BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING

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1 BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING FOR MEMBERS OF NCSU POLICE DEPARTMENT IN ACCORDANCE WITH OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) BLOODBORNE PATHOGEN STANDARD 29 CFR

2 Important!!! For any injury or exposure to hazardous substances. Notify your supervisor immediately Questions regarding this training should be directed to the Environmental Health & Safety (EHS) Biosafety Officer at

3 Why is bloodborne pathogen training required every year? 1. It is the law 2. It is North Carolina State University s responsibility 3. Knowing this information can protect your health and the health of others 4. It works!

4 1. It is the law The Occupational Safety and Health Administration (OSHA) is a federal agency charged with enforcing health and safety legislation. OSHA makes sure that employers such as NC State University keep you, the worker, safe from workplace hazards. Some jobs at NC State are more likely to come into contact with hazards than others. The hazards we are concerned about in this program are germs called bloodborne pathogens.

5 2. It is the university s responsibility Departments, Supervisors, and/or Principal Investigators must prove to OSHA that they are following the Bloodborne Pathogens Standard by implementing an Exposure Control Plan. By law, the Exposure Control Plan must detail certain steps that are taken to keep workers safe, that is, the plan to control every worker s exposure to bloodborne pathogens. This training module reviews the unique plan to control or avoid exposures to bloodborne hazards for all members of NC State University s Police Department. Examples of job classifications in the NC State Police Department that are expected to have jobrelated ( occupational ) exposures to bloodborne pathogens include Administrative Sworn Personnel such as Police Officers, Detectives, and Security Guards whether full or part time. As a condition of employment, each officer must know the location of--and comply with--the contents of their Exposure Control Plan.

6 3. Knowing this information can protect your health and the health of others For some NC State police officers, the potential for exposure to bloodborne pathogens may exist when encountering spilled human blood or body fluids, or materials or waste contaminated with human blood or body fluids. The potential for exposure exists when officers are involved in assisting with automobile accident victims; working a crime scene; or processing suspects. In these situations they may encounter blood-contaminated hypodermic needles or weapons. Officers may also be required to search suspects, or subdue violent and combative people. There is an extremely diverse range of potential situations, which may occur in the control of persons with unpredictable, violent, or psychotic behavior. Therefore, informed judgment of the individual officer is paramount when unusual circumstances or events arise. The recommendations in this training should serve as an aid to rational decision making in those situations where specific guidelines do not exist, particularly where immediate action is required to preserve life or to prevent significant injury.

7 4. It works! Research shows that trainings such as this reduce the number of exposures in just about every group studied including emergency response personnel! # of exposures reported nationally (Source: CDC [2002a].)

8 Exposure Determination The NC State Police Department, in cooperation with EHS, uses the Exposure Control Plan to document and track the status of occupational exposure determinations to bloodborne pathogens every 12 months. This is according to the OSHA Standard (29 CFR ). For officers, their exposure determination is documented on their department s Exposure Control Plan. Each determination must be made without regard to use of personal protective equipment and should be conducted upon orientation and no later than 10 days after the date of employment (OSHA). This determination must made without regard to use of PPE.

9 How do I determine Occupational Exposure? The OSHA definition states that you have Occupational Exposure if your duties may result in a reasonably anticipated skin, eye, mucous membrane or parenteral contact* with human blood or other potentially infectious materials. *Parenteral contact is: piercing mucous membranes or skin barrier through such events as needlesticks, human bites, cuts and abrasions. for definitions of blood or OPIM (other potentially infectious materials), read on

10 What are Other Potentially Infectious Materials (OPIM)? Bloodborne pathogens live and grow best in human blood. However, other human body fluids may also carry these germs. When making an Exposure Determination, we must also consider that OPIM are able to provide an environment for bloodborne pathogens to live and grow: Semen Vaginal secretions Any fluid surrounding organs in the body Visible blood in saliva, vomit, or feces

11 More OPIM Also considered Other Potentially Infectious Materials (OPIM) are: Any body fluid visibly contaminated with blood; All body fluids when it is difficult to differentiate between body fluids; Any unfixed organ or tissue from a human, living or dead (clinics & morgues) and; Other experimental human material (from laboratories) whether purposely infected or otherwise. so if I come into contact with this material as part of my job, I need to be enrolled in the Bloodborne Pathogens program.

12 Law Enforcement Tasks with Occupational Exposure Arrests Routine Interrogations Domestic Disputes Lock-up Operations Assaults Disruptive Behavior Searches Evidence Collection Transportation of Prisoners Crime Scene Processing First Aid Emergency Medical Response

13 Environmental Health & Safety can help As a University worker, if you have concerns about your exposure to bloodborne pathogens, you should discuss them with your supervisor and EHS. Your supervisor and EHS can help determine ways to make your job safer.

14 Now that we ve discussed how your exposure determination was made, let s look at what it means to be exposed.

15 Epidemiology Simply put, epidemiology is the science of tracking the spread of disease among a population. The population of concern in this training is NC State University law enforcement officers because of their potential exposure to bloodborne pathogens on the job. And the diseases of concern here are those caused by bloodborne pathogens.

16 What are Bloodborne Pathogens? Bloodborne Pathogens are germs that live and grow best in human material like blood. They enter your body through a puncture in your skin or through your eyes, nose or mouth. Many serious diseases are linked to bloodborne pathogens, but few bloodborne pathogens are frequently responsible for infections in the workplace. OSHA defines bloodborne pathogens as: Pathogenic microorganisms that are present in human blood that can cause disease in humans.

17 The Big Three As part of this training, officers should know some basic concepts about these diseases so that they can discuss them with their supervisor, co-workers, family members, their health care provider, and provide accurate information to the public. The risks and infections of the Big Three bloodborne pathogens will be discussed in this training: Hepatitis B Virus (HBV) Hepatitis C Virus (HCV) Human Immunodeficiency Virus (HIV)

18 Disease Transmission Hepatitis B, Hepatitis C and HIV are passed by contact with the blood or other body fluids of someone who has the virus. The three main ways to get hepatitis B, C, or HIV are: (1) having sex without latex condoms with someone who is infected; (2) being born to a mother who is infected; and (3) sharing needles and syringes with someone who is infected. We know that these viruses can be carried in infected human bodily fluids such as those defined under Other Potentially Infectious Materials (OPIM) in this training. And, if the Potentially Infectious Material contains enough of these pathogens, they can get into your bloodstream and may eventually cause disease. They can enter the bloodstream if the fluids come into contact with an unprotected break in your skin such as an open wound, acne, rash, etc. or if you experience a splash to your eyes, nose, or mouth.

19 Viral Hepatitis Hepatitis means inflammation of the liver. Viral hepatitis is inflammation of the liver caused by a virus. Your liver helps your body digest food, store energy, and get rid of poisons. It acts as a filtration system for your body. As the filter begins to fail, impurities build up in your body and symptoms can occur such as jaundice (yellowing color of the skin and eyes), dark urine, extreme fatigue, anorexia, nausea, abdominal pain, and sometimes joint pain, rash, and fever.

20 Types of Viral Hepatitis There are at least five types of viral hepatitis and each one is caused by a different virus. Hepatitis B is caused by hepatitis B virus (HBV), and hepatitis C is caused by hepatitis C virus (HCV). In the United States, HBV and HCV are the most common types related to occupational exposure to bloodborne pathogens. Viral Hepatitis At least 5 types: Hep A Hep B Virus (HBV) Hep C Virus (HCV) Hep D Hep E

21 Hepatitis B in the U.S. Annually, there are 10,000 new cases of Hepatitis B virus (HBV) reported in the U.S., with an estimated one to two million carriers of HBV. The hepatitis B virus takes about 2 months to show up in your blood. It may stay in your blood for months or years. Nine out of every 10 adults will get rid of the virus from their bodies after a few months. We say they have acute hepatitis B. One out of every 10 adults will never get rid of the virus from their bodies. We say they have chronic hepatitis B. They are called carriers. Most people with chronic hepatitis B will remain carriers of the virus if they do not get treated. The best things carriers can do is make sure their babies get all of their hepatitis B shots, make sure they do not spread it to their sex partners, and get good medical care. (Source:

22 Hepatitis B Vaccination A safe and effective vaccine to prevent hepatitis B has been available since In short, a vaccine teaches your body how to defend against the virus and fight it off before it can make you sick. All NC State University officers must meet the requirements for Hepatitis B vaccination as a condition of employment. OSHA requires that vaccination be made available within 10 working days of initial assignment. This is a one-time requirement. Do you still need to schedule or decline the Hepatitis B vaccine at NC State University?

23 Getting Vaccinated Exam Request Form If you find you still need the Hep B vaccine, complete the Exam Request Form As an employee, the vaccine is offered by NC State University at no cost to you: 1. Notify your Supervisor. 2. Notify Student Health of your request because you are employed by NC State University Police Department. 3. Schedule your appointment with Student Health as indicated on the Exam Request Form. A series of 3 shots Your initial visit 1 month later 6 months later

24 Hep B vaccine Declination Form If you ve had the vaccine in the past at a location other than NCSU Student Health Services, you need to officially decline the Hepatitis B vaccination with NC State University by completing the Declination Form and returning it to Student Health. Other reasons people may decline the Hepatitis B vaccination include current illnesses, pregnancy, or medications; They could lead to complications with the vaccination. As a member of the NC State University Police Department, if you are not getting a Hepatitis B vaccination at Student Health Services you must complete the Hepatitis B declination form. If you decline the vaccination, you may receive it at any time in the future by filling out the Exam Request Form and submitting it to Student Health Services.

25 Hepatitis B Vaccine information For health concerns regarding this vaccination you may: Discuss your concerns with Student Health Services; Discuss your concerns with your personal health care provider; and Review CDC information about the vaccine at

26 Hepatitis C Virus Hepatitis C virus is the most frequently occurring bloodborne pathogen infection. At least 85 out of 100 people infected with HCV become chronically infected, and chronic liver disease develops in an average of 67 out of 100. HCV is most often transmitted by large or repeated percutaneous (skin puncture) exposures to blood, such as through the transfusion of blood or blood products from infected donors and sharing of contaminated needles among injection drug users. There is no vaccine to prevent hepatitis C. A healthy and diseased human liver

27 Hepatitis A? Unlike Hepatitis B and C, Hepatitis A is not a bloodborne pathogen. Instead, it is transmitted by the fecal oral route. It is mentioned here because many people in the USA (33 out of 100 people) have had Hepatitis A virus with the most common being school children and young adults. Infection with HAV is always acute; it is therefore much less severe than HBV or HCV. A vaccine is available for HAV. All prevention programs for NC State University employees should emphasize proper handwashing after visiting or working in bathrooms or other fecalcontaminated areas. Source: Viral Hepatitis and Liver Disease 1984;9-22 J Infect Dis 1989;160:

28 Wash Your Hands Often! Wash your hands with soap and water for 20 Seconds. The suds scrub dirt and germs away. Don't Leave Anything Out. Wash your hands front and back and between the fingers. Soap up your wrists too. And don't forget your fingernails. Hands are to be washed immediately or as soon as feasible after removal of gloves or other personal protective equipment. Use a utility or restroom sink for handwashing, do not use sinks in food preparation areas. If handwashing facilities are not immediately available use antiseptic hand cleanser and/or disposable wipes for the short term... but wash your hands as soon as handwashing facilities are available.

29 HIV HIV stands for human immunodeficiency virus. It is different from most other viruses because it attacks the immune system. The immune system gives our bodies the ability to fight infections. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome), the final stage of HIV infection. It can take years for a person infected with HIV, even without treatment, to reach this stage. Having AIDS means that the virus has weakened the immune system to the point at which the body has a difficult time fighting infections.

30 HIV Testing The only way to know whether you are infected is to be tested for HIV. You cannot rely on symptoms alone because many people who are infected with HIV do not have symptoms for many years. Someone can look and feel healthy but can still be infected. In fact, one quarter of the HIV-infected persons in the United States do not know that they are infected. Once HIV enters the body, the body starts to produce antibodies substances the immune system creates after infection. Most HIV tests look for these antibodies rather than the virus itself. There are many different kinds of HIV tests, including rapid tests and home test kits. All HIV tests approved by the US government are very good at identifying HIV.

31 More about HIV HIV is a fragile virus. It cannot live for very long outside the body. As a result, the virus is not transmitted through day-to-day activities such as shaking hands, hugging, or a casual kiss. You cannot become infected from a toilet seat, drinking fountain, doorknob, dishes, drinking glasses, food, or pets. You also cannot get HIV from mosquitoes. HIV can enter the bloodstream similarly to HBV: if potentially infectious materials (like blood) come into contact with an unprotected break in your skin such as an open wound, acne, rash, etc. or if you experience a splash into your eyes and/or nose.

32 Exposure Incident Now that we ve discussed what it means to be exposed, let s look what to do in the event of a potential exposure. An important part of this training program is to make sure all officers know (1) if they have an exposure incident and (2) what to do after they have an exposure incident. An exposure incident could happen three ways: 1. When human blood or other potentially infectious material (OPIM) get onto an unprotected break in your skin such as an open wound, acne, rash, etc.; or 2. When blood or OPIM splashes or otherwise gets into your eyes, nose, or mouth; or 3. If you are cut or stuck by an object (it must break the skin) that is contaminated with human blood or OPIM.

33 Fights and assaults Law enforcement officers are exposed to a range of assaultive and disruptive behavior through which they may potentially become exposed to blood or other body fluids containing blood. Behaviors of particular concern are biting, attacks resulting in blood exposure, and attacks with sharp objects. Such behaviors may occur in a range of law enforcement situations including arrests, routine interrogations, domestic disputes, and lockup operations. Hand-to-hand combat may result in bleeding and may thus incur a greater chance for blood-to-blood exposure, which increases the chances for bloodborne disease transmission.

34 What is a BBP Exposure? The OSHA Definition: A specific eye, mouth, other mucous membrane, non-intact skin or parenteral contact with blood or OPIM that results from the performance of an employee s duties. Also, remember: NC State University requires you to report ANY incident resulting in injury from the performance of your duties. BBP Exposure = Blood, OPIM contact with: Eye, Nose, Mouth, Shaving cut, rash, etc.

35 Searches and Evidence Handling Criminal justice personnel have potential risks of acquiring HBV or HIV infection through exposures which occur during searches and evidence handling. Penetrating injuries are known to occur, and puncture wounds or needle sticks in particular pose a hazard during searches of persons, vehicles, or cells, and during evidence handling.

36 What to do for needlesticks, cuts from contaminated objects, scratches or splashes to an unprotected open wound: 1. Remove contaminated gloves and if possible, allow the wound to bleed freely for a minute. 2. Wash the wound with soap and water for 15 minutes and apply sterile gauze or a bandage, if necessary. 3. Decontaminate and remove protective clothing if necessary and 4. Notify your Supervisor and seek medical attention immediately

37 What to do for splash to eyes, nose, or mouth: 1. Rinse the area with continuous clean running water. 2. Eyes should be irrigated for at least 15 minutes using an emergency eyewash station if available or a sink. 3. Decontaminate and remove protective clothing and 4. Notify your Supervisor and seek medical attention immediately

38 Report Exposures Immediately! Immediately report exposures to your supervisor and seek medical attention. After any exposure to human blood or OPIM, officers must be seen immediately at an Occupational Health Clinic or Emergency Room. Supervisors should notify dispatch to help determine the need for immediate treatment and direct the officer to the proper location for appropriate blood tests to be drawn and medications to be dispensed. Dispatch maintains needlestick packets with the Duke Occupational Health Hotline phone number and other required information. If the packet cannot be obtained or Fire Protection personnel is unavailable, call the Duke Occupational Health Hotline at for assistance.

39 Post Exposure Evaluation Following the incident, you may be provided with a post exposure medical evaluation. This evaluation could include: Documenting routes of exposure Documenting circumstances of the incident Identifying sources of contamination Blood tests with consent from employee Post exposure prophylaxis and counseling Employees are not billed for work-related injuries and medical records are kept separate and confidential from performance reviews.

40 Reporting Injuries The supervisor is responsible to follow-up all injuries with standard reporting procedures. The Accident Report Form Flowchart is a helpful guide. It is available from the EHS website.

41 Bloodborne Pathogens Spills Spills may occur during traffic accidents, when an injured person drips blood on the floor, or when specimen containers of human blood or other potentially infectious materials (OPIM) leak. Employees designated to participate in emergency and decontamination procedures are exposed to blood or OPIM; they are to be thoroughly familiar with proper cleaning and decontamination procedures so that the contamination is contained and exposure to other people is minimized.

42 Remember Your Sharps Precautions During a Spill Contaminated broken glassware is cleaned up by mechanical means (e.g. tongs, forceps, pieces of cardboard).

43 Bloodborne Pathogens Spill Clean Up Kits Typically Include: 1 pair disposable latex gloves, 1 disposable faceshield, 1 disposable face mask, 1 pair disposable shoe covers, 1 disposable apron, 1 absorbent pack (w/ MSDS), 2 disposable towelettes (w/ MSDS), 2 scoops/scrapers, 2 biohazard bags with ties, 1 disposable towel, 1 instruction sheet, 1 can 12 oz. Disinfectant spray (w/ MSDS)

44 Spill Clean Up Inside university buildings Designated crews in Facilities Housekeeping are properly trained to handle spills of human blood and body fluids within University buildings. Outside university buildings Fire Protection and EHS should be consulted regarding spill clean up of human blood and body fluids exterior to university buildings. Officers may be requested for crowd control or other assistance to keep others out of the area until safe.

45 What to do with biohazard waste after spill clean up Never throw untreated biohazard waste in the regular trash! The disposal of this waste generated on the NC State University campus is subject to federal, state, and local regulations. After spill clean-up is complete, waste must be removed from public access. If waste needs to be removed, contact your supervisor. The supervisor is responsible for contacting the Department of Environmental Health and Safety at After the location and other pertinent information is given, EHS will remove the waste for proper disposal.

46 Preventing Incidents at NC State University Now that we ve discussed how to respond in the event of a potential exposure, let s look at how to protect ourselves and others from exposure. Make sure you know what s expected to prevent exposures and protect the campus community. It all starts with UNIVERSAL PRECAUTIONS.

47 Universal Precautions In the mid-1980s, health care facilities began adopting universal precautions against exposure to body fluids. These were followed in 1992 with the OSHA BBP Standard. These measures were included in annual training requirements which reduced incidents of work-related Hepatitis infections.

48 What Are Universal Precautions? Universal Precautions is the basis of every Bloodborne Pathogens training program. It is a simple approach to protecting yourself on the job. Because an Exposure Determination has already been made for your position, whenever you suspect the material is contaminated with bloodborne pathogens, you always respond AS IF bloodborne pathogens are present. Universal Precautions takes the guesswork out of responding to an incident. This means that if you anticipate human blood, body fluids (except sweat), or OPIM, you always wear appropriate Personal Protective Equipment and follow the specific requirements designated in this training and your Exposure Control Plan. This is also true for anything with a biohazard label on it.

49 Biohazard Symbol Communication of hazards is a key component to any OSHA and other safety program. The Biohazard symbol is used to alert others of the potential presence of biohazardous materials such as human blood, body fluids, and OPIM. This symbol is fluorescent orange or red/orange with contrasting letters and has the universal biohazard symbol.

50 Biohazard Labels In laboratories, biohazard labels are commonly used on: Containers of biohazard waste Refrigerators and freezers used to store human specimens Containers used to store, transport and ship human specimens Any equipment that could be potentially contaminated with human blood, OPIM, and other material that could allow bloodborne pathogens to live or to grow. We use the biohazard symbol at NC State University to provide a method for hazard communication between lab workers, visiting professors, Facilities Operations workers, Housekeeping personnel, vendors, and others who may come into contact with this material.

51 Biohazard Door Signs The Universal Biohazard Symbol may be posted on entryways to laboratories on campus. These laboratories are called Biosafety Level 2 or BSL-2 labs. Posted BSL- 2 areas are laboratories designated to work with bloodborne pathogens or with material that may allow germs that cause illness to humans, including bloodborne pathogens, to live and grow. It is safe to enter areas that are labeled with a BIOHAZARD symbol. DO NOT handle anything labeled as biohazardous in these areas without special training. For example, it is very important that all open sores are covered and protected if work is required in these areas. Wear gloves and face protection when working in areas where contact with blood or OPIM is possible. Untreated waste in biohazard waste bins should never be handled by untrained workers in BSL-2 areas.

52 Sharps Disposal Containers Sharps containers are appropriate for any contaminated object that can penetrate the skin such as: Needles Scalpels Razor blades Syringes with/without needles Specimen tubes and Broken glass Overfilling the sharps container can result in exposures when the next person tries to use the container. Dispose of sharps in containers immediately and never allow a container to fill over 2/3 full.

53 Sharps Precautions Needles/contaminated sharps: Must never be bent, recapped or removed; Must never be sheared or broken; Must be placed in a plastic sharps container labeled with the biohazard symbol. While processing the crime scene, personnel should be alert for the presence of sharp objects such as hypodermic needles, knives, razors, broken glass, nails, or other sharp objects. Needles and other sharp objects recovered as evidence should be manipulated as little as possible and should be stored and transported in a puncture-proof container. After use, disposable blades and other sharp items should be placed in puncture-resistant containers for disposal. Contaminated disposable needles are to be placed in red plastic sharps containers (available from cabinet in squad room/supply room) after use.

54 Work Practice Controls: General Work Practice Controls specifically reduce the likelihood of exposure by altering the manner in which a task is performed. Hand washing. Hands are to be washed immediately or as soon as feasible after removal of gloves or other personal protective equipment. Use a utility or restroom sink for handwashing, do not use sinks in food preparation areas. If handwashing facilities are not immediately available use antiseptic hand cleanser and/or disposable wipes. Wash your hands as soon as handwashing facilities are available. Prevent Ingestion. Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited during duties where there is reasonable likelihood of exposure to blood or other potentially infectious material. Storage of food and drink is prohibited in refrigerators, freezers, shelves, cabinets or on countertops or bench tops where blood or other potentially infectious materials are present.

55 More General Work Practice Controls Sharps Precautions. Disposing of sharps in the proper container and disposing of the container when it is 2/3 full helps keep others safe. Remember, any contaminated object that can penetrate the skin, including needles, scalpels and glass objects requires extra attention. Contaminated needles. Contaminated needles are not to be bent, broken, recapped, or removed from the syringe. If you have no way to tell if the needle is contaminated or not, use Universal Precautions: assume the needle is contaminated. Contaminated needles are to be placed in the plastic sharps containers described previously and autoclaved before disposal. Broken glassware which may be contaminated with human blood or OPIM must not be collected directly with the hands. Wear gloves and use tongs or a brush and dust pan. While small shards of contaminated broken glass can be placed into sharps containers, large contaminated broken glass items must be autoclaved separately in a hard-walled container (such as a cardboard box) lined with a biohazard bag. The autoclaved glass waste is to be disposed of in a larger cardboard box lined with a plastic bag, clearly marked with the "GLASS AND SHARPS" label.

56 Work Practice Controls--Searches and Evidence Handling The following work practice controls will help to reduce the risk of infection during searches and evidence handling: 1. An officer should use great caution in searching the clothing of suspects. Individual discretion, based on the circumstances at hand, should determine if a suspect should empty his own pockets or if the officer should use his own skills in determining the contents of a suspect's clothing. 2. A safe distance should always be maintained between the officer and the suspect. 3. Wear protective gloves if exposure to blood is likely to be encountered. 4. If cotton gloves are to be worn when working with evidence of potential latent fingerprint value at the crime scene, they can be worn over protective disposable gloves when exposure to blood may occur. 5. Always carry a flashlight, even during daylight shifts, to search hidden areas. Whenever possible, use long-handled mirrors and flashlights to search areas (e.g., under car seats). 6. If searching a purse, carefully empty contents directly from purse, by turning it upside down over a table. 7. Use puncture-proof containers to store sharp instruments and clearly marked plastic bags to store other possibly contaminated items. 8. To avoid tearing gloves, use evidence tape instead of metal staples to seal evidence.

57 Personal Protective Equipment Personal protective equipment (PPE) is specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (including uniforms) are not PPE. PPE is worn when there is a need to provide protection for clothing skin eyes nose mouth

58 PPE Personal protective equipment should be present in each patrol car for use in emergency and criminal response situations. Replacement gloves and sharps disposal containers are kept in the cabinet in the squad room/supply room. The cabinet is restocked regularly by Fire Protection. Nitrile gloves are issued on your duty belt. They do deteriorate over time! Every couple of months replace the issued gloves on your duty belt if unused. Not all types of gloves are suitable for all situations. Vinyl or latex rubber gloves provide little protection against sharp instruments, and they are not puncture-proof. There is a direct trade-off between level of protection and manipulability. In other words, the thicker the gloves, the more protection they provide, but the less effective they are in locating objects. Thus, there is no single type or thickness of glove appropriate for protection in all situations. Officers should select the type and thickness of glove which provides the best balance of protection and search efficiency.

59 Know the limitations of your PPE Officers may confront unusual hazards, especially when the crime scene involves violent behavior, such as a homicide where large amounts of blood are present. Protective gloves should be available and worn in this setting. In addition, for very large spills, consideration should be given to other protective clothing, such as overalls, aprons, boots, or protective shoe covers. Gloves should be changed if torn or soiled and always removed prior to leaving the scene. While wearing gloves, avoid handling personal items, such as combs and pens that could become soiled or contaminated. Face masks and eye protection or a face shield are required for situations which could lead to potential exposures to blood via a splash to the face, mouth, nose, or eyes.

60 PPE Removal All PPE must be removed and disposed of prior to leaving the area. Here is a sample removal technique when gloves are contaminated: 1. Grasp outside of glove with opposite glove hand; peel off 2. Hold removed glove in gloved hand 3. Slide fingers of ungloved hand under remaining glove at wrist 4. Peel glove off over first glove 5. Discard glove in waste container 6. Wash hands immediately

61 PPE (continued) PPE is NOT worn outside of the work area. Gloves must be removed prior to washing hands and leaving the area. DO NOT wear gloves on elevators (even if they are clean ) or use them to open doors or touch equipment (i.e. phones, computers) that others will be handling without gloves.

62 Laundry Although soiled clothing or uniforms may contain organisms that cause disease, the risk of actual disease transmission is negligible. Therefore, simple hygienic measures for handling and washing linens are recommended. 1. Handle uniforms soiled with blood as little as possible, using gloves and appropriate protective clothing. 2. Place uniforms soiled with blood in bags that prevent leakage. 3. Contaminated uniforms cannot be taken home for cleaning. Contact your supervisor so that arrangements can be made for laundering.

63 Safety Resources Below is a list of Safety Resources that can provide you with more safety information. OSHA Topics Page OSHA's Bloodborne Pathogens Standard Exposure to Blood: What Health Care Workers Need to Know (CDC) As It Should Be Done: Workplace Precautions Against Bloodborne Pathogens (24 minute video, OSHA) Sharps Safety: Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program (CDC)

64 Questions??? If you have any questions, please contact the Biosafety Officer in Environmental Health and Safety at between 8 am and 5 pm. Don t forget to take the exam to get credit for this course! To begin the exam, click here

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