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Bloodborne pathogens 5 09



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  • 1. Bloodborne Pathogens Presented to: Center for Children & Families, Inc May 28, 2009 Stephanie Bagley, RN, CPTC© Business & Legal Reports, Inc. 0507
  • 2. Regulatory Requirements • OSHA = Occupational Safety & Health Administration • Federal Law requires: • Employer to provide training, equipment • Employee to learn and follow requirements • Employer and Employee must work together to provide a safe work place for everyone.© Business & Legal Reports, Inc. 0507
  • 3. Bloodborne Pathogens Work Place Accidents
  • 4. Session Objectives You will be able to: • Identify bloodborne pathogens (BBPs) • Understand how diseases are transmitted • Determine your risk of exposure • Protect yourself from exposure through prevention • Respond appropriately if exposed • Understand your right to medical evaluations© Business & Legal Reports, Inc. 0507
  • 5. What Are Bloodborne Pathogens? • Micro-organisms present in human blood that can cause disease • Viruses, bacteria, parasites, fungi • Primary workplace pathogens • Human immunodeficiency virus (HIV) • Hepatitis B virus (HBV) • Hepatitis C virus (HCV) • Prion Disease (CJD classic & variant)© Business & Legal Reports, Inc. 0507
  • 6. Transmission of Pathogens • Blood, Body Fluids • Contaminated sharp objects or needles • Broken skin, including rashes • Mucous membrane (splash) • Eyes • Mouth • Nose© Business & Legal Reports, Inc. 0507
  • 7. Bloodborne Pathogens Law 29 CFR 1910.1030 requires: • A written Exposure Control Plan (ECP) is required to be available in the workplace • Engineering and work practice controls • Personal Protective Equipment (PPE) • Training • Employees must comply© Business & Legal Reports, Inc. 0507
  • 8. Bloodborne Pathogens Law (cont.) • Medical surveillance • Free Hepatitis B vaccination; prior to potential exposure (required within 10 days of beginning work); temporary workers included • Signs and labels may be appropriate • Equipment and procedures will be provided and must be followed • Wash Hands properly; scrub, 3” above wrist, rinse thoroughly, dry, dispose© Business & Legal Reports, Inc. 0507
  • 9. What is the ECP? Exposure Control Plan • Identifies jobs - tasks for potential exposure; Levels: I (exposure), II (no routine exposure, but may perform level 1 tasks, or III (tasks do not involve exposure) • Describes engineering and safe work practices (PPE) • Outlines training requirements • Identifies the placement and use of signs and labels • Explains how to decontaminate equipment or tools and work surfaces© Business & Legal Reports, Inc. 0507
  • 10. ECP (cont.) • Describes how biohazard waste is handled (agreement with biomedical waste company) • Explains the recordkeeping requirements (keep copy of final signed manifest that pick up material was destroyed)© Business & Legal Reports, Inc. 0507
  • 11. Hepatitis B Vaccination • Endorsed by medical communities • Safe when given to infants, children, and adults • Offered to all potentially exposed employees (full time, part time, temporary, volunteers, etc.) • Provided at no cost to employee (immediate is better; but laws requires within 10 days of beginning work) • Vaccination declined, must be in writing© Business & Legal Reports, Inc. 0507
  • 12. Hepatitis B Virus (HBV) • 1.25 million people infected (rate of new infections has declined with vaccine use) • Symptoms • Jaundice, fatigue, and abdominal pain • No appetite, nausea, and vomiting • Vaccine available since 1982 • HBV can survive outside the body Image Credit: State of WA-WISHA Services© Business & Legal Reports, Inc. 0507
  • 13. HIV – Human Immunodeficiency Virus AIDS – Acquired Immunodeficiency Syndrome • HIV (virus infection) leads to AIDS (virus infection, symptoms) • HIV attacks and depletes the human immune system (Acquired Immune Deficiency Syndrome) • Early HIV symptoms resemble common cold or flu virus • HIV testing (NAT) and/or antibody testing is the only way to know for sure • HIV does not survive outside the body • No cure yet • HIV—virus present in body; AIDS—virus + symptoms© Business & Legal Reports, Inc. 0507
  • 14. Hepatitis C Virus (HCV) • HCV is the most common chronic bloodborne infection—3.9 million infected (2.7 Million chronic liver disease; 1/3 to Cancer) • Symptoms can take years to manifest • Flu-like symptoms, jaundice, dark urine, and fatigue • Loss of appetite, nausea, and vomiting, and abdominal pain • Treatment is marginally effective (10 to 40% respond)© Business & Legal Reports, Inc. 0507
  • 15. Prion Disease • aka—Transmissible Spongiform Encephalopathies • Family of rare progressive neurodegenerative disorders • Affect both humans and animals • Long incubation periods, neuron loss, failure to induce inflammatory response • Rapidly progressive, always fatal© Business & Legal Reports, Inc. 0507
  • 16. Prion – CJD Classic & Variant • Classic Creutzfeldt - Jakob (CJD) • Dementia as early symptom • Median age at death 68; 4-5 month illness • 1 case/million of population • Variant CJD – Mad Cow • Psychiatric/behavioral symptoms; delayed neruo signs • median age at death 28; 14 month illness • Route of infectivity—Eye, non-intact skin, mucous membranes, needles/sharps • High infectivity: spinal fluid, brain, eye • Low infectivity: kidney, lung, liver, nodes, placenta • Autopsy with evaluation of head the greater concern© Business & Legal Reports, Inc. 0507
  • 17. Protect Yourself • Review the Exposure Control Plan and OSHA regulation • Take Universal Precautions • Use Personal Protective Equipment (PPE) • Follow safe work practices • Get the Hepatitis B vaccination • Follow decontamination and disposal procedures; wash hands© Business & Legal Reports, Inc. 0507
  • 18. Take Universal Precautions OSHA defines as an approach to infection control • Treat all blood and body fluids as if infected • Use barrier protection (gloves, masks, aprons, eyewear) to avoid contact with infected body fluids • Immediately clean up From: osha.gov and decontaminate surfaces and equipment Image Credit: OSHA© Business & Legal Reports, Inc. 0507
  • 19. Use Personal Protective Equipment • Barrier protection prevents exposure • Use gloves when applying bandages or cleaning up • Eyewear or masks protect against splashes; eye wash station • Protective clothing or aprons protect against splashes (blood, body fluids)© Business & Legal Reports, Inc. 0507
  • 20. Avoid Puncture Wounds • Use tongs, forceps, or similar tools to pick up contaminated items, especially to protect against sharp objects Image Credit: State of WA-WISHA Services© Business & Legal Reports, Inc. 0507
  • 21. Safe Work Practice—Do’s • Remove contaminated PPE and clothing before leaving the work area • Disinfect contaminated equipment • Wash up immediately after exposure • Have Eye Wash Station in work area • Seek immediate medical attention • Double-glove to reduce contamination risk (if need to remove top pair to answer phone, scratch; then replace) • Dispose of contaminated items properly© Business & Legal Reports, Inc. 0507
  • 22. Safe Work Practice—Don’ts • No eating, drinking, cigarettes, cosmetics or other personal items in any work areas where there is the possibility of exposure to blood or body fluids • Do not place or store food in any work areas where blood or body fluids are or may be - (ie: refrigerators, on bathroom/kitchen shelves, cabinets, countertops, or work surfaces where blood/body fluids may be)© Business & Legal Reports, Inc. 0507
  • 23. General Decontamination (assume all blood & body fluid is contaminated) • Wear appropriate gloves and glasses to protect eyes, nose, mouth, and skin • Use a body fluid disposal kit • Use 10% bleach or EPA-approved disinfectant for spills • Immediately dispose of contaminated items© Business & Legal Reports, Inc. 0507
  • 24. Decontamination Involving Sharp Objects • Remove glass and other sharps materials using a brush and dust pan, or tongs • Do not use your hands • Use paper/absorbent towels to soak up the residual liquids • Disinfect all surfaces, and allow time to dry before using again; Kill time with most agents is 10 minutes (check manufacturer information)© Business & Legal Reports, Inc. 0507
  • 25. Biohazard Disposal— Regulated Waste • Liquid or semi-liquid blood or other potentially infectious materials (body fluids) • Contaminated items that would release blood or body fluids if compressed • Contaminated sharp objects • Items caked with dried blood or body fluids capable of release during handling • Pathological and microbiological wastes containing blood or body fluids© Business & Legal Reports, Inc. 0507
  • 26. Label All Regulated Waste Containers • Labels communicate a hazard • Place regulated waste in containers that have the universal biohazard symbol • The term “Biohazard” must be on the label • Note: unregulated waste is band-aids, paper towels, kleenex, etc. • Not biohazard; no labels Image Credit: OSHA© Business & Legal Reports, Inc. 0507
  • 27. Exposure Incident • Wash cuts and skin thoroughly • Rinse nose and mouth • Flush eyes with clean water or sterile solution • Clean all contaminated surfaces • Report all incidences of exposure on OSHA Forms individual; annual posting (300, 300A, 301)© Business & Legal Reports, Inc. 0507
  • 28. Post-Exposure Evaluation • Confidential medical evaluation • Document route of exposure • Identify source individual • Test source person’s blood (if possible; consent) • Provide results to source and exposed employees Image Credit: State of WA-WISHA Services© Business & Legal Reports, Inc. 0507
  • 29. Key Points to Remember • Bloodborne pathogens can cause fatal disease • Be aware of exposure at work • Take universal precautions • Use PPE and safe work practices • Decontaminate yourself and equipment • Understand and follow exposure incident procedures • Report incidences of exposure© Business & Legal Reports, Inc. 0507