Bloodborne Pathogen Control Annual Refresher Training Instructor: Holly Niehoff, R.S. Environmental Health & Safety Office: 606-783-2584 Cell: 606-207-9425
What is the Purpose of OSHA?• OSHA requires all employers, even those with only one employee, to provide a safe and healthy workplace for employees.• OSHA exists only for the protection of employees in the workplace.
What Are The Responsibilities Under OSHA?Employers:Are required to comply with the OSHA standards.This means provide a safe and healthy workplace for employees.Provide training to all employees on hazards in the workplace (e.g.bloodborne pathogens)Employees:You must comply with OSHA rules and regulations; these are not anoption! You have the responsibility for participating in youremployer’s safety program and notifying the employer ofoverlooked hazards or controls).You have the responsibility for reporting any occupational illnessesor injuries, including sharps injuries or exposures to bloodbornepathogens. (CFR 29 OSHA 1910.1030)
MSU Bloodborne Pathogen Exposure Control PlanIncluded in the Infection Control Plan are the following:• Universal / standard precautions• Engineering and work practice controls• Personal protective equipment• Effective housekeeping• Hepatitis B vaccination• Post-exposure evaluation and follow-upA Copy of the Exposure Control Plan is on MSU EHS website.
What Are Bloodborne Pathogens? They are microorganisms capable of producing disease.They are found in the blood of infected individuals and can be spread to others by blood or body fluids. There are more than 25 bloodborne pathogens known today, and that number is increasing. Hepatitis B, hepatitis C, and human immunodeficiency virus are 3 of the most significant bloodborne pathogens.
How Could You Come in Contact With Bloodborne Pathogens?Bloodborne pathogens are spread through severalroutes:In the workplace:Splash, splatters or spills; sharp injuries.Injections, IV’s, surgical and dental procedures, invasiveprocedures, handling/cleaning contaminated items.Human bites.In the general community:Sexual contact, sharing dirty needles, tattoos, bodypiercing, acupuncture. Mother to fetus at birth;through breast milk.
Hepatitis B Virus• Strong concentrations of Hepatitis B Virus in body fluids make it highly contagious and easily spread.• HBV can be contracted by touching contaminated surfaces where the virus has been shown to live as long as four weeks.• Not just through needle sticks!• Vaccine is available to prevent HBV infection!
What Is Your Chance Of Becoming Infected With Hepatitis B Virus (HBV) at the Workplace?• Hepatitis B Virus: There are currently over one million people in the U.S. infected.• If an employee, not vaccinated against HBV, is exposed to an infected patient: The chance the employee will become infected with HBV is 1 in 6. (This exposure rate is based upon needle stick injuries in health care, a common mode of transmission.)
Which bloodborne pathogen is the leading cause of liver transplants in the U.S.?• The liver is the largest internal organ!• In children, it is about the size of a grapefruit.• In adults, it is about the size of a football.
Hepatitis C Virus• Hepatitis C Virus (HCV) is more common in the U.S. than HBV. CDC estimates 3.2 million Americans have it. HCV is different from other types of hepatitis in that it is more likely to cause a chronic carrier state and more likely to lead to cirrhosis, liver cancer, and death. It kills more people in the US than HIV. Most of them are in the 45-64 year old range. There is no vaccine or cure for HCV but they have treatments similar to HIV that. Individuals may have HCV for up to twenty years before showing any symptoms of disease. Up to ¾ do not know they have it until the liver is severely damaged.
What Is Your Chance Of Becoming Infected With Hepatitis C Virus (HCV) at the Workplace?Hepatitis C Virus: There are currently four millionpeople in the U.S. infected.If an employee is exposed to an infected patient:The chance the employee will become infectedwith HCV is 1 in 100 (This exposure rate is basedupon needle stick injuries and cut exposures inhealth care, a common mode of transmission.)Recent studies suggest that HCV may survive on environmental surfaces atroom temperature at least 16 hours, but no longer than 4 days
Symptoms of Viral HepatitisIf symptoms occur, the individual mayexperience any or all of the following:Loss of appetite, extreme tiredness,nausea/vomiting/diarrhea, abdominal pain,dark tea or cola colored urine, jaundice,arthritis/joint pain, or rash.
Which bloodborne pathogen has infectedbetween 10 to 12 million people worldwide?
What Do You Need To Know About Human Immunodeficiency Virus (HIV)?• Infection with HIV in the workplace represents a small but real hazard. With almost a million AIDS cases reported in the general population, there is ever-increasing potential for exposure.• Although there is currently no vaccine that is effective against HIV, the barrier techniques used to prevent HBV and HCV will also be effective against HIV.
HIV (Cont.)• Individuals may have HIV infection for up to 10 years before showing any symptoms of disease. These individuals can transmit the virus to others through direct contact with blood or other body fluids and through sexual intercourse. This can happen regardless of whether or not they have developed the symptoms of AIDS.• Only blood and blood products, semen, vaginal secretions and human milk have been directly linked to transmission of HIV.
What Are The Symptoms of HIV?• Approximately 50% of HIV-infected individuals will have one or more of the following symptoms within 2- 4 weeks after becoming infected: Fever illness (similar to mono or influenza and resolves on its own) Fatigue Body aches Rash (similar in appearance to measles) Swollen lymph nodes Headache Loss of appetite Weight loss
What Is Your Chance of Becoming Infected With HIV at the Workplace?• HIV: Almost 900,000 people in the U.S. have been infected. If an employee is exposed to an infected patient: The chance that the employee will become infected with HIV is 1 in 300 (This exposure rate is based upon needle stick injuries and cut exposures in health care, a common mode of transmission).
When Could You Have an Exposure To a Bloodborne Pathogen at the Workplace?• Anytime you come in contact with blood or potentially infectious body fluids. This includes: Infected blood or body fluids coming in contact with mucous membranes of the eyes, nose or mouth. Needle sticks, puncture wounds or cuts from contaminated objects. Non-intact skin such as abrasions, cuts, rashes or burns. Touching blood, or other potentially infectious materials, or a contaminated surface, with bare hands - because people may be unaware of skin abrasions.
How Could You Become Infected With A Bloodborne Pathogen at the Workplace?• Simply put, if an infected person’s blood enters your bloodstream you may become infected with whatever viruses that person is carrying. Unfortunately, a person may be infected with a bloodborne pathogen and not know it.• Therefore, we have to assume that everyone we come into contact with is infected and protect ourselves accordingly!
What Tasks or Procedures May Result in an Exposure at the Workplace?• Drawing blood• Administering injections• Assisting and Handling instruments during patient procedures• Collecting and handling lab specimens• Cleaning treatment area/exam rooms/Instruments• Handling biohazardous waste• Handling contaminated items• All invasive procedures
How Can You Protect Yourself Against Bloodborne Pathogens ?• By using:• Universal / Standard Precautions• Engineering Controls• Work Practice Controls
What Are Universal/Standard Precautions?• Universal Precautions:• This is the practice of treating all blood and certain body fluids as potentially infectious.• Standard Precautions• CDC expanded Universal Precautions to include ALL body fluids as potentially infectious.
When Do You Use Universal/Standard Precautions?• ALL Workers will use Standard Precautions any time there is a risk of being exposed to human blood and other potentially infectious body fluids.• All patients’ blood and body fluids will be treated as though known to be infectious for HBV, HCV, HIV, and other bloodborne pathogens.
What are Engineering Controls?• Engineering controls: These are the physical or mechanical systems in place to eliminate bloodborne pathogens at their source and prevent them from reaching employees• Examples:• Sharps with safety devices.• Disposable sharps containers.• Hand washing facilities.• Labeled, leak proof biohazardous bags and containers.
What Are Work Practice Controls?• These are the specific on the job procedures you must follow to reduce exposure to blood or other potentially infectious materials.• Examples:• Hand hygiene.• Proper disposal of sharps, needles, contaminated objects.• Effective housekeeping procedures.• Safe handling of lab specimens.• Precautions to take in possibly contaminated areas
What is Hand Hygiene? Wash Hands: Before gloving or applying any personal protective equipment. Immediately after removing gloves. Before leaving the work area. After touching a possibly contaminated surface. Before and after eating. After using the restroom. Wash hands thoroughly with warm water and soap.***Where no sink is available, an alcohol based hand cleaner (gel or foam) will be used as a temporary measure, followed by hand washing with soap and water as soon as possible.
What Are Disposable/Contaminated Sharps?• Disposable/Contaminated Sharps are any contaminated object that can puncture the skin. Examples: Needles, scalpels, broken glass, slides, extracted teeth with roots, exposed ends or dental wires, and any other objects capable of penetrating the skin. Place all of these items immediately into a sharps container after use.
What you should know about sharps containers:• Sharps containers are an engineering control.• These containers should be;• Labeled and color-coded red.• Rigid and puncture-resistant. Leak proof.
What Should You Know About Sharps Containers?• Sharps Containers:•• Keep sharps containers upright at all times• NEVER overfill a sharps container• Seal the lid tightly prior to transporting the container• If the outside of the container becomes contaminated, it should be placed in another leak proof container prior to disposal
Barriers• What items can be worn as a protective barrier between your body and potentially dangerous body fluids of others?
What Is Personal Protective Equipment? Specialized clothing or equipment worn by an employee for protection against a hazard EXAMPLES:• Gloves• Fluid Resistant Gowns• Face Shield with Mask• Resuscitation Equipment• Masks
Why Should You Use Personal Protective Equipment?Use Personal Protective Equipment (PPE) toprevent blood or other potentially infectiousmaterial from passing through or contacting thefollowing:Your work clothes, street clothes, orundergarments.Your skin, eyes, nose or other mucousmembranes.
When Should You Wear Personal Protective Equipment?Wear personal protective equipment wheneverthere is a risk of occupational exposure.Personal protective equipment is selected basedupon the type of exposure that is anticipated.Prior to use, inspect all personal protectiveequipment.Replace if damaged
In What Order Do You Apply Personal Protective Equipment?• Gown• Respirator or mask• Face shield with mask or goggles• Gloves
How Should You Remove Personal Protective Equipment?In general, start from the most contaminated item andwork your way to the least contaminated item.This usually means removing your gloves first.Turn items wrong-side-out as you are removing them.Wash your hands immediately.Dispose of equipment before leaving the work area.
What Are Some General Rules You Should Follow? Do not eat, drink, apply cosmetics or lip balm, handle contact lenses or smoke in areas where there is risk for contamination. Blood or other potentially infectious materials should always be in a closed, biohazard label container/bag that prevents leakage during collection, handling, processing, storage, transportation, or shipping. This sign tells you when blood or other potentially infectious materials may be present and designates lab areas, refrigerators or contaminated equipment.
What Is Regulated Waste?• Blood or other potentially infectious materials• Items coated with dried blood or other potentially infectious materials and are capable of releasing these materials during handling• Contaminated sharps (e.g. needles, blades, broken tubes, glass)• Pathological and microbiological waste containing blood or other potentially infectious material
What Should You Know About Disposal of Regulated Waste?• Regulated waste requires disposal in a biohazard container appropriate for the specific type of waste: Sharps containers (e.g. needles, scalpels, lancets, broken glass) Biohazard labeled bags (e.g. saturated dressings/gauze; grossly contaminated gloves) Regulated waste is required to be pick-up by a medical waste disposal contractor.
What Items Can Go Into The Regular Trash?• Gloves• Exam table paper• Alcohol swabs• Band-aids/dressings• Cotton balls/Gauze pad• Towels/drapes• Urine specimen cups• Tampons/sanitary pads• Tongue depressor blades• Face masks• Lab utensils
How Do You Handle an Accident/Spill Involving Blood or Body Fluids ? Spill kits are available for spills involving blood or body fluids. Isolate the area where the spill occurred by placing up a hazard sign or having another employee stay at the site to warn others Put on gloves, mask, eyewear, and fluid-proof gown (contained in the PPE kit) Apply the absorbent material in the spill kit to absorb the blood or body fluid Allow absorbent material to solidify and gel for several minutes before cleaning up.
How Do You Handle an Accident/Spill Involving Blood or Body Fluids ? (Cont)• Place the absorbed material and all disposable clean-up items in the biohazard bag using the scoop/brush provided. Clean area where the spill occurred with: (1) germicidal wipe/cleaner provided, then with (2) a disinfectant per label directions. Place remaining items in the biohazardous bag provided. Remove and dispose the personal protective equipment. (Remove gloves first). Place the biohazard bag into the central biohazard container. Wash hands with soap and running water.
What Programs Are In Place To Protect You ?• Hepatitis B Vaccine Program Hepatitis B vaccine may be utilized, in case of an exposure. The vaccine is given in a series of three shots over a six-month period. YOU MUST GET ALL SHOTS IN THE SERIES!
What Plan Is In Place If You Have An Exposure?MSU has a post-exposure follow-up program providingimmediate counseling and medical evaluation.The importance of participating in the post-exposurefollow-up program cannot be overemphasized.Decisions involved in management of an exposure arecomplex.Employees who have suffered an exposure often needemotional support as well as medical advice.You have the right to accept/decline a medical evaluation
What Do You Do If You Have An Exposure?• FIRST: Immediately wash the affected skin with soap and water; flush nose, eyes, or mouth quickly and thoroughly with saline or water. SECOND: Immediately report the incident to your supervisor. THIRD: Have source wait with you if possible until MSU Clinic staff have arrived and both person’s blood can be tested. At the very least, get their name, contact information and information on where they will be until EHS or clinical staff can assist you. FOURTH: Refer to the MSU Bloodborne Pathogens Exposure Control Plan
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