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Bloodborne Pathogens This training module is designed to provide a basic understanding of bloodborne pathogens, common modes of their transmission, methods of prevention, and other pertinent information. This program is designed to meet the requirements of the Occupational Safety and Health Administration‘s (OSHA) Bloodborne Pathogens Standard, 29 CFR 1910.1030. Athelas Institute, Inc. Developed from Oklahoma State University Bloodborne Pathogens Training http://img.docstoccdn.com OSHA’s official Bloodborne Pathogens Standardmay be found at: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_ table=STANDARDS&p_id=10051 What are Bloodborne Pathogens? • Microorganisms such as viruses or bacteria that are carried in the blood and can cause disease. • There are many types including malaria, syphillis, and brucellosis • Human Immunodeficiency Virus (HIV) and Hepatitis B (HBV) are the two specifically addressed by OSHA’s standards. HIV HBV • HIV is the virus that leads to acquired immunodeficiency syndrome (AIDS). A person can carry HIV for many years and not have symptoms until it turns into full-blown AIDS. • AIDS attacks the person's immune system, which makes it difficult for the body to fight off disease. • Scientists and medical authorities agree that HIV does not survive well outside the body. Drying of HIV-infected human blood or other body fluids reduces the risk of environmental transmission to essentially zero. • HIV is found in very low quantities in saliva and tears in some AIDS patients. HIV has not been found in the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in the transmission of HIV. • 1–1.25 million Americans are chronically infected • Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting • May lead to chronic liver disease, liver cancer, and death • Vaccination available since 1982 • HBV can survive for at least one week in dried blood HIV Stages of Progression • First stage: happens when a person is actually infected with HIV. May show no or few signs of illness for many years. • Second stage: an individual may begin to suffer swollen lymph glands or other lesser diseases, which begin taking advantage of the body’s weakened immune system. The second stage is believed to eventually lead to AIDS. • Third stage: the body is completely unable to fight off life threatening diseases and infections HIV Symptoms • Symptoms of HIV infection can vary, but often include: – – – – – – – – – Weakness Fever Sore throat Nausea Headaches Diarrhea White coating on the tongue Weight loss Swollen lymph glands HBV Symptoms • Symptoms of HBV infection include: Much like the mild “flu” Fatigue Stomach pain Loss of appetite Nausea Jaundice (yellowing of skin) and darkened urine will occur as the disease progresses – Can take 1-9 months before symptoms become noticeable – – – – – – What do you do if you think you have been exposed to HIV or HBV? Exposure Consult with your physician or doctor ASAP Semen Any body fluid that is visibly contaminated with blood Saliva Vaginal secretion Bloodborne Pathogens: Modes of Transmission Amniotic fluid Cerebrospinal fluid Synovial fluid Peritoneal fluid Pleural fluid HIV and HBVare most commonly transmitted through: Sexual contact Sharing of hypodermic needles From mothers to their babies at/before birth Accidental puncture from contaminated needles, broken glass, or other sharps • Contact between broken or damaged skin and infected body fluids • Contact between mucous membranes and infected body fluids • • • • Accidental puncture from contaminated needles and other sharps can result in transmission of bloodborne pathogens. http://i.istockimg.com http://www.sodahead.com http://1.bp.blogspot.com In most work places or laboratories, transmission is most likely to occur because of accidental puncture from contaminated needles, broken glass, or other sharps; contact between broken or damaged skin and infected body fluids; or contact between mucous membranes and infected body fluids. For example, if someone infected with HBV cut his or her finger on a piece of glass, and then you cut yourself on the now infected piece of glass, it is possible that you could contract the disease. Anytime there is blood-to-blood contact with infected blood or body fluids, there is potential for transmission. UNBROKEN SKIN FORMS AN IMPERVIOUS BARRIER AGAINST BLOODBORNE PATHOGENS. HOWEVER • Infected blood can enter your system through: – – – – – http://media.photobucket.com Open sores Cuts Abrasions Acne Any sort of damaged or broken skin such as sunburn or blisters • Bloodborne Pathogens may also be transmitted through mucous membranes: – Eyes, nose, mouth http://www.functionalnutrition.eu Personal Protective Equipment Work Practices Engineering Controls It is extremely important to use personal protective equipment and work practice controls to protect yourself from bloodborne pathogens Universal Precautions • A prevention strategy in which all blood and potentially infectious materials are treated as if they are, in fact, infectious, regardless of the perceived status of the source of the individual. WHETHER YOU THINK THE BLOOD/BODY FLUID IS INFECTED WITH BLOODBORNE PATHOGENS OR NOT, YOU TREAT IT AS IF IT IS. Personal Protective Equipment • The first thing you should do in any situation where you may be exposed to bloodborne pathogens is to ensure you are wearing personal protective equipment. • For example, you probably see medical personnel, doctors, nurses, dentists, dental assistants, etc. wear latex or protective gloves as a precaution. http://www.fulloma.com • Rules to follow: To protect yourself, it is essential to have a barrier between you and the potentially infectious material. – Always wear personal protective equipment in exposure situations – Remove personal protective equipment that is torn or punctured, or has lost its ability to function as a barrier to bloodborne pathogens – Replace personal protective equipment that is torn or punctured – Remove personal protective equipment before leaving work http://www.kchealthcare.com What to Wear & When… If you are working in an area with routine exposure to blood or potentially infectious materials, the necessary personal protective equipment should be readily accessible. Contaminated gloves, clothing, personal protective equipment, or other materials should be placed in appropriately labeled bags or containers until it is disposed of, decontaminated, or laundered. It is important to find out where these bags or containers are located in your area before beginning your work. • Bleeding control—latex gloves • Spurting blood—latex gloves, protective clothing (smocks or aprons), respiratory mask, eye/face protection (goggles, glasses, or face shield) • Post-accident cleanup—latex gloves • Janitorial work—latex gloves Personal Protective Equipment GLOVES • • • • • Should be made of latex, nitril, rubber, or other water impervious materials. Double gloving provides an additional layer of protection for thinner gloves If you have a cut or sore already, these should be covered with a bandage before wearing gloves If a glove is damaged (tear or puncture), don’t use it! When removing gloves, do not touch the outside of the gloves with any bare skin, and be sure to dispose in a proper container. http://www.ehs.okstate.edu Personal Protective Equipment GOGGLES • Used when there is a risk of splashing or vaporization of contaminated fluids. • Bloodborne pathogens can be transmitted through thin membranes of the eye (protect them!) http://img.directindustry.com Personal Protective Equipment FACE SHIELD • Will protect against splashed to the nose and mouth. • Provides additional face protection when worn with goggles. APRONS • Helps protect clothing and keeps blood or other contaminated fluids from soaking through to the skin. * Clothing that becomes contaminated with blood should be removed as soon as possible because fluids can seep through and come in contact with the skin. Contaminated laundry should be handled as little as possible, and should be placed appropriately in a labeled bag or container until it becomes decontaminated, disposed of, or laundered. Be Creative http://www.tiricosuave.com • If you find yourself in a situation where you have come in contact with blood or other body fluids and you don’t have standard personal protective equipment handy, be creative, but cautious! http://1.bp.blogspot.com Hygiene Practices HANDWASHING • The most important practice used to prevent transmission • The easiest practice used to prevent transmission • Hands or other skin should be thoroughly following exposure • Use antibacterial soap if possible and avoid harsh soaps that might open fragile scabs or sores NEVER EAT, DRINK, OR SMOKE • If you are working in an area where there is reasonable likelihood of exposure (i.e. a lab), you should never: – – – – – Eat Drink Smoke Apply cosmetics or lip balm Handle contact lenses Decontamination & Sterilization • All surfaces and equipment that come in contact with blood or potentially infectious material must be contaminated and sterilized ASAP. • Decontamination should be done by: • Using a solution of household bleach diluted between 1:10 and 1:100 with water (10% bleach = 1/4 cup bleach per one gallon of water). • Lysol or some other EPA-registered tuberculocidal disinfectant (check labels to make sure they meet this http://www.ehs.ku.edu requirement) Decontamination & Sterilization • If/when cleaning up a blood spill: – Carefully cover the spill with paper towels or rags. – Pour the 10% solution of bleach over the towels or rags and let soak for at least 10 minutes. • This process ensures any bloodborne pathogens are killed before you begin cleaning or wiping the material. • You should also leave disinfectant in place for 10 minutes also when decontaminating equipment and other objects. • By covering the spill before using the disinfectant, you are decreasing the risk for splashing and vaporization. Sharps Needles Broken Glassware • Handle & dispose of carefully to avoid contact or puncture • Must be disposed in sharps container • Sharps containers must be closeable, puncture-resistant, leak-proof on sides and bottom, and must be labeled or color-coded • When moving sharps containers, make sure the container is closed to prevent spilling or protrusion of contents. • Needles should never be recapped • Needles should be moved only by using a mechanical device or tool such as forceps, pliers, or broom and dustpan • Should be disposed of in labeled sharps container only • Broken glass visibly contaminated with blood must be sterilized with an approved disinfectant solution before it is disturbed or cleaned up. • Decontaminated glassware may be disposed of in a sharps container. • Broken glassware with no visible contamination should not be picked up with the hands, but swept into a dustpan. • Uncontaminated glassware may be disposed of in a puncture resistant, closeable container (cardboard box, coffee can) Exposure Controls • Warning labels must be affixed to containers of regulated waste, refrigerators, and freezers containing blood or other potentially infectious materials. – Labels are fluorescent orange, red, or orange-red • Bags used to dispose of regulated waste must be red or orange-red, and they must have the biohazard symbol readily visible. • Regulated waste should be double bagged http://24.media.tumblr.com Exposure Controls REGULATED WASTE • • • • • Any liquid or semi-liquid blood or other potential infectious materials Contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed Items that are cracked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling Contaminated sharps Pathological and microbiological wastes containing blood or other potentially infectious materials NON-REGULATED WASTE • • • Does not fit the definition of any regulated waste. Non-regulated waste that is not generated by a medical facility such as the Student Health Center, Wellness Center, or human healthrelated research laboratory may be disposed in regular plastic trash bags if it has been decontaminated or autoclaved prior to disposal. All bags containing such materials must be labeled, signed, and dated, verifying that the materials inside have been decontaminated according to acceptable procedures that pose no health threat. Emergency Procedures • In an emergency situation involving blood or potentially infectious materials, you should always use Universal Precautions and try to minimize your exposure by wearing gloves, splash goggles, packet mouth-to-mouth resuscitation masks, and other barriers. If blood is splashed into the eye or mucous membrane, flush the affected area with running water for at least 15 minutes Exposure Wash the exposed area thoroughly with soap and running water. Use nonabrasive, antibacterial hand soap. Report the exposure to your supervisor ASAP Fill out an exposure report form, if you desire. This form will be kept in your file for 40 years. You may request blood testing or Hepatitis B vaccination if you have not already received it. Hepatitis B Vaccinations • Employees who have routine exposure to bloodborne pathogens shall be offered the Hepatitis B vaccine series at no cost to themselves unless: – They have previously received the vaccine – Antibody testing has revealed they are immune – The vaccine is contraindicated for medical reasons • Although your employer must offer the vaccine to you, you do not have to accept that offer. You may opt to decline the vaccination series, in which case you will be asked to sign a declination form. • If you decline the offer, you may still receive the series at anytime during your employment thereafter. Hepatitis B Vaccinations • If you are exposed to potentially infectious materials on the job, you may request a Hepatitis B vaccination at that time. • If the vaccine is administered immediately after exposure, it is extremely effective at preventing the disease. • The vaccination is given in a series of 3 shots. The second is given one month after the first, and the third is given five months after the second. This builds the body’s immunity to the virus. • There is no danger of contracting the disease from the vaccination. • Once vaccinated, there is no need to receive the series again. • Booster shots are available, and may be recommended (for example, if there is an outbreak at a particular location.) http://www.messianictrust.org