Bloodborne Pathogens & Disease Transmission

1. Training for the
Solid Waste Industry

2. Why is This Issue So Important?
• Solid waste personnel can be exposed to BBPs
and other diseases through improper or even
illegal disposal of infectious waste.
• Customers and facility contractors can expose
solid waste personnel through routine
interactions (both office and operations.)
• Providing first aid exposes the rescuer.
• Effective personnel training is a key to
minimizing exposures.

3. This is a Serious Issue for the
Solid Waste Industry
Information for this presentation
provided by OSHA, CDC, NIOSH,
and the Center for Women’s
Health Information Center.

4. What is a Bloodborne Pathogen?
• Bloodborne Pathogens means pathogenic microorganisms that are
present in human blood and can cause disease in humans. These
pathogens include, but are not limited to, hepatitis B virus (HBV)
and human immunodeficiency virus (HIV).
• Bloodborne Pathogens are infectious microorganisms in human
blood that can cause disease in humans. These pathogens include,
but are not limited to, hepatitis B (HBV), hepatitis C (HCV) and
human immunodeficiency virus (HIV). Needle sticks and other
sharps-related injuries may expose workers to bloodborne
pathogens. Workers in many occupations, including first aid team
members, housekeeping personnel in some industries, nurses and
other healthcare personnel may be at risk of exposure to
bloodborne pathogens.

5. How are BBPs transmitted?
• Exposure Incident means 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.
• Other Potentially Infectious Materials means (1) The following human body fluids:
semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid,
pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any
body fluid that is visibly contaminated with blood, and all body fluids in situations
where it is difficult or impossible to differentiate between body fluids; (2) Any
unfixed tissue or organ (other than intact skin) from a human (living or dead); and
(3) HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-
containing culture medium or other solutions; and blood, organs, or other tissues
from experimental animals infected with HIV or HBV.
• Parenteral means piercing mucous membranes or the skin barrier through such
events as needle sticks, human bites, cuts, and abrasions.

6. OSHA’s
Bloodborne Pathogen Standard
• OSHA's Bloodborne Pathogens Standard (29 CFR
1910.1030) as amended pursuant to the 2000 Needle
stick Safety and Prevention Act, is a regulation that
prescribes safeguards to protect workers against health
hazards related to bloodborne pathogens. It has
provisions dealing with exposure control plans,
engineering and work practice controls, hepatitis B
vaccination, hazard communication and training, and
recordkeeping. The standard imposes requirements on
employers of workers who may be exposed to blood or
other potentially infectious materials such as certain
tissues and body fluids.

7. Examples of BBP and
Other Diseases of Concern
• Hepatitis A
• Hepatitis B
• Hepatitis C
• HIV
• Viral Hemorrhagic Fevers
• Tuberculosis
• Rabies, West Nile Disease, Lyme Disease

8. Types of Hepatitis
• Hepatitis A: caused by eating food and drinking water infected with a
virus called HAV. It can also be caused by anal-oral contact during sex.
While it can cause swelling and inflammation in the liver, it doesn't lead to
chronic, or life long, disease. Almost everyone who gets hepatitis A has a
full recovery.
• Hepatitis B: caused by the virus HBV. It is spread by contact with an
infected person's blood, semen, or other body fluid. And, it is a sexually
transmitted disease (STD). Having unprotected sex (not using a condom)
with an infected person. It can be transmitted by:
• Sharing drug needles (for illegal drugs like heroin and cocaine or legal drugs like vitamins and
steroids).
• Getting a tattoo or body piercing with dirty (unsterile) needles and tools that were used on someone
else.
• Getting pricked with a needle that has infected blood on it (health care workers can get hepatitis B
this way).
• Sharing a toothbrush, razor, or other personal items with an infected person.
• An infected woman can give hepatitis B to her baby at birth or through her breast milk.
• Through a bite from another person.
Source: National Women's Health Information Center

9. Types of Hepatitis - Continued
• Hepatitis B: With hepatitis B, the liver also swells.
Hepatitis B can be a serious infection that can cause
liver damage, which may result in cancer. Some
people are not able to get rid of the virus, which
makes the infection chronic, or life long. Blood banks
test all donated blood for hepatitis B, greatly
reducing the risk for getting the virus from blood
transfusions or blood products.
Source: National Women's Health Information Center

10. Types of Hepatitis - Continued
• Hepatitis C: caused by the virus HCV. It is spread the same way as
hepatitis B, through contact with an infected person's blood, semen, or
body fluid (see above). Like hepatitis B, hepatitis C causes swelling of the
liver and can cause liver damage that can lead to cancer. Most people who
have hepatitis C develop a chronic infection. This may lead to a scarring of
the liver, called cirrhosis. Blood banks test all donated blood for hepatitis
C, greatly reducing the risk for getting the virus from blood transfusions or
blood products.
• Hepatitis D: caused by the virus HDV. You can only get hepatitis D if you
are already infected with hepatitis B. It is spread through contact with
infected blood, dirty needles that have HDV on them, and unprotected sex
(not using a condom) with a person infected with HDV. Hepatitis D causes
swelling of the liver.
• Hepatitis E: caused by the virus HEV. You get hepatitis E by drinking water
infected with the virus. This type of hepatitis doesn't often occur in the
U.S. It causes swelling of the liver, but no long-term damage.
Source: National Women's Health Information Center

11. HIV
• HIV: HIV stands for human immunodeficiency virus. It is the virus that can
lead to acquired immunodeficiency syndrome, or AIDS. Unlike some other
viruses, the human body cannot get rid of HIV. That means that once you
have HIV, you have it for life.
• Casual Contact: HIV cannot be spread by casual contact such as hugging
or shaking hands.
• Can someone get HIV from being spit on or scratched by an HIV-infected
person?
• No. HIV cannot be spread through saliva, and there is no documented case of transmission from an
HIV-infected person spitting on another person. There is no risk of transmission from scratching
because there is no transfer of body fluids between people.

12. HIV
• How can someone working in the solid waste industry become infected with
HIV in the work environment?
• Being stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for
health care workers.
• Being bitten by a person with HIV. Each of the very small number of documented cases has
involved severe trauma with extensive tissue damage and the presence of blood. There is no
risk of transmission if the skin is not broken.
• Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or
blood-contaminated body fluids. These reports have also been extremely rare.
• HIV does not survive long outside the human body (such as on surfaces), and
it cannot reproduce. It is not spread by:
• Air or water.
• Insects, including mosquitoes or ticks.
• Saliva, tears, or sweat. There is no documented case of HIV being transmitted by spitting.
• Casual contact like shaking hands or sharing dishes.
• Closed-mouth or “social” kissing
• Toilet seats.

13. Tuberculosis
• Tuberculosis: caused by a bacterium called Mycobacterium tuberculosis.
The bacteria usually attack the lungs, but TB bacteria can attack any part
of the body such as the kidney, spine, and brain. If not treated properly, TB
disease can be fatal.
• How is it transmitted? TB is spread through the air from one person to
another. The TB bacteria are put into the air when a person with TB
disease of the lungs or throat coughs, sneezes, speaks, or sings. People
nearby may breathe in these bacteria and become infected.
• TB is NOT spread by:
• shaking someone's hand
• sharing food or drink
• touching bed linens or toilet seats
• sharing toothbrushes
• kissing

14. Rabies, West Nile Disease,
and Lyme Disease
• Rabies:
• Spread by infected animals.
• Avoid contact with raccoons, rats, etc.
• Report any animal bites and seek medical attention.
• West Nile Disease:
• Spread by mosquitos.
• Use mosquito repellent with DEET.
• Lyme Disease:
• Spread by ticks.
• Check for ticks after possible exposure.
• Report tick bites and seek medical attention if symptoms
develop (rash, “bulls eye ring”, swelling around bite area.)

15. Iowa Regulations for Infectious Waste
• 567—109.9(455B,455D) Infectious waste. Infectious
waste which is generated and treated at a medical
clinic, doctor’s office, nursing care facility, health care
facility, dentist’s office or other similar facility may be
placed with municipal solid waste and not handled in a
special way if it is rendered nonpathological, does not
contain free liquids, and sharps are shredded, blunted,
granulated, incinerated or mechanically destroyed. The
generator of the infectious waste must notify the
waste hauler and the sanitary landfill that infectious
waste is being placed with the regular municipal solid
waste and, with the notice, certify that the infectious
waste is properly treated in accordance with the
requirements of this rule.

16. How Can BBPs and Diseases be
Transmitted at Solid Waste Facilities?
• Punctures
• Eyes
• Inhalation
• Ingestion
• Bites
• Laceration
• Scratches that break skin

17. What are Specific Hazards for Solid
Waste Personnel?
• Materials Collection
• Materials Sorting/Processing
• Equipment Inspection/Maintenance
• Landfill Active Face
• Transfer Station/Recycling Center Tip Floor
• Providing First Aid
• Human Interaction
• Animal Interaction

18. Stay Safe!
• Implement the use of universal precautions
• Treat all human blood and other potentially infectious material
as if known to be infectious for bloodborne pathogens.
• Practice good personal hygiene.
• Provide personal protective equipment (PPE), such as
gloves, eye protection, and masks.
• Make available hepatitis B vaccinations to all workers with
occupational exposure.
• Make available post-exposure evaluation and follow-up to
any occupationally exposed worker who experiences an
exposure incident.
• Provide information and training to workers.

19. As the Saying Goes….
If it is wet, and it’s not
yours….
DON’T TOUCH IT!!

20. Information Sources
• Occupational Safety and Health Agency (OSHA)
• www.osha.gov
• National Women’s Health Information Center
• www.womenshealth.gov
• Centers for Disease Control (CDC)
• www.cdc.gov
• The National Institute for Occupational Safety
and Health (NIOSH)
• www.cdc.gov/niosh/

21. Contact Information:
Losscontrol@iowaleague.org
800.257.2708
www.imwca.org