Download Bloodborne Pathogens 2014

BLOODBORNE
PATHOGEN
TRAINING
INTRODUCTION
 On December 6, 1991, the Occupational Safety and Health
Administration (OSHA) published their standard for
occupational exposure to bloodborne pathogens.
 OSHA website www.osha.gov
 These standards require the employer to provide annual
education regarding the occupational hazard of bloodborne
pathogens. There are 14 required components of this
education which will be covered today.
 OSHA standards are federal law and compliance is
mandatory.
 However, it is more important to recognize that this
standard was established to help protect the
school employee from the serious workplace
hazard of bloodborne pathogens.
WHAT ARE BLOODBORNE PATHOGENS?
Viruses, bacteria and other microorganisms that are
carried in the bloodstream and can cause disease
If a person comes in contact with blood infected with a
bloodborne pathogen he or she may become infected
EXAMPLES OF BLOODBORNE PATHOGENS
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
HEPATITIS B (HBV)
HEPATITIS C (HCV)
NON A, NON B HEPATITIS
SYPHILIS
MALARIA
POTENTIALLY INFECTIVE BODILY FLUID
Exposure to human blood carries the greatest risk for
acquiring a bloodborne pathogen
Other body fluids have demonstrated a viral load sufficient to
potentially transmit infection. These fluids are:
cerebrospinal fluid
synovial fluid
pleural fluid
amniotic fluid
pericardial fluid
peritoneal fluid
semen
vaginal secretions
any body fluid contaminated with blood
saliva in dental procedures
body fluids in emergency situations that cannot be recognized
TRANSMISSION
HIV and Hepatitis B virus are transmitted “blood to blood” by the following
routes:
 Sexual contact
 Sharing HIV or HBV contaminated needles or syringes
 From mother to unborn child
HCV is transmitted by:
 “Blood to blood” through broken skin (scratch, cut, chapped hands)
 The risk of HCV transmission by household contact and sexual activity is
believed to be low
 Transmission from mother to unborn child is uncommon.
TRANSMISSION
In the workplace HIV, HBV and HVC are transmitted by the
following routes:
 Through skin injuries (needlestick/sharp puncture)
 By contact with broken skin (scratch, cut, chapped hands)
 Spray or splash into mucous membrane (mouth, nose or
eyes)
RISK OF INFECTION
In order for a person to become infected after
exposure:
A pathogen must be present
There must be enough of the pathogen present to
cause disease
The pathogen must have an entry site
The recipient must be susceptible to the pathogen
RISK OF INFECTION AFTER
OCCUPATIONAL EXPOSURE
(INFECTION RISK FROM A PERCUTANEOUS EXPOSURE)
Hepatitis B
Viral
particles/mL of
serum/plasma
102 - 108
Hepatitis C
100 - 106
3%
HIV
100 - 103
0.3%
Virus
Infection risk
30%
HUMAN IMMUNODEFICIENCY
VIRUS (HIV)
 First cases of HIV/AIDS were reported in 1981
 25 million people have died of AIDS since 1981
 33 million living with HIV/AIDS in 2007 (over
one million in the US)
 38,000 newly diagnosed cases of AIDS each
year in US
SYMPTOMS OF HIV INFECTION
Range from no symptoms to severe immunodeficiency or
Acquired Immune Deficiency Syndrome (AIDS)
Initial infection can be followed by an acute flu-like illness.
Symptoms include:
fever
swollen neck glands
sweats
rash
malaise
sore throat
headache
HUMAN IMMUNODEFICIENCY VIRUS
 The risk for disease progression increases with the duration of
infection.
 Less than 5% of HIV-infected adults develop AIDS within 2 years of
infection
 20-25% will develop AIDS within 6 years after infection and 50%
within 10 years.
 When an HIV-infected person develops certain diseases or
conditions, they are then classified as having AIDS. Three of the
most common clinical conditions are P. carinnii pneumonia, HIV
wasting syndrome, and candidiasis of the esophagus.
WHAT IS HEPATITIS?
Inflammatory liver disease
Caused by a virus
Causes scarring of the liver tissue
Increases liver cancer risk
HEPATITIS B VIRUS (HBV)
Hepatitis B In the United States
12 million Americans have been infected (1 out of 20 people)
More than one million people are chronically infected
Up to 40,000 new people will become infected each year
5,000 people will die each year from hepatitis B and its
complications
Approx. 1 health care worker dies each day from HBV
SYMPTOMS OF HEPATITIS B VIRUS
Ranges from no symptoms to hepatic (liver) failure. The
disease has a long incubation period from 30 to 180 days.
Initial symptoms are nonspecific, typically include:
Fatigue
Loss of appetite
Vomiting
Fever
Rash and joint pain
These symptoms last 3-10 days. This is followed by the onset
of jaundice (yellowing of the skin) or dark urine.
Fulminant viral hepatitis is defined as the development of
severe acute liver failure with hepatic encephalopathy
within 8 weeks of the onset of symptoms with jaundice.
Can lead to hepatocellular cancer
HEPATITIS B VIRUS (HBV)
Treatable if acquired
Preventable through vaccination
HEPATITIS C VIRUS (HCV)
 Actual incidence of Hepatitis C infection is not known
 Prior to donor screening for anti-HCV, HCV was the
most common cause of post-transfusion hepatitis
 HCV accounts for about 20% of acute viral hepatitis
cases in US
 Prevalence is highest among injecting drug users and
hemophilia patients
 About one quarter of HIV-infected persons in the U.S.
are also infected with HCV.
SYMPTOMS OF HEPATITIS C
 Similar to Hepatitis B (jaundice, fatigue, loss of
appetite, vomiting)
 50% and possibly 60-70% of acute HCV infections
lead to chronic infection
 Chronic Hepatitis C is one of the most common
indications for liver transplantation in adults
 There is no vaccine for prevention of Hepatitis C
infection and no post-exposure prophylaxis
EXPOSURE CONTROL PLAN
 Contains the policies and procedures to protect
GDS employees from acquiring a bloodborne
pathogen
 Contains a complete listing of all job categories
that have been identified as having the risk of
occupational exposure to blood and body fluids
 A copy of the Exposure Control Plan is located in
the Health Room and the Training Room.
JOB CLASSIFICATIONS
The following positions at GDS are identified at risk for
exposure to bloodborne pathogens:
BCC Child Care staff
Science teachers
Bus Drivers
Janitorial Staff
PE teachers, athletic coaches & athletic trainer
First Responders
Health Room Staff
PREVENTION
All employees identified as being “at risk” for
occupational exposure to bloodborne pathogens are
offered Hepatitis B vaccine
There is no cost to the employee for the vaccine
Vaccination is a series of three injections
The HBV vaccine can be obtained from Health Services
PREVENTION
Employees who are eligible to receive the vaccine but
decline, must sign a declination statement form
Employees who initially decline the vaccine but later
elect to receive it may have the vaccination provided
at no cost
PREVENTION: WORK AREA
PRACTICES
 In work areas where there is exposure to infectious
materials employees are not to eat, drink, apply
cosmetics, smoke, or handle contact lenses
 Food and beverages are not to be kept in
refrigerators, cabinets or on counters where
exposure to infectious material may result
PREVENTION: WORK AREA
PRACTICES
 Universal Precautions: All blood or other
potentially infectious materials will be treated
as infectious
 “If it’s ooey gooey and not yours don’t touch
it!”
 Universal Precautions will be observed at GDS
in order to prevent contact with blood or other
potentially infectious materials.
UNIVERSAL PRECAUTIONS
Universal Precautions also means that all GDS
employees practice appropriate handwashing and
use personal protective equipment to prevent
direct contact with a person’s blood or body fluids.
Consistent practice of Universal Precautions is the
best method that employees can use to protect
themselves from occupationally acquiring a
bloodborne disease.
PERSONAL PROTECTIVE
EQUIPMENT
 Personal protective equipment (PPE) is
specialized clothing and equipment worn to
prevent direct contact with blood or other body
substances
 PPE should be readily available and is provided
to the employee at no cost
PERSONAL PROTECTIVE EQUIPMENT
PPE includes:
 Disposable, single-use gloves in first-aid kits, AED cases,
Science classrooms, janitorial supplies, and Trainers
office
 Protective eyewear in laboratory classrooms, janitorial
supplies and the nurse’s office
 CPR resuscitation masks with one-way valve in first-aid
kits and AED cases and health room
PPE DISPOSAL
 PPE should be carefully removed immediately
after use and hands thoroughly washed.
 Soiled gowns and gloves should be disposed
of in the regular trash and then double-bagged
 Employees are responsible for using PPE when
instructed and whenever clinically indicated to
prevent exposure to blood and body fluids.
ENGINEERING CONTROLS
Engineering controls are items that remove the bloodborne
pathogen hazard from the workplace.
Sharps containers labeled with the biohazard symbol will be
located in the Health Room and athletic training room.
The containers are to be utilized for the disposal of all sharps
such as needles, glass, or other sharp instruments
contaminated with blood or other potentially infectious
materials.
They are considered regulated waste. Return full containers to
nurse for proper disposal.
ENGINEERING CONTROLS
Contaminated needles and other contaminated sharps shall
not be bent, recapped or removed. If for any reason it is
necessary that a contaminated needle or other sharp be
recapped or removed, such recapping or needle removing
must be accomplished through the use of a mechanical
device or a one-handed technique. All contaminated
sharps are to be disposed of in sharps containers.
All procedures involving blood or other potentially infectious
materials shall be performed in such a manner as to
minimize splashing, spattering, and generation of droplets
of these substances.
UNIVERSAL BIOHAZARD SIGN
The universal biohazard sign is used to alert
employees when containers contain infectious
materials.
CONTAMINATED PERSONAL
CLOTHING
 As soon as possible clothing should be carefully
removed, avoiding contact with the garment's
outer surface to prevent skin contamination.
Students/staff may not return to class with soiled
clothing. No exceptions.
 The contaminated garment should be placed in a
fluid resistant bag and marked “biohazard.”
 Take bag to the nurse’s office. (Clothes may be
sent home with individual if blood and clothes
belong to the same person).
SPILLS OF BLOOD/BODY FLUID
All spills must be safely and properly cleaned up as soon as
possible. Do not clean the spill yourself, call the office to
have janitorial staff clean the area.
Hepatitis B virus can survive on surfaces dried and at room
temperature for at least 7 days
SPILLS OF BLOOD/BODY FLUID
Janitorial staff should use the following guidelines:
Wear gloves and other appropriate PPE as indicated
A solution of 1:10 bleach and water or an EPA-approved
disinfectant detergent (i.e. Vesphene) should be used.
Small spills are cleaned by first wiping the spill then
cleaning the area with the disinfectant.
Large spills should first be flooded with the disinfectant,
the spill wiped or mopped up, then the area cleaned
with the disinfectant.
SPILLS OF BLOOD/BODY FLUID
If broken glass is involved, it should be carefully
removed using a mechanical device such as tongs
or forceps and the broken glass placed in the
sharps container. Never pick up broken glass by
hand.
EXPOSURE INCIDENTS
You are considered potentially exposed to a
bloodborne pathogen if you contact blood or
other infectious body substances in any of the
following ways:
Needlestick/sharp injury that punctures the skin
Splash to the mucous membranes of the eyes,
nose and/or mouth
Potentially infectious fluid that contacts broken
or abraded skin
EXPOSURE FOLLOW-UP
Knowing the right steps to take after an exposure
incident is critical in reducing the likelihood of
acquiring a bloodborne pathogen.
Immediately after any exposure incident:
Wash the exposed area with soap and water; if the
exposure involves the eyes, you should flush with
tap water
Report the incident to your supervisor
Report to the School Nurse or Athletic Trainer
POST EXPOSURE FOLLOW UP
 The school nurse will evaluate your exposure incident.
 A Post-Exposure Evaluation and Follow-Up Form shall
then be completed by the employee.
 After the report is completed and filed with the School
Nurse, a confidential medical evaluation and follow-up
shall be given by or under the supervision of a
licensed physician at no cost to the employee.
 If the exposed employee refuses the post-exposure
evaluation and follow-up, the employee shall complete
and sign a Post-Exposure Refusal Form.