OFFSHC BBP

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In May 2013, Bryan K. Stolte, Ph.D., C.I.H. briefed OFFSHC on the bloodborne pathogens (BBP). Dr. Stolte discussed the related OSHA standards and the elements required in the exposure control plans. He stated that the Best Practice for BBP is to implement hands on training for new employees and follow up frequently. He also emphasized practicing universal precautions.

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OFFSHC BBP

  1. 1. Bloodborne Pathogens Bryan K. Stolte, Ph.D., C.I.H. May 9, 2013
  2. 2. Introduction Approximately 5.6 million workers in health care and other occupations are at risk of exposure to bloodborne pathogens (BBPs). OSHA’s BBP Standard prescribes safeguards to protect workers against the health hazards from exposure to blood and other potentially infectious materials. Exposure Control Plans must contain elements necessary to comply with and implement changes required by the OSHA standard. 2 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  3. 3. Regulatory Requirements OSHA 29 CFR 1910.1030 Effective March 6, 1992 Update effective January 1, 2002 Purpose: To eliminate or minimize occupational exposure to BBPs. www.osha.gov (search bloodborne pathogens) 3 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  4. 4. Does the BBP Standard Apply to You? If you may come into contact with blood, or potentially contaminated biological fluids during the performance of the following: Emergency Response Team - When you are a member of a MERT Team. First Aid and CPR Responder - When you have been provided with First Aid-CPR training in accordance with the Installation First AidCPR Training Policy. Then the answer is yes! 4 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  5. 5. What are BBPs? Microorganisms found in human blood and/or contaminated body fluids that cause disease in humans. Examples: Human immunodeficiency virus (HIV) - Acquired Immunodeficiency Syndrome (AIDS) Hepatitis B Virus (HBV) Hepatitis C Virus (HCV) Syphilis Malaria 5 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  6. 6. Potentially Contaminated Body Fluids Potentially Infectious Material (PIM) Sexually transmitted fluids Body fluids visibly contaminated w/blood Amniotic, pericardial, pleural fluid, synovial, cerebrospinal, peritoneal, etc. Saliva (when contaminated with blood) 6 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  7. 7. Body Fluids considered uncontaminated if free of blood Urine Vomit Tears Perspiration List strictly academic. Employees must follow “Universal Precautions” (i.e., think worse case scenario) Universal Precautions – You must consider ALL blood and body fluids as if they are infectious with HIV, Hepatitis C, Hepatitis B and other BBPs. 7 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  8. 8. HIV / AIDS - Modes of Transmission and Incubation Period The Human Immunodeficiency Virus (HIV-1) leads to Acquired Immunodeficiency Syndrome (AIDS) for most affected people. Modes of Transmission Exposure to contaminated blood or potentially infectious body fluids, sexual contact, and sharing contaminated needles. Incubation Period: Less than 1 year to 15 years or longer 8 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  9. 9. HIV / AIDS - Symptoms Some symptoms can be related to other illnesses. The only way to determine whether you are infected is to be tested for HIV infection. Signs and symptoms for HIV vary. If you have any illness or persistent changes in health you must see your personal doctor. 9 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  10. 10. Hepatitis B - Modes of Transmission This virus is found in the blood and in potentially infected body fluids. Hepatitis B is an infection of the liver. The Hepatitis B virus can survive for 7 or more days in dried blood on environmental surfaces or contaminated instruments. Modes of Transmission Exposure to contaminated blood or potentially infectious body fluids, sexual contact, and sharing contaminated needles. An infected mother can transmit the infection to her fetus through the placenta. 10 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  11. 11. Hepatitis B – Acute vs. Chronic Infections When acute infections are experienced, if the body can’t clear the virus within 6 months the individual is considered chronically infected. There is no cure for chronic infections. Individuals that were able to clear the virus, will have developed antibodies against Hepatitis B and will not be able to transmit the virus. 11 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  12. 12. Hepatitis B – Incubation Period and Symptoms Incubation Period: 45 days to 180 days Symptoms Nausea, vomiting, loss of appetite, fatigue, vague abdominal discomfort, diarrhea, jaundice, and joint pain. About 30% of affected individuals are asymptomatic. Signs and symptoms are less common in children than adults. 15 to 25 % become chronically infected. 12 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  13. 13. Hepatitis C - Modes of Transmission Hepatitis C is the most common chronic bloodborne infection in the US. Infection may lead to chronic liver disease. The Hepatitis C virus can survive from 16 hours to no more than 4 days on environmental surfaces or contaminated instruments. Modes of Transmission Exposure to contaminated blood or potentially infectious body fluids, sexual contact and sharing contaminated needles. An infected mother can transmit the infection to her fetus through the placenta. 13 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  14. 14. Hepatitis C – Chronic Infections No protective antibodies are developed, therefore infected individuals that respond to treatment can get infected again. The reason why most individuals remain infected is due to changes in the virus during infection, which results in changes that are not recognized by preexisting antibodies. This appears to be how the virus establishes and maintains long-lasting infection. 14 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  15. 15. Hepatitis C – Incubation Period and Symptoms Incubation Period: 2 weeks to 6 months Symptoms Abdominal pain, jaundice, dark urine, loss of appetite, nausea, and fatigue. About 80% of infected individuals are asymptomatic. Chronic infection can develop in 75 to 85% of infected individuals. 15 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  16. 16. Malaria - Modes of Transmission, Incubation Period and Symptoms Malaria is a serious , sometimes fatal, disease caused by a parasite. Modes of Transmission – Bite of a malaria-infected mosquito, blood transfusion, needle use. Incubation Period: One week to one year Symptoms Initially shaking chills, fever, headache, muscle aches, sweating, fatigue. May cause anemia and jaundice. 16 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  17. 17. Written Exposure Control Plan Required by OSHA. Must be available to employees. Posted on the QACC/Services and the Real Estate EH&S websites and/or posted at your site. Copies can be obtained from a Field Supervisor, MERT Team Captain or NAR Regional EH&S Manager. Identifies job classifications and tasks where exposures to BBP can occur. Describes post-exposure evaluations and follow-ups. 17 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  18. 18. Written Exposure Control Plan (Continuation) Plan includes: Procedures Biohazard Labeling Policies Employee Information / Training Universal Precautions Engineering Controls Workpractice Controls PPE Recordkeeping Exposure Incidents, PostExposure Evaluations and Follow-Ups Methods of Decontamination 18 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  19. 19. What is an exposure incident? An exposure incident is a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties. Notes: Non-intact skin includes skin with dermatitis, hangnails, cuts, abrasions, chafing, acne, etc. Parenteral contact means the piercing of mucous membranes or the skin barrier through events such as needle sticks, human bites, cuts & abrasions. 19 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  20. 20. Potential Routes of Exposure Ingestion Inhalation Absorption through mucous membranes (i.e., nose, mouth, stomach, intestines, bronchial tubes, urinary tract) or eyes. Contact with blood or “Potentially Infectious Materials” (PIM) resulting from a break in the skin caused by human bites, sharp objects and needles. Note: People should not be touching their mouth, nose or eyes if their hands haven’t been washed. 20 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  21. 21. Preventing Exposure Universal precautions Treat all body fluids as if contaminated with a BBP. Engineering and work practices controls Personal protective equipment Prevent PIM from reaching eyes, mouth, or mucous membranes. Good housekeeping Clean spills immediately with 1:10 to 1:100 dilution of bleach/water solution. 21 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  22. 22. Engineering Controls These controls reduce employees exposure by either removing the hazard or isolating the worker. Example: Sharps Disposal Container Note: hollow-borne needles considered more severe than solid materials (i.e., scalpels) 22 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  23. 23. Work Practice Controls These controls reduce the likelihood of exposure by altering how a task is performed. Examples: Wearing two pairs of impermeable gloves (latex or nitrile gloves) and face protection. Adequate hand washing (antiseptic towelettes or alcohol based hand cleanser if water and soap are not available). Remove contaminated garments. No eating, drinking, smoking, applying cosmetics/lip balm or handling contact lenses in areas where blood or PIM are present. 23 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  24. 24. Personal Protective Equipment Examples of personal protective equipment Gloves (Latex or Nitrile Gloves) Safety Glasses Face Shields One-way air valve resuscitation mouthpieces 24 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  25. 25. Good Housekeeping BBP Decontamination A bleach solution diluted between 1:10 (1/4 cup bleach to 1 gallon water) to 1:100. Must be freshly mixed! Tools for cleanup Brooms Brushes Dust pans Disposable clothes Use proper PPE and Universal Precautions. Wash hands and exposed body parts immediately. 25 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  26. 26. Surface Decontamination Clean gross contamination with soap and water first to ensure the disinfectant is completely effective. Ensure 15 minutes contact time with contaminated Surface. 26 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  27. 27. Sharps Handling and Disposal Use tongs or other means to pick up contaminated sharps and broken glass. Do not pick up contaminated sharps and broken glass directly with hands even if gloves are worn. Use sharps containers for syringes, needles, and broken glass. 27 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  28. 28. Sharps Containers Sharps containers must be: closable, puncture resistant, leak proof on sides and bottom, and labeled or color-coded Upon closure, duct tape may be used to secure the lid of a sharps container as long as the tape does not serve as the lid itself. Containers must be closed prior to removal. 28 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  29. 29. Biohazard Waste Regulated Waste (Don’t put in regular garbage) Place waste material in red biohazard container / bag 3rd party disposal not normal trash Small Biohazard Bag provided with 514A First Aid Kit 29 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  30. 30. Biohazard Labels Biohazard Labels must be used: When equipment cannot be properly decontaminated On waste containers Red bags or containers may be substituted for labels. 30 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  31. 31. Post-Exposure Follow-Up Wash hands and exposed body parts immediately with soap and water. When in remote locations with no potable water, use antiseptic towelettes or alcohol based cleansers until able to wash hands. Mucous membranes should be flushed with water for at least 15 minutes. 31 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  32. 32. Post-Exposure Follow-Up Incident Reporting Report incident to your supervisor and the EH&S Manager immediately The employee must: - complete the Biological Exposure Incident Report Form (414) and the Hepatitis B Vaccine Immunization Form (413), - submit to the main ALU EH&S Office at fax number 1-908-5825907 within the work shift the incident occurred and - The supervisor must ensure immediate medical attention. 32 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  33. 33. Post-Exposure Follow-Up Incident Reporting (cont.) If the exposure incident occurred outside of normal hours of operation, the affected employee must: - complete forms 413 and 414 and - proceed to his or hers private physician or local emergency care facility for initial evaluation and treatment within 24 hours - notify ALU EH&S on the next day of operation The supervisor contacts their NAR Regional EH&S Manager for assistance in completing the electronic On Job Injury/Illness Incident and Investigation form (E083) and submits following the instructions on the form. Affected employees names are omitted from the final record of injury reports to protect employee’s confidentiality. 33 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  34. 34. Post-Exposure Follow-Up In the event of an exposure incident, the source individual’s blood is screened for HBV, HCV and HIV unless prohibited by law or consent not given by the source individual. Blood testing will occur at specific intervals. Regardless of the test results, treatment protocols are individualized. The Healthcare Provider shall complete the necessary information on the 413 and 414 forms. Once all three vaccination series and follow-up visits are completed, employee submits or asks the Healthcare Provider to submit the 413 and 414 forms to the main ALU EH&S Office. 34 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  35. 35. Post-Exposure Follow-Up You will be offered a Hepatitis B vaccine if not previously vaccinated. During follow-up of an exposure incident you will be asked to be tested for HIV and HBV. Testing will not be done unless consent is given If vaccine is declined, declination form must be signed. Physician follow-up to discuss test results and further evaluation. 35 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  36. 36. Hepatitis B Vaccination Available to affected employees at no cost A series of 3 shots A yeast derivative that cannot transmit HBV 36 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  37. 37. Hepatitis B Vaccination Affected employees: Employees certified in First Aid-CPR and current in Bloodborne Pathogens training Members of Medical Emergency Response Teams (MERT) Employees having experienced an exposure incident Pre-exposure vaccinations available to employees provided with First Aid-CPR training in accordance with the Installation First Aid-CPR Training Policy and members of a MERT Team upon request. Post-exposure vaccinations will be available to all affected employees no later than 24 hours after an exposure incident has occurred. 37 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  38. 38. Forms 413 and 414 Completed 413 and 414 forms are classified as a medical record. Distribution of completed forms must be limited to EH&S, the Healthcare Provider and ALU employees designated to administer medical records and process worker’s compensation claims. Completed forms must not be copied or included in local employees files. 38 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  39. 39. Training Provided at no cost to employees during working hours. Annual refresher Training records maintained for 3 years 39 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  40. 40. Alcatel-Lucent - Installation First Aid-CPR Training Policy Installation management shall ensure that all Installation installers and maintenance technicians on each job site have a valid* certificate in Standard First Aid-CPR. Local management is responsible for selecting and scheduling the subject training in order to maintain current certification status. * Meeting current requirements as set forth by either the American Red Cross, the American Heart Association, the American Safety & Health Institute, the Emergency Care and Safety Institute or the National Safety Council. 40 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  41. 41. Employee Medical Records Employee medical records: - must be kept confidential - not disclosed or reported without the employee’s written consent (unless required by law) - must be maintained for duration of employment plus 30 years 41 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####
  42. 42. Summary The Alcatel-Lucent Exposure Control Plan plays an important role in the implementation of safeguards intended to protect workers against the health hazards from exposure to blood and other potentially infectious materials. Your assistance in the implementation of this plan is essential. Your input into the plan is encouraged. Additional information regarding Bloodborne Pathogens and other infectious diseases can be found at the following websites: www.osha.gov www.cdc.gov www.usphs.gov 42 | Presentation Title | Month 2006 All Rights Reserved © Alcatel-Lucent 2006, #####

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