Exposure Control

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This is a training module for volunteers at the Open Door clinic.

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Exposure Control

  1. 1. Exposure Control Volunteer Training Module Open Door Clinic
  2. 2. Exposure Control Plan • Employers must develop an Exposure Control Plan and make it accessible to all employees. • The Exposure Control Plan identifies tasks and procedures, as well as job classifications, where occupational exposure to blood occurs. • The plan specifies the procedure for evaluating circumstances surrounding exposure incidents. • Employers must update their Exposure Control Plan to include: • changes in technology that reduce/eliminate exposure • annual documentation of consideration and implementation of safer medical devices • solicitation of input from non-managerial employees
  3. 3. Methods of Compliance The Bloodborne Pathogen Standard specifies methods that are to be used to minimize the transmission of bloodborne pathogens in the work place. These methods include: • Universal Precautions • Engineering and Work Practice Controls • Personal Protective Equipment (PPE) • Appropriate Housekeeping Measures
  4. 4. Universal Precautions • The Bloodborne Pathogen Standard requires that employers implement a standardized approach to infection control called Universal Precautions. • The concept of Universal Precautions is that all blood and potentially infectious materials must be treated as if they are known to contain HIV, HBV, or other bloodborne pathogens.
  5. 5. Engineering and Work Practice Controls Engineering Controls • Controls that isolate or remove the bloodborne pathogens hazard from the workplace. Work Practice Controls • Controls that reduce the likelihood of exposure by altering the manner in which a task is performed.
  6. 6. Engineering and Work Practice Controls Exposure Determination • To select the proper engineering and work practice controls to implement in the workplace, the employer must make an exposure determination. This determination must contain: • A list of all job classifications in which all employees in those job classifications have occupational exposure; • A list of job classifications in which some employees have occupational exposure, and • A list of all tasks and procedures or groups of closely related task and procedures in which occupational exposure occurs and that are performed by employees in job classifications listed in accordance with the provisions of paragraph (c)(2)(i)(B) of this standard.
  7. 7. Engineering Controls Needlestick Safety Two commonly used engineering controls are • Needleless Systems: devices that do not use a needle for: • Collection of bodily fluids • Administration of medication/fluids • Any other procedure with potential percutaneous exposure to a contaminated sharp • Sharps with Engineered Sharps Injury Protections (SESIP) • Non-needle sharp or a needle with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident.
  8. 8. SESIPExamples
  9. 9. Engineering Controls Signs and Labeling • The warning label must include the universal biohazard symbol and the term "biohazard“. • Warning labels must be affixed to containers of regulated waste, refrigerators and freezers containing blood or other potentially infectious material. • Contaminated equipment must also have a warning label.
  10. 10. Engineering Controls Signs and Labeling • Some common exceptions to the labeling requirements are: • Containers of blood, blood components, and blood products bearing an FDA required label. • Individual containers of blood or OPIM that are placed in secondary labeled containers. • Specimen containers, if the facility uses Universal Precautions when handling all specimens. • Regulated waste that has been decontaminated. • HIV and HBV Research Laboratory and Production Facilities must have biohazard signs posted at the entrance.
  11. 11. Work Practice Controls
  12. 12. Work Practice Controls Hand Hygiene • Thoroughly wash hands or other exposed skin with soap and water as soon as possible. • Wash your hands with soap and water every time you remove your gloves. • Use soft, antibacterial soap, if possible. • If skin or mucous membranes come in direct contact with blood, wash or flush the area with water as soon as possible. • Where handwashing facilities are not available, use antiseptic hand cleansers or antiseptic towelettes.
  13. 13. Personal Hygiene • Minimizing splashing, spraying, spattering and generation of droplets when attending to an injured person. • Refraining from eating, drinking, smoking, applying cosmetics or lip balms, or handling contact lenses where there is a reasonable likelihood of occupational exposure. • Keeping food or drink away from refrigerators, freezers, shelves cabinets or on countertops or bench tops where blood or other potentially infectious materials are present. • Refraining from mouth pipetting/suctioning of blood or other potentially infectious materials.
  14. 14. Personal Protective Equipment • The type of protective equipment appropriate for your job or research varies with the task and the degree of exposure you anticipate. Equipment that protects you from contact with blood or other potentially infectious materials (OPIM) may include: • Gloves • Eye protection • Masks and face shields • Gowns, aprons and other protective body clothing
  15. 15. Personal Protective Equipment Gloves • Gloves should be made of latex, nitrile, rubber, or other water impervious materials. • Never use gloves that are damaged, such as torn or punctured. • Remove contaminated gloves carefully, avoiding touching the outside of the gloves with bare skin. • Dispose of contaminated gloves in a proper container.
  16. 16. Personal Protective Equipment Eye Protection
  17. 17. Personal Protective Equipment Masks and Face Shields • Masks and face shields provide additional protection for tasks that may generate splashes, spray, spatter, or droplets of blood or other potentially infectious materials, and eye, nose, or mouth contamination can be reasonably anticipated. • Masks and face shields are not a substitute for eye protection, and must be used in combination with suitable eye protection.
  18. 18. Personal Protective Equipment Protective Body Clothing
  19. 19. Personal Protective Equipment General Guidelines • Persons should be trained to use the equipment properly. • The equipment should be appropriate for the task and should fit properly, especially gloves. • The equipment should be free from physical flaws that could compromise safety. • Persons must use appropriate protective equipment each time they perform a task involving potentially infectious materials. • The employer should issue PPE or make it readily accessible in the work area. • The employer should maintain, replace or dispose of any PPE at no cost to employees. • Persons should remove all PPE prior to leaving the work area. • Persons should place removed PPE in an appropriately designated area or container for storage, washing, decontamination or disposal. • Persons should remove garments such as lab coats or aprons that are penetrated by blood or other potentially infectious materials immediately or as soon as feasible.
  20. 20. Appropriate Housekeeping Measures • Clean and decontaminate all equipment and working surfaces after contact with blood or other potentially infectious materials. • Contaminated work surfaces should be decontaminated: • after completing procedures • immediately or as soon as feasible if they are heavily contaminated or if there has been a spill of blood or other potentially infectious materials • at the end of the work shift if the surface may have become contaminated since the last cleaning. • Inspect and decontaminate bins, pails, cans, and similar receptacles intended for reuse. • Clean and decontaminate receptacles immediately or as soon as feasible upon visible contamination.
  21. 21. Appropriate Housekeeping Measures Glassware Handling and Disposal • Use items such as a brush and dust pan, tongs, or forceps to clean up broken glassware. • Sterilize broken glassware that has been visibly contaminated with blood with an approved disinfectant solution before disturbing it or cleaning it up. • Dispose of decontaminated glassware in an appropriate sharps container. • Dispose of uncontaminated broken glassware in a closable, puncture resistant container.
  22. 22. Appropriate Housekeeping Measures Glassware Handling and Disposal • Non-regulated waste that is not generated by a medical facility or human health-related research laboratory may be disposed in regular plastic trash bags if it has been decontaminated or autoclaved prior to disposal. Check with your supervisor for specific requirements and procedures for handling and disposing of wastes at your institution.
  23. 23. Quick Check Summary What are “Universal Precautions”? What are Engineering Controls? List other exposure control methods.

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