Bloodborne Pathogens

1. 1

2. OSHA’SOSHA’S
OCCUPATIONALOCCUPATIONAL
BLOODBORNE PATHOGENBLOODBORNE PATHOGEN
(29 CFR 1910.1030)

3. Today’s ObjectivesToday’s Objectives
 Overview Bloodborne Pathogen Standard
 Exposure Control Plan
 Pathogens: HIV and HBV
 Control Methods:
Administrative
Work Practices
PPE
 Spill Kit

4. Purpose of Bloodborne
Pathogen Standard
To limit the occupational
exposure to bloodblood and other
potentially infectious material
since any exposure could result
in transmission of diseasedisease or
deathdeath…

5. Occupational ExposureOccupational Exposure
 Covers all employees who could be
“reasonably anticipatedreasonably anticipated” as the result
of performing their job duties, to face
contact with blood and othercontact with blood and other
potentiallypotentially infectious materialsinfectious materials.
“Good Samaritan” acts such as
assisting a co-worker with a nosebleed
would not be considered occupational
exposure.

6. What are BLOODBORNEBLOODBORNE
PATHOGENSPATHOGENS?
MicroorganismsMicroorganisms that are
present in human blood or
other potentially infectious
materials such as bodily fluidsbodily fluids
that can cause deathdeath or diseasedisease
in Humans.

7. Other Potentially InfectiousOther Potentially Infectious
Materials (OPIM)Materials (OPIM) Include;
Semen, vaginal secretions,
cerebrospinal fluid, synovial fluid,
pleural fluid, pericardial fluid,
peritoneal fluid, amniotic fluid and
any body fluidbody fluid visibly contaminated
with bloodblood and all bodybody fluidsfluids in
situations where it is difficult or
impossible to differentiate between
body fluids.

8. TheThe Deadliest Bloodborne PathogensDeadliest Bloodborne Pathogens ...
(but not limited to)(but not limited to)
 HIVHIV - Human
Immunodeficiency
Virus (causes
AIDS)
 HBV & HCVHBV & HCV -
Hepatitis B &
Hepatitis C Virus
(causes cirrhosis of
the liver and liver
cancer)

9. HUMANHUMAN
IMMUNODEFICIENCY VIRUSIMMUNODEFICIENCY VIRUS

10. HIVHIV Facts
 Incubation period:
 3 - 6 months (average)3 - 6 months (average)
 Symptoms Include:
 Weakness
 Fever
 Nausea
 Headaches
 Diarrhea
 Other “flu-like”
symptoms
 Has no vaccineno vaccine
 Has no cureno cure
 Generally leads to
the development of
AIDS
 Can be transmitted
through contact
with bloodblood, semensemen
and vaginal fluidsvaginal fluids
 Very fragile outside
human host

13. HEPATITIS A VIRUSHEPATITIS A VIRUS
Hepatitis A is usually a mild
illness characterized by
sudden onset of fever, malaise,
nausea, anorexia, and
abdominal discomfort,
followed in several days by
jaundice
Transmitted by contact with
fecal mater
Vaccine is available

15. HEPATITIS B VIRUSHEPATITIS B VIRUS

16. Hepatitis BHepatitis B Facts IncubationIncubation period:
 6 weeks to 6 months
 SymptomsSymptoms Include:
 “Flu-Like”
 Fatigue
 Stomach Pain
 Loss of Appetite
 Nausea, vomiting
 Diarrhea
 Dark urine
 Jaundice
 HBVHBV is the most prevalent form
of viral Hepatitis
 Higher Concentration than HIV
(in same amount of blood)
 Very resilient pathogen, known
to survivesurvive outside of human host
in dry blooddry blood for up to 1 week1 week
and possibly longerlonger
 Infects approx. 300,000300,000 new
people each year (USA)
 An estimated five millionmillion
Americans are carriers
 Vaccine is available

17. Concentration of Hepatitis BHepatitis B
VirusVirus in Various Body FluidsBody Fluids
 HighHigh Concentration –
Blood, Serum, Wound Exudates
 ModerateModerate Concentration –
Semen, Vaginal Fluid, Saliva
 LowLow Concentration / Not DetectableNot Detectable -
Urine, Feces, Sweat, Tears, Breastmilk

18. HEPATITIS C VIRUSHEPATITIS C VIRUS…
An Emerging Concern

19. Hepatitis CHepatitis C (Continued)
 Hepatitis CHepatitis C has infected nearly 4 million Americans.
 Estimated 35,00035,000 Americans are infected annually.
 Total mortality is 8,000 to 10,0008,000 to 10,000 per year.
 HCVHCV has the ability to mutate, thus currently there is nono
vaccinevaccine or immune goblin products to prevent
transmission.
 Primary mode of infection for occupational exposure
would be through contact with contaminated blood.
 Average incubation period is 6 - 76 - 7 weeks with a range of
2 -16 weeks.

20. Hepatitis CHepatitis C (Continued)
 Since there is no protective antibody response
identified, no one is immune to HCV.
 Chronic liver diseaseChronic liver disease develops in about 85%
of persons infected with HCV.
 20% of the chronically infected progress to
cirrhosiscirrhosis and liver cancerliver cancer.
 Symptoms may take decadesdecades to show.

21. Cirrhosis of the LiverCirrhosis of the Liver

22. RoutesRoutes of Occupational
ExposureExposure
 Eyes
 Nose
 Mouth
 Skin
 Needle Sticks
 Breaks in the Skin; cuts, dermatitis
 Acne
 Using Engineering, Work Practice, and PPEEngineering, Work Practice, and PPE
ControlsControls will assist you in preventing
Occupational ExposureOccupational Exposure

25. Chance of InfectionInfection Through
Occupational Exposure
 In an event of exposure
through a needle stick;
 HIVHIV - Less than 1%1%
chance of infection
 HCVHCV - Between 5 - 10%5 - 10%
 HBVHBV - Up to 30%30% chance
of infection

26. BloodborneBloodborne Facts...
(Information from CDC)
 Over 90,00090,000 work
related Bloodborne
infections annually
 200 Deaths200 Deaths annually
resulting from
infections
 99.9% directly exposed
to an active BBP test
positive within 3
months of exposure

27. CDC Has Confirmed ...
 At least eight
housekeepers and
laundry workers have
contracted HIVHIV from
occupational
exposure.
 Five have since dieddied.
 Most of the exposures
were cause by needleneedle
stickssticks.

28. How do we implement this
program? What’s involved?
 Exposure Control PlanExposure Control Plan - Requires
employers to have a written plan covering
employee tasks and procedures covering
possible exposure to Bloodborne Pathogens.
Plan must be accessible to employees and
reviewed and updated annually by the
employer.
 EPA’ Emergency Responders Health and Safety
Manual Chapter II-4

29. Use of Universal PrecautionsUniversal Precautions
(Engineering Controls...

30. Followed by Work PracticeWork Practice &
PPE ControlsPPE Controls

31. Proper DisinfectionDisinfection &
DisposalDisposal...

32. Always Limit the RiskLimit the Risk of Exposure
By Practicing Proper Controls!

33. Universal Precautions: EngineeringUniversal Precautions: Engineering
Controls,Controls, Work Practice ControlsWork Practice Controls &
PPE
 Engineering Controls
o physical or mechanical
systems your employer
provides to eliminate
hazards at their source
o An example would be;
tongs for removal of sharps
 Work Practice
Controls
o Proper work
procedures such as
how to dispose of
needles in a sharps
container
o Hand washing
 PPE
o Proper Use of PPE’s

34. Methods of Compliance
 Mandates UNIVERSALUNIVERSAL
PRECAUTIONSPRECAUTIONS
(treating all body
fluids / materials as if
infectious). Requires
employees to use
appropriate personal
protective equipment
such as gloves, masks,
mouthpieces, gowns and
resuscitation bags.

35.  Requires vaccinations
to be made available
to all employees who
have occupational
exposure to blood
within 10 working
days of assignment,
at no cost.
 Effectiveness rate of
vaccination is 90%.
Hepatitis BHepatitis B Vaccination

36. If Employees Choose Not to
Vaccinate...
Employees must sign a
declination formdeclination form if they choose
not to be vaccinated, but later
may opt to receive the vaccine
at no cost to employee.

37. If You Are ExposedExposed ...
 In the event of exposure, it is vital
to report the incident immediately.
 Many times, illness can be avoided
with prompt medical attention.
 PathogensPathogens all have an incubationincubation
period. Though they vary in times,
swift medical response will
increase your chances of fighting
infection.

38.  Post Exposure Evaluation and Follow Up -
Specifies procedures to be made available to all
employees who have had an exposure incident.
Specific information is in your Exposure Control
Plan.
 Hazard Communication - Requires warning
labels including the universal bio-hazard symbolbio-hazard symbol
affixed to all containers for transport of bloodblood and
other potentially infectious materials. Red bagsRed bags
or containers may be used instead of labeling.
Post Exposure Evaluation & Hazard
Communication

39.  Information and Training - Mandates training
within 90 days of effective date, initially upon
assignment and annually. Training records must
be kept for 3 years.
 Recordkeeping - Calls for medical records to be
kept for each employee with occupational exposure
for the duration of employment plus 30 years, and
must be confidential. Records must be available to
subject employee and disposal of records must be
in accord with HIOSH’s standard covering access
to records.
Training & Recordkeeping

40. What is the penalty for non-
compliance?
 Penalties assessed
for failure to comply
range from
maximum fines of
$7,000.00$7,000.00 to $70,000$70,000
(willful violation)(willful violation)

41. ...In the Worst Case...
DISEASEDISEASE or DEATH!DEATH!

42. SafetySafety the Priority!
 Infection ControlInfection Control
o Reducing the potential of
infections by controlling
harmful bacteria.
o Using the right products &
following proper procedures.
o Protect yourself by using
PPE’s.
o Education, understanding
bacteria & their environment.

43. BE AWARE!BE AWARE!
 OSHA’s Bloodborne Pathogen: Final Rule is
specific in addressing issues concerning
Bloodborne Pathogens.
 However, there are many othermany other
microorganismsmicroorganisms that can also cause diseasedisease
Always use proper Work Practice Controls!

44. Bacteria Grows Rapidly
Unless Controlled...
 If one micro-organism
(germ) was left behind
on a toilet seat at 8:00
am this morning...
 By 8:00 P.M. tonight,
12 hours later it would
have multiplied
to........
 64 BILLION!64 BILLION!

45. The Presence of SUPERSUPER GERMSGERMS
Makes Attention to Detail Vital...
 Many strains of bacteria are now
resistant to penicillin and anti-biotics,
including; T.B., E. coli, Staph
(MRSA) & (VISA), Pneumococcus,
VRE’s, etc.
 Always wear gloves to protect
yourself from exposure to BODILYBODILY
FLUIDS!FLUIDS! Especially when cleaning
areas or handling materials exposed
to BLOOD & BODY FLUIDSBLOOD & BODY FLUIDS.
 Perform a thorough job, use the right
product and method, don’t cut
corners.
 Wash your hands as often as possible.

46. Frightening Facts...
 50%50% of all Americans dodo notnot
wash their handswash their hands before
leaving the washroom.
 25%25% of the people leave the
washroom with fecalfecal
coliformcoliform (E.coli) on their
hands.
 76 Million Americans76 Million Americans suffer
from foodborne illness
annually.
 5,200 people5,200 people in this country
diedie of bacterial food
poisoning annually.

47. Recent Outbreaks of Hepatitis AHepatitis A & E.coli 0:157E.coli 0:157
Proves The Importance of Handwashing...”It’s In
Your Hands”
 7 Basic Steps to Handwashing
 Turn on water
 Wet hands thoroughly
 Apply soap
 Scrub vigorously for at least 10
seconds
 Rinse completely w/ water
 Dry hands w/ paper towel
 Turn off water w/ paper towel

48. Use Protective Equipment...
 Especially when
cleaning areas that
have the presence of
bodily fluids.bodily fluids.
 Protect your hands
with gloves!gloves!
 Remember, bacteria
multiplies rapidly!
 Prevent their
spread!FREE

50. Latex Allergies
Serious healthcare concern
Caused by skin contact
with, or inhalation of,
latex rubber proteins
Thought to currently
effect 8 to 12 % of the
health care profession
OSHA reports 20
occupational deaths from
latex related allergies

51. The word "allergy" means "altered working". It was coined at
the beginning of the 20th century to describe the fact that
dogs immunised with venom proteins from another animal
had fatal reactions when they had another injection of that
protein. Instead of being protected by immunization; the dogs
died during the "allergic reaction". In fact they had a kind of
reaction for which the experimenters coined the word
"anaphylaxis", meaning the opposite of "prophylaxis" or
protection.

53. Latex AllergiesWhat are some of the
symptoms of latex allergy?
localized skin rash or itching
(generally on the hands);
hives;
swollen red skin;
swollen lips and tongue with
difficulty breathing, wheezing;
shortness of breath;
dizziness;
fainting;
abdominal pain;
diarrhea;
anaphylactic shock.

54. What’s Your Risks?
Those who frequently use latex
gloves and other latex-
containing materials are at risk
A-topic individuals (those with
multiple allergic conditions) are
at increased risk for developing
latex allergy
Latex allergy is also associated
with allergies to certain foods,
especially:
– Avocado, potato, banana,
tomato, chestnuts, kiwi fruit,
and papaya

55. Arm Your Facility Properly..
 Use an approved
hospital gradehospital grade
disinfectant to clean
and disinfect surfaces
 A disinfectant with a
HBVHBV or TB KillTB Kill rating
is recommended
 An absorbent is also
useful to aid in
cleanups
TB PLUSTB PLUS
FRESHFRESH
&&
CLEANCLEAN
IIII

56. Summary…Play It Safe!
 Always wear
Personal Protective
Equipment in the
presence of bloodblood
and body fluidsbody fluids
 Beware of sharps!
 Handwashing
 Use UniversalUniversal
Precautions!Precautions!