Download Slide 1

Slide 1
Compass Academy
BLOODBORNE
PATHOGENS
Employee Training

Please read all of the information on the slides and the text below each slide.

Take the test at the end of the training module.

To get credit for completing the quiz put your name at the top of the page and
send it as an attachment to the school nurse via e-mail to
[email protected]
Slide 2
CONTENTS OF THE
EXPOSURE CONTROL PLAN
 Compliance
 Prevention
 Protection
 Work Practices
 Engineering controls
 Occupational Health

To comply with federal laws, Compass Academy has an Exposure Control
Plan; there are 6 components as listed above.

The purpose of the Plan is to reduce, minimize, or eliminate occupational
exposure to potentially infectious materials which could cause disease or
death.

Compass Academy is required by federal laws (namely OSHA laws) to
assist you in understanding how to protect yourself from getting diseases
through direct contact with human blood.

Compass Academy is also required by federal law to record annual
training of every employee.
Slide 3
PERSONAL PROTECTIVE EQUIPMENT
(PPE)
Protects you from contact with human blood
and body fluids

Personal protective equipment is provided to reduce the potential for exposure.

Gloves will be the most commonly used personal protective equipment in a
school district. Gloves should be worn for any contact with blood or blood
products. Before putting on gloves, you should first wash your hands. After you
have put the gloves on, check for proper fit and punctures. Pull them snug to
insure a good fit. To remove the gloves, they should be rolled or pulled from the
wrist to the fingers so that the glove is inside out. One glove should be folded
into the other and then discarded. This minimizes contamination.
Slide 4
BLOODBORNE PATHOGENS

• Definition:
• Examples:
• Pathogenic
microorganism
• HIV (AIDS)
• Present in human
blood
• Hepatitis B
• Can infect and cause
disease in humans
• Hepatitis C
Bloodborne pathogens are disease-causing microorganisms that are
present in human blood; they can infect and cause disease in humans.

These pathogens include the Human Immunodeficiency Virus (HIV) (the
virus that causes AIDS), and the Hepatitis B Virus (HBV). Other
bloodborne pathogens are: Syphilis, Hepatitis C, and Hepatitis D.

Bloodborne pathogens are spread through blood or other potentially
infectious materials. The body fluid with the highest risk is blood. Saliva
has the lowest risk.

The usual manner to invade the body is blood to blood contact. However,
bloodborne pathogens could also enter the body through mucous
membranes in the eyes, nose, and mouth.
Slide 5
CHARACTERISTICS OF
HEPATITIS B VIRUS (HBV) AND
HEPATITIS C VIRUS (HCV)
 Attacks liver
 Modes of transmission
Sexual contact
Needle sharing
Mother to baby
Blood & body fluid contact
 HBV is vaccine-preventable (not HCV)

The liver is an important organ in the human body since it performs several
functions including filtering the blood. When the liver is inflamed due to illness or
injury, it does not work well. We call the inflammation of the liver hepatitis.
There are many forms of hepatitis. We now have hepatitis A, B, C, D, and E.
Other types keep being identified. It can be caused by viruses, other diseases, or
toxic substances such as alcohol.

The most common cause of hepatitis is viral. Hepatitis B virus (HBV) and
hepatitis C virus (HCV) can be transmitted from one person to another through
sexual contact and through contact with blood. Those who share needles are at
high risk of getting hepatitis. Infected mothers can also give hepatitis to their
babies. We currently have a good way of preventing the transmission of hepatitis
B through vaccination. Unfortunately, we do not have a vaccine to prevent
hepatitis C.
Slide 6
HEPATITIS B
 Damages liver
 9 of 10 infected develop acute hepatitis
 1 of 10 of infected adults become “carriers”
 The younger you get infected, the more
likely you are of being chronically ill
 5000 die/year with related diseases

Nine out of every ten adults will get rid of the virus from their bodies after
a few months. This is ACUTE HEPATITIS. One out of every ten adults
will never get rid of the virus from their bodies. This is CHRONIC
HEPATITIS. These people remain infectious and we call them “carriers”.
These people can transmit HBV to their sexual partners and others who
come into contact with their blood.

Most adults who contract HBV go through the course of illness and
develop HBV antibodies. These individuals are not infectious and now
have a natural immunity to the disease.

It is dangerous when very young children get Hepatitis B. Nine of ten
babies born to infected mothers will end up being carriers. This is why the
state of Texas has mandated that children in school be immunized against
Hepatitis B.

With the help of vaccination, the rate of HBV infection declined by almost
90% in children younger than 19 years by the year 2002.
Slide 7
HEPATITIS C
 Most patients remain infected
 75-85% develop long term liver disease
 The leading indication for liver transplants
 May involve damage to other organs
 May lead to Liver Cancer

This is a serious form of liver disease. In the past, we only knew of
Hepatitis A (which is not Bloodborne) and Hepatitis B, but we now know
that there are several other types of Hepatitis.

For purposes of this training, we will concentrate on …
o Hepatitis B Virus (HBV)
o Hepatitis C Virus (HCV) and
o Human Immunodeficiency Virus (HIV).
Slide 8
INFECTIOUS BODY FLUIDS –
HBV AND HCV
Blood
Serous fluid
Semen
Vaginal secretions
Saliva (in dental procedures)

Infectious body fluids include blood, serous fluid (clear or yellowish fluid
with blood), semen, vaginal fluids and saliva mixed with blood.

When a human bite breaks the skin, it is considered a potential HBV
exposure, but not a high risk for either HBV or HIV exposure.

If human saliva falls into your eyes or nose, it is considered an exposure
but this is a very low risk.
Slide 9
MODE OF TRANSMISSION –
HBV AND HCV
 Sexual contact (Less for HCV)
 Exposure to blood
* Sharing of contaminated needles, razors,
toothbrushes, skin piercing, tatoos,
manicure tools, etc.
* Blood contact with non-intact skin
* Transfusions
 Infected mother to child

HBV and HCV are passed from person to person through sexual contact and
through direct contact of blood; the risk for HCV is lower than HBV.

There is also a possibility of contamination by direct contact with surfaces. To
prevent this, surfaces contaminated with blood should be cleaned thoroughly.
HBV can survive dried and at room temperature for at least one week. Our
custodians use solutions approved for the use of cleaning up blood.

HIV is spread in similar ways. However, for HIV to be passed from one person to
another, it usually takes more contact with a larger amount of blood as compared
to the Hepatitis virus.

Always discourage the sharing of personal items such as razors among our
students.

Bloody items need to be handled with gloves and bagged separately; bloody
surfaces and items need to be cleaned and disinfected immediately; any sharp
instrument with blood needs to be thrown in a red biohazard sharps/needle box.
Slide 10
EXAMPLES OF PERSONS AT RISK FOR
HEP C AND WHO SHOULD GET TESTED
Anyone who ever injected illegal drugs, even
if they injected only once years ago
 Persons who received a blood transfusion
before July 1992
 Someone born to a woman who was HCV
positive at the time of the birth

Because the symptoms may not be obvious, those who have injected drugs
may not know they were infected with the virus several years ago.

Anyone who received transfusions before 1992 may not have received the
benefits of this improved testing.
Slide 11
SYMPTOMS OF HBV AND HCV
 Jaundice
 Fatigue
 Possible stomach pain
 Loss of appetite
 Nausea
 Darkened urine
=============================
*** 30% with HBV and 80% with HCV
have NO SYMPTOMS

Symptoms might not be immediately noticed or diagnosed. There are
blood tests to help in the diagnosis.

Of great concern is that MANY PEOPLE HAVE NO SYMPTOMS but
are carrying the disease around and may be infecting others.
Slide 12
HEPATITIS B VIRUS IS NOT SPREAD BY.
..
 Coughing
 Sneezing
 Air
 Food (unlike Hepatitis A)
 Water
 Urine
 Feces (unlike Hepatitis A)
==============
(Also not likely to spread Hep C)

Body fluids generally not considered infectious include urine and feces,
unless they are contaminated with visible blood.

HBV is not spread by air, food, water, sneezing or coughing.
Slide 13
HEPATITIS B VACCINE
 Employees at risk of exposure are
offered Hepatitis B vaccine
 Employee may decline the vaccine
 Employees who initially decline
can later receive it

The hepatitis B vaccine will be offered to employees who are determined
to have occupational exposure to bloodborne pathogens.

The vaccination will be provided at no cost.

First, we must determine that you are at risk for exposure to blood.
Slide 14
HEPATITIS B GUIDELINES
At my workplace I…
(almost never) (a few times)
(6-12/year)
1. Am bitten by a student
2. Am scratched with potential for blood
contacting broken skin
3. Clean up students’ blood
4. Clean and dress oozing/bloody wounds
____________________________________________________________

If all the listed exposures to blood occur “almost never” your occupation is
not likely placing you at risk. However, you should consult with your
school nurse after any exposure incident.

If all exposure incidents listed occur a few times a year or less, you are not
at increased risk for Hepatitis B. Vaccine should be considered most
seriously by those who circled more than 3 “A few times” a year. If you
checked one or more on the “6-12/year” column, you should strongly
consider receiving the Hepatitis B vaccine series.

If you are determined to be at risk, you will be asked if you do, or do not,
want the vaccine at the beginning of each school year.
Slide 15
HEPATITIS B VACCINATION
 Three injections in deltoid muscle
 Mild to no side effects
 Produces only one antibody
 Series of 3 injections
* Immediately
* 6 – 8 weeks
* Six months

If you receive the vaccine prior to exposure to hepatitis B, your body will
develop antibodies against the disease. While no vaccine is 100%
effective, the efficacy of the vaccine is very high --- 80-95% effective.
However, efficacy is influenced by such factors as age, gender and body
mass, i.e. an overweight smoker over the age of 40 may not respond as
well as a 20 year old non-smoker who is not overweight.

At this time there is no vaccine available for Hepatitis C Virus. We can
only offer you the Hepatitis B vaccine. You should take all 3 injections to
get the most protection against Hepatitis B.

If you have received all three injections of the Hepatitis B vaccine in the
past, there is no need to repeat this.
Slide 16
THE GOOD NEWS ABOUT
HEPATITIS
Since 1995, HAV decreased by 88%
 Since 1990, HBV decreased by 79%
 Since 1992, HCV decreased by 92%

In March 2007, the CDC reported that the rates of newly diagnosed cases
of Hepatitis A, B, and C had all declined due to better rates of vaccination,
especially of children and due to decreased infections because of greater
awareness, counseling, case finding, education and prevention.

Blood donations are also better screened.

Problems remain among unvaccinated adults and those adults with risk
factors such as intravenous drug users or those with multiple sex partners.
Problems also remain among older adults who got infected years ago and
are now developing chronic hepatitis.
Slide 17
CHARACTERISTICS OF HUMAN
IMMUNODEFICIENCY VIRUS (HIV)
Attacks immune system
 Modes of transmission
→Sexual contact
→Sharing needles
→Mother to baby
→Other blood &
body fluid contact
 Not vaccine preventable
 Virus is killed easily outside the body

HIV is the virus that causes AIDS (autoimmune deficiency syndrome).

HIV destroys the immune system in humans by attacking the T-helper
cells (or CD4 cells) in the body. These T cells help your body fight off
infections. The antibody response (the body’s response to the virus)
commonly shows within 3 – 6 months. Some people will develop
detectable antibodies within 2 to 8 weeks. 90% develop antibodies by 3
months. In rare cases, it takes up to 6 months.

If you think you have been exposed to HIV, you should be tested
immediately for a baseline reading, at 6 weeks, 3 months, and 6 months.

About 25 - 30% of HIV-infected persons in the United States are also
infected with Hepatitis C virus (HCV). The percentage could be as high as
90% if the HIV infection was obtained by sharing dirty needles.
Slide 18
SYMPTOMS OF HIV
 Weakness
 Fever
 Sore throat
 Nausea
 Headaches
 Diarrhea
 Loss of weight
 Not able to fight infections
 Sometimes no immediate symptoms

Symptoms are not always immediate; some infected individuals may have
no symptoms for many years. When they do appear, they may not be
immediately diagnosed as having HIV.

The CDC estimates that about one million people in the United States are
living with HIV or AIDS. About one fourth of these people do not even
know that they are infected.

The CDC also estimates that 1700 teenagers ages 15 to 19 were diagnosed
with HIV during 2007.
Slide 19
MODES OF HIV TRANSMISSION
Sexual contact
Exposure to blood
* Contaminated needle sharing
* Blood contact with non-intact skin
* Transfusions
* Infected mother to child

Exposure to blood would include blood contact with broken skin or
mucous membranes. Exposure to blood is the only work-related or
occupational means of transmission. This virus is very fragile. Unlike the
Hepatitis virus, it will not live very long outside of the human body.

The greatest risk is in a person’s personal life, and is not work related.
The more sexual partners you have, the greater the risk you have of getting
HIV.

If you are an intravenous drug user and you share needles with others, you
are at high risk of getting HIV.

There are very few to no cases of household members contracting HIV
from nonsexual contact. Casual contact is not a mode of transmission.
Slide 20
BODY FLUIDS CONTAINING HIV
 Blood
 Serous fluid
 Vaginal fluids
 Semen
 Saliva (in dental procedures)

Blood has the highest concentration.

Serous fluid is the clear or yellowish fluid typically present with blood.

Saliva has a low risk.
Slide 21
AIDS IS NOT SPREAD BY:

Donating blood
Hand shakes
Telephone
Swimming pool
Coughing
Food/Water
Restaurants
Sneezing
Faucets
Door Knobs
Hot Tubs
Beverages
Schools
Hugging
Clothing
Toilet Seats
Touching
Day Care Centers
Combs
Mosquitoes
Public Transportation
There is no reason to be afraid of having casual contact with someone who
has HIV or AIDS.
Slide 22
THE GOOD NEWS ABOUT HIV
Those infected are
now living longer.
There are good
medications to help.

New medications are being developed every year and people are living
much longer than before. However, treatment is costly. The immune
system remains fragile, and HIV infected persons are immunocompromised – they are at risk for catching several illnesses because they
may not be able to fight infections. Some will respond differently and
have been able to lead productive lives even though they are afflicted.

If you want more information for someone who is HIV positive you can
go to this website…
http://www.cdc.gov/hiv/pubs/brochure/livingwithhiv.htm
Slide 23
WHAT IS AN EXPOSURE?
Blood contact with broken skin
Piercing mucous membranes or skin:
Needle sticks
Bites
Cuts
Abrasions

Here is an example of an exposure: You are assisting a student who fell
and cut his head; the blood is profuse and seeps through the cloth you are
using to put pressure on the wound. You are not wearing gloves, and
blood comes into contact with your hand which is severely chapped.

An exposure simply means you have come in contact with human blood or
body fluids and your skin is not intact.

One of the most important actions you can take to reduce your risk of
infections is to maintain your skin in good condition. Your skin is a good
barrier to bloodborne pathogens. Do not allow your skin to get overly
cracked because your skin may get small openings with the cracks. Use
lotion on dry skin. Cover any open sores or abrasions while you are at
school.

To avoid cuts, never pick up broken glass with your hands. Use a broom
and a dust pan instead.
Slide 24
FIRST AID PROCEDURES
 Use personal protective
equipment
 Call for assistance
 Instruct injured person on
self-care
 Dispose of material appropriately
 Wash hands thoroughly
 Report to Exposure Control Officer

If you are called upon to deliver first aid, you should use gloves and/or
other types of barriers and avoid direct contact with blood. Advise the
injured person to apply pressure himself if possible. Get rid of all bloody
materials carefully in a plastic bag. You should double bag the contents
for extra protection. Remember to wash your hands.

If you give CPR (cardiopulmonary resuscitation) mouth to mouth without
a shield, this is considered an exposure. Before you need it, find out what
items are available to you at your school such as face/mouth shields when
performing CPR. Remember that the risk is low from saliva so do not
hesitate to give CPR mouth to mouth if you need to.

If you think you were exposed to body fluids or if you performed mouth to
mouth CPR, OSHA Bloodborne Pathogen Standards direct you to report
to the “Exposure Control Officer” -- this means call the school nurse.
Slide 25
INJURED STUDENT/ATHLETE
 Cover any open sores before
playing
 If injured when playing,
clean/cover wound
 Remove/replace clothing
with blood on it
 Surfaces with blood need to be cleaned
 Put clothing stained with blood in plastic bag

If you help a student who is bleeding, remember to cover open sores
before resuming the activities.

Use extra care in handling any clothing and the surface area that gets
blood on it. Seek advice from the school custodians for proper clean up of
the surfaces.
Slide 26
NOSEBLEEDS
 Sit student up
 Head slightly forward
 Ask student to pinch
nose lightly
 Ask student to hold tissue under nose
 If you assist, wear gloves

Students can have nosebleeds for a variety of reasons.

Follow these steps and/or seek advice from your school nurse.
Slide 27
POST-EXPOSURE PROCEDURES
For Exposed Individuals:
 Wash exposed area thoroughly
 Report incident to supervisor
 Fill out exposure report form
 Request blood testing
 If needed, get Hep B vaccine
 Get evaluation by MD

In the event of an exposure incident, it is important to wash the skin or
flush the mucous membrane immediately. If an exposure incident occurs,
a confidential medical evaluation and follow-up will take place.

All aspects of the post-exposure and follow-up are confidential.

You may consult your personal physician if you choose or go to the
emergency department.

Remember that if you are exposed to blood, you should act quickly.
Please call the school nurse ir you have any questions.
Slide 28
POST-EXPOSURE PROCEDURES
Remember to take these steps:
 Wash the affected part of your body with plenty
of soap and water
 If your eyes were affected, flush them very well
with water
 Call school nurse; forms to complete are online
 Report to the E R of Med Center Hosp in Odessa

Remember that if your skin is intact, there is very little risk of any
exposure even if someone’s blood fell on you.

Remember that human saliva is a very low risk for an exposure to you. If
someone spits at you, there would have to be some blood in the saliva for
you to be exposed and it is unlikely in most situations.

You have the right to receive medical treatment at no cost to you when
you have a possible exposure to a bloodborne pathogen while at work.
Only you can decide if you want to be treated.

You should not delay in taking action when you are exposed to blood or
human secretions.
Slide 29
WORK PRACTICES TO PREVENT
EXPOSURE / REDUCE RISKS
 Universal precautions – MOST IMPORTANT
 Handwashing facilities /suitable cleanser
 Procedures to minimize needle sticks, blood
splashing, etc.
 Appropriate storage/disposal

Universal Precautions mean……treating all blood and certain body fluids
as if they are infectious.

Frequent hand washing with plenty of soap is the single most important
factor utilized for all types of infection control.
Slide 30
BLOODBORNE PATHOGENS
SUMMARY
1. Compass Academy has an Exposure Control Plan.
2. This BBPathogen training must be recorded by law.
3. BBPathogens include HBV, HCV and HIV.
4. Hepatitis B vaccine is available if you are at risk.
5. Use barriers/gloves; practice Universal Precautions.
6. Handle glass, needles, all sharps carefully.
7. Avoid contact with blood.
8. If exposed, wash immediately.
9. If exposed, receive a medical evaluation.
PLEASE NOTE:
Hepatitis B vaccination is offered to Compass Academy
employees whose job category places them at risk for blood
exposures. If you feel you are at risk as defined by slide
#14, contact your school nurse for information on
vaccination.
This is the end of the training. Please proceed to the test that follows.