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Definition on bloodborne pathogens on workers to their health.ppt
- 1. OSHAcademy Course 755 BloodbornePathogens
- 2. Disease PATHOGENS • Parasite • Bacteria •Fungi • Virus
- 3. Disease TRANSMISSION • Air • Fecal •Bloodborne
- 4. What are Bloodborne Pathogens? • How are they harmful ? • How are they contracted ? • Some facts and figures
- 5.
- 6. Definitions Other potential infectiousmaterials (OPIM)
- 7. Hepatitis B orC Virus • Inflammation of the liver • Causes liver damage ranging from mild to fatal • Can live in a dry environment for at least 7 days
- 8. HBV -Hepatitis B •Very infectious – 1/3 no symptoms, 1/3 flu-like, 1/3 severe – 6 to 10% of cases infectious for life (carrier state) • In the past, 140,000-300,000 new infections per year – 5,000-6,000 deaths/yr from chronic liver disease • Safe and effective vaccine is now available – Many HCW are not vaccinated
- 9. HBV - HepatitisB Health Care Workers and HBV • Approximately 400 HCW infected annually • This is a decrease from 17, 000 in 1983 and 1,000 in 1994. • 25% of infected develop acute hepatitis • 10-30% of health/dental workers show evidence of past HBV infection
- 10. HCV - HepatitisC • Affects 4 times more people than HIV • 4 million Americans infected • Only 25% of those infected have been diagnosed • In 1995, estimated 560-1120 cases among HCW in U.S.
- 11. HCV - HepatitisC • Symptoms may or may not be present • Infection may lead to carrier state • Carrier state can develop with or without symptoms • Carrier state can lead to chronic liver disease, cirrhosis (10 year latency), or cancer (alcohol is strong co-factor) • Leading cause of liver transplant in U.S.
- 12. HCV - HepatitisC • 85% of Hepatitis C infections persist for life • 70% develop chronic liver disease • Signs and symptoms may not appear until 10 years after infection • Onset of symptoms may present with severe liver disease • No broadly effective treatment • No vaccine available
- 13. HCV - RiskFactors • Blood transfusion prior to 1992 • IV drug use • Unprotected sex (multiple sexual partners) • Occupational percutaneous exposure to blood with contaminated sharp –Risk is intermediate between Hepatitis B and HIV
- 14. Human Immunodeficiency Virus(HIV) • Attacks the human immune system • Can live in a dry environment for only a few hours • > 1 million infections in U.S. • 56 documented cases among HCW; • 138 cases of possible occupational transmission
- 15. AIDS • AIDS =Acquired Immunodeficiency Syndrome • Results from destruction of the human immune system from infection with HIV • Some have no symptoms, or less severe symptoms • No vaccine available yet
- 16. HBV & HIVCompared HBV HIV • HCW cases 400/yr. 56 • Risk of infection – Needle stick 6-30/100 1/300 • Vaccine available Yes No
- 17. HBV & HCVCompared Hepatitis C • Infectivity: Low • Nucleic Acid: RNA • Carrier state: > 80% • Route: Blood Hepatitis B Very High DNA Variable {10-50%} Blood
- 18. Exposure Control Plan “Toeliminate or minimize employee exposure” • Exposure determination • Controls – Universal precautions (or equivalent system) – Engineering controls – Work practices – Personal protective equipment – Housekeeping
- 19. Exposure Control Plan •Hepatitis B vaccination • Post exposure evaluation & follow-up • Communication and training • Recordkeeping
- 20. Exposure Determination • Dowe have job classifications where ... All employees are occupationally exposed? • List the classifications Some employees are occupationally exposed? • List the classifications • List the tasks with exposure • Determine exposure without regard for PPE the worker uses
- 21. First Aid First aidtraining Good Samaritan Collateral duty* Designated responder Not covered by BBP Standard BBP standard applies * if First-Aid response is an expected part of the job BBP standard applies
- 22. Universal Precautions Treat asif known to be infectious All human blood Certain human body fluids All human body fluids if they can’t be distinguished
- 23. Engineering Controls • Isolateor remove the bloodborne pathogen hazard from the workplace » A physical guard » Barrier » Environmental controls » Other devices
- 24. Engineering Controls • Annualevaluation and documentation • Solicit input from patient care providers • Implement commercially available, effective and appropriate devices • Document justifications for not using safer devices
- 25. Physical Guard Sharps disposalcontainers • Closable • Puncture resistant • Leakproof • Labeled
- 26.
- 27.
- 28. Other Devices • Avoidrecapping • Use Safer Sharp Devices » needleless IV systems » retractable syringes and lancets » puncture-resistant capillary tubes
- 29. Work Practice Controls Safersteps to do the job! • Prohibit two-handed needle recapping • Do not bend, break or remove needles (incl. phlebotomy) • Wash hands between glove use • Flush body parts with water after contact with blood or OPIM • Remove PPE before leaving work area
- 30. Examples of WorkPractice Controls
- 31. Personal Protective Equipment PPE Providedat no cost to employee » Gloves » Gowns » Face shields and/or masks » Eye protection » Resuscitation devices » Lab coats
- 32. PPE Gloves • Latex • Nitrile •Vinyl • Utility
- 33.
- 34. PPE Eye - Faceprotection and masks
- 35.
- 36. Housekeeping Maintain a cleanand sanitary workplace • Written cleaning and decontamination schedule • Contaminated waste disposal methods • Laundry DISINFECTANT
- 37. Regulated Waste • Bloodor OPIM » Liquid » Semi-Liquid » Contaminated sharps » Lab or medical waste • Other items caked with dried blood or OPIM
- 38. Regulated Waste Containers •Easily accessible • Leakproof • Maintained upright • Labeled or color coded • Replaced routinely ( no overfill!!!) • Disposal » County or City Health Dept.. Regulations
- 39. Regulated Waste Handling •When moving containers: » Close immediately » If leaking, place in secondary container » If reusable, clean in a manner that will not expose employees.
- 40. Laundry • Handle aslittle as possible! » Bag/containerize where used » Don’t sort or rinse where used » Labeled or color coded containers » Leak-proof containers if leaks are likely • Employees must wear proper PPE!!!
- 41. Hepatitis B Vaccine •3 shot series • Effective for 95% of adults • Post-vaccination titers for high risk HCW • Exposure without vaccination » Immune globulin ASAP after exposure » BeginVaccination series
- 42. Hepatitis B Vaccination •Make Hepatitis B vaccination available » Declination statement required » Available at later date if desired • No cost to employees • Reasonable time and place • If series is interrupted, continue at any time rather than restart series
- 43. Exposure Incident Contact withblood or OPIM via: • Cuts, puncture, needle sticks • Mucous membrane • Eye • Non-intact skin
- 44. Post Exposure Evaluation •Provide medical evaluation ASAP • Testing for HBV, HCV, HIV • HIV/HBV PEP when indicated • Identify source individual, if possible • Obtain consent for blood test • Provide information to healthcare provider • Routes of entry • Employee’s job duties • Copy of the regulation Employer Responsibility:
- 45. Post Exposure Evaluation •Insure that the healthcare provider provides to exposed employee: • Results of the source individuals test (if legal) • Results of exposed employee’s test • Post exposure treatment as needed • Provided at no cost to employee
- 46. Medical Evaluation andFollow-up • Provide in writing to employer: • Employee has been informed of the results • Employee has been informed of any medical conditions resulting from exposure • All specific findings or diagnoses are confidential to employee Healthcare Provider’s Responsibility:
- 47. Communication • Signs andlabels » Regulated waste » Containers with blood or OPIM » Laundry » Biohazard symbol
- 48. Training • Provided tooccupationally exposed employees: » At time of initial assignment » At least annually thereafter » Cover specific required elements » Interactive » Qualified trainers
- 49. Recordkeeping • Medical records »HBV vaccination status » Written medical opinion of exposure incidents » Exposure incident details » Maintain for length of employment + 30 years
- 50. Recordkeeping • Training records »Dates » Content summary » Trainer name & qualifications » Attendee’s names & job titles » Maintain for 3 years
- 51. Sharps Log • Maintaina separate sharps injury log • Document sharps injuries on the OSHA 300. • Recorded as confidentiality case • Must contain: – Type and brand of device involved – Department or work area where exposure occurred – An explanation of how the incident occurred
- 52. Plan Evaluation • Reviewand/or update annually • Whenever necessary to reflect changes that affect occupational exposure, including improved safety devices
Editor's Notes
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