Bloodborne: = transmitted by blood (or other body fluids) Pathogen = microorganism capable of causing disease If it s wet and it s not yours, don t touch it! Bacterial: Straph & Strep Viral: HBV, HCV, HIV 300,000 cases of bbp infections are reported yearly to the CDC Estimated as many as 3 million people infected with HCV and most don t know they have it What are some Examples of Bloodborne Pathogens?? HIV Hepatitis C Hepatitis B Can acquire from blood body fluids containing visible blood Semen, vaginal secretions other potentially infectious material (OPIM) cerebral spinal fluid (CSF), synovial fluid, pleural fluid, peritoneal fluid, amniotic fluid Not infectious for blood borne pathogens Feces Urine Tears Saliva ** unless visible blood Vomitus Sputum (mucus) Sweat Occupational exposure occurs by: percutaneous injury (needlestick or cut) contact with mucous membranes contact with non-intact skin in which there is blood, body fluids with visible blood, OPIM (other potentially infectious materials) 1
HIV virus that causes AIDS incubation period 1 to 3 months person is infectious from onset of infection throughout life all persons are susceptible HIV Symptoms suffer flu-like illness (fever, fatigue, diarrhea) carry the virus and show NO symptoms for years eventually develop AIDS develop AIDS-related illness (cancer, neurological problems and other opportunistic infections) HIV risk of transmission needlestick: 0.3% splash/spray to mucuous membranes: 0.09% non-intact skin: less than mucous membrane exposure Chances of Infection If you are exposed to HIV infected blood/body fluids by: A dirty needle/sharp: 3 in 1000 (0.3%) Mucous membrane splash: 1 in 1000 (0.1%) Non intact skin: 1 in 1000 (0.1%) Prompt antiviral treatment after exposure can reduce risk of infection by 60 80% Hepatitis means inflammation of the liver. Most people who contract hepatitis will heal in about six months. In others, the virus can cause liver damage and be life threatening. There is a vaccination for Hepatitis B. HBV virus that causes hepatitis B incubation period 45 to 180 days Acute inflammation of liver 90% clear infection 25 million infected yearly 100x more easily to contract then HIV 2
Symptoms of Hepatitis B HBV Contract via: Sharing contaminated needles/syringes Tattooing, ear piercing, acupuncture Unprotected sexual contact w/infected partner Contaminated SHARPS exposure Fatigue Loss of appetite, nausea Jaundice (yellowing of skin and eyes) Fever Abdominal pain, joint pain 30% have no symptoms Preventable HBV risk of transmission needlestick: 22-31% if source is HBeAG + needlestick: 1-6% if source is HBeAG - direct or indirect contact with nonintact skin or mucous membranes is an important source of occupational exposure Effectiveness at least 90% of adults are immune after completing the three doses of vaccine since 1985, 90% reduction of number of HCW infected with HBV, largely due to vaccine administered by deep intramuscular injection 3 doses given: 1st two doses 1 month apart, last dose is given 5 months after second dose SLH will test antibody levels at 1-2 months after last dose to test for immunity non-responders will be-revaccinated HCV virus that causes hepatitis C incubation period 6 to 9 weeks Most common chronic blood borne infection in US Causes liver damage, cirrhosis and liver cancer Leading reason for liver transplants 3
Symptoms of Hepatitis C HCV Transmission Multiple sex partners Infected mother to baby Illegal drug use (60%) Tattooing Occupational exposure Same as Hepatitis B May occur within 2 weeks to many years 85% don t know they are infected Hepatitis C Vaccine HCV risk of transmission needlestick: 1.8% mucous membranes: rare non-intact skin: very rare There is NO vaccine and NO cure for Hepatitis C! There are 50,000 needlesticksannually related to HCV infected patients Many contagious people show no signs or symptoms of infection. Only blood tests can positively identify these diseases. HAV Not a BBP Most common form of hepatitis Often associated with contaminated food in restaurants and cafeterias. 4
Pathogens can enter your body through various avenues Cuts, scratches Skin abrasions Dermatitis, eczema Acne areas Mucus membranes: eyes, nose, mouth Any sort of damaged or broken skin such as sunburn or blisters When you touch a surface that has been contaminated with infected blood and then, transfer the germs to your eyes, nose, mouth or open skin. The Hepatitis B virus is very durable; studies show that HBV can survive on surfaces dried and at room temperature for a week. HIV, on the other hand, is very fragile and will not survive very long outside of the human body. However, because HIV is such a devastating disease, all precautions must be taken to avoid exposure. OSHA requires that our District have a written Exposure Control Plan. What is the Purpose? When an exposure incident occurs, we will know how to respond quickly and appropriately, ensuring a positive outcome. What is Included? --Identification of personnel covered by the OSHA standard. --Analysis of potential hazards of each job description. --Determination of measures to be taken to reduce the risk of exposure to bloodborne pathogens on the job. --Written procedures related to exposure risks. It is impossible to tell who is infected with a disease simply by appearances; many people who are infected show no visible signs or symptoms and may not even know their infectious state. Therefore, using universal precautions is essential. UNIVERSAL PRECAUTIONS is a prevention concept in which all blood and body fluids are treated as if they are infectious. In other words, whether or not you think the blood/body fluid is infected with bloodborne pathogens, you treat it as if it is. Using this, along with other protective practices can greatly reduce your risk. Where is it located? Business Office and School Health Offices. Treat all blood and body fluids as potentially infectious. Critical because it is impossible to tell who is infected with HBV or HIV by appearances. Many have no knowledge or symptoms of their disease. Work Practice Controls refers to specific procedures one must follow on the job to reduce exposure to blood or other potentially infectious materials. For example, our custodial staff has special training in proper procedures for cleaning up blood and body fluid spills. 5
Do not eat, drink, apply make-up, handle contact lenses, or smoke in areas with likely exposure to blood or OPIM testing areas areas where specimens located Do not store food or beverages in refrigerators, freezers, coolers, shelves, cupboards where specimens are located Do not place hands into used sharps containers Use a brush and dustpan or tongs or forceps to pick up broken glass or other sharp items Work Practice Controls When to wash hands (Lather 15 sec.) * Waterless hand cleaner-only if no soap and water available! Hand-washing: Single most important means of preventing the spread of infection Before and after touching someone or something potentially infectious After removing gloves After handling potentially infectious material After using the bathroom Before eating, smoking, applying cosmetics, handling contact lens Waterless alcohol gel may use if hands are not visibly soiled more effective against organisms convenient gentler to skin than soap, water, paper towels takes less time than soap and water wash gowns, gloves, surgical masks, face shields, goggles, shoe covers, aprons provides protection for clothing, skin, eyes, mouth, nose 6
Gloves must be worn if you anticipate exposure to another person s blood, potentially infectious materials, mucous membranes or non-intact skin. Keep gloves within easy reach at all times; all staff should have access. Your building nurse will supply you with gloves as needed. Unsure of the proper way to remove gloves? Follow these steps listed below. If you have any questions, consult with your building nurse for a demonstration. 1. With both hands gloved, peel one glove off by grabbing it in the middle of your palm and pulling it off your fingers last (the glove should come off your hand inside out). Hold it in the gloved hand. If you assist with first aid where blood or body fluids are involved, you must wear gloves. Replace gloves as soon as you can if they are torn, punctured, contaminated or defective in any way (sometimes they wear out). Do NOT reuse disposable gloves. Always wash your hands after taking your gloves off. 2. With the exposed hand, peel the second glove FROM THE INSIDE, tucking the first glove inside the second. 3. Dispose of the gloves properly. 4. Never touch the outside of the gloves with your bare skin. 5. Wash your hands as soon as possible. Minimize blood spatter when helping an injured and bleeding person. Handle contaminated laundry/ clothing as little as possible. Reducing your Risk: Personal Hygiene Reminders Dispose sharps(needles, broken glass, bloody metal) and infectious wastes in designated containers. Call a custodian for clean-up of blood or body fluids. Cover cuts, scratches, rashes or other open sores on exposed skin. Avoid eating, drinking, applying makeup or lip balm where there is a possibility of exposure. Encourage students to selfadminister first aid if possible. Avoid picking-up broken glasswith your bare hands. Use a broom and dustpan, tongs or some other device. Inspect and cleanwastepaper baskets and other receptacles that are reused (and have a likelihood of becoming contaminated with blood or other infectious materials) on a regular basis. Avoid sharing razors, toothbrushes or other personal items. Avoid handling contact lenses where there is a possibility of exposure. Safety devices on sharps: needles, lancets must be used if available evaluated by staff Shearing, breaking, bending, re-capping of contaminated sharps is prohibited Do not remove needle from used tube holder after phlebotomy Place used sharps in disposal containers immediately after use Sharps containers puncture resistant leakproof labeled or red in color stabilized if portable 7
Sharps containers Replace sharps containers when 2/3 full The users of the containers are responsible for replacing when necessary International BiohazardousWaste Symbol A type of staph bacteria that is resistant to antibiotics. There has been a lot of hype and media attention surrounding MRSA so let s get a few things straight: Staph bacteria is common and found everywhere. MRSA can be treated, it is resistant to some but not all medications. Starts as small red bumps that resemble pimples, boils or spider bites. Can turn into deep, painful abscesses Bacteria can burrow into the body causing infection in bones, joints, surgical wounds, the blood stream, heart valves and lungs. 8
Prevent the Spread By: Standard/ Universal Precautions Hand Washing Gloves Keep Personal Items Personal Keep Wounds Covered 9