2 Session Objectives Identify bloodborne pathogens (BBPs) Understand how diseases are transmitted Risk of exposure Protecting yourself from exposure through prevention Responding appropriately if exposed Right to medical evaluations
3 What Are Bloodborne Pathogens? Microorganisms present in human blood that can cause disease Viruses (Hepatitis; flu) Bacteria (tuberculosis) Parasites (malaria) Primary workplace pathogens Human immunodeficiency virus (HIV) Hepatitis B virus (HBV) Hepatitis C virus (HCV)
4 HIV and AIDS HIV leads to AIDS HIV attacks and depletes the human immune system Early HIV symptoms resemble flu virus HIV antibody test is the only way to know for sure HIV does not survive outside the body No cure yet
5 Hepatitis B Virus (HBV) 1.4 million people infected Leads to liver disease or liver cancer Symptoms Jaundice, fatigue, and abdominal pain No appetite, nausea, and vomiting Vaccine is available HBV can survive outside the body
6 Hepatitis C Virus (HCV) HCV is the most common chronic bloodborne infection 3.2 million infected Can lead to chronic liver disease and cancer Symptoms can take years to manifest Flu-like symptoms, jaundice, dark urine, and fatigue Loss of appetite, nausea and vomiting, and abdominal pain Treatment is marginally effective
7 Transmission of Pathogens Contaminated sharp objects or needles Broken skin, including rashes Mucous membranes Eyes Mouth Nose
8 Potential Exposures All body fluids except sweat may contain potential infectious agents Blood is the most critical vehicle Saliva if contains blood
9 Possible Exposure Incidents During an accident While administering First Aid During post-accident clean-up When performing routine maintenance or janitorial work
10 Risk of Infection after Exposure (needle stick or cut exposure to blood) HBV (unvaccinated) 6-30% depending on virus status of source individual. HCV 1.8% HIV 0.3% (1 in 300) The risk after exposure of the eye, nose, or mouth to HIV-infected blood is estimated to be, on average, 0.1% (1 in 1,000). The risk after exposure of the skin to HlV-infected blood is estimated to be less than 0.1%.
11 The ABC s of Viral Hepatitis Type of Viral Hepatitis Mode of Transmission / Prevention Hepatitis A (HAV) Hepatitis B (HBV) Hepatitis C (HCV) Hepatitis D (HDV) Contaminated food and water. There is a safe HAV vaccine. Infected blood, sex, and needles. From an infected mother to her newborn. There is a safe HBV vaccine. Infected blood and needles. There is no vaccine. Must already have hepatitis B. Infected blood, sex, and needles. From an infected mother to her newborn. Get the hepatitis B vaccine. Hepatitis E (HEV) Contaminated water. There is no vaccine.
12 Bloodborne Diseases Any Questions? Do you understand: The definition of bloodborne pathogens? Transmission of bloodborne pathogens? How you could be exposed?
13 Bloodborne Pathogens Law 29 CFR requires employers with workers who might be exposed to bloodborne pathogens in the workplace to provide: A written Exposure Control Plan (ECP) Engineering and work practice controls Personal protective equipment (PPE) Training
14 Bloodborne Pathogens Law (cont.) Medical surveillance Free hepatitis B vaccination Signs and labels Other equipment and procedures
15 What is the ECP? Identifies jobs and tasks for potential exposure Describes engineering and safe work practices Outlines training requirements Identifies the placement and use of signs and labels Explains how to decontaminate equipment and work surfaces
16 ECP (cont.) Describes how biohazard waste is handled Explains the recordkeeping requirements Changes as practices and technology change
17 Universal Precautions Treat all human blood and bodily fluids as if they are infected with HIV, HBV, HCV and other bloodborne pathogens.
18 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
19 Bloodborne Pathogens Law Who should be included in an ECP? OSHA defines occupational exposure as: reasonably anticipated skin, eye, mucous membrane or parenteral contact with blood or potential infectious materials that may result from the performance of an employee's duty.
20 Exposure Determination Reasonably Anticipated Exposure: First Aid Responders Custodial Personnel Possible Maintenance Plumbers Groundskeepers
21 Protect Yourself Review the ECP and OSHA regulation Take universal precautions Use personal protective equipment Follow safe work practices Get the hepatitis B vaccination Follow decontamination and disposal procedures
22 Take Universal Precautions Treat all blood and bodily fluids as if infected Use barrier protection to avoid contact with infected bodily fluids Immediately clean up and decontaminate surfaces and equipment Image Credit: OSHA
23 Use Personal Protective Equipment Barrier protection prevents exposure Use gloves when applying bandages or cleaning up Eyewear or masks protect against splashes Protective clothing or aprons protect against spurting blood
24 PPE (cont.) Use a mask for nose and mouth protection Use a CPR mask Be prepared to use impromptu barriers such as a garbage bag, plastic, paper, or your shirt
25 Personal Protective Equipment First line of defense Limitations Rules: Remove before leaving work area Wash hands after removing Properly dispose of contaminated PPE
26 Avoid Puncture Wounds Use tongs, forceps, or similar tools to pick up potentially contaminated items Image Credit: State of WA-WISHA Services
27 First-Aid Response Adopt Universal Precautions Encourage self-care Use PPE Avoid applying pressure without barrier
28 General Decontamination Wear appropriate gloves and glasses to protect eyes, nose, mouth, and skin Use a bodily fluid disposal kit Use 10% bleach or EPA-approved disinfectant for spills Dispose of contaminated items
29 Decontamination Involving Sharp Objects Remove glass and other sharp materials using a brush and dust pan, or tongs Do not use your hands Use paper/absorbent towels to soak up the residual liquids Disinfect all surfaces, and allow time to dry before using again
30 Housekeeping: Spill Cleanup 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
31 Is This a Safe Work Practice? Yes or No? Removing contaminated PPE and clothing before leaving the work area Seeking immediate medical attention Eating, drinking, smoking, or applying cosmetics in any work areas where there is the possibility of exposure to blood Wearing double gloves to reduce contamination risk
32 Is This a Safe Work Practice? Yes or No? (cont.) Disposing of contaminated items properly Storing food in any work area where blood or bodily fluids may be present Disinfecting contaminated equipment and work surfaces Washing up immediately after exposure
33 ECP, Precautions and Safe Practices Any Questions? ECP? Universal precautions or PPE? Safe work practices?
34 Biohazard Disposal Regulated Waste Liquid or semi-liquid blood or other potentially infectious materials (OPIM) Contaminated items that would release blood or OPIM if compressed Contaminated sharp objects Items caked with dried blood or OPIM, capable of release during handling Pathological and microbiological lab wastes containing blood or OPIM
35 Label All Regulated Waste Containers Labels communicate a hazard Place regulated waste in containers that have the universal biohazard symbol The term Biohazard must be on the label Image Credit: OSHA
36 Biohazard Disposal Unregulated Waste Blood or OPIM absorbed without the release of liquid when compressed Adhesive bandages or tissues Gauze, paper towels, and disposable PPE Absorb all liquid Double-bag waste Image Credit: OSHA
37 Unregulated Waste Labeling Labels not typically required but a good idea
38 Which of the following is considered a regulated waste? Items caked with dried blood Adhesive bandages or tissues Contaminated sharp objects Liquid or semi-liquid blood Disposable PPE that results from the cleanup of a cut Blood that is absorbed without release of a liquid when compressed Pathological and microbial lab wastes containing blood or OPIM
39 Exposure Incident Wash cuts and skin thoroughly Rinse nose and mouth Flush eyes with clean water or sterile solution Clean all contaminated surfaces Report all incidents
40 Post-Exposure Evaluation Confidential medical evaluation Document route of exposure Identify source individual Test source person s blood Provide results to source and exposed employees Image Credit: State of WA-WISHA Services
41 Hepatitis B Vaccination Endorsed by medical communities Safe when given to infants, children, and adults Offered to all potentially exposed employees Provided at no cost You can decline and change your mind
42 Decon, Disposal, and Incidents Any Questions? Do you understand decontamination and disposal of blood or OPIM? Exposure incidents? The hepatitis B vaccination?
43 Key Points to Remember Bloodborne pathogens can cause fatal disease Be aware of exposure at work Take universal precautions Use PPE and safe work practices Decontaminate yourself and equipment Understand and follow exposure incident procedures Report exposure incidents
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