Training presentation bloodborne pathogens
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Occuptional Exposure , mostly in Hospital Set ups and medical professionals.
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Training presentation bloodborne pathogens
- 1. Bloodborne Pathogens Dr. Mangesh Pawale, MBBS, CPS-TDD, AFIH Occupational Health
- 2. Bloodborne Pathogen Standard • Required by OSHA (29 CFR 1910.1030) • Applies to employees in all industries who may be exposed to blood or other potentially infectious materials (OPIM)
- 3. What are Bloodborne Pathogens? • Microorganisms such as viruses or bacteria that are present in human blood and can cause diseases in humans – Human Immunodeficiency Virus (HIV) – Hepatitis B Virus (HBV) – Hepatitis C Virus (HCV)
- 4. Human Immunodeficiency Virus (HIV) • The virus which causes AIDS • Devastates the body’s immune system • Symptoms: flu like illness, weakness, diarrhea, weight loss • Signs of illness may not be present for years • AIDS is chronic and fatal
- 5. Hepatitis B (HBV) • Attacks the liver • Survives in dried blood for up to 1 week at room temperature • 300,000 new infections each year; 3,000 annually result in death • Symptoms: fatigue, nausea, vomiting, abdominal pain, anorexia • Can be chronic and fatal
- 6. Hepatitis C (HCV) • Can lead to chronic hepatitis, cirrhosis and liver cancer, in 75% of cases • 4 million infected in U.S. – Only 25% diagnosed • Can be chronic and fatal • 12,000 deaths annually • No effective vaccine exists
- 7. Potentially Infectious Materials • Blood • Human bodily fluids such as: – Semen, vaginal secretions, lung fluid • Any bodily fluid containing visible blood • Any bodily fluid that cannot be identified
- 8. How Are They Transmitted? • Puncture wounds caused by sharp objects • Infectious materials contacting open wounds, cuts, or broken or damaged skin • Infectious materials contacting mucous membranes of eyes, nose and mouth
- 9. Possible Exposure Incidents • During an accident • While administering First Aid • During post-accident clean-up • When performing routine maintenance or janitorial work
- 10. Exposure Control Plan • Universal precautions • Engineering controls • Work practice controls • Post-exposure follow-up
- 11. Universal Precautions • Treat all human blood and bodily fluids as if they are infected with HIV, HBV, HCV and other bloodborne pathogens.
- 12. Engineering & Work Practice Controls • Engineering Controls – Handwashing facilities – Biohazard waste bags • Work Practice Controls – Personal protective equipment (PPE) – First aid response – Spill clean-up – Laundry – Waste disposal – Exposure response
- 13. Personal Protective Equipment • First line of defense • Limitations • Rules: – Remove before leaving work area – Wash hands after removing – Properly dispose of contaminated PPE
- 14. First-Aid Response • Adopt Universal Precautions • Encourage self-care • Use PPE • Avoid applying pressure without barrier
- 15. Housekeeping: Spill Clean-up • Use PPE & Universal Precautions • Cover spill or area with paper towel or rags • Pour disinfectant solution over towels or rags • Leave for at least 10 minutes • Place materials in appropriate container • Arrange for pick-up and disposal
- 16. Housekeeping: Waste Disposal • Use PPE when handling • Leak-proof containers • Proper labeling – Labels – Red Bags or Containers • Drop-off sites
- 17. Housekeeping: Contaminated Laundry • Laundry soiled with blood or OPIM • Use PPE • Handle as little as possible • Pre-soak all contaminated clothing • If blood or OPIM gets on clothing, remove and thoroughly wash with detergent ASAP
- 18. Exposure Incident Response • Contact with skin: wash exposed areas with antibacterial soap and running water • Contact with eyes or mucous membranes: flush affected area with running water for at least 15 minutes • Contact with clothing: remove contaminated clothing, wash underlying skin • Report exposure to supervisor immediately
- 19. Post-Exposure Evaluation • Confidential medical evaluation and follow-up after exposure incident – Identify and document source and circumstances of exposure – Test source individual’s blood for HIV/HBV – Provide blood sample • Healthcare professional’s written opinion
- 20. Hepatitis B Vaccination • Made available after exposure incident
- 21. Summary • Bloodborne Pathogens • Transmission • Potentially infectious materials • Exposure incidents • Prevention – Universal Precautions – PPE • Response
- 22. Questions & Quiz
Editor's Notes
- Today’s session is the topic of bloodborne pathogens. You’ll be learning what they are, their dangers, how they are transmitted, what you must do on the job to avoid them, and what to do if you've been potentially exposed.
- By law OSHA requires training in bloodborne pathogens for workers at risk of occupational exposure to bloodborne pathogens as part of their normal job duties. You’re at risk of occupational exposure when there is a reasonable chance that you may have skin, eye, or mucous membrane contact with blood or other potentially infectious materials in the course of performing your normal responsibilities. Although the risk of occupational exposure is highest for healthcare workers, as we will see, you still do have exposure risks as part of your jobs. We’re here today to alert you to them and minimize them.
- HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). AIDS attacks the body’s immune system and weakens it so it cannot fight off other diseases. There are roughly 1 million persons infected with HIV in the U.S. In 2000, there were 45,000 new cases. Symptoms vary, but often include flu like symptoms such as weakness, fever, sore throat, nausea, headaches, diarrhea, a white coating on the tongue, weight loss or swollen lymph glands. After the initial infection, it may be years before a person infected with HIV shows any signs of illness. While treatment is improving, AIDS is a fatal disease for which there is no known cure.
- Hepatitis B is a virus that affects the liver. While initially causing inflammation of the liver, it can potentially lead to more serious conditions such as cirrhosis and liver cancer. HBV can survive in dried blood for up to 7 days, making it a significant concern for housekeepers, janitors, custodial personnel, laundry personnel whose contact with dried blood may come outside of an emergency or first aid situation. Its symptoms are similar to a mild flu, starting with a sense of fatigue and stomach pain. However, it may take up to 9 months before symptoms become noticeable. Hepatitis B can be chronic and fatal. Even if it is diagnosed and you get help, there’s a chance you won’t recover. About 6-10% of infected adults cannot clear the virus from their livers and develop chronic HBV. That is, they become HBV carriers for life. 25% of these carriers later develop cirrhosis. There is no known cure for chronic HBV. One strain, fulminant hepatitis, develops in about 1-2% of cases and is 85% fatal even with the most advanced medical care. There is a vaccine for HBV, which can minimize your chances of acquiring the disease, which we’ll discuss later.
- Like HBV, Hepatitis C (HCV) is a virus that affects the liver. On average 75% of patients with HCV infection later develop chronic Hepatitis, cirrhosis, or liver cancer. Nearly 4 million Americans are infected with HCV. However, only 25% are diagnosed. HCV can be chronic and fatal. It’s responsible for 8,000-10,000 deaths annually. Unlike HBV, there is no effective vaccine to prevent acquisition of HCV.
- Bloodborne pathogens are transmitted when infectious materials enter the bloodstream through various forms of contact, which we’ll see in a minute.| Blood is the primary carrier, however, there are other potentially infectious materials (OPIM) which should be treated just as seriously. OPIM, include vaginal secretions, cerebrospinal fluid, joint fluid, lung fluid, pericardial fluid, and other bodily fluids. You can be infected by any bodily fluid that is visibly contaminated with blood. You can be infected by any bodily fluid where it is impossible to differentiate and identify exactly what it is.
- We’ve seen that you can get HIV, HBV and HCV when infectious materials get into the body. How does this happen? On the slide, you can see some of the more common ways infectious materials can get into your bloodstream. Sharp objects puncturing your skin is one way. In medical settings, where there are a lot of needles, this is especially dangerous. But this can happen anywhere. For example, you handle broken glass covered with someone else’s blood and are cut. Even small cuts, acne, or sunburn blisters can provide routes for bloodborne pathogens to enter the body. So if you have a small cut on your finger or blister on your arm and you come into contact with someone else’s blood, you can become infected with a disease. Your eyes, nose and mouth also provide routes of entry. For example, if you rub your eyes or nose with contaminated gloves or clothing, maybe your sleeve, you’ve put yourself at risk. The following slide gives some examples of likely exposure incidents in an industrial or office setting.
- These are some of the most likely situations where you can be exposed to bloodborne pathogens in an industrial or general office setting. You’re at risk for exposure if you are near an accident. You may be splashed by blood. You may come into contact with blood or OPIM while administering first aid. For example, you may have to apply pressure to a gushing wound.. During clean-up, you’re at risk for contact with potentially infectious materials that are still on the accident scene. You're also at risk during routine maintenance or janitorial work, where blood or OPIM can still be present on equipment that hasn’t been properly decontaminated. You’re at risk when handling laundry, such as contaminated protective personal equipment (PPE) or clothing covered with potentially infectious materials.
- We have a written Exposure Control Plan, as required by OSHA, that outlines what we are doing to insure you do not come into contact with a bloodborne pathogens on the job and what the procedures are to follow when an exposure incident does occur. We will now review the basic components of how we can all prevent transmission of bloodborne pathogens on the job.
- Universal precautions are the building blocks of exposure control. It’s a preventive approach to controlling the spread of infectious diseases in which ALL human blood and other bodily fluids are treated as if they are infected with HIV, HBV and other bloodborne pathogens. The take-away here is simple and straightforward: when you come into contact with blood or other bodily fluids, you will treat them as if they were infected. As far as you are concerned, every drop of blood, every speck, is in fact carrying HIV - no ifs, ands, or buts.
- Engineering controls and work practice controls work in tandem to prevent exposure. Not only do you have to follow the right procedures; you have to use the right equipment. Engineering controls are items designed to reduce your exposure either by removing, eliminating or isolating hazards. Some examples include spill kits, handwashing stations, eye wash stations, biohazard waste bags and boxes, or in a healthcare setting, resheathing devices on needles and scalpels. Work practice controls work hand-in-hand with engineering controls. These are specific practices and procedures you perform as part of your job to eliminate the threat of exposure. We’ll review use of personal protective equipment, emergency response situations, proper handwashing, clean-up, laundry and waste disposal.
- Personal protective equipment (PPE) is your first line of defense against infection on the job. As it’s intended to be a barrier against transmission, appropriate PPE doesn’t allow blood or other potentially infectious materials to pass through it under normal circumstances. PPE should be used when there’s a reasonable chance of contact with blood or OPIM. Gloves should be worn whenever providing first aid or medical care, whenever you handle soiled materials or equipment, and whenever you are cleaning up spills of risky materials. Protective clothing should be worn in cases where splashes or spills are likely and also when working with risky materials. Face protectors such as splash goggles should be worn whenever risky materials could splash, splatter or spray in your face. Resuscitation equipment should be used instead of mouth-to-mouth. There are limitations. PPE must be clean and in good repair. PPE that is torn, punctured or has lost its ability to function as an effective barrier should not be used. Disposal PPE should not be reused under any circumstances. And while using PPE, don’t forget the basics - don’t touch your eyes or nose with gloves, for example. Reusable PPE should be placed in the proper disposal containers or laundry receptacles. Wash your hands with soap and water after you have removed any PPE you’ve used.
- If you are responding to an emergency situation, remember the most important rule - adopt universal precautions. Treat all blood or bodily fluids as if infectious. Encourage as much self-care by the victim as possible under the circumstances. For example, if it’s a small cut, let them apply direct pressure themselves. Wear PPE at all times in activities where there is a high likelihood of exposure risk in your emergency response situation. If you have to apply pressure to stop bleeding, at no time are you to use just your hands. Wear gloves. Remember - no wound is too small. It just takes a drop of blood to infect you.
- When you are assigned the task of clean-up after an accident, adopt universal precautions and use appropriate PPE. Remember, HBV can survive in dried blood for up to 7 days. So don’t assume that if blood or OPIM is dry, you can cut corners. You are still at risk of infection. If you are assigned to clean up a spill, cover the area containing blood or OPIM with paper towels or rags, pour a disinfectant solution over the towels, leave for at least 10 minutes, then remove. When finished, place materials in waste disposal bag. Arrange for pick-up and disposal. We’ll talk about proper labeling next.
- If you are involved in waste disposal, adopt universal precautions and wear appropriate PPE when handling infectious waste containers. Containers must be leak-proof and be clearly labeled. You should use labels containing the biohazard symbol. These should also be fluorescent orange with letters and symbols in contrasting color. You can also use leak-proof red bags or red containers instead of labels. Know the specific drop-off sites for infectious waste in your area. Never put it in a normal trash container.
- Contaminated laundry is clothing or PPE that is soiled with blood or OPIM. Remember, even though blood or OPIM is dried, you still can be infected. When dealing with contaminated laundry: use PPE, such as gloves or aprons; handle as little as possible; and pre-soak all contaminated clothing in disinfectant. If blood or OPIM gets on your clothing, remove it and wash with detergent as soon as possible.
- If you believe you have been exposed, immediate action can greatly reduce your chances of infection. Whenever infectious materials come into contact with your skin, you must immediately wash the exposed area thoroughly with antibacterial soap and running water. Whenever infectious materials come into contact with your eyes or mucous membranes, flush with running water for at least 15 minutes. If there is contact with your clothing, remove and wash the underlying skin thoroughly with antibacterial soap and running water. Report any potential exposure to your supervisor immediately. As you’ll see on the next slide, the more we know about the incident, the better we’ll be able to help you going forward.
- After you report the exposure incident to your supervisor, you will receive a confidential medical evaluation and follow-up care. You will be asked to assist in identifying and documenting the source of and circumstances surrounding your exposure. The source individual’s blood will be tested for HBV and HIV as soon as possible (if consent is provided). You will then be asked for a blood sample in order to determine if infection has occurred. You may decline consent for HIV testing. However, your blood sample will be kept for 90 days. So if you change your mind at any time during that period, you can still request the test. A healthcare professional’s written opinion will be provided to you within 15 days, which will let you know whether or not you are infected.
- Hepatitis B vaccination is made available to all employees within 10 working days of initial assignment to duties with occupational exposure risk. The vaccine is extremely effective in preventing the disease if administered immediately after exposure. It is given in a series of three shots, which gradually build up your immunity to the Hepatitis B virus. There is no danger of you getting the disease from the shots. Vaccination is offered following an exposure incident at no cost to you unless you have previously received the vaccine series. Once vaccinated, a person does not need to receive the series again. The first shot is given immediately after the incident. This is followed by a second shot one month after the first and a third shot 5 months after the second. You can opt to decline the vaccine series, in which case you will be asked to sign a declination form. If you decline the offer, you still can choose to have the vaccine series administered at a later date.
- Here’s a quick recap of what we covered in today’s session. Bloodborne pathogens are microorganisms such as viruses or bacteria that are present in human blood and can cause diseases in humans. The most common of these diseases are Human Immunodeficiency Virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV). They are transmitted through contact with blood and other potentially infectious materials that enter the bloodstream. Potentially infectious materials include blood, any bodily fluid that is visibly contaminated with blood, vaginal secretions, joint fluid, lung fluid, and other bodily fluids or bodily fluids where it is impossible to differentiate and identify the precise bodily fluid. You are exposed to bloodborne pathogens through puncture wounds caused by needles, broken glass and other sharp objects; infectious materials entering open wounds, cuts, or broken or damaged skin; or infectious materials entering mucous membranes of eyes, nose and mouth. Exposure can be prevented by a combination of engineering controls and work practices. Adopt Universal Precautions - treat all blood and bodily fluids as if they were infectious. Use Personal Protective Equipment. Wear gloves, splash goggles, resuscitation masks, and other barriers in situations where there is a risk of exposure. Never reuse disposal PPE. Disinfect all areas where bodily fluids have spilled and place clean-up materials in proper containers. Label all waste with proper biohazard labels or deposit in red, leak-proof containers or bags. If you believe you’ve been exposed, wash the exposed area immediately with antibacterial soap and running water. If fluids enter eyes or nose, flush with running water for at least 15 minutes. Immediately report the incident to your supervisor. You will receive post-exposure evaluation and follow-up which includes a confidential medical evaluation and blood testing.
- Now we’ll open up the floor for questions on any of the material we’ve covered.