A few years ago 5,000 to 8,500 cases a year were reported (in Ohio). That has dropped dramatically to about a 1,000 reported cases a year. OUTCOMES 1) Get it ; Get Over it 2) Carrier 3) Chronic Liver Disease
Blood is the main emphasis here. It takes so many parts per million of saliva to cause transmission it is not to be concerned about.
These symptoms can be mistaken for flu like symptoms.
Previous name: Before 1992 there was no test, diagnosis was by exclusion and was referred to as NON A/NON B. The test: 1) Initial Exposure 2) 6 weeks Later 3) then follow up 2 months later Degree of Risk ( talk about a good rule of 3 here shortly) 85 % of Hepatitis C exposures are carriers for life. IV Drug users Prison Population Social Economic Problem Bad Liver ( Cost to you) Drug therapy-- $1200 per month
We talk about Hepatitis A because people associate it with a bloodborne pathogen. It is not. Good hand washing of course is the key to this one. The vaccine for this hepatitis is NOT required by OSHA !
Early 80’s really became noticeable. Degree of Risk--- Rule of 3 is the best way to remember this. Good Needle Stick 1) 30 % Chance Hep B 2) 3% Chance Hep C 3) .3% Chance Hiv
Sterile Body Fluids: Spinal Fluids Plural Fluids The “Does not Include” -- OSHA does not care about these
What do you think they are ? Engineering Controls --- Manufacturing ? Federal State Level Only Health Care Nursing Home Front Line Worker Involve Record Keeping Sharps Container Needle Sticks --- Senate Bill 183 Legislation
Hand Washing Not a Harsh Soap (Talk about How to and emphasize it is friction that helps to remove harmful bacteria and viruses) Should be in your exposure control Plan Eating Drinking Smoking Soap Selection Alternatives Squirt Gels Foams Universal Precautions Discrimination (Violation if not)
Clean -up Kits Health Care -- Have to have two way breathing barrier.
Def of Exposure ? Selecting Medical Service : Do this ahead of tiical me. Decide where you want to send them Medical Record--not the Boss, not HR…. If you don’t have this set up,leave the record at the Urgent Care Facility. Keep these records 30 years beyond employment. Needle Sticks recorded on the OSHA log.
Do not have to have a Kit -EPA Approved -Tuberculosis (cidal) -Hepatitis B approved Absorbent, Disinfect & Through away -1part bleach & 10 parts water -No older than 24 hours -Education thing - Bleach ….corrosive Dispatch -- a stabilized bleach solutiion has a shelve life of 1 year Lysol IC (Infection Control) Don’t be impressed by just AIDS control
Bloodborne Pathogens Division of Safety & Hygiene DHO UNIT 13 BLOODBORNE PATHOGENS
Bloodborne Pathogens Division of Safety & HygieneObjectives:• Identify five classes of microorganisms by describing their characteristics• List six components of the chain of infection• Differentiate between antisepsis, disinfection and sterilization
Basic Understanding of Infection ControlNormal FloraNonpathogensPathogensVirulenceHostHealth Care Workersneed to know howdiseases are transmittedand avoid being the linkto further transmission.
BacteriaCocci are round, one celled plants classifiedaccording to shape and arrangement. Diplococci are arranged in pairs Examples: Gonorrhea, Meningitis and Pneumonia
Streptococci are spherical bacteriaarranged in chains:Examples: Strept. throat, Scarlet Fever,Rheumatic FeverStaphlococci are clusters of cocci.Examples: Wound infections, Impetigo,Toxic Shock Syndrome. Often causingpurulent material to be formed.
OTHER BACTERIABACILLI (RODS) are large,rod-shaped cellsFound singly or in groupsExamples Anthrax, Salmonella, TB,Tetanus, Typhoid SPIRILLA are curved or spiral bacteria That are arranged singly or in colonies. Examples: Campylobacter, Syphilis, Lyme Disease ANTIBIOTIC ARE OFTEN EFFECTIVE AGAINST A BACTERIAL INFECTION
Another version of Bacteria: RICKETTSIARickettsia species are small, Gram-negative bacilli that areobligate intracellular parasites. Called “oblate” because theycan reproduce only inside other living cells.Examples: Rocky Mountain Spotted Fever, Chlamydia. The Lone Star tick, Amblyomma americanum, a common, human- biting tick.
OTHER PATHOGENS:PROTOZOA are complex one-celledanimals that can live in human fluidsand cause disease. Many have flagella.Examples: Giardia (Travelers Diarrhea)Trichomonas, Malaria Fungi are simple plants but without chlorophyll. Yeast and mold are types Fungi. They must parasitize as they cannot make food. Examples; Candida (Thrush), Tinea (Ringworm),
VirusesViruses are intracellular parasitesthat consist of a DNA or RNA coresurrounded by a protein coat andsometimes a lipoprotein envelope.They invade cells and insert theirown genetic code into the host.Thus, the pirate the hosts nutrientsand organelles, multiply and infectother cells.Examples: Cold, Influenza, WestNile Virus, Avian Flu, Polio,Mono,Measles, Mumps, HBV,HCV, HIV.
Bloodborne Pathogens Division of Safety & Hygiene Hepatitis B• Most common occupationally-acquired infection• Blood borne, sexual contact and perinatal• Virus attack livers and can cause lifelonginfection, cirrhosis of the liver, liver cancer,liver failure and death.• Vaccine available. Required by OSHA.
Bloodborne Pathogens Division of Safety & Hygiene Hepatitis B Found in: • Blood • Vaginal Secretions • Semen • Saliva
Bloodborne Pathogens Division of Safety & Hygiene Signs and Symptoms: • Nausea • Lack of appetite • Fatigue • Joint pain • Dark urine • Jaundice • Fever
Bloodborne Pathogens Division of Safety & Hygiene Hepatitis C • The hepatitis C virus (HCV) is a blood-borne virus that was previously referred to as non- A/non-B hepatitis •As many as 80-85% of people initially infected with HCV may become chronically infected •No vaccine available •Today HCV is the leading reason for liver transplants
Bloodborne Pathogens Division of Safety & Hygiene Hepatitis A • Not bloodborne • Severity of disease • Poor sanitation • Raw seafood • Daycare centers • Vaccine
Hepatitis DA defective virus that needs the HBV to exist Co-infection with HBV Chronic liver disease with cirrhosis, liver cancer, and fulminant hepatitis also possible.
Bloodborne Pathogens Division of Safety & Hygiene HIV • HIV infection is a viral infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system, resulting in infections that are hard for the body to fight. • People who become infected with HIV may have no symptoms for up to 10 years, but they can still transmit the infection to others. • No vaccine, no cure
Bloodborne Pathogens Division of Safety & Hygiene HIV Signs & Symptoms (many have all, none, or some) • Night sweats • Swollen glands • Fever, chills • Flu-like • Joint Pain • Fatigue • Rash
Factors required for growthWarmMoistDarkAerobic require oxygen to liveAnerobic live and reproduce without oxygen
CLASSIFICATIONS OF DISEASES AND INFECTIONSENDOGENOUSEXOGENOUS NOSOCOMIAL OP ORT P UNISTIC
The Chain of Infection Infectious Agent Reservoir HostSusceptible Host Portal of Exit Portal of Entry Mode of Transmission
Bloodborne Pathogens Division of Safety & Hygiene UNIT 13:2 Exposure Control
Bloodborne Pathogens Division of Safety & HygienePotentially InfectiousMaterials Blood Mucus Semen Vaginal Secretions Sputum Saliva Other Body fluids “Visible soiled” objects Tissue/Cell specimens Mucous Membranes Non-intact skin “IF IT IS WET AND FROM THE BODY, CONSIDER IT INFECTIOUS”…..better safe than sorry.
Bloodborne Pathogens Division of Safety & Hygiene Standard (Universal) Precautions An approach to infection control. All human blood and certain body fluids are treated as if known to be infectious. STANDARD PRECAUTIONS: are the rules designed to protect the patient and HCW
Bloodborne Pathogens Division of Safety & Hygiene Methods of Control
Bloodborne Pathogens Division of Safety & Hygiene Methods of Control (Cont.) Hand sanitizers with 60% or more alcohol are very effective. • Always wash hands: •Visibly contaminated •After using bathroom •Before you eat •When hands feel “sticky” • Pathogens that are spores ( C-Difficile)
Bloodborne Pathogens Division of Safety & Hygiene Gloves • Disposable - not reused • Change if torn or punctured • Awareness of latex allergic reactions • Use of utility gloves
PPESyringes with protection devicesGloves with choices to avoid latexMasks with various filters (e.g N95)Face ShieldsBiohazard symbol to warn of body fluid
Bloodborne Pathogens Division of Safety & Hygiene Exposure Incident A specific eye, mouth, or other mucous membrane, non-intact skin or parenteral contact with blood or other potentially infectious material that results from the performance of an employee’s duties.
Bloodborne Pathogens Division of Safety & Hygiene Post-exposure follow-up • Definition of “exposure” • Selecting medical service • Informing the employee • Recordkeeping • Confidentiality of results
Bloodborne Pathogens Division of Safety & Hygiene Blood spill clean-up • Use correct “–cidal” • Follow “wait” time • Performed by someone with HBV vaccine