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WELCOME
2010 - 2011
OSHA UPDATE
BLOODBORNE
PATHOGENS
Nancy Allen, RN, BS, MPH, COHN-S, CCM/R
EMPLOYEE HEALTH NURSE CONSULTANT
TOPICS
OSHA
 TERMS
 UPDATES
 HEPATITIS B
 HEPATITIS C
 HIV
 REPORTING AN EXPOSURE

OBJECTIVES

To have a basic understanding of blood borne
pathogens and the role of OSHA

To understand how to report an exposure

To understand the role of the school nurse in an
exposure.
WHY?
1. IT IS AN OSHA FEDERAL
REQUIREMENT
2. Through education and understanding,the
employee will be protected and the risk of
an exposure can be reduced.
WHAT IS OSHA?
OCCUPATIONAL SAFETY
AND
HEALTH ADMINISTRATION
(Started in 1970)
SCHOOL DISTRICT’S EXPOSURE CONTROL
PLAN (ECP) NEEDS TO BE BASED ON:
29 CFR 1910.1030
BLOODBORNE PATHOGENS
STANDARD
FEDERAL Register
December 6, 1991
OSHA STANDARD ADDRESSES:
RULES FOR PROTECTING HEALTH
AND SAFETY WORKERS FROM
OCCUPATIONAL EXPOSURE TO
BLOOD AND CERTAIN OTHER
BODY FLUIDS POTENTIALLY
CONTAINING BLOODBORNE
PATHOGENS.
BBP TRAINING IS MANDATORY
UPON EMPLOYMENT FOR NEW
HIRES AND ANNUALLY FOR
ALL EMPLOYEES.
BBP TRAINING INCLUDES:





NEW HIRE EDUCATION AND TRAINING
ANNUAL EDUCATION AND TRAINING
AVAILABILITY OF PPE (Personal Protective
Equipment)
OFFERING OF HEPATITIS B TO AT RISK
EMPLOYEES
PROPER REPORTING OF
NEEDLESTICKAND BLOOD/BODY FLUID
EXPOSURES
EXPOSURE CONTROL PLAN
IS WRITTEN TO:



MINIMIZE EXPOSURE TO BLOOD OR
OTHER POTENTIALLY INFECTIOUS
MATERIALS (OPIM)
MANAGE EXPOSURES PROPERLY AND
MEDICALLY
DESCRIBE ENGINEERING AND WORK
PRACTICE CONTROLS WHICH REDUCE
RISK.
SCHOOL NURSES AND MEDICAL
SAFETY DEVICES
IMPLEMENTATION OF SAFER
NEEDLE/SYRINGE DEVICES IN
SCHOOL DISTRICTS TO KEEP
THE SCHOOL NURSE SAFE FROM
BLOODBORNE PATHOGENS
STANDARD PRECAUTIONS
 TREAT
ALL BLOOD AND
BODY FLUIDS AS IF THEY
ARE KNOWN TO BE
INFECTIOUS
AT-RISK EMPLOYEES

THOSE EMPLOYEES WHO, BY NATURE
OF TASK, HAVE THE POTENTIAL TO BE
EXPOSED TO BLOOD, BODY FLUIDS OR
OTHER POTENTIALLY INFECTIOUS
MATERIALS
PPE – PERSONAL
PROTECTIVE EQUIPMENT






GLOVES
MASKS
EYE PROTECTION
FACE SHIELDS
RESPIRATORS
GOWNS, APRONS, LAB COAT
WORK PRACTICE CONTROLS




HAND WASHING
PROPER USE OF SHARPS CONTAINER – ¾ FULL
STORAGE AND SHIPPING OF CONTAMINATED
EQUIPMENT
NO EATING, DRINKING, SMOKING, HANDLING
CONTACT LENSES AND APPLYING MAKE-UP
AT WORK AREAS
ENGINEERING CONTROLS
 RESPIRATOR
 MEDICAL
SAFETY
DEVICES
 SHARPS CONTAINERS
OPIM – OTHER POTENTIALLY
INFECTIOUS MATERIAL
ANY BODY FLUID THAT IS
GROSSLY CONTAMINATED
WITH BLOOD OR ANY
INTERNAL BODY
CAVITY FLUID
SMALL WASTE GENERATORS




Each School District is a small waste generator if they
produce < 50 pounds/month. R.61-105, infectious
Waste Management Act, Effective June 24, 2005
Some Districts may have agreement with local Health
Department
Transport Sharps containers in a box in car trunk
Diapers, sanitary napkins, wound dressings in school
setting are not infectious. Use appropriate PPE
(OSHA) Regular trash.
LATEX SENSITIVITY
IN SCHOOLS

School nurse should notify School District Staff
about Latex Allergies.

Non-latex products – Band – Aids, BP Equipment,
resuscitative equipment

Be aware of products with latex – balloons, rubber
bands, Squishie balls, rubber toys, erasers
HEPATITIS C VIRUS
RISK FACTORS

3-4 MILLION CHRONIC CARRIERS IN USA
(CDC)

36,000 NEW INFECTIONS ANNUALLY IN US

50,000-70,000 CASES ESTIMATED IN SOUTH
CAROLINA
WHAT IS HEPATITIS B?






VIRAL INFECTION OF THE LIVER
SYMPTOMS – NONE/MILD/SEVERE
CHRONIC CARRIERS (5%) CAN DEVELOP
CHRONIC LIVER DISEASE AND CAN INFECT
OTHERS
95% SPONTANEOUS RESOLUTION
INCUBATION PERIOD – AVERAGE 60-90 DAYS,
RANGE 45-180 DAYS.
HEPATITIS B VACCINE – PROVIDES
IMMUNITY (3 vaccine series)
WHAT IS HEPATITIS C?






VIRAL INFECTION OF THE LIVER
CAN LEAD TO CIRRHOSIS AND CANCER
LEADING INDICATOR FOR LIVER
TRANSPLANT
FLU-LIKE SYMPTOMS OR NO SYMPTOMS
INCUBATION PERIOD – AVERAGE 6-7
WEEKS. RANGE 2-26 WEEKS
NO VACCINE AVAILABLE
WHAT IS HIV/AIDS?
HIV=VIRUS THAT CAUSES AIDS
 Human ImmunodeficiencyVirus that Destroys T Cells, which
are necessary for Healthy Immune System.
 INCUBATION PERIOD: Conversion to HIV positive within
25 Days to 3 months. Rarely Longer Than 6 months
 Can be HIV POSITIVE but not have developed AIDS
 PEP (Post Exposure Prophylaxis) is available – Initiate as soon
as possible!! Interval after which there is no benefit for
humans is undefined.
AIDS=ACQUIRED
IMMUNODEFICIENCY SYNDROME

1/2 PEOPLE Who Are HIV positive DEVELOP
AIDS WITHIN 10 YEARS

HIV + Certain Chronic Disease/Destroyed
T Cells=AIDS
HEPATITIS B, HEPATITIS C
& HIV
Life-threatening BBP
 Transmitted through exposure to blood and
other infectious body fluids
 Anyone with occupational exposure is at risk
 Workers must use PPE and engineering
controls

OCCUPATIONAL EXPOSURES:
HCW (HCP) RESPONSIBIBILTIES
KNOW BASIC BBP (HBV, HCV, HIV)
ISSUES
 ATTEND ANNUAL BPP TRAINING
 KNOW WHAT IS A BONA FIDE
EXPOSURE
 REPORT IT!!! PER SCHOOL DISTRICT
POLICY
 IF YOU DON’T KNOW, ASK!!!

IF YOU THINK YOU HAVE
BEEN EXPOSED
IMMEDIATELY TAKE CARE
OF YOURSELF AND
IMMEDIATELY NOTIFY THE
APPROPRIATE PERSON IN
YOUR SCHOOL DISTRICT
DEPENDING ON THE EXPOSURE
SCHOOL NURSE WILL IMMEDIATELY
ASSIST THE EXPOSED PERSON
WASH HANDS
 FLUSH EYES WITH WATER
 REMOVE ANY SOILED CLOTHING
 GET HELP FROM ANOTHER TRAINED
FIRST RESPONDER
 DO NOT DELAY IN REPORTING

PAPERWORK WILL BE
DONE BY THE
DESIGNATED PERSON IN
YOUR SCHOOL DISTRICT.
THIS MAY VARY FROM
DISTRICT TO DISTRICT
EACH SCHOOL DISTRICT IS
RESPONSIBLE FOR DEVELOPING A
POST EXPOSURE MANAGEMENT
PROCEDURE
THE SCHOOL NURSE MAY BE
CONSULTED IN DEVELOPING THIS
CDC BBP OEM/PEP
Guidelines: Summary
1.
2.
3.
4.
5.
6.
Provide immediate care to the exposure site. Notify
supervisor immediately!!!!
Evaluate risk of exposure (type of fluid, type of
exposure)
Evaluate exposure source for BBP’s
Evaluate the exposed person
Give PEP (HIV, HBV) for exposures posing risk of
infection transmission
Perform appropriate follow-up testing and provide
counseling
QUESTIONS???
To complete your update, please click
link below to take the BBP Test.
Please see your school nurse regarding the test.