Bloodborne pathogens 5 09

Bloodborne Pathogens
Presented to:
Center for Children & Families, Inc

May 28, 2009
Stephanie Bagley, RN, CPTC

© Business & Legal Reports, Inc. 0507

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.


Work Place Accidents

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


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)


Transmission of Pathogens
• Blood, Body Fluids
• Contaminated sharp
objects or needles
• Broken skin, including
rashes
• Mucous membrane
(splash)
• Eyes
• Mouth
• Nose


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


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


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


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)


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


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


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


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)


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


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

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


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


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)


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


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


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)


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

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)


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

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


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)

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


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

Bloodborne pathogens 5 09

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