborne
pathogens
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HIV and AIDS
Do Exposures Always Cause Infection?
• NO
• Whether pathogens are
present in the source
blood or body fluid
• The risk of infection
• after an exposure
depends
• on:
•
Acquired immunodeficiency syndrome (AIDS) is caused by the
human immunodeficiency virus (HIV)
• The number of pathogens
present
•
There are almost one million HIV-positive people in the U.S.
• The type of injury or
exposure
• Your current health and
immunization status
HIV and AIDS
HIV and AIDS
• AIDS damages cells essential for immune function
Transmission
Through an infected person’s body fluids
Signs & Symptoms
One quarter of the HIV-infected persons in the U.S.
do not know that they are infected.
Loss of appetite
Fever
Swollen lymph nodes
Night sweats
Inability to fight off infection
• People with AIDS are more susceptible to opportunistic
infections
• The disease is eventually fatal
Severity
Life-long
Prevention
No Vaccine
Weight Loss
Skin rashes
Diarrhea
Tiredness
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OSHA Standard
• Requires employers to use strategies to reduce
occupational exposures:
Prevention
• Engineering controls
• Work practice controls
• Personal protective equipment
• Universal precautions
Engineering Controls
Work Practice Controls
• Needleless systems
• Use of personal protective equipment (PPE)
• Eye wash stations
• Handwashing
• Handwashing facilities
• Decontamination and sterilization of equipment
and areas
• Biohazard labels
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Personal Protective Equipment
• Gloves
OSHA Standard
Requires that your employer:
• Jumpsuits, aprons
– Provide PPE at no cost
• Eye shields, goggles
– Train you how to use equipment
• Face masks, face shields
– Must clean, repair, or replace it as needed
• Caps
• Booties
For Unexpected Exposure
Employer Responsibilities
•
If blood or OPIM splashes in your eyes or other mucous membranes, flush
area with running water for 20 minutes
• Identify and document source of blood or OPIM
•
Wash any exposed area well with soap, using an antibacterial soap
• Obtain consent and arrange to test the source blood
– Gently treat any scabs and sores
• Inform you of the test results
• Report the exposure to your supervisor
• Arrange for you to have your blood tested
• Save any potentially contaminated object for testing
purposes
• Arrange counseling and medical care for you as needed
• Seek medical care
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Three Types of Airborne Pathogens
• Viral
Airborne Pathogens
• Bacterial
• Fungal
Airborne Pathogens
• Precautions for tuberculosis also lower the risk
for other airborne pathogens
– Meningitis
– Influenza
– Pneumonia
– Tuberculosis
Airborne Pathogens
• Spread by inhaling the germ
• Coughing or sneezing tiny droplets of moisture
into the air containing pathogens
• Pathogens can remain airborne for several
hours
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Airborne Transmission
• Depends On:
– How contagious the
infectious person is
Tuberculosis
Transmission
Signs & Symptoms
Many people with TB infection
have no symptoms!
Weight loss
Fever
Night sweats
Feeling weak
– Where the exposure occurs
– How long the exposure
lasts
Inhaling the TB pathogen after an
infected person coughs or sneezes
Severity
Skin test cannot distinguish between TB
infection and TB disease
Chest x-ray and phlegm sample needed to
determine diagnosis
– How healthy you are at the
time of the exposure
Prevention
Engineering Controls
H1N1 and EMS
H1N1 (“Swine Flu”)
• EMS personnel should stay more than 6 feet away from
patients and bystanders with symptoms and exercise
appropriate routine respiratory droplet precautions while
assessing all patients for suspected cases of swineorigin influenza.
• Assess all patients for symptoms of acute febrile
respiratory illness (fever plus one or more of the
following: nasal congestion/ rhinorrhea, sore throat, or
cough).
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H1N1 and EMS
H1N1 and EMS
• If no acute febrile respiratory illness, proceed
with normal EMS care.
• If symptoms of acute febrile respiratory illness,
then assess all patients for travel to a
geographic area with confirmed cases of swineorigin influenza within the last 7 days or close
contact with someone with travel to these areas.
Questions
• If travel exposure, don appropriate PPE for suspected
case of swine-origin influenza.
• If no travel exposure, place a standard surgical mask on
the patient (if tolerated) and use appropriate PPE for
cases of acute febrile respiratory illness without
suspicion of swine-origin influenza (as described in PPE
section).
Contact: Renee Anderson
509-232-8155
1-866-630-4033
[email protected]
Fax: 509-232-8168
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