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Bloodborne Pathogens poliomyelitis

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					Bloodborne Pathogens

          Rebecca S. Schlecht
      Director, Human Resources
    Danville Area Community College
             2000 E. Main St.
            Danville, IL 61834
              217-443-8756
           schlecht@dacc.edu
   Bloodborne Pathogens

 Occupational exposures to bloodborne and other
pathogens and consequent infection can occur not
 only as the result of accidents, but also during the
performance of routine work activities. Therefore, it
makes good sense to plan your work with regard to
          the basic principles of biosafety.
Bloodborne Pathogens

       Part I:
The Infectious Disease
       Process
     Bloodborne Pathogens
Microorganisms include the following
classifications:
    Bacteria
    Viruses
    Fungi
    Algae
    Yeasts
    Protozoa
These microorganisms are too small to be seen by the unaided human
eye.


                            They are found in the soil, in the water,
                            and on plants and animals. In fact, billions
                            are found in humans on the skin and in
                            both the nasal and intestinal tracts.
Bloodborne Pathogens
     Although most microorganisms live in
 harmony with the human body, some—called
  pathogens—can infect the body and cause
 disease. Infectious diseases range from mild
  illnesses, such as a cold, to fatal illnesses,
                 such as AIDS.
   Bloodborne Pathogens




 We occasionally come into contact with people or
animals that are infected and thus expose ourselves
   to the pathogens of their diseases. In fact, our
  environment is such that everyday we live with
         some risk of exposure to diseases.
      Bloodborne Pathogens
Some individuals, because of the work they
do, are ―at risk‖ for occupationally acquired
infection. For this reason, DACC has
developed training and procedures to help
minimize your health risks.

This training program will cover:
       the infectious disease process
       potential exposure risks to employees
       work practices that will minimize your risk of exposure to
        pathogenic microorganisms



    Let's start by exploring the infectious disease process.
   Bloodborne Pathogens
  The infectious disease process is defined as the
interaction between the pathogenic microorganism,
the environment, and the host. The process may be
    thought of as a circular chain with six links.




    The following story illustrates the chain…
   Bloodborne Pathogens
The chain begins with the
existence of a specific
pathogenic microorganism.




                        The second link is the
                        reservoir, an environment
                        where the pathogen can
                        survive.
    Bloodborne Pathogens
                         The third link is the
                         means of escape
                         from the reservoir.



The fourth link is the
mode of transmission
from the reservoir to
the host.
    Bloodborne Pathogens
The fifth link is the means
of entry into the host.




                              And the last link is the
                              host's susceptibility to
                              the pathogenic
                              microorganism.
   Bloodborne Pathogens
For an infectious disease to occur, each link in the
             chain must be connected.
   Bloodborne Pathogens




If even one link of the chain is missing, it interrupts
 the process, and no infection will occur. Here the
 chain is broken at the point of host susceptibility.
    Bloodborne Pathogens
Here the mode of
transmission breaks
the chain of infection.




Before looking at the infectious disease process for
 several different illnesses, see if you can correctly
          answer the following question…
      Bloodborne Pathogens
The chain of infection illustrates?

A.   Contact with a pathogen means
     you will become fatally ill.

B.   Every link in the chain must
     be broken to prevent infection.

C.   You can prevent infection by
     interrupting the process anywhere
     in the chain.

D.   All microorganisms are hazardous
     to your health.
                                         And the answer is…
   Bloodborne Pathogens

C. You can prevent infection by
   interrupting the process anywhere
   in the chain.
Bloodborne Pathogens
               Hepatitis B Virus (HBV)

      The microorganism known as Hepatitis B Virus (HBV)
     causes an inflammation of the liver. This can result in
illnesses such as chronic hepatitis, cirrhosis of the liver, and
   liver cancer. Because the virus is present in the blood or
body fluids of a person with the Hepatitis B Virus, it is termed
a bloodborne pathogen. Hepatitis B Virus is a serious health
concern for any employee whose work responsibilities bring
           them in contact with blood or body fluids.
Bloodborne Pathogens



    Human Immunodeficiency Virus (HIV)
    The Human Immunodeficiency Virus (HIV) is another
      bloodborne pathogen. This life-threatening virus
 compromises the body's immune system. Early symptoms
may be similar to those of the flu. During later stages of the
disease, the body is incapable of warding off other infections
                which frequently prove fatal.
     Bloodborne Pathogens
             Penetration into the Bloodstream
  Bloodborne pathogens are transmitted when an individual comes in
contact with an infected person's blood or body fluids. However, contact
  alone does not mean infection will result. Pathogens must enter the
 bloodstream to cause infection. In the workplace, an employee may be
      exposed to HBV or HIV when infected blood or body fluid is
           allowed to enter the body by means of penetration.

This can occur through:
    a needle stick
    a cut or break in the skin
    contact with mucous membranes
     such as those of the eye, nose,
     and mouth
      Bloodborne Pathogens
                       Preventive Measures
To interrupt the chain of infection for HBV or HIV, use the following
preventive measures:

Wash your hands to remove infectious
organisms before they can enter the body.


                               Wear gloves as a barrier when handling
                               blood and other body fluids.



Wear face protection when work tasks
include the potential for spraying
or splattering of body substances.
     Bloodborne Pathogens
                              Use caution when handling needles or
                              other sharp objects. They can penetrate
                              the skin and create entries for pathogens.


The safest way to handle contaminated
needles or other sharp objects is to place
them directly into a labeled sharps
container without recapping. This practice
minimizes your risk of a needle stick. If
your work requires you to recap needles,
you will want to learn a special one-handed technique.

Finally, receive an HBV vaccination to decrease your susceptibility to the
disease. Presently, no vaccine for HIV is available.
     Bloodborne Pathogens
Preventing infection from bloodborne pathogens involves?

A.   Vaccination against HIV.

B.   Preventing blood or body
     fluids from contacting your
     skin or mucous membranes.

C.   Washing your hands before beginning work.

D.   Wearing gloves as a barrier against
     needle sticks.

                                           The answer is…
   Bloodborne Pathogens
B. Preventing blood or body fluids from
   contacting your skin or mucous
   membranes.
     Bloodborne Pathogens
               Mycobacterium (tuberculosis)

Another group of pathogens known as
Mycobacterium cause the chronic lung
disease tuberculosis (TB). Although
human beings are the main reservoirs,
other primates, cattle, and swine can also
be reservoirs. TB is transmitted
primarily through the air. A person with
an active case of TB discharges the microorganisms by coughing or
sneezing.

Inhalation: Exposure occurs when others breathe the contaminated air.
Once inhaled, the pathogen may lodge in lung tissue and produce
lesions.
      Bloodborne Pathogens
                       Preventive Measures

How then can employees protect themselves from airborne diseases such
as TB?

If necessary, and risk factors for TB are
present, wear respiratory protection.




                               Screen yourself for exposure to TB by
                               receiving a TB skin test.
     Bloodborne Pathogens
TB is an airborne disease?


A.   Transmitted by plants.

B.   That used to be a health concern,
     but is not relevant in the workplace any longer.

C.   Prevented by wearing a respiratory mask to prevent
     inhaling contaminated air.

D.   Prevented by holding your breath.

                                               The answer is…
   Bloodborne Pathogens
C. Prevented by wearing a respiratory
   mask to prevent inhaling
   contaminated air.
    Bloodborne Pathogens
                           Salmonella
 The next disease, salmonellas, is caused by a group of bacteria called
 salmonella. The most common manifestation of this disease is acute
gastroenteritis or intestinal inflammation. Both animals and humans are
reservoirs for the salmonella organism. Diseased animals and humans
         discharge large numbers of salmonella in their feces.
     Bloodborne Pathogens
                              Ingestion




  Infection results from ingesting (i.e., through the mouth) salmonella
   organisms. Employees may be exposed to these organisms when
handling soiled diapers and linens, working with animals, or cleaning and
                            maintaining restrooms.
      Bloodborne Pathogens
                       Preventive Measures
You can guard against salmonella exposure by incorporating the
following practices into your daily routine:


As a first line defense against ingesting
microorganisms, don't put anything in
your mouth while at work.




                                       Wear gloves when your hands will
                                       likely come in contact with
                                       contaminated materials.
     Bloodborne Pathogens

                            Wipe counters with a disinfectant after
                            performing tasks with materials that
                            may be contaminated.




And, thoroughly wash your hands after
handling potentially contaminated items.
Even microscopic amounts of fecal matter
may contain millions of salmonella
organisms.
     Bloodborne Pathogens
Preventing ingestion of salmonella
organisms involves?


A.   Not washing your hands if they look clean.

B.   Wearing gloves, washing hands, and disinfecting work
     surfaces.

C.   Not eating right after work.

D.   Putting only your own pencils and pens in your mouth.


                                              The answer is…
   Bloodborne Pathogens
B. Wearing gloves, washing hands, and
   disinfecting work surfaces.
     Bloodborne Pathogens
In summary, the infectious disease process typically consists of three
routes of entry:

    PENETRATION into the bloodstream, exemplified by HBV and HIV;

    INHALATION of airborne organisms, illustrated by TB; and

    INGESTION of organisms, demonstrated by salmonella.


    As seen in the examples, occupational exposures and consequent
infection can occur not only as the result of accidents but also during the
performance of routine work activities. Therefore, it makes good sense to
      plan your work with regard to the basic principles of biosafety.
     Bloodborne Pathogens
The best strategy to decrease your risk of infection is to?

A.   Enhance your susceptibility
     through proper nutrition.

B.   Not worry about things you
     cannot see.

C.   Rely on vaccination.

D.   Break the chain of infection by using several preventive
     measures.


                                               The answer is…
   Bloodborne Pathogens
D. Break the chain of infection by using
   several preventive measures.
     Bloodborne Pathogens
                  ―AT RISK‖ employees continue!

At risk employee groups include, but are not limited to:
     Athletic Trainers and Coaches
     Building Services Attendants
     Child Development Center staff
     First Aid / CPR Instructor
     Groundskeeper
     Instructors of Invasive Labs
     Maintenance Mechanics
     Nursing and C. N. A. staff
     Science Lab staff
Bloodborne Pathogens

     Part II:
 Exposure Control
     Strategies
     Bloodborne Pathogens
The next part of this program will cover exposure control strategies that
include the use of:

    universal precautions
    immunization
    good personal work habits
    containment
    personal protective equipment
    decontamination
    emergency procedures for
     accidental exposures
     Bloodborne Pathogens
                     Universal Precautions

Universal precautions are work practices
that reduce your risk of exposure to
pathogens found in blood and body fluids,
particularly HBV and HIV. A government
regulation referred to as the "Bloodborne
Pathogen Rule" requires that employees
with a risk of occupational exposure receive training in universal
precautions and other safety measures. At-risk employees are those
individuals whose work responsibilities could potentially bring them in
contact with blood and body fluids.
      Bloodborne Pathogens
              Preventing Accidental Exposures

Most occupational exposures to bloodborne pathogens occur accidentally from:

    needle sticks
    injuries from sharp objects
    splashes to the eyes, nose, and mouth
    contact with broken skin

The following universal precautions are aimed at preventing these exposures:

    Eliminate the use of needles and sharp instruments whenever possible.
     Choose safer alternatives for your work tasks.
    When use of needles and sharps is required, place used items directly into a
     sharps container located within easy reach. Remember that recapping
     should be avoided, because it increases your risk of needle stick injuries.
    Use only labeled, leak-proof, puncture-resistant sharps containers to help
     avoid accidental exposure of co-workers and waste handlers down the line.
    Bloodborne Pathogens
   Wear personal protective equipment such as gloves, face shields,
    eyewear with side shields, and gowns to prevent contact with blood
    and body fluids. Properly decontaminate or dispose of this
    equipment after use.




   Wash your hands routinely, even after removing gloves. Gloves may
    have minute holes through which fluids can pass.
     Bloodborne Pathogens
                           Immunization
Finally, decrease your susceptibility to infection by being immunized.

Recommended Vaccines:

    HBV for potential exposure to
     blood or body fluids
    Measles, Rubella, Diphtheria,
     Poliomyelitis, and Tetanus for
     anyone who has not been
     vaccinated in childhood
    Tetanus and Rabies for work with animals
    Other vaccines for foreign travel and research with pathogens
     Bloodborne Pathogens
The HBV vaccine is offered free of charge
to all employees who may be occupationally
exposed to blood or other body fluids. The
vaccine is effective in more than 90% of
healthy people who receive the series of
injections. It is administered intramuscularly
in three doses within a six-month period. The most common side effect
of vaccination is soreness at the injection site.



                             If you decide against vaccination, you will
                             be required to sign a declination form.
                             However, you will remain eligible for
                             vaccination if you desire it at a later time.
   Bloodborne Pathogens
Following universal precautions means you should?

A. Handle every sample as if it
   is infectious.
B. Use protective equipment
   only when you think the
   sample is from a patient with HBV.
C. Think about washing your hands and do so when
   you have time.
D. Use needles and blades whenever possible.


                                      The answer is…
   Bloodborne Pathogens

A. Handle every sample as if it is
   infectious.
        Bloodborne Pathogens
                     Good Personal Work Habits
Hand Washing:

       Conscientious hand washing is an essential part of your daily
        regimen. Hands routinely come into contact with items and
        materials that may be contaminated with pathogens.
       Hands also unconsciously touch the eyes, nose, and mouth
        numerous times throughout the day. These body areas are potential
        portals of entry for infectious organisms. Because of these factors,
        it is extremely important to wash your hands frequently.
       Wash hands immediately if you contact potentially contaminated
        material.
       Wash them after:
          handling infectious waste, even if it is properly contained
          removal of gloves
          using the restroom
       And finally, wash your hands before going on breaks and before
        leaving work at the end of the day.
     Bloodborne Pathogens
Proper hand washing involves the following steps:

   Wet both hands and wrists. Lather well using
    two squirts of soap or hand washing solution.

   Spread the lather to the back of the hands and
    wrists. Clean between the fingers. Washing time
    should be at least 10 seconds.

   Rinse hands and wrists well to remove all soap.

   Dry hands completely. Turn off the water using
    disposable towels when the faucet has handles.
    This prevents recontamination of the hands.
    Bloodborne Pathogens
Many personal activities increase the risk of
exposure to pathogens transmitted by hand and
mouth. Therefore, the following activities are
discouraged in your work area:

   smoking (prohibited)
   eating or drinking
   food storage
   application of cosmetics or
    contact lens
     Bloodborne Pathogens
Hand washing is an important work habit because?

A.   It is easy for everyone to remember.

B.   After you wash your hands, you can
     eat lunch in the lab.

C.   It removes pathogens that you may not know are on your
     hands.

D.   One thorough cleansing lasts all day.

                                             The answer is…
   Bloodborne Pathogens
C. It removes pathogens that you may
   not know are on your hands.
      Bloodborne Pathogens
                              Containment

Another approach to preventing exposure
to pathogens is to ensure containment of
potentially infectious materials, that is, to
prevent the contamination of other items
whenever possible.

An action as simple as opening a container can create a hazard by
splashing or spraying material onto your hands and work area.

                                Procedures that can result in the
                                generation of droplets include pipetting,
                                vortex mixing of unsealed containers, and
                                decanting liquids.
     Bloodborne Pathogens
Careful, thoughtful manipulation of potentially
infectious materials is the key to avoiding
splashes, spills, and the production of droplets.
Using safety devices and equipment appropriate
to the task also helps to minimize the release of
pathogens into your work environment.



                              Centrifuge containers prevent splattering of
                              materials if the sample container is
                              damaged during centrifugation. You will
                              avoid the need for extensive environmental
                              cleanup by containing the spill within a
                              secondary container.
     Bloodborne Pathogens
                              When your work involves manipulations of
                              potentially infectious materials, be certain
                              equipment is functioning properly and is
                              designed to keep the materials contained.




If you must carry potentially infectious
materials to another area, place the primary
containers in a leak-proof container to
prevent a spill during transport.
    Bloodborne Pathogens
              Personal Protective Equipment




   Now let's turn our attention to the use of personal protective
    equipment – barriers you wear to prevent contact with infectious
    materials.

   DACC provides lab coats, gowns, gloves, caps, shoe covers, and
    respiratory and eye protection, as needed. Choosing the appropriate
    form of protection depends on work tasks and situations you might
    encounter.
     Bloodborne Pathogens
As mentioned earlier, gloves prevent direct
contamination of the hands and are especially
necessary to block entry of pathogens if the
skin is broken. Remember, you must wash your
hands after removing gloves.




                            Properly fitted face masks offer protection
                            against inhalation of airborne pathogens.
                            Put on a mask before entering an area
                            where there is a risk of respiratory
                            exposure.
Bloodborne Pathogens
       During work activities where splashes to
       the face might occur, wear both a mask and
       eye protection or a face shield to prevent
       contact with infectious organisms.




       If you work with blood or other potentially
       infectious materials, you must wear
       protective garments designed to prevent
       these materials from soaking through to
       your clothing or skin. Garments such as
       gowns, lab coats, aprons, and coveralls
       offer such protection.
      Bloodborne Pathogens
All personal protective clothing and
equipment must be removed before
leaving the work area so as not to
accidentally expose others. When
removing garments, grasp the clean
side, peel off the article, and fold the
contaminated side inward.



Place contaminated items in a
designated container.
     Bloodborne Pathogens
Personal protective equipment must be?

A.   Designed to allow pathogens to contact your skin.

B.   Removed when leaving the work area and going to the
     cafeteria for lunch.

C.   The same for all tasks.

D.   Stylish and flattering.



                                             The answer is…
   Bloodborne Pathogens
B. Removed when leaving the work area
   and going to the cafeteria for lunch.
     Bloodborne Pathogens
                        Decontamination




The next portion of this program will examine various decontamination
   procedures used to destroy pathogens on items and materials that
          become contaminated during regular work activities.
    Bloodborne Pathogens
Waste items that have been properly decontaminated may be discarded
                         in the regular trash.
   Bloodborne Pathogens
One particular means of decontamination is with the use of chemical
disinfectants. Choosing the type and concentration of a disinfectant
   depends on its effectiveness against specific pathogens. Soak
contaminated items in a suitable chemical disinfectant to render them
 safe for further handling. Items may then be washed, and if needed,
                               sterilized.
Bloodborne Pathogens
     An important practice aimed at preventing
     transmission of pathogens is routine use of
     chemical disinfectants for wiping work surfaces.
     Wipe your work area with an appropriate
     disinfectant before starting work, between projects,
     immediately after a spill, and at the end of the work
     shift.

     Use a disinfectant to wipe equipment that cannot
     be autoclaved or soaked. This is especially
     important if the equipment is sent elsewhere to be
     recalibrated or repaired.


     If parts of the equipment cannot be disinfected, the
     equipment must be packaged and labeled to
     ensure that others will handle it with caution.
     Bloodborne Pathogens

The fluorescent orange or red biohazard
emblem is used to communicate a risk of
exposure to pathogens.




                            Biohazard labels must be affixed on
                            refrigerators, freezers, and any other
                            containers used for storage or transport of
                            potentially infectious materials.
      Bloodborne Pathogens
                               The biohazard label on a waste bag or use
                               of a red bag signify that items inside pose
                               an exposure risk. These containers require
                               careful handling until they can be
                               decontaminated by methods such as
                               autoclaving or incineration.




To handle an infectious waste bag, grasp
and lift the bag by its top. If an infectious
waste bag develops a leak or a tear, contact
your supervisor immediately.
      Bloodborne Pathogens
Never discard needles, syringes, blades, or other
sharp objects directly into waste bags because of
the high puncture risk. Instead, place them in an
approved, puncture-resistant, leak-proof sharps
container that is labeled or color coded red by the
supplier.

Use the approved sharps container for all sharp
items, even those free of pathogens. Never reach
inside, and be sure to replace containers when
about three-fourths full. Overfilling containers is
hazardous.

Contaminated laundry and linens should be placed
in designated bags provided by DACC for safe
collection and decontamination.
     Bloodborne Pathogens
A sharps container is?

A.   Safe to use when more than three-fourths full.

B.   Any rigid container you can find.

C.   Leak-proof, puncture-resistant, and
     properly labeled by the supplier.

D.   Optional for labs using
     uncontaminated sharps.



                                              The answer is…
   Bloodborne Pathogens
C. Leak-proof, puncture-resistant, and
   properly labeled by the supplier.
      Bloodborne Pathogens
                      Accidental Exposures

Earlier in the program, it was mentioned that most
occupational exposures to pathogens occur
accidentally from needle sticks, injuries from sharp
instruments, splashes onto mucous membranes of
the face, or contact with broken skin.

If your skin is cut or punctured while
handling potentially infectious materials:

    encourage the wound to bleed
    flush with water
    apply antiseptic

Then notify your supervisor, and immediately seek medical attention.
      Bloodborne Pathogens
If you receive a splash to the face or any other unprotected skin:




    flush well at the nearest sink or
     eyewash fountain
    notify your supervisor
    seek medical attention
   Bloodborne Pathogens
DACC has developed a Bloodborne Pathogens Exposure Control Plan
            (available in the DACC Safety and Procedures Plan)
      that outlines how to report an exposure incident, where to
go to receive an immediate medical evaluation, and what services are
 available for follow-up care. Review the Exposure Control Plan so
              that you know what to do in an emergency.
      Bloodborne Pathogens
If handled properly, accidental spills of potentially infectious materials
onto environmental surfaces need not result in personal exposure.
Employ the following cleanup procedure…

Immediately decontaminate the surface area;

    Place paper towels over the spill;
    Gently pour a disinfectant on the towels;
    And allow the area to soak for about 10
     minutes before cleanup.

If broken glass or other sharp equipment is
involved, scoop up the material with a dust
pan or cardboard to avoid the risk of injury.
Place materials in a puncture-resistant
container and then in a biohazard bag.
     Bloodborne Pathogens
Some spills require special cleanup techniques. If a spill of pathogenic
material transmitted through inhalation occurs…


    leave the room
    close the doors
    restrict access
    immediately call Campus Security
     (dial 888)



Other accidental spills might involve the release of hazardous chemicals
or materials along with pathogens. If such a situation occurs, be sure to
report this additional information when you call Campus Security.
     Bloodborne Pathogens
Emergency situations such as needle sticks, spills, or
splashes of infectious material?

A.   Don't happen in my building.

B.   Are of little concern if I have had
     a tetanus shot.

C.   Need not be reported until
     someone gets sick.

D.   Should be planned for in advance so the appropriate
     response can be initiated promptly.




                                                           The answer is…
   Bloodborne Pathogens

D. Should be planned for in advance so
   the appropriate response can be
   initiated promptly.
     Bloodborne Pathogens
This program has covered exposure control strategies that include the
use of:



   universal precautions
   vaccination
   good personal work habits
   containment
   personal protective equipment
   decontamination
   emergency procedures for accidental exposures
   Bloodborne Pathogens
If you have any questions or concerns, please contact your
          immediate supervisor or Rebecca Schlecht.

   Rebecca Schlecht can be reached at 217.443.8756 or
                    schlecht@dacc.edu

				
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