bloodborne pathogens Northshore Technical Community College

							THE OCCUPATIONAL
SAFETY AND HEALTH
 ADMINISTRATION
    STANDARD
   What is the bloodborne pathogens standard?
   Who needs bloodborne pathogens (BBP)
    training?
   What content needs to be included?
   Employers Duties                Employees Duties
       identify job risks and          follow employer’s plan
        classify                        know job classification
       provide appropriate             complete training
        training                        use equipment provided by
       provide a plan                   employer
       provide appropriate         Compliance
        equipment
   Compliance
   Documents
   General explanation of
    bloodborne pathogens
   Hepatitis B immunization
   Explanation of tasks that may
    involve exposure
   Disease-causing
    microorganisms that may be
    present in human blood or
    OPIM (other potentially
    infectious material)
       Viruses
       Bacteria
       Parasites
   Puncture wounds or cuts
   Contact (touch, splash, or spray)
    with blood or OPIM on:
       mucous membrane
       non-intact skin
         cuts, abrasions, burns
         acne, rashes
         papercuts, hangnails
       contaminated sharps
   Objective of BBP standard
    is to minimize or eliminate
    the hazard posed by work
    that may expose one to
    blood or OPIM
   If a risk of exposure exists one
    should know:
     if there is a way to prevent
      infection
     symptoms and course of infection
     availability of counseling
     availability of post-exposure
      treatment & follow-up
   Occupational contact with blood or
    OPIM is considered an exposure
    incident
   If an exposure occurs:
       wash with soap & water
       report incident
       document incident
       seek “immediate” medical evaluation
       follow employer’s exposure control plan
   “Immediate” means prompt medical evaluation
    and prophylaxis
   An exact timeline cannot be stated
   Time limits on effectiveness of prophylactic
    measures vary depending on the infection of
    concern
        Minimal Information to Report

   Date and time of         Work practice
    incident                  being followed
   Job classification       Engineering
   Location in the           controls in use
    worksite where           Procedure being
    incident occurred         performed
                             PPE in use
   Entitled to confidential medical evaluation
   Personal decision about blood testing
   Blood may be tested only with consent
   Blood may be stored for 90 days, while
    considering testing
   Interpretation of any test results occurs with
    health care provider
   Blood may be tested for antibodies to:
       Human Immunodeficiency Virus (HIV)
       Hepatitis C Virus (HCV)
       Hepatitis B Virus (HBV)
       Other disease-causing organisms
   Source blood may also be tested with consent
   Results of tests of source blood will be made
    known to exposed person
   Definition
   Signs and symptoms
   Course of infection
   Prevention and control
   Post-exposure prophy-laxis
    and follow-up care
   HIV is Human Immunodeficiency Virus
   HIV can cause acquired immune deficiency
    syndrome (AIDS)
   Risk of HIV infection from a puncture injury
    exposure to HIV infected blood is very low --
    0.3%
   Signs and symptoms include:
     Weight loss
     Night sweats or fever
     Gland swelling or pain
     Muscle and/or joint pain

   Cannot rely on signs and symptoms to confirm if
    one is infected
   Incubation period from HIV infection to AIDS
    can be 8 to 10 years

   Varies greatly among individuals
   There is no vaccine to prevent HIV
    infection

   Follow Universal Precautions
   No cure for HIV infection      Treatment requires
   Testing schedule for HIV        health care provider
    antibodies                     OSHA requires treatment
       at time of exposure         that meets most recent
       at 3 months                 CDC guidelines
       at 6 months
                                   Treatment may include
   HIV antibodies usually          antiviral medications and
    become detectable within
                                    a protease inhibitor
    3 months of infection
   HCV is Hepatitis C Virus
   It affects the liver
   It is most common chronic bloodborne infection in
    US
   Needlestick injury is only occupational risk factor
    associated with HCV
   Risk of HCV infection after exposure to HCV
    infected blood is 1.8%
   70 to 75% of those with acute HCV infection have
    no symptoms
   Jaundice - yellow color to skin and
    whites of eyes
   Fatique
   Headache
   Abdominal Pain
   Loss of appetite
   Nausea and vomiting
   Incubation period averages 7 weeks

   Chronic liver disease may occur in
    70% of those infected with HCV
   No vaccine exists to prevent HCV
    infection

   Follow Universal Precautions
   No cure for HCV                Treatment of HCV
   No post-exposure pro-           requires a health care
    phylaxis recommended            provider
   Tests for HCV anti-bodies      OSHA requires treat-ment
    & liver function                that meets most recent
    recommended at time of          CDC guidelines
    exposure
                                   HCV infection treatment
   Tests should be repeated        may include liver
    4-6 months post exposure
                                    transplant
   HBV is Hepatitis B Virus

   It affects the liver

   Prevalence of HBV infection among
    healthcare workers is 10 times greater than
    HCV infection
   Jaundice - yellow color to the
    skin and whites of eyes
   Fatigue
   Headache
   Abdominal Pain
   Loss of appetite
   Nausea and vomiting
   Incubation period averages 12
    weeks
   Most cases of HBV resolve
    without complications
   Chronic liver disease may
    occur in 6 to 7% of those
    infected with HBV
   A vaccine does exist to prevent HBV
    infection

   Employers are required to offer HBV
    vaccination HBV vaccination to
    employees covered under BBP standard

   Follow Universal Precautions
   No cure for HBV             Treatment requires
    infection                    health care provider
   Post-exposure               OSHA requires
    prophy-laxis should          treatment meet
    begin within 24              CDC’s most recent
    hours; no later than 7       guidelines
    days after exposure
                                HBV infection
   Exposed person
                                 treatment may
    should receive HBV
                                 require liver
    vaccine
                                 transplant
   Employees with routine occupational exposure to
    blood/OPIM have right to HepB vaccination at no
    personal expense
   Employee refusal established by signing HepB
    vaccination declination form
   Vaccine is Recombivax HB or Energix-B
   Must be made available within 10 working days of
    initial assignment to job
   Vaccine given in 3 doses over 6 months
       1st on initial assignment
       2nd one month later
       3rd five months after 2nd dose
   CDC recommends HepB antibody testing 1 to 2
    months following 3rd dose
   Employer cannot require employee to use health
    insurance to cover test cost
   Pre-screening is not required
   HBV is declining because of vaccine use!
   Engineering Controls

   Work Practice Controls

   Personal Protective Equipment

   Universal Precautions
   Design safety into work tools and work space
    organization

   Engineering controls can:
       Decrease risk of exposure to hazards
       Eliminate hazards
       Isolate hazards
   Hand and eye washing facilities

   Sharps container use

   Biohazard labeling

   Self-sheathing needles

   Needleless IV systems
   Label liquid or semi-liquid blood or
    OPIM
   Label item(s) contaminated with blood
    or OPIM
   Label sharps contaminated with blood or
    OPIM
   Label containers holding contaminated
    equipment for storage, handling and
    transport
 closable and puncture resistant
 leak proof

 labeled or color-coded

 functional

 sufficient in number

 easily accessible and main-

 tainted in upright position
 replaced per agency policy

 NOT be overfilled
   Reusable sharps require proper
    handling (mechanical means) and
    decontamination

   Retractable needles

   Needleless systems
   Behaviors using engineering controls safely
    and effectively
   Work Practice Controls include:
     using sharps containers
     using an eyewash station
     WASHING HANDS after using PPE
     cleaning work surfaces
     proper laundering
   break, shear, bend or        pipette or mouth suction
    recap needles                 blood or OPIM
   reach into used sharps       eat, drink, smoke, apply
    containers                    cosmetics, or handle
   pick up contaminated          contact lenses in areas of
    items, such as broken         potential occupational
    glass with bare hands         exposure
   use a vacuum cleaner to      store beverages or food in
    clean up contaminated         refrigerators, freezers, or
    items                         cabinets where blood or
   open or empty sharps          OPIM are present
    containers
   Readily available facilities

   Washing after removing PPE

   Using antiseptic hand cleanser when a
    sink isn’t readily available
   First roll out paper towel
    or have towel readily
    available so as not to
    touch other surfaces to
    reach it
   Turn on tap water and
    adjust temperature

   Use plenty of soap
   Wash hands using
    friction on all
    surfaces for at least
    30 seconds
   Dry hands
    thoroughly

   DO NOT turn off
    the water yet
   Turn off tap with a
    dry part of the
    towel

   DO NOT touch
    surfaces with clean
    hands
   Clean work surfaces according to employer’s
    exposure control plan
   Use PPE and EPA-approved solution
   10% bleach and water must be replaced weekly
   Place contaminated laundry in color-coded laundry
    bag, use PPE, and handle as little as possible
   DO NOT take contaminated materials home to
    launder!
   Specialized clothing/equipment used for protection
    when risk of exposure exists
   Must prevent blood or OPIM from contaminating
    clothing or skin
   Must be available at no cost to employee
   Must be in appropriate sizes
   Must be in good working condition
   Must be properly maintained
   Employee must be trained in proper use
   Gloves
   Masks
   Eye shields
   Gowns/aprons
   Resuscitation devices
   Medical products containing latex must be
    labeled

   Allergies to latex are increasing

   Substitutes for latex-containing materials
    must be made available
   Infection control approach that treats
    all human blood and certain body fluids
    as if they are known to contain
    bloodborne pathogens
   Blood
   Semen
   Vaginal secretions
   Cerebrospinal, synovial or pleural fluid
   Body fluids containing visible blood
   Any unidentifiable body fluid
   Saliva from dental procedures
   Universal Precautions do not apply to these
    fluids UNLESS blood is visible:
       feces            nasal secretions
       sputum           ear secretions
       sweat            urine
       vomits
   An acceptable alternative to Universal
    Precautions

   Treats ALL body fluids and substances as
    infectious
   Site specific plan provided by employers to protect
    employees with occupational exposure risk
   Lists job classifications with exposure risk
   Identifies engineering controls, work practice
    controls, PPE and Universal Precautions
   Identifies who will be trained and trainer
   Includes record keeping provisions and is
    reviewed annually
         Bloodborne Pathogens Training (High Risk)




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