Often groups are not considered when dealing with issues like BBP Exposure. I will sometimes provide free classes to tattoo artist groups and folks that are historically left out of conventional health and safety thinking

1. Bloodborne Pathogens Awareness
Shawn Holle, Safety Analyst
Occupational Safety & Health

2. 12/08/15 DPH OSH Section 2
Training
 Potential Occupational Exposures
 HIV, HBV, HCV, MRSA, GAS
 Exposure Prevention
 Hepatitis B Vaccination
 Post Exposure Follow-up
 Recordkeeping

3. 12/08/15 DPH OSH Section 3
What Is a Bloodborne Pathogen?

4. 12/08/15 DPH OSH Section 4
Exposure Risks on the Job?
 What Do You Do?

5. 12/08/15 5
Exposure Risks on the Job?
 Inking
 Cleanup
 Housekeeping
 Assault / Combative Clients
 First Aid
 CPR

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Where Are the Risks?
 Needles
 Body Fluids
 Covered Surfaces
 Used PPE
 Towels

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Common Occupational Exposures
 Needlesticks or Cuts 82%
 Contact With Non-intact Skin 03%
 Splashes to Mucous Membranes 14%
 Bites 01%

8. 12/08/15 DPH OSH Section 8
Human Immunodeficiency Virus (HIV)
 Blood
 Body Fluids

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HIV: Occupational Transmission Risk
Needlestick 0.3%
Mucous Membrane .09%
Non-Intact Skin .09%

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Occupational Transmission Stats
HIV+ Health Care Workers 23,473
Documented Seroconversions 57
Developed AIDS 26
Possible Seroconversions 139

11. 12/08/15 DPH OSH Section 11
Viral Hepatitis
Type A B C
Virus Source Feces
Blood/ Blood
Derived
Body Fluids
Blood/ Blood Derived
Body Fluids
Transmission Route Fecal-Oral
Percutaneous /
Permucosal
Percutaneous /
Permucosal
Incubation Period 2 to 6 Weeks 4 to 26 Weeks 6 to 7 Weeks
Chronic Infection No Yes Yes
Symptoms
Abrupt Onset Insidious Onset Abdominal Pain
Abdominal Pain Abdominal Pain Diarrhea
Nausea Loss of Appetite Jaundice
Fatigue Malaise Vomiting
Diarrhea Diarrhea
No SymptomsJaundice Jaundice
No Symptoms Vomiting

12. 12/08/15 DPH OSH Section 12
Hepatitis A: Fecal-Oral Transmission
 Contaminated Food
 Contaminated Water
 Close Personal Contact
 Blood Exposure (Rare)

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0
20
40
60
80
100
120
140
Y 99 Y 00 Y 01 Y 02 Y 03 Y 04 Y 05 Y 06
Hep A Infections CCSF

14. 12/08/15 DPH OSH Section 14
Hepatitis B: Blood Transmission
 1.25 Million Americans Chronically Infected
 HBV Survives at Room Temperature X 2 Weeks
 Needlestick Transmission Risk = 6% to 30% (UV)
 Declining Rates

15. 12/08/15 DPH OSH Section 15
0
10
20
30
40
50
60
70
Y 99 Y 00 Y 01 Y 02 Y 03 Y 04 Y 05 Y 06
Hep B Infections In CCSF

16. 12/08/15 DPH OSH Section 16
Hepatitis C: Blood to Blood Transmission
 4 Million Americans Infected
 No Vaccine
 80% NO Symptoms
 75%- 85% Chronically Infected Carriers
 Main Reason for Liver Transplants

17. 12/08/15 DPH OSH Section 17
Source: CDC Sentinel Counties Study of Acute Viral Hepatitis
Occupational
4%
Unknown
10%
Sexual
15%
Injecting Drug Use
60%
Other High Risk
1%
Transfusions
10%
Hepatitis C: Who Gets It?

18. 12/08/15 DPH OSH Section 18
MRSA
 Methicillin-Resistant Staphylococcus Aureus
 Resistant To Several Antibiotics (Methicillin & Other Penicillins)
 One Of The Most Common Causes Of Skin Infection
 Frequently Found On Skin Or In Noses Of Healthy People
 25-30% Of The US Population Carry Some Type Of Staph On Their
Bodies But Are Not Ill Or Infected
 Often A Skin Infection:
 Pimples
 Boils
 Rashes

19. 12/08/15 DPH OSH Section 19
Colonization v Infection
 Colonization: Bacteria Present But Not Causing Illness
 Infection: Present & Causing Illness
 People Colonized Or Infected Can Spread MRSA

20. 12/08/15 DPH OSH Section 20
MRSA Transmission
 Skin To Skin Contact
 Contaminated Surfaces
 Shared Items (Towels, Exercise
Equipment, Handcuffs, Shackles)
 Lesions

21. 12/08/15 DPH OSH Section 21
Group A Streptococcal Disease (GAS)
Necrotizing Fasciitis
 Group A Streptococcus
 Exposure By Direct Contact with Mucous or
Opens Lesions of Infected Individuals
 10,000 Cases Per Year (600 NF Cases)

22. 12/08/15 DPH OSH Section 22
Protection On The Job?
Universal Precautions
Assume All Human Blood & Body Fluids Are Infectious

23. 12/08/15 DPH OSH Section 23
Handwashing is Most Effective Way to
Prevent Disease Transmission

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Work Practices
 Reduce Risk by Changing Work Practices

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Engineering Controls
Isolate or Remove Hazard From Workplace
Tools
Gloves
Sharps Containers
Biohazard Bags

26. 12/08/15 DPH OSH Section 26
 No Cost
 Available
 Right Size
 Employer Responsible
Personal Protective Equipment
Clothing or Equipment Worn That Keeps Blood From Clothing, Skin, Eyes, Mouth, or
Mucous Membranes

27. 12/08/15 DPH OSH Section 27
Administrative Controls
 Written Procedures
 Training
 Clear Communication

28. 12/08/15 DPH OSH Section 28
Housekeeping
 Tasks
 Location
 Surfaces
 Contaminants

29. 12/08/15 DPH OSH Section 29
HBV Vaccine
 95% - 99% Effective Prevention of HBV Infection
 Mild Soreness & Redness at Injection Site
 Fever, Nausea, Rash, Fatigue, Joint Pain (Rare)

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Hazard Communication / Warning Labels
 Regulated Waste Containers
 Disposal Containers
 Contaminated Laundry
 Slop Sinks

31. 12/08/15 DPH OSH Section 31
Post Bloodborne Pathogens Exposure
 First Aid
 ID Exposure Source
 Needlestick Hotline (415) 469-4411
 Visit a Doctor