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Hepatitis

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safety

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									              Hepatitis
The Risk is right outside this door
           Blood borne disease
    Don't let your Company Drop the
                  Bomb

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       What are Bloodborne Pathogens ?
• Pathogenic organisms that are present in human
  blood and can cause disease in humans.
   – Hepatitis
   – HIV
   – Malaria
   – Brucellosis




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Where are they found ?

• Blood and Potentially Infectious
  Materials:
  –   Semen
  –   Cerebrospinal Fluid
  –   Vaginal Secretions
  –   Breast Milk
  –   Synovial Fluid
  –   Amniotic Fluid
  –   Skin tissue, cell cultures
  –   Saliva, Vomit, and Urine

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                     Hepatitis A - E
• Inflammation of the liver, usually due to a virus
   – Symptoms
       • Jaundice
           – Yellow Skin, Eyes
       • Abdominal Pain, Intermittent nausea
       • Fever & Vomiting
       • Fatigue
       • Dark Urine
       • Loss of Appetite




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           Hepatitis B
• Transmitted primarily through "blood to blood"
  contact
• Transmitted most often during blood
  transfusions and by contaminated needles and
  syringes
• The primary concern is for personnel who may
  come in contact with blood or potentially
  infectious materials in a non first-aid or medical
  care situation
• Hepatitis B Virus is very durable, and can
  survive in dried blood for up to seven days
• Vaccine available & effective


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P bar Y Safety Consultants Alberta Canada
P bar Y Safety Consultants Alberta Canada
                   Hepatitis C
• Transmitted in blood or body fluids, via transfusion
  or IV drug use.
• No vaccination exists for HCV.
• 36,000 new infections/year.
• Most common chronic bloodborne infection in the
  North America
• Progressive – may lead to cirrhosis or cancer, and
  death.


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                  Hepatitis D
• Transmitted primarily through injected drug use and
  sexual contact
• Needs HBV to replicate – co-infection
• Low risk in US
   – <10% of HBV carriers
• Prevention – HBV Vaccine




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                  Hepatitis E
• Transmitted in contaminated drinking water
  – Person to person uncommon
  – All US cases occur in travelers
• No vaccine




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   Human Immunodeficiency Virus
• HIV – virus that leads to AIDS
• Primarily of concern to personnel providing
  first aid or medical care in situations involving
  fresh blood or other potentially infectious
  materials
• Estimated chance of contracting HIV in a
  workplace environment are only 0.4%
• Precautions must be taken to avoid exposure

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        Modes of Transmission
• Blood or other infectious material could enter
  your system via:
  – Unprotected opening in the skin
  – Unprotected mucus membrane openings
  – Penetration of the skin
     • Accidental puncture from wreckage material could
       result in transmission




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Exposure Control Plan (O H & S)

   • Exposure Determination
     – ID jobs where occupational exposure may occur
   • Occupational Exposure
     – Reasonably Anticipated Exposure
        • skin, eye, mucous membrane, parenteral contact in
          course of duties
   • Must Determine
     – Jobs where all are exposed
     – Jobs where some are exposed

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      Exposure Control Plan


• Written plan required
• Plan must be reviewed at least annually to
  reflect changes in:
   – tasks, procedures, or assignments which
      affect exposure, and
   – technology that will eliminate or reduce
      exposure
• Must solicit input from potentially exposed
  employees
• Plan must be accessible to employees

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Some Workers Who are at Risk

  • Physicians, nurses and emergency
    personnel
  • Orderlies, housekeeping personnel,
    and laundry workers
  • Dentists and other dental workers
  • Laboratory and blood bank
    technicians
  • Medical examiners
  • Accident Investigators
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         How does exposure occur?

• Most common: needle sticks
• Cuts from other contaminated sharps (scalpels,
  broken glass, etc.)
• Contact of mucous membranes (for example, the
  eye, nose, mouth) or broken (cut or abraded) skin
  with contaminated blood




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          Engineering Controls
• Sharps disposal containers
• Self-sheathing needles
• Products designed to enhance safety
  – Antiseptic Towelettes
  – Biohazard Bags
  – Disinfectants
  – Sharp Disposal                                           Containers



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        Work Practice Controls
• Planning-Signs & Labels
• Common Sense
• Avoiding Contamination-no food or smoking in
  work areas/ near biohazard
• Alert for potential cross-contamination
  – Hand to Face
  – Fomites
• Move Contaminated Wreckage minimally
• Washing hands

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   Personal Protective Equipment
• Universal Precautions
  – Treat all human blood and certain body fluids as if
    they are infectious
  – O H & S governs this
     • Must be observed in all situations where there is a
       potentially infectious material




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      Protective Equipment
• Provided at no cost to employee
• Worn if reasonably anticipated
  exposure
• Disposable vs. Non-disposable
  – Non must be disinfected after use
• Items include:
  – Gloves
  – Boots/covers
  – Masks/Mouthpieces and resuscitation
    devices-one way valve
  – Goggles/face shields/eye protection
  – Gownsbar Y Safety Consultants Alberta Canada
         P
         Housekeeping

• Performed by all Personnel/Investigators
• Protect equipment
• Decon parts before shipping
• Store contaminated items in labeled
  containers
• Do not take contaminated laundry home
  or to commercial cleaner
    – Use designated facilities

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               Housekeeping
•   Assume scene is potentially contaminated
•   PPE is to keep you clean
•   Do not contaminate your equipment
•   Segregate contaminated items & label
•   Regulated Waste
•   Laundry
•   Biohazard Warning Labels

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    Hepatitis B Vaccination

• Must make available, free of charge
  at a reasonable time and place, to
  all employees at risk of exposure
  within 10 working days of initial
  assignment unless:
  – employee has had the vaccination
  – antibody testing reveals immunity



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                   If Exposed
• Relax…
  – Wash area for 20 minutes with soap & running
    water
  – If cut, save the item for contamination testing
  – Report the incident/exposure
  – Report to MTF or other healthcare professional




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Post-Exposure Follow-Up
• Document routes of exposure and how exposure
  occurred
• Obtain consent from the source individual and the
  exposed employee and test blood as soon as
  possible after the exposure incident
• Provide risk counseling and offer post-exposure
  protective treatment for disease when medically
  indicated in accordance with current government
  Public Health Service guidelines
• Provide written opinion of findings to employer and
  copy to employee within 15 days of the evaluation


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     Training Requirements


• Provide at no cost to employees
  during working hours
• Provide at time of initial assignment
  to a job with occupational exposure
  and at least annually thereafter
• Additional training needed when
  existing tasks are modified or new
  tasks are required which affect the
  worker’s occupational exposure
• Maintain training records for 3 years

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              Training Elements

• Copy of the standard
• Modes of transmission
• Site-specific exposure control plan
• Hazard recognition
• Use of engineering controls, work practices
  and PPE
• Live question and answer sessions

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Medical Recordkeeping Requirements

  • Employee’s name and social security
    number
  • Employee’s hepatitis B vaccination
    status
  • Results of examinations, medical
    testing, and post-exposure evaluation
    and follow-up procedures
  • Health care professional’s written
    opinion
  • Information provided to the health
    care professional
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    Medical Recordkeeping Requirements

• Employee medical records must be kept
  confidential and not disclosed or reported
  without the employee’s written consent
  (unless required by law)

• Medical records must be maintained for
  duration of employment plus 30 years
  according to O H & S’s rule governing access to
  employee exposure and medical records

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                  Questions
• Questions are always good at this point
• Or is it toooooooooooo late




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