Bloodborne Pathogens Introduction In an educational environment, it s very important to know how to protect yourself and students from bloodborne diseases like AIDS and hepatitis B. At the same time it is important to safeguard the rights and dignity of all students and staff. In this session we will review bloodborne diseases, the risk of exposure at school, simple measures you can take to protect yourself and students against exposure and an approach you can take to help students deal with their fears about these diseases. How the Diseases are Transmitted Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). Unlike AIDS, hepatitis B can often be treated successfully. In fact, a vaccine is now available to help protect you against getting the hepatitis B virus. Yet, unless you re effectively vaccinated, hepatitis B is a bigger threat to you than AIDS because it is more contagious and much more common but, like AIDS, it can be deadly. If you become infected with HBV, you may feel like you have the flu, or you may be sick you have to be hospitalized. Each year 4,000 t0 5,000 people in the U.S. die from the chronic liver disease that the virus can cause. Just by looking at someone, it s not possible to tell who is infected with a bloodborne disease. Infected persons can be male, female, married, single, gay, or straight. They can be students or staff members. What s more, they may not even know they are infected! People can carry either disease for many years without showing any symptoms. Yet, since these people are contagious, they can unknowingly spread the diseases to others. AIDS and hepatitis B are primarily spread by three types of body fluids: Blood Vaginal secretions Semen Both diseases can also be passed from pregnant women to their children, before, during or after birth. To actually get one of these diseases, blood or other body fluids containing HBV or HIV must get inside your body and enter the bloodstream through a break in the skin or through the mucous membranes. The two most common ways this happens are: Having sex with an infected person Sharing needles to inject drugs During sex, HIV or HBV can enter the body through the vagina, penis, mouth or rectum. When people share needles, the viruses can enter the body if the skin is punctured by a contaminated needle.
The viruses may also enter your body if contaminated blood or body fluids get on your broken skin or in your eyes, nose or mouth. Normally, your skin acts as a protective barrier to keep viruses out. But cuts, sores, or even tiny breaks in the skin from dermatitis or acne can be doorways for the viruses to enter your body. Getting Beyond the Myths of Transmission Most of the workplace situations people tend to worry about are actually quite harmless. HIV and HBV are not spread through the air as are cold and flu germs, so you will not get either disease from working alongside someone who is infected or from touching, kissing on the cheek, coughing or sneezing. You also will not get either disease by: Sharing things like telephones or bathrooms with an infected person Using eating utensils, water fountains, gym equipment or swimming pools Having contact with someone s sweat Being exposed to someone s saliva In school settings, sporting events are a concern for many people. According to government researchers, the odds of contracting HIV during a sporting event, with the exception of boxing, are greater than a million to one. Even when ad athlete is injured and bleeds, it is unlikely that enough of one person s blood could enter another person s body during competition, even in a contact sport. Despite what you may have heard, you won t get AIDS from mosquitoes, or other insects. Unlike other diseases such as malaria and yellow fever, HIV does not live in a mosquito and is not transmitted through a mosquito s salivary glands. Also, you will not get HIV from giving blood at a blood band or other established collection center. The sterile needles used for blood donations are used once and then destroyed. The Real Risk of Transmission at School It comes down to this: to transmit HIV or HBV at school, there must be contact between broken skin or mucous membranes and infected blood. Even though the risks of getting a bloodborne disease in a school setting are slim, it is important to be aware of how you might be exposed to potentially infectious materials at work. Remember, HIV and HBV may be present in blood or any body fluid or substance that is visibly contaminated with blood. Some typical circumstances where blood is likely to be encountered include fights, sports injuries, nosebleeds and accidents in shop class, cooking labs, science labs or any other setting where students use glass or sharp objects. As a precaution, any time you are faced with blood, you should take the appropriate steps to protect yourself. At times you have to deal with other body substances such as nasal discharge, urine, feces or vomit. Unless you can see blood in these substances, they will not transmit bloodborne diseases. However, any
human body substance should be handled carefully because it could be contaminated with other infectious materials. Staying Safe: An Educated Approach Incidents where blood is encountered can occur anywhere and at any time. In order to be prepared for these incidents, it is a good policy to have available a first-aid kit which includes disposable singe=use gloves, bandages and disinfectant. These kits should be available in every room, on each school bus and on every playground. Here are some simple precautions you can take to protect yourself against the risk of exposure to bloodborne pathogens. Use protective barriers to avoid contact with blood Never touch blood or any moist body substance with your bare skin. When there is a bleeding injury, have the injured person, if possible, apply pressure on it. You can help the person, if necessary, but always use a barrier to avoid direct contact with blood. Disposable single-use gloves are best, but in an emergency you can use whatever is handy a thick wad of paper, or a clean plastic bag. Never wash or decontaminate disposable gloves for reuse. When removing gloves, be careful not to expose your skin to the outside of the gloves. Always wash your hands promptly and thoroughly with soap and running water for at least 15 seconds after contact with blood or other fluids or substances even if gloves or other barriers were used. Dry with disposable towels. Athletic trainers should carry a first-aid kit containing disposable single-use gloves, bandages and towelettes. In addition, assistive-breathing devices should be available in athletic settings. These devices can protect you from blood or other contaminated materials that might be in the victim s mouth if you have to give mouth-to-mouth resuscitation. To avoid other players contacting blood during an athletic event, remove an athlete with a bleeding injury from play immediately. The injured person should return to play only after the bleeding is stopped, the wound is cleansed and covered and any bloodied clothes are changed. Use caution when cleaning-up Call a Custodian if possible. Wear rubber utility gloves to clean up blood or body fluid spills. Discard gloves if they are damaged in any way. Clean contaminated surfaces with a germicidal cleaning agent - or use a proper mixture of bleach and water. Cover large spills of blood, vomit or urine with absorbent sweep material to prevent fluids from spreading. Then clean the area using standard procedures.
Use a fresh bleach solution to clean athletic equipment visibly contaminated with blood. Allow to dry before reusing. Dispose of waste carefully Use a study plastic bag to discard all blood-soaked bandages and cleaning materials. Seal the bag and place in a leak proof container where it will not be disturbed until picked up for disposal. Remember: Be alert for sharp objects such as a used syringe when emptying trash containers. Never push trash down in waste receptacles. Instead, shake down trash bags carefully, seal and carry away from your body. If you re exposed to blood If you come in contact with blood or body fluids, follow these procedures: In case of contact with skin, wash the blood or body fluid off immediately with non abrasive soap and water. If blood or body fluids get in your eyes, immediately flush your eyes with running water for at least 15 seconds at a sink or eyewash fountain. If mucous membranes are contacted by blood or body fluids, flush them with water immediately. Report the incident immediately to your supervisor (who will contact the school nurse). If you are exposed to a potentially infectious substance, your employer can advise you about testing, counseling and any other steps you may wish to take. Help Students Cope: Fight Fear with Facts The best weapon for fighting the fear students may have about bloodborne diseases is knowledge. Make sure students know the facts about these diseases. HIV is a fragile virus that cannot survive away from a person s body fluids unless it is kept under controlled laboratory conditions. After years of study, researchers have found that none of the family members, friends or caregivers of people with AIDS have ever become infected through casual contact. Make sure students know how they won t get bloodborne diseases not from a drinking fountain, not from a toilet seat, not from being friends. Make students aware of common sense rules of good hygiene to protect against any type of infection. Hand washing is the single most important method of infection control there is. For the sake of general good health, students need to wash their hands before eating. After using the bathroom or alter contacting any moist body substance. Make sure students know to avoid practices which could put them in contact with blood. For example, sometimes people bleed while brushing their teeth, while shaving and when wearing pierced earrings.
For those reasons, students should not share razors, toothbrushes or pierced earrings, even though there are no known cases of HIV being transmitted in these ways. Students should be warned about risky behaviors such as I injecting drugs or sharing any type of needle. When someone injects a drug, some of the blood is drawn back up into the needles and syringe. Some of the blood stays in the needle, so if the person is infected with HIV or HBV, there will be viruses in the blood. Anyone else who uses the needle and syringe or other contaminated drug paraphernalia can get infected. Steroids, hormones and vitamins are also injectable drugs. Bodybuilders who share needles to inject steroids have become infected with HIV. The same principles apply to students who get tattoos, ear and body piercing or acupuncture. A student could be at risk for a bloodborne disease unless he or she is absolutely certain the needles are sterile. Disposable needles should be used once and the discarded. Summary By taking a few sensible precautions you don t have to worry about getting a bloodborne disease at school. By making students aware of the facts about these diseases, you can dispel fear and give them a lesson to live by.