Bloodborne Pathogens

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1 Bloodborne Pathogens

2 OSHA Regulation OSHA 29 CFR Bloodborne Pathogens Covers any work involving human blood, body fluids, or human cell lines

3 OSHA s Standards Format All OSHA standards follow a similar format: Administrative Controls Engineering Controls Work Practices Personal Protection Training Programs Record Keeping Requirements

4 Specifics of Bloodborne Pathogen Regulation Specific requirements for Bloodborne Pathogens standard: Written Exposure Control Plan Engineering/Work Practice Control Plan Use of Universal Precautions Personal Protective Equipment Free Hepatitis B Vaccination Annual Training Labeling Follow Up after an Exposure

5 Universal Precautions According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV (Hepatitis B), and other bloodborne pathogens.

6 Bloodborne Pathogen Transmission Bloodborne pathogens are transmitted through contact with infected human blood and other body fluids such as: Semen Vaginal secretions Cerebrospinal fluid Synovial fluid Pleural fluid Peritoneal fluid Amniotic fluid Saliva

7 Occupational Exposure An occupational exposure is defined as an exposure to broken skin, eyes, mucous membrane, or a percutaneous injury (needle stick) with blood or other potentially infectious materials that may result from the performance of an employee s duties.

8 Skin Provides a Barrier Unbroken skin forms an impervious barrier against bloodborne pathogens. However, infected blood can enter your system through: Open sores Cuts Abrasions Acne Any sort of damaged or broken skin such as sunburn or blisters

9 Mucous Membranes Bloodborne pathogens may also be transmitted through the mucous membranes of the: Eyes Mouth Nose

10 What Are Bloodborne Pathogens? Bloodborne pathogens are microorganisms such as viruses or bacteria that are carried in blood and can cause disease in people

11 Types of Bloodborne Pathogens Bloodborne pathogens include: Hepatitis B (HBV) Hepatitis C Human Immunodeficiency Virus (HIV) Other diseases

12 Hepatitis B (HBV) Is the most common bloodborne pathogen Is a virus that causes infection and inflammation of the liver Is transmitted primarily through blood to blood contact Can lead to serious conditions such as cirrhosis and liver cancer Can survive in dried blood for up to seven days

13 No Cure for HBV Currently, there is no cure or specific treatment for HBV.

14 HBV Symptoms Mild flu-like symptoms Fatigue Possible stomach pain Loss of appetite Nausea Jaundice Darkened urine About 30% of infected people demonstrate no symptoms Even though these people don t display symptoms, they are still infectious

15 Hepatitis B Vaccinations Employees who have reasonably anticipated exposure to bloodborne pathogens shall be offered the Hepatitis B vaccine series at no cost to themselves unless: They have previously received the vaccine series Antibody testing has revealed they are immune The vaccine is contraindicated for medical reasons

16 Hep B Vaccination Process Series of three shots Second shot is given one month after the first Third shot follows five months after the second It is very important to receive all three of the vaccines This series gradually builds up the body s immunity to the Hepatitis B virus Complete immunity not reached until all three vaccines are received

17 Hep B Vaccination After the 1991 Bloodborne Pathogens Standard required that the vaccine be offered, cases of hepatitis B in health care workers dropped from 17,000 annually to 400 annually and they continue to drop This demonstrates the effectiveness of the hepatitis B vaccine

18 Human Immunodeficiency Virus (HIV) AIDS, or acquired immune deficiency syndrome, is caused by a virus called the human immunodeficiency virus, or HIV It may be many years before AIDS actually develops

19 HIV HIV attacks the body s immune system, weakening it so that it cannot fight other deadly diseases AIDS is a fatal disease, and while treatment for it is improving, there is no known cure

20 HIV Symptoms Symptoms of HIV infection can vary, but often include: Weakness Fever Sore throat Nausea Headaches Diarrhea White coating on the tongue Weight loss Swollen lymph glands Even though some people that have HIV may not display symptoms, they are still infectious

21 HIV and Direct Contact Although HIV virus is very fragile and will not survive very long outside of the human body, it is a primary concern to health care employees As of June 2001, there were at least 57 CDCdocumented cases of health care workers with occupationally acquired HIV and at least 137 cases of possible transmissions

22 Occupationally-Acquired HIV/AIDS United States Cases since June 2001: 57 total cases documented by the CDC Most occurred through needle sticks or cuts (48) Some occurred through exposures of eyes, nose, or mouth to blood (6) Two from both a splash to the face and a needle stick One unknown type of exposure in an HIV research lab Percutaneous, 48 Mucocutaneous, 6 Both, 2 Unknown, 1.2

23 Protection Hand washing Personal Protective Equipment

24 Hand Washing Hand washing is one of the most important (and easiest) practices used to prevent transmission of bloodborne pathogens Wash hands or other exposed skin thoroughly as soon as possible following an exposure incident

25 Hand Washing Wash hands before eating, drinking, smoking, handling contact lenses, applying lip balm or cosmetics Keep hands away from eyes, nose, mouth Use antibacterial soap Don t use harsh, abrasive soaps

26 Alcohol Based Products Hand sanitizers are ideal when there s no soap and water Apply to your palm (read label for amount) Rub hands together, covering all surfaces, until they are dry

27 Ability of Hand Hygiene Agents to Reduce Bacteria on Hands Bacterial Reduction (%) Baseline Time After Disinfection (minutes) Alcohol-Based Handrub (70% Isopropanol) Antimicrobial Soap (4% Chlorhexidine) Plain Soap Adapted from: Hosp Epidemial Infect Control, 2 nd Edition, 1999.

28 Personal Protective Equipment To protect yourself, it is essential to have a barrier between you and the potentially infectious material The best protection against exposure is to ensure you are wearing the appropriate personal protective equipment (PPE)

29 Goggles, Face Shields, & Lab Coats Use goggles if there is a risk of splashing or vaporization of contaminated fluids Face shields provide additional face protection for the nose and mouth A lab coat should be worn whenever working with blood or body fluids

30 Gloves Gloves should be made of latex, nitrile, or rubber Some people develop allergies to latex, so other types of gloves will be available to you Inspect gloves before use Double gloving can provide an additional layer of protection

31 Reducing the Risk of Infection Double Gloving Multiple studies indicate wearing two pairs of gloves provides a wiping effect Gloves wipe the blood contamination off the outside of the needle Double gloving reduces the amount of contamination during a needle stick or cut

32 Gloves If you have cuts or sores on your hands, you should cover these with a bandage or similar protection as an additional precaution before donning your gloves Don t touch the outside of used gloves

33 Rules to follow: Treat all blood or potentially infectious body fluids as if they are contaminated Always wear personal protective equipment in exposure situations Replace PPE that is torn or punctured

34 Rules to follow: Remove PPE before leaving the work area Properly disinfect or dispose of used PPE Wash hands immediately after removing PPE

35 Hygiene Rules If you are working in an area where there is reasonable likelihood of exposure, you should never: Eat Drink Smoke Apply cosmetics Handle contact lenses

36 Food Rules Do not keep food or drink in refrigerators, freezers, shelves, cabinets, or on countertops where blood or potentially infectious materials are present

37 Needle & Syringe (Sharps) Safety The Centers for Disease Control and Prevention estimates that each year 385,000 needle sticks and other sharps related injuries are sustained by hospital-based healthcare personnel Data from National Surveillance System for Health Care Workers (NaSH) show that nurses sustain the highest number of percutaneous injuries

38 Needle and Syringe (Sharps) Safety Occupational Groups Exposed to Blood/Body Fluids NaSH 6/95 to 12/01 Clerical/Admin, 1% Student, 4% Housekeeping/ Maintenance, 3% Other, 5% Dental, 1% Nurse, 44% Technician, 15% Physician, 28%

39 Needle and Syringe (Sharps) Safety Injuries most often occur after use and before disposal of a sharp device NEVER recap needles or syringes The majority of occupational acquired infections have resulted from injuries from hollow-bore, blood-filled devices

40 Safety Devices The BBP Standard has a requirement to implement the use of engineering controls, which includes safer medical devices The standard defines Engineering Controls as controls (e.g., sharps disposal containers, selfsheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needleless systems) that isolate or remove the bloodborne pathogens hazard from the workplace.

41 Signs and Labels Warning labels must be placed on containers of regulated waste, equipment such as refrigerators and freezers containing blood or other potentially infectious material; and any other containers used to store, transport, or ship blood or other potentially infections materials

42 Emergencies In an emergency situation, always use Universal Precautions Minimize your exposure by wearing: Gloves Splash goggles Other barrier devices

43 If you are exposed or have a needle stick: Wash the exposed area thoroughly with soap and running water Use non-abrasive antibacterial soap Flush mouth/nose/eyes for 15 minutes if blood is splashed in mucous membranes

44 More Actions if Exposed Report the exposure to your supervisor Call University Police at (864) so the Director of Health Services can be contacted

45 Decontamination & Sterilization All surfaces, tools, equipment, and other objects that come in contact with blood or potentially infectious materials must be decontaminated and sterilized as soon as possible Equipment and tools must be cleaned and decontaminated before servicing or being put back to use

46 Decontamination of Surfaces A solution of sodium hypochlorite (household bleach) dilution of 1:10 with water (1 part bleach, 9 parts water) should be used to decontaminate biological spills

47 Contaminated Clothing Remove clothing that is contaminated with blood as soon as possible Use Universal Precautions when handling contaminated laundry Place clothing in approved and labeled bags or containers

48 Spill Cleanup Carefully cover the spill with paper towels or rags Gently pour 10% solution of bleach over the towels or rags. Let sit for 10 minutes Collect & dispose of waste

49 Broken Glassware Don t pick up broken glassware with your hands All contaminated broken glass should be removed with a mechanical device and discarded directly into a puncture-resistant biohazard sharps container

50 Infectious Waste All sharps (needles, syringes, scalpels) must be disposed in a sharps container NEVER put a sharp in the normal trash All contaminated waste must be placed in a medical waste receptacle

51 Summary Always act as if you are working with infectious materials using Universal Precautions Select the proper PPE to reduce the potential for exposure to bloodborne pathogens Report all suspected exposures Don t handle sharps or broken glass with your hands Properly dispose of infectious waste, PPE, and sharps

52 For additional information, see the BBP Exposure Control Policy You may now finish this safety training tutorial by completing the OSHA Assessment Quiz

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