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Bloodborne Pathogens Updated to include the  Needlestick Act
 
Bloodborne Pathogens <ul><li>OSHA Regulation 29CFR 1910.1030 </li></ul><ul><li>History & Effective Dates </li></ul><ul><li...
Bloodborne Pathogens <ul><li>1991 - OSHA publishes the final regulation for Bloodborne Pathogens in December. </li></ul><u...
Bloodborne Pathogens <ul><li>To assure that no employee will suffer material health or functional impairment due to an exp...
Employer Requirements <ul><li>Requirements of the Employer </li></ul><ul><li>Employee education and training </li></ul><ul...
Scope and Coverage <ul><li>Original thrust was aimed at: </li></ul><ul><ul><li>Hospitals </li></ul></ul><ul><ul><li>First ...
Scope and Coverage also effects: <ul><li>Maintenance and Custodial workers </li></ul><ul><li>Housekeeping and Laundry serv...
Needlestick Prevention   <ul><li>Needlestick incidents do happen! </li></ul><ul><li>Be prepared! </li></ul><ul><li>All nee...
Needlestick Prevention Cont. <ul><li>Once the worker has been stuck he has been exposed! </li></ul><ul><li>Record the inci...
Bloodborne Pathogens <ul><li>There is one exemption to the rule! </li></ul><ul><li>The Good Samaritan clause </li></ul><ul...
Occupational Exposure <ul><li>Any reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood... <...
Determination of Exposure <ul><li>“ Potentially Infectious” materials include: </li></ul><ul><ul><li>semen </li></ul></ul>...
Employee Education and Training <ul><li>Epidemiology of bloodborne diseases is the study of the incidence, distribution an...
Symptoms of Hepatitis B <ul><li>Yellow Eyes & Skin (Jaundice) </li></ul><ul><li>Abdominal pain </li></ul><ul><li>Fever and...
Symptoms of AIDS <ul><li>Fever </li></ul><ul><li>Swollen Glands </li></ul><ul><li>Diarrhea </li></ul><ul><li>Extreme Weigh...
<ul><li>Needles come in all shapes and sizes.  </li></ul><ul><li>Check manufacturers for the safest needle! </li></ul>Need...
Modes of Transmission <ul><li>Parenteral </li></ul><ul><ul><li>Intravenous Injection  </li></ul></ul><ul><ul><li>Accidenta...
Most Common Means of Transmission <ul><li>Currently unprotected sex is the most common means of transmission.  </li></ul>
Control Measures <ul><li>Engineering Controls </li></ul><ul><ul><li>Serve to reduce employee exposure in the workplace by ...
Control Measures Cont.. <ul><li>Work Practice Controls </li></ul><ul><ul><li>Reduce the likelihood of exposure through the...
Control Measures Cont.. <ul><li>Personal Protective Equipment (PPE) </li></ul><ul><ul><li>Minimizes the risk of infectious...
Universal Precautions <ul><li>An approach to infection control  </li></ul><ul><li>All human blood and certain human body f...
HBV Vaccinations <ul><li>HBV Vaccinations are the most important part of HBV infection control </li></ul><ul><li>Gloves an...
Post Exposure Evaluation and Follow-up <ul><li>Exposure Incident means a specific eye, mouth, other mucous membrane, non-i...
Post Exposure Evaluation and Follow-up Cont. <ul><li>Following a report of an exposure incident, the employer provide a co...
Regulated Waste Disposal <ul><li>Contaminated items that: </li></ul><ul><ul><li>Would release blood or other potentially i...
Housekeeping and Laundry <ul><li>Keep the work-site in a clean and sanitary condition. </li></ul><ul><li>Use a hospital gr...
Tags, Labels & Bags <ul><li>Tags and Labels shall be fluorescent orange or red-orange with lettering and the Biohazard sym...
Recordkeeping <ul><li>The employer shall establish and maintain an accurate record for each employee with an occupational ...
Recordkeeping Cont. <ul><li>The employer shall maintain records for: </li></ul><ul><ul><li>The duration of the employment ...
Sharps Injury Log <ul><li>The Sharps Injury Log must document: </li></ul><ul><ul><li>Type and brand of device </li></ul></...
Exposure Control Plan <ul><li>Must Address: </li></ul><ul><ul><li>Exposure Determination </li></ul></ul><ul><ul><li>Employ...
Exposure Control Plan Cont. <ul><li>Reviewed AND updated annually </li></ul><ul><li>Reflect technological changes </li></u...
New Legislation <ul><li>Needlestick Safety and Prevention Act, November 6, 2000 </li></ul><ul><li>OSHA directed to revise ...
Four areas for revision <ul><li>Modification of definitions </li></ul><ul><li>Revision and Updating the Exposure Control P...
Definitions <ul><li>Engineering Controls </li></ul><ul><li>Needleless Systems </li></ul><ul><li>Sharps with Engineered Sha...
Wash Your Hands <ul><li>Hand washing after using toilet: </li></ul><ul><ul><li>Women  74% </li></ul></ul><ul><ul><li>Men  ...
Hanta Virus <ul><li>46 year old elementary school teacher </li></ul><ul><li>Colorado’s fifth Hanta Virus victim in a year ...
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Bloodborne Pathogens Needlestick

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Bloodborne Pathogens Needlestick

  1. 1. Bloodborne Pathogens Updated to include the Needlestick Act
  2. 3. Bloodborne Pathogens <ul><li>OSHA Regulation 29CFR 1910.1030 </li></ul><ul><li>History & Effective Dates </li></ul><ul><li>Purpose of the Regulation </li></ul><ul><li>Employer Requirements </li></ul><ul><li>Scope and Coverage </li></ul><ul><li>Exposure Control Plan </li></ul>
  3. 4. Bloodborne Pathogens <ul><li>1991 - OSHA publishes the final regulation for Bloodborne Pathogens in December. </li></ul><ul><li>1992 - OSHA regulation effective in March </li></ul><ul><li>1992 - Deadline for the completion of the written Exposure Control Plan (May) </li></ul><ul><li>2000- Needlestick Safety and Prevention Act </li></ul>
  4. 5. Bloodborne Pathogens <ul><li>To assure that no employee will suffer material health or functional impairment due to an exposure to hazardous agents while in the course of their employment. </li></ul>
  5. 6. Employer Requirements <ul><li>Requirements of the Employer </li></ul><ul><li>Employee education and training </li></ul><ul><li>Protective measures and equipment </li></ul><ul><li>Written Documentation </li></ul><ul><li>Recordkeeping </li></ul>
  6. 7. Scope and Coverage <ul><li>Original thrust was aimed at: </li></ul><ul><ul><li>Hospitals </li></ul></ul><ul><ul><li>First Responders (ambulance, fire, police) </li></ul></ul><ul><ul><li>Dental practices </li></ul></ul><ul><li>Non medical classifications: </li></ul><ul><ul><li>Funeral directors and morticians </li></ul></ul><ul><ul><li>Police crime labs </li></ul></ul><ul><ul><li>Barbers and cosmetologists </li></ul></ul>
  7. 8. Scope and Coverage also effects: <ul><li>Maintenance and Custodial workers </li></ul><ul><li>Housekeeping and Laundry services </li></ul><ul><li>Waste Handling and Disposal services </li></ul>
  8. 9. Needlestick Prevention <ul><li>Needlestick incidents do happen! </li></ul><ul><li>Be prepared! </li></ul><ul><li>All needlestick incidents are preventable! </li></ul>
  9. 10. Needlestick Prevention Cont. <ul><li>Once the worker has been stuck he has been exposed! </li></ul><ul><li>Record the incident!! </li></ul><ul><li>Treat the worker! </li></ul>
  10. 11. Bloodborne Pathogens <ul><li>There is one exemption to the rule! </li></ul><ul><li>The Good Samaritan clause </li></ul><ul><ul><li>A De minimus classification </li></ul></ul><ul><ul><li>No penalties for violation </li></ul></ul>
  11. 12. Occupational Exposure <ul><li>Any reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood... </li></ul><ul><li>.... or any other potentially infectious materials that may result from the performance of an employees duties. </li></ul>
  12. 13. Determination of Exposure <ul><li>“ Potentially Infectious” materials include: </li></ul><ul><ul><li>semen </li></ul></ul><ul><ul><li>vaginal secretions </li></ul></ul><ul><ul><li>cerebrospinal fluid </li></ul></ul><ul><ul><li>synovial fluid </li></ul></ul><ul><ul><li>pleural fluid </li></ul></ul><ul><ul><li>pericardial fluid </li></ul></ul><ul><ul><li>peritoneal fluid </li></ul></ul><ul><ul><li>amniotic fluid </li></ul></ul><ul><ul><li>saliva in dental procedures </li></ul></ul>
  13. 14. Employee Education and Training <ul><li>Epidemiology of bloodborne diseases is the study of the incidence, distribution and control of Hepatitis B and HIV/AIDS </li></ul><ul><ul><li>Hepatitis is an inflammation of the liver </li></ul></ul><ul><ul><li>HIV/AIDS destroys the ability to fight infections </li></ul></ul>
  14. 15. Symptoms of Hepatitis B <ul><li>Yellow Eyes & Skin (Jaundice) </li></ul><ul><li>Abdominal pain </li></ul><ul><li>Fever and Vomiting </li></ul><ul><li>Dark Urine </li></ul><ul><li>Fatigue </li></ul>
  15. 16. Symptoms of AIDS <ul><li>Fever </li></ul><ul><li>Swollen Glands </li></ul><ul><li>Diarrhea </li></ul><ul><li>Extreme Weight Loss </li></ul><ul><li>Skin Lesions </li></ul><ul><li>Mental Disorientation </li></ul>
  16. 17. <ul><li>Needles come in all shapes and sizes. </li></ul><ul><li>Check manufacturers for the safest needle! </li></ul>Needlestick Prevention
  17. 18. Modes of Transmission <ul><li>Parenteral </li></ul><ul><ul><li>Intravenous Injection </li></ul></ul><ul><ul><li>Accidental Needlestick </li></ul></ul><ul><li>Sexual </li></ul><ul><ul><li>Unprotected Sex </li></ul></ul><ul><li>Mucous Membrane </li></ul><ul><ul><li>Respiratory tract </li></ul></ul><ul><ul><li>Alimentary tract ( Nutrition/Digestive) </li></ul></ul>
  18. 19. Most Common Means of Transmission <ul><li>Currently unprotected sex is the most common means of transmission. </li></ul>
  19. 20. Control Measures <ul><li>Engineering Controls </li></ul><ul><ul><li>Serve to reduce employee exposure in the workplace by either isolating the worker from the exposure or removing the hazard </li></ul></ul><ul><li>Examples </li></ul><ul><ul><li>Surgical gloves </li></ul></ul><ul><ul><li>Self retracting needles </li></ul></ul><ul><ul><li>Sharps Containers </li></ul></ul>
  20. 21. Control Measures Cont.. <ul><li>Work Practice Controls </li></ul><ul><ul><li>Reduce the likelihood of exposure through the alteration of the manner in which the task is performed. </li></ul></ul><ul><li>Examples </li></ul><ul><ul><li>Using Gloves </li></ul></ul><ul><ul><li>Hand washing </li></ul></ul><ul><ul><li>Method of removing contaminated gloves </li></ul></ul><ul><ul><li>Recapping needle procedures </li></ul></ul>
  21. 22. Control Measures Cont.. <ul><li>Personal Protective Equipment (PPE) </li></ul><ul><ul><li>Minimizes the risk of infectious materials entering into the workers body through </li></ul></ul><ul><ul><ul><li>skin lesions or </li></ul></ul></ul><ul><ul><ul><li>entry through the eyes, nose, or mouth </li></ul></ul></ul><ul><li>Examples </li></ul><ul><ul><li>Gloves </li></ul></ul><ul><ul><li>Gowns </li></ul></ul><ul><ul><li>Face Shields </li></ul></ul>
  22. 23. Universal Precautions <ul><li>An approach to infection control </li></ul><ul><li>All human blood and certain human body fluids are treated as if known to be infected! </li></ul>
  23. 24. HBV Vaccinations <ul><li>HBV Vaccinations are the most important part of HBV infection control </li></ul><ul><li>Gloves and other PPE do not prevent puncture wounds or unanticipated exposures. </li></ul><ul><li>Set of three inoculations </li></ul><ul><li>Good for ten years </li></ul>
  24. 25. Post Exposure Evaluation and Follow-up <ul><li>Exposure Incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other infectious materials that result from the performance of an employees duties. </li></ul>
  25. 26. Post Exposure Evaluation and Follow-up Cont. <ul><li>Following a report of an exposure incident, the employer provide a confidential medical evaluation which will include: </li></ul><ul><ul><li>Documentation of route of exposure </li></ul></ul><ul><ul><li>HIV/HBV status of the source individual </li></ul></ul><ul><ul><li>Serological testing of the blood ASAP </li></ul></ul><ul><ul><li>Post exposure vaccine (HBIG) if indicated </li></ul></ul><ul><ul><li>Medical evaluation of the reported illness </li></ul></ul><ul><ul><li>Counseling of the exposed individual </li></ul></ul>
  26. 27. Regulated Waste Disposal <ul><li>Contaminated items that: </li></ul><ul><ul><li>Would release blood or other potentially infectious materials </li></ul></ul><ul><ul><ul><li>IF they are </li></ul></ul></ul><ul><ul><ul><ul><li>Pourable </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Drippable </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Compressible </li></ul></ul></ul></ul>
  27. 28. Housekeeping and Laundry <ul><li>Keep the work-site in a clean and sanitary condition. </li></ul><ul><li>Use a hospital grade VIRUCIDE </li></ul><ul><li>OR a 1:10 bleach to water solution </li></ul>
  28. 29. Tags, Labels & Bags <ul><li>Tags and Labels shall be fluorescent orange or red-orange with lettering and the Biohazard symbol in a contrasting color. </li></ul><ul><li>Bags must have this label on them or they must be red in color and leak proof. </li></ul>
  29. 30. Recordkeeping <ul><li>The employer shall establish and maintain an accurate record for each employee with an occupational exposure incident. </li></ul><ul><li>Records shall include: </li></ul><ul><ul><li>Name & Social Security Number of employee </li></ul></ul><ul><ul><li>Copy of employees HBV vaccination records </li></ul></ul><ul><ul><li>Copy of all medical testing and findings </li></ul></ul><ul><ul><li>Copy of physicians written opinion </li></ul></ul>
  30. 31. Recordkeeping Cont. <ul><li>The employer shall maintain records for: </li></ul><ul><ul><li>The duration of the employment </li></ul></ul><ul><ul><li>PLUS 30 years </li></ul></ul><ul><ul><li>Records must be kept CONFIDENTIAL! </li></ul></ul>
  31. 32. Sharps Injury Log <ul><li>The Sharps Injury Log must document: </li></ul><ul><ul><li>Type and brand of device </li></ul></ul><ul><ul><li>Work area where incident occurred </li></ul></ul><ul><ul><li>Explanation of how incident occurred </li></ul></ul>
  32. 33. Exposure Control Plan <ul><li>Must Address: </li></ul><ul><ul><li>Exposure Determination </li></ul></ul><ul><ul><li>Employee Education and Training </li></ul></ul><ul><ul><li>Control Measures </li></ul></ul><ul><ul><li>HBV Vaccinations </li></ul></ul><ul><ul><li>Post Exposure Evaluation and Follow Up </li></ul></ul><ul><ul><li>Regulated Waste Disposal </li></ul></ul><ul><ul><li>Tags, Labels, and Bags </li></ul></ul><ul><ul><li>Housekeeping and Laundry </li></ul></ul><ul><ul><li>Record keeping </li></ul></ul>
  33. 34. Exposure Control Plan Cont. <ul><li>Reviewed AND updated annually </li></ul><ul><li>Reflect technological changes </li></ul><ul><li>DOCUMENT consideration of safer medical devices </li></ul><ul><li>Document solicitation from non-managerial employees </li></ul>
  34. 35. New Legislation <ul><li>Needlestick Safety and Prevention Act, November 6, 2000 </li></ul><ul><li>OSHA directed to revise Bloodborne Pathogen regulation within 6 months </li></ul><ul><li>Congress exempts OSHA from procedural requirement for promulgation of regulation in order to comply with the Act </li></ul>
  35. 36. Four areas for revision <ul><li>Modification of definitions </li></ul><ul><li>Revision and Updating the Exposure Control Plan </li></ul><ul><li>Solicitation of Employee Input </li></ul><ul><li>Recordkeeping </li></ul>
  36. 37. Definitions <ul><li>Engineering Controls </li></ul><ul><li>Needleless Systems </li></ul><ul><li>Sharps with Engineered Sharps Injury Protection </li></ul>
  37. 38. Wash Your Hands <ul><li>Hand washing after using toilet: </li></ul><ul><ul><li>Women 74% </li></ul></ul><ul><ul><li>Men 61% </li></ul></ul><ul><li>New York City- 60% </li></ul><ul><li>Chicago- 78% </li></ul><ul><li>New Orleans- 69% </li></ul><ul><li>Atlanta Braves Game- </li></ul><ul><ul><li>Women 89% </li></ul></ul><ul><ul><li>Men 46% </li></ul></ul><ul><ul><li>Pass the popcorn!! </li></ul></ul>
  38. 39. Hanta Virus <ul><li>46 year old elementary school teacher </li></ul><ul><li>Colorado’s fifth Hanta Virus victim in a year </li></ul><ul><li>She lasted five days – </li></ul><ul><li>Lived on a ranch with husband and 3 children </li></ul><ul><li>200 cases nationwide </li></ul>

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