OSHA Bloodborne Pathogens Training

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					Washington College

OSHA Bloodborne Pathogens Training

8/21/2008

Osha Bloodborne Pathogens Training for RAs

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Introduction
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OSHA training for Resident Hall Advisors
Developed by: Dawn Nordhoff, CRNP Director, Health Services

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Topics of Discussion
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Bloodborne Pathogens HIV Hepatitis B and C Hepatitis B Vaccination Exposure Determination Standard Precautions Engineering and Work Practice Controls Clean-up Exposure Emergencies
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Bloodborne Pathogens
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A bloodborne pathogen is a microorganism that is carried, replicated and/or transmitted in blood or blood products and is capable of causing disease. All human blood and potentially infectious body fluids should be treated as infected. Some bloodborne pathogens include HIV, Hepatitis B and C, Syphilis, Malaria, Babesiosis, Brucellosis, and CreutzfedltJakob disease.
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How are bloodborne pathogens spread?
By injection, cuts or sticks from contaminated sharps and needles or sharing of needles during drug use Contact between blood and pre-existing skin lesions Contact with infectious body fluids through the eyes, nose, and mouth including sharing of straws to snort drugs Sexual Contact Mother to Baby during pregnancy or during breast feeding
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Contaminated
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All body fluids containing visible blood and certain other body fluids such as saliva during dental procedures, synovial fluid, cerebrospinal fluid, pleural fluid, peritoneal and pericardial fluid and amniotic fluid, semen, and vaginal fluids are considered contaminated.
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Not contaminated
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Feces, nasal secretions, sputum, sweat, tears, urine, saliva, breast milk, and vomitus are not considered contagious unless blood is present.

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Human Immunodeficiency Virus
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Is the virus known as HIV and the one that causes AIDS (Acquired Immunodeficiency Syndrome). HIV attacks the body’s immune system, weakening it so that it can not fight other infections.

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HIV
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Approximately 45,000 people are infected with HIV in the United States every year. There are approximately 1 million people living with AIDS in the U.S. These numbers could be much higher as many people who are infected are completely unaware of it.
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HIV
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Unlike the Hepatitis B virus, HIV is very fragile and will not survive long outside the human body. The chances of contracting HIV in the workplace are only 0.4%. However, because it is such a devastating disease, all precautions must be taken to avoid exposure.
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Symptoms of HIV Infection
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Initially, the person infected with HIV may show few or no symptoms. There may be cold or flu like symptoms initially that are ignored. Later symptoms may include weakness, fever, sore throat, nausea, headache, diarrhea, white coating on the tongue, weight loss and swollen lymph nodes.
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Symptoms of HIV
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Eventually the immune system becomes so depressed that the person becomes ill with other diseases and infections resulting in death.

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Hepatitis
Hepatitis is a general term for inflammation of the liver. There are several causes including: Excessive use of alcohol Illicit drug use Prescription or OTC drug interactions Immune Response Viral infections including mono
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Hepatitis
There are several different type of viruses that infect the liver. Hepatitis A Hepatitis B Hepatitis C Hepatitis D Many more have been identified
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Hepatitis B and C
Hepatitis B and C are transmitted primarily through blood and body fluids.

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Hepatitis C
Hepatitis C is a type of viral infection that affects the liver. 60-70% of patients have no symptoms 75-85% of patients become chronic carriers Anti-HCV can usually be detected within 12 weeks of exposure
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Hepatitis C
The leading cause of chronic liver disease and the number one indication for liver transplantation in the U.S. Approximately 4 million people in the U.S. are positive for Hepatitis C

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Complications
Complications of Hepatitis C include: Liver Cancer Cirrhosis Chronic Liver Disease Death

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Treatment
Peginterferon alfa 2a or 2b is the newest treatment
Liver Transplant

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Hepatitis C
You can be re-infected with other strains of Hepatitis C The HCV antibody remains positive for life but does not protect you from future infections There is no vaccine for Hepatitis C Re-infection after transplant is common because it is difficult to filter it from the blood
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Hepatitis B (HBV)
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Hepatitis B is a virus that infects the liver and causes inflammation. Causes swelling, soreness, and loss of normal liver functions It can also lead to more serious conditions such as cirrhosis of the liver and liver cancer

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Hepatitis B is transmitted primarily through blood to blood contact. There is no specific treatment for HBV.

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Hepatitis B
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The Hepatitis B virus is very hardy and can survive in dried blood for many days.

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Symptoms of HBV
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Initially there will be Flu like symptoms such as: Fatigue Stomach Pain Loss of appetite Nausea Weakness Headache Fever
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HBV Symptoms
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As the disease continues to develop jaundice or yellowing of the skin will occur along with darkening of the urine. Sometimes people infected with HBV will not have any symptoms or will not develop them for up to 9 months.
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A person infected with Hepatitis B will usually have a positive test for the HBV surface antigen within 2-6 weeks from the start of symptoms Approximately 85% of infected persons will recover in 6-8 weeks The other 15 % become chronic carriers of the disease and can transmit it to others
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Complications of Hepatitis B
Liver Cancer Cirrhosis Chronic liver disease Death

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Treatment of Hepatitis B
Symptomatic (rest, fluids) Interferon A Liver transplant Post exposure treatment of HBIG and HBV vaccine

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Good News
There is a way to prevent Hepatitis B infection. There is a vaccine for Hepatitis B. It is given in a series of 3 shots. The second shot is given one month after the first shot and the third shot is given 5 months after the second shot. This vaccine is free to RAs and it is available at the Health Center
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Hepatitis B Vaccine
The vaccine is contraindicated in people with a severe yeast allergy.
It may cause some side effects such as discomfort, bruising or swelling at the injection site, headache, fatigue, weakness, malaise, and a slight fever. When these sympoms occur they do not last long and most people do not have any symptoms.
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Should I get the vaccine?
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RAs should have the Hepatitis B vaccine!

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Exposure Determination
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As a RA you have been determined to be in the risk category that may occasionally cause you to be in a situation that would put you at risk for exposure

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Real Life
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You may be the first person to respond to a student’s call for help if they are injured and bleeding or you may go to check on someone in your hall and find that they have cut wrists and are in a pool of blood. You can’t get to them without coming in contact with the blood.
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If you find yourself in this kind of situation please stop and protect yourself as much as possible. Use Standard Precautions and Work Practice Controls.
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Standard Precautions
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Standard precautions means covering areas of your body to prevent contact with potentially contaminated blood or body fluids. Even if you have had the Hepatitis B vaccine you are still at risk for HIV and Hepatitis C as well as other bloodborne pathogens

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Put on protective gloves, gowns, goggles and face shields as the situation indicates. If you come in contact with any possible contaminated fluids, wash your hands and other exposed areas ASAP with an antibacterial soap and water or a gel cleaner.
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Work Practice Controls Using protective equipment such as gloves and gowns is considered a work practice control.
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Other controls include:
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Use of safer sharps such as disposable needles that do not require recapping Proper handling and disposal of sharps Prevention plan and Post exposure policy

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Prevention
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In addition to avoiding contact with blood and body fluids you can also protect yourself and others by reporting sharps that are not disposed of in a puncture proof container. Educating students regarding proper disposal of sharps and use of personal protective equipment when possible exposure exists.
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Proper clean up
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Finally, if there is blood or body fluids to clean up, wear protective equipment and use the kit on your hall. A diluted bleach solution of 1:10 should be used to clean all surfaces affected after the debris has been cleaned. Leave the solution on and let the area air dry. Always use a brush and dust pan to clean up glass or other sharp objects to prevent injury and contamination.
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Exposure Emergencies
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If someone must be cared for immediately and this results in a possible exposure please follow these guidelines. 1. Remove clothing that is contaminated. 2. Thoroughly wash contaminated area with soap and running water. 3. Then GO IMMEDIATELY TO THE EMERGENCY DEPARTMENT AT CHESTER RIVER HOSPITAL CENTER FOR AN EXPOSURE EVALUATION
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Post exposure prophylaxis
If it is determined that you had a true exposure and may be at risk for contracting a bloodborne illness you will have blood drawn and be offered several medications that may reduce your risk for HIV. You may also be given shots to reduce your risk of Hepatitis B and C. These medications should be given within the first 2 hours after exposure. It is critical that you go to the Emergency Department immediately if exposed.
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Report the incident to college officials
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As soon as possible report the incident to the Director of Health Services and the Director of Residential Life. We will help you with follow up and all the required paper work.

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Questions???

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A copy of the Bloodborne Pathogens Compliance Plan for Washington College can be found in the following offices: Health Services, Public Safety, Student Affairs and Human Resources
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