Download Powerpoint Document What is Your Responsibility?

Bloodborne Pathogens….
What Is Your
Responsibility?
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Courtesy of Schools Insurance Authority
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Objectives
• Describe the modes of transmission and
symptoms of bloodborne pathogens
• List universal precautions, engineering
controls, work practices and personal
protective equipment (PPE) necessary to avoid
infection.
• Describe the efficiency, safety and benefits of
HBV vaccine.
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Objectives
• Explain what to do if there is blood exposure.
• Identify the location of the exposure control
plan and the Cal-OSHA standard.
• Identify potentially hazardous situations at the
worksite and explain how to avoid the risk of
bloodborne pathogen exposure
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Infection- A major cause of disease and death in man
Microorganisms that cause disease:
– Viruses
– Bacteria
– Rickettsiae
– Protoza
– Fungi
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Some Familiar Viral Diseases:
•AIDS
•Shingles
•Mumps
•Chickenpox
•Common Cold
•Smallpox
•Herpes
•Influenza
•Mononucleosis
•Hepatitis
•Polio
•Measles
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Conditions Needed for Infection to Occur:
1.
2.
3.
4.
A germ.
A “vehicle” to carry the germ.
A “route” for the germ to get into the body.
A weak immune system or lots of strong
germs.
Remember: Germs are Everywhere!
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Diseases in the Blood
HEPATITIS B Virus (HBV) – causes hepatitis, an
inflammation of the liver.
HUMAN IMMUNODEFICIENCY VIRUS (HIV) – causes
Acquired Immune Deficiency Syndrome (AIDS).
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Hepatitis B Virus
 Incubation Period

6 weeks to 6 months
 Symptoms



May or may not be symptomatic
Mild to severe to fatal
Loss of appetite, fatigue, nausea, vomiting, abdominal
pain, jaundice, dark urine,
 Progression



Acute hepatitis – 50%
Carriers – 10% (at high risk for chronic liver disease,
cirrhosis, liver cancer and are infectious to others)
Death – 1% with acute hepatitis
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Transmission of Hepatitis B Virus
•
•
•
•
•
•
•
•
Break in skin
Mucus Membrane Exposure
Sexual Contact
Contaminated Needles
Before or During Birth
Inanimate Objects
Saliva/Human Bite
Blood Transfusion – can screen for virus
Not Easily Transmitted
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Risk Factors Associated with
Reported Hepatitis B, 1990-2000, United States
Other*
Injection drug use
14%
15%
Sexual contact with
hepatitis B patient
13%
Household contact of
hepatitis B patient
2%
Men who have
sex with men 6%
Unknown 32%
Blood transfusion
0%
Medical
Employee 1%
Multiple sex partners
Hemodialysis 0%
17%
*Other: Surgery, dental surgery, acupuncture, tattoo, other percutaneous injury
Source: NNDSS/VHSP
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Hepatitis B Vaccine
• Efficacy: 85-95% effective. Effective for
approximately 10 years.
• Safety, Side Effects: Very safe – will not cause
Hepatitis B.
• Administration: Intramuscular injection in arm – 3
doses over 6 months.
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Hepatitis B Vaccine
• Benefits: Confers immunity to Hepatitis B
disease.
Offered free of charge to employees with
occupational risk of exposure to blood.
• Declination of Vaccine: Identified at risk
employees must sign a form if they do not
wish to have the Hepatitis B vaccine.
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Trends & Statistics
• Number of new infections per year have declined
from an average of 260,000 in the 1980’s to about
60,000 in 2004.
• Highest rate of disease occurs in 20-49 year olds.
• Greatest decline has happened among children and
adolescents due to routine hepatitis B vaccination.
• Estimated 1.25 million chronically infected
Americans, of whom 20-30% acquired their infection
in childhood
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HIV – Human Immunodeficiency Virus
• Human – refers to a virus whose host is a
person.
• Immunodeficiency – decreasing immune
function in a person.
• Virus – an organism which infects and
destroys cells.
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AIDS – Acquired Immune Deficiency
Syndrome
• Acquired – not inherited.
• Immune – dealing with the body’s defense system.
• Deficiency – decreased defense capability.
• Syndrome – observable set of clinical signs and
symptoms.
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AIDS in California 1983-2006
143,946 AIDS cases
82,989 Deaths
Top 10 AIDS Counties as of
December 2006:
Los Angeles
52,042
San Francisco
26,991
San Diego
13,032
Alameda
6,979
Orange
6,958
Riverside
5,199
Santa Clara
3,754
Sacramento
3,507
San Bernardino
3,485
Contra Costa
2,648
California Department of Health Services Office of AIDS.
HIV/AIDS Epidemiology Branch
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AIDS in California 1983-2006
143,946 AIDS Cases
82,929 Deaths
Children
Teens
20-29 yrs.
30-39 yrs.
40-49 yrs.
Over 50 yrs.
California Department of Health Services Office of AIDS.
HIV/AIDS Epidemiology Branch
904
624
21,722
62,425
40,171
18,100
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Transmission
4 Body Fluids
4 Body Openings
•
•
•
•
•
•
•
•
Blood
Semen
Vaginal Fluids
Breast Milk
Rectum
Mouth
Genitals
Broken Skin
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High Risk Behaviors for the Transmission of
HIV
• Sexual intercourse with a person who has HIV.
• Blood-to-blood transmission (intravenous
drug use-sharing needles with someone who
has HIV).
• HIV-infected mother to child (before birth,
during birth, breast feeding).
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HIV Is Not Transmitted By:
•
•
•
•
•
•
•
•
Casual Contact
Hugging or kissing
Mosquitoes or insects
Donating blood
Telephones
Sharing food
Hot tubs or swimming
Being a friend
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How Bloodborne Pathogens Can Be Spread In
The Work Environment:
• Accidental injury.
• Breaks in the skin or mucous membrane
exposure.
• Indirect transmission.
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Universal Precautions
The term “universal precautions” refers to a
method of infection control in which all
human blood and other potentially infectious
materials are treated as if known to be
infectious for HIV and HBV. Universal
precautions do not apply to feces, nasal
secretions, sputum, sweat, tears, urine, or
vomit unless they contain visible blood.
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Why Universal Precautions?
Many people who have an infectious disease have
no visible symptoms. Some have no knowledge of
their condition. HIV and HBV infect people from:
•All age groups
•Every socioeconomic class
•Every state and territory
•Rural areas and inner cities
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Minimizing The Risks
• Attend Bloodborne Pathogens In-service
• Know Location of your district’s Exposure Control
Plan
• Be informed regarding:
–
–
–
–
–
–
Engineering controls
Employee work practices
Personal protective equipment
Housekeeping procedures
Hepatitis B Vaccine
Procedures to follow in an exposure incident
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Handwashing –
The single most effective method of preventing the spread of
infection.
Before:
• Drinking or eating
• Handling clean utensils, equipment or food
Before and After:
• Going to the Bathroom
After:
•
•
•
•
•
Contact with any body secretions
Handling soiled diapers, garments, or equipment
Caring for children, especially those with discharges
Removing disposable gloves
Removing lab coat or smock
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Gloves
When:
• If care provider has an open lesion on his/her hands.
• Handling contaminated disposable items (tissues,
diapers, etc..)
• Direct hand contact with body fluids is anticipated.
• Cleaning up body fluid spills
• Diapering
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Gloves
Type:
• Non-sterile latex or vinyl disposable.
• General purpose utility gloves (e.g. rubber
household gloves) for housekeeping chores.
Note:
• Dispose of disposables in plastic lined waste baskets
– emptied daily.
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Housekeeping
 GOOD HOUSEKEEPING IS EVERYONE’S
RESPONSIBILITY!
 Clean equipment and work surfaces daily
 Dispose of broken glass and other sharps safely
 Disinfect the equipment used to sweep up
contaminated material
 Dispose of infectious waste properly
 Handle all soiled materials as potentially infectious
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Authorized Labeling
BIOHAZARD
Or in the case of Regulated Waste the Legend:
BIOHAZARD WASTE
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Disinfectants
EPA/District approved disinfectant.
Household chlorine bleach in 1:10 solution
equals 10%, ¼ cup of bleach to 2 ½ cups water
in a bottle – mixed fresh daily.
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Trash Disposal
 Puncture proof (SHARPS) container required for
needles, syringes or broken glass with blood.
 Do not break or recap needles – place intact syringes
with needles into container
 Use Biohazardous (red labeled) bags to dispose of
trash containing liquid blood or body excretions that
may contain visible blood.
 Use disposable plastic liners for all trash containers.
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What To Do If There Is An Exposure?
 Wash exposed area(s) as soon as possible.
 Report the incident to your supervisor as soon as
possible.
 Discuss the exposure with your physician or your
district’s workers’ compensation physician.
 If you have not had the Hepatitis B vaccine series,
discuss with your doctor.
 Hepatitis B vaccine can be given up to 24 hours after
exposure and still be effective in preventing disease.
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Legalities of Testing
 Misdemeanor to disclose blood test results of HIV positives
except by written authorization.
 CH&S Code Chapters 1.11 & 1.12, Sections 119.21, 199.30, 199.31 &
199.37
 Blood test to detect AIDS virus may not be used to determine
employability or insurability.
 Employees cannot be required to take blood test.
 No one can be required to share results of AIDS/HIV tests.
 Employees may be required to have physical to determine
that health is appropriate to work with children.
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Relative Health Risks
Risks
Motorcycling
Smoking 20 cigarettes per day
Power boating
Taking Birth Control Pills
Varicose Veins (Legs)
Normal Child Delivery
Hepatitis B After Transfusion
AIDS After Transfusion
Deaths Per Person Per Year
1/50
1/200
1/5,900
1/50,000
1/666
1/9,999
1/200,000
1/225,000
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