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BLOODBORNE PATHOGENS TRAINING
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BLOODBORNE PATHOGENS AND HEPATITIS B
OSHA’S 1991 bloodborne pathogens standard includes
provisions for medical follow up for workers who have an
exposure incident. The most obvious exposure incident is a
needlestick. But any specific eye, mouth, other mucous
membrane, non-intact skin, or parenteral contact with blood,
body fluids, or other potentially infectious materials is
considered an exposure incident and should be reported to
the employer.
INFECTIOUS DISEASES CAUSED BY BLOODBORNE
PATHOGENS
Incubation Period: HIV antibiotics may be identified in the
body anywhere from 6 weeks to 3 months from the time of
the infection, although symptoms may not manifest
themselves for 10 – 12 years. At this time we have only a
few years’ experience with AIDS, since the disease was first
discovered in 1981.
Period of Communicability: Probably from the time of
infection throughout the remainder of the person’s life.
B.
Exposure incidents can lead to infection from Hepatitis B
virus (HBV) or human immunodeficiency virus (HIV) which
causes AIDS. Although few cases of AIDS are directly
traceable to workplace exposure, every year about 8,700
health care workers contract Hepatitis B from occupational
exposures. Approximately 200 will die from this bloodborne
infection. Some will become carriers, passing the infection
on to others.
A.
HIV/AIDS
Human Immunodeficiency Virus (HIV) attacks the body’s
immune system causing the disease known as AIDS, or
Acquired Immune Deficiency Syndrome. Currently, there is
no vaccine to prevent infection.
Signs and symptoms include:
1.
Period of severe fatigue: persists for more than several
weeks.
2.
Sudden weight loss: 10 lbs. Or more in less than 60
days.
3.
Night sweats and/or fever: drenching night sweats and
chills with fevers.
4.
Diarrhea: diarrhea persisting for more than 1 week is
common with AIDS.
5.
Bruising and/or bleeding easily.
6.
Coughing.
7.
Skin rashes and spots.
Kaposis Sarcoma also
common. Lesions.
8.
Swollen glands: Enlarged, hard, painful lymph nodes in
at least 2 parts of the body (excluding the groin).
9.
Oral Thrush: Creamy white, curd-like patch that coats
tongue and surrounds throat and esophagus. It is the
esophageal thrush that is case-defining for AIDS.
Spread: The AIDS virus has been found in blood, semen,
saliva, urine, tears and other body fluids, but transmission
has NOT been shown to occur from contact with fluids other
than blood and semen. In adults, the virus is most often
spread through sexual contact or by sharing needles. Most
children who are infected acquire the virus from their infected
mothers during pregnancy or at the time of birth. Some
children have been infected through transfusions of blood
products that contained the AIDS virus. It is possible that
spread may occur by getting blood from an infected person
into open cuts, abrasions, mouth or eyes of another person.
AIDS is NOT spread by coughing, sneezing, hugging or by
contact with eating utensils, faucets or toilet seats. The
chance of becoming infected by a needle stick is less than
0.5%.
HEPATITIS B
Hepatitis means “inflammation of the liver”. Hepatitis B is the
major infectious blood-borne hazard you face on the job.
The chance of becoming infected from a needlestick slip are
much greater than Hepatitis A; 30%. If you become infected
with Hepatitis B:

You may suffer from a loss of appetite, tiredness,
abdominal pain, nausea and vomiting; rash or joint pain,
jaundice.

Your symptoms can vary greatly from none at all to
severe illness.
The virus is present in the blood and other body fluids. It can
be spread from person to person by getting blood or body
fluids from an infected person into open skin cuts, abrasions,
mucous membranes such as the eyes, nose, and mouth of
another person, or by sexual contact.
Incubation Period: Ranges from 2-6 months; the average is
3 months.
Period of Communicability: May be infectious for many
weeks before onset of symptoms and remain infectious for 48 months. Some people (about 10%) are chronic carriers of
the virus and may be infectious for life.
C.
HEPATITIS A
Hepatitis A is an infection of the liver. Symptoms are usually
sudden, with loss of appetite, nausea, tiredness, fever, and
stomachache. Dark-colored urine, light-colored stools and
jaundice.
Hepatitis A virus is spread when the virus leaves the body
through the stool of an infected person and enters another
person when contaminated food or objects are placed in the
mouth. The chance of becoming infected from a needlestick
slip is much lower than Hepatitis B, only 0.5%.
Incubation Period: The incubation period is 2-6 weeks after a
person is exposed to the virus; most commonly one month.
Period of Communicability: The contagious time period is 2
weeks before to 1 week after onset of symptoms.
METHODS OF TRANSMISSION
Transmission of bloodborne pathogens can occur in the
following ways:
1. Directly through person to person contact or indirectly by
a person coming in contact with a contaminated surface
or object. This is the most common means of disease
transmission.
2.
3.
Airborne transmission occurs by “droplet infection” via
breathing, talking, coughing, or through contaminated
dust. These can be the most difficult to control.
Bloodborne transmission occurs through contact with
blood, semen, vaginal secretions or body fluids. (These
substances are also known as infectious materials).
Generally, these diseases are transmitted through skin,
eyes, damaged skin or mucous membranes (mouth,
vaginal or rectal tissue). This mode of transmission
includes but is not limited to Hepatitis B virus (HBV) and
Human immunodeficiency virus (HIV).
WHAT DOES THE VACCINATION INVOLVE?
care professional evaluating an employee after an exposure
incident will receive the following information:
1.
2.
3.
4.
5.
6.
A copy of the OSHA regulations.
A description of the exposed employee’s duties as they relate to
the exposure incident.
Documentation of the route(s) of exposure and circumstances
under which exposure occurred.
Results of the source individual’s blood testing, if available.
All medical records relevant to the appropriate treatment of the
employee including vaccination status.
Consents needed for HIV screening and HBV treatment.
The medical evaluation and follow-up will include the
following:
The exposed employee’s blood shall be collected as soon as
possible and tested after consent is obtained for HIV and HBV
status.
Post exposure prophylaxis, when medically indicated, as
recommended by the U.S. Public Health Service.
Counseling.
Evaluation of reported illnesses.
The Hepatitis B vaccination is a non-infectious, yeast-based
vaccine given in three injections in the arm. It is prepared
from recombinant yeast cultures, rather than human blood or
plasma. Thus, there is no risk of contamination from other
bloodborne pathogens nor is there any chance of developing
HBV from the vaccine.
1.
STANDARD PRECAUTIONS
A copy of the health care professional’s written opinion shall
be provided by the employer to the employee within 15 days
of the completion of the evaluation. The health care
professional’s written opinion for Hepatitis B vaccination shall
be limited to whether Hepatitis B vaccination is indicated for
an employee, and if the employee has received such
vaccination. The health care professional’s written opinion
for post-exposure evaluation and follow-up shall be limited to
the following information:
1. That the employee has been informed of the results of
the evaluation.
2. That the employee has been told about any medical
conditions resulting from exposure to blood, body fluids,
or other potentially infectious materials which require
further evaluation or treatment.
3. All other findings or diagnoses shall remain confidential
and shall not be included in the written report.
Standard precautions have been established to reduce the
occurrence of bloodborne transmission. AIDS and Hepatitis
B are two communicable diseases which require the use of
Standard Precautions.
Standard Precautions require that all human blood and all
body fluids are treated as if they are known to be infected
with HIV, HBV, and other bloodborne pathogens.
Standard Precautions require:






Handwashing
Use of gloves when in contact with blood or body fluids
Use of personal protective equipment
Bagging contaminated laundry
Cleaning and disinfecting procedures for contaminated surfaces
Disposal of sharps
MEDICAL EVALUATION AND FOLLOW-UP
An Exposure Incident is defined as a specific eye, mouth,
other mucous membrane, non-intact skin or parenteral (skin
piercing) contact with blood, body fluids, or other potentially
infectious materials that results from the performance of an
employee’s duties.
If an Exposure occurs, employees should follow this
procedure:
1.
2.
3.
4.
5.
Immediately wash hands and contact area with soap and
water. If mucous membranes or eyes are the contact area,
flush with water.
Notify organization’s administration that an Exposure has
occurred.
Complete an “Exposure Incident” form.
Call your physician and schedule a medical evaluation
immediately.
Complete the top section of the “Post Exposure Medical
Evaluation” form and take this form with you to the medical
evaluation.
A medical evaluation will occur within 24 hours after
exposure and will be at no cost to the employee. The health
2.
3.
4.
The health care professional’s written opinion shall be kept in
the employee’s medical record.
In addition to counseling the employee, the health care
provider will provide a written report to the employer. This
report simply identifies whether Hepatitis B vaccination was
recommended for the exposed employee and whether or not
the employee received vaccination. The health care provider
also must note that the employee has been informed of the
results of the evaluation and told of any medical conditions
resulting from exposure to blood or body fluids which require
further evaluation or treatment. Any added findings must be
kept confidential.
CONFIDENTIALITY
Medial records must remain confidential. They are not
available to the employer. The employee must give specific
written consent for anyone to see the records. Records must
be maintained for the duration of employment plus 30 years
in accordance with OSHA’s standard on access to employee
exposure and medical records.