21 Bloodborne

8/16/2019 21 Bloodborne

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OSHA Office of Train 1

Bloodborne Pathogens


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IntroductionIntroduction

Approximately 5.6 million workers in health care and

other facilities are at risk of exposure to bloodborne

pathogens such as human immunodeficiency virus

(HI ! the virus that causes AI"#$% the hepatitis &

virus (H&$% and the hepatitis ' virus (H'$

#HA)s &loodborne *athogens standard prescribes

safeguards to protect workers against the health

ha+ards from exposure to blood and other potentially

infectious materials% and to reduce their risk from this

exposure


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Who is covered by theWho is covered by the

standard?standard? All employees who could be ,reasonably anticipated-

as the result of performing their ob duties to face

contact with blood and other potentially infectious

materials

,/ood #amaritan- acts such as assisting a co0worker

with a nosebleed would not be considered

occupational exposure


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Some Workers Who are at RiskSome Workers Who are at Risk

*hysicians% nurses and emergency room personnel rderlies% housekeeping personnel% and laundry workers

"entists and other dental workers

1aboratory and blood bank technologists and technicians

2edical examiners 2orticians

1aw enforcement personnel

3irefighters

*aramedics and emergency medical technicians Anyone providing first0response medical care

2edical waste treatment employees

Home healthcare workers


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How does exposure occur?How does exposure occur?

2ost common4 needlesticks

'uts from other contaminated sharps (scalpels%

broken glass% etc.$

'ontact of mucous membranes (for example% the

eye% nose% mouth$ or broken (cut or abraded$ skin

with contaminated blood


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Exposure Control PlanExposure Control Plan

Identifies obs and tasks where occupational exposureto blood or other potentially infectious material occurs

"escribes how the employer will4

se engineering and work practice controls

nsure use of personal protective e7uipment

*rovide training

*rovide medical surveillance

*rovide hepatitis & vaccinations

se signs and labels


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Exposure Control PlanExposure Control Plan

8ritten plan re7uired *lan must be reviewed at least annually to reflect changes in4

tasks% procedures% or assignments which affect exposure%and

technology that will eliminate or reduce exposure Annual review must document employer)s consideration andimplementation of safer medical devices

2ust solicit input from potentially exposed employees in theidentification% evaluation and selection of engineering and

work practice controls *lan must be accessible to employees


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niversal Precautionsniversal Precautions

9reat all human blood and certain body fluids as if

they are infectious

2ust be observed in all situations where there is a

potential for contact with blood or other potentially

infectious materials


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En!ineerin! andEn!ineerin! and

Work Practice ControlsWork Practice Controls

9hese are the primary methods used to control

the transmission of H& and HI

8hen occupational exposure remains afterengineering and work practice controls are put in

place% personal protective e7uipment (**$ must

be used


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9hese controls reduce

employee exposure by

either removing the ha+ard

or isolating the worker.xamples4

En!ineerin! ControlsEn!ineerin! Controls

#harps disposal containers

#elf0sheathing needles

#afer medical devices :eedleless systems

#harps with engineered sharps inury protections


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Sa"er #edical $evicesSa"er #edical $evices

Needless Systems: a device that does not use

needles for the collection or withdrawal of body

fluids% or for the administration of medication or

fluids

Sharps with Engineered Sharps Injury Protections:

a non0needle sharp or a needle device used for

withdrawing body fluids% accessing a vein or artery%

or administering medications or other fluids% with abuilt0in safety feature or mechanism that effectively

reduces the risk of an exposure incident


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Work Practice ControlsWork Practice Controls

8ash hands after removing

gloves and as soon as

possible after exposure

"o not bend or break sharps

:o food or smoking in work

areas

9hese controls reduce the

likelihood of exposure by

altering how a task is

performed. xamples4


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Personal Protective E%uipmentPersonal Protective E%uipment

#peciali+ed clothing or e7uipment

worn by an employee for

protection against infectious

materials 2ust be properly cleaned%

laundered% repaired% and

disposed of at no cost to

employees

2ust be removed when leaving

area or upon contamination


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Examples o" PPEExamples o" PPE

/loves

/owns

3ace shields ye protection

2outhpieces and

resuscitation devices


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Housekeepin!Housekeepin!

1ocation within the facility

9ype of surface to be cleaned

9ype of soil present

9asks or procedures being performed

2ust develop a written schedule for cleaning and

decontamination at the work site based on the4


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Housekeepin!Housekeepin! &cont'd(&cont'd(

After completion ofprocedures%

8hen surfaces arecontaminated% and

At the end of the work shift

8ork surfaces must be

decontaminated with an

appropriate disinfectant4


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Re!ulated WasteRe!ulated Waste

2ust be placed in closeable%

leak0proof containers built to

contain all contents during

handling% storing% transporting

or shipping and be appropriately

labeled or color0coded.


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)aundry)aundry

Handle contaminated laundry as

little as possible and use **

2ust be bagged or containeri+ed

at location where used

:o sorting or rinsing at locationwhere used

2ust be placed and transported in

labeled or color0coded containers


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Hepatitis * +accinationHepatitis * +accination Re%uirementsRe%uirements

2ust make available% free of charge ata reasonable time and place% to allemployees at risk of exposure within

;< working days of initial assignmentunless4

employee has had the vaccination

antibody testing reveals immunity

9he vaccination must be performed by

a licensed healthcare professional


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Hepatitis * +accinationHepatitis * +accinationRe%uirementsRe%uirements &cont'd(&cont'd(

2ust be provided even if employee initially declines

but later decides to accept the vaccination

mployees who decline the vaccination must sign a

declination form

mployees are not re7uired to participate in antibody

prescreening program to receive vaccination series

accination booster doses must be provided if

recommended by the .#. *ublic Health #ervice


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What to do i" an exposure occurs?What to do i" an exposure occurs?

8ash exposed area with soap and water

3lush splashes to nose% mouth% or skin with water

Irrigate eyes with water or saline =eport the exposure

"irect the worker to a healthcare professional


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Post,Exposure -ollow,pPost,Exposure -ollow,p

"ocument routes of exposure and how exposureoccurred

=ecord inuries from contaminated sharps in a sharpsinury log% if re7uired

btain consent from the source individual and the

exposed employee and test blood as soon as possibleafter the exposure incident

*rovide risk counseling and offer post0exposureprotective treatment for disease when medically indicatedin accordance with current .#. *ublic Health #ervice

guidelines *rovide written opinion of findings to employer and copy

to employee within ;5 days of the evaluation


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*ioha.ard Warnin! )abels*ioha.ard Warnin! )abels

8arning labels re7uired on4

'ontainers of regulated waste

=efrigerators and free+erscontaining blood and other

potentially infectious materials ther containers used to store%

transport% or ship blood or otherpotentially infectious materials

=ed bags or containers may besubstituted for labels


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/rainin! Re%uirements/rainin! Re%uirements

*rovide at no cost to employees

during working hours

*rovide at time of initial assignment

to a ob with occupational exposure

and at least annually thereafter

Additional training needed when

existing tasks are modified or new

tasks are re7uired which affect the

worker)s occupational exposure 2aintain training records for > years


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/rainin! Elements/rainin! Elements

'opy of the standard

2odes of transmission

#ite0specific exposure control plan Ha+ard recognition

se of engineering controls% work practices and **

1ive 7uestion and answer sessions


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Sharps In0ury )o!Sharps In0ury )o!

mployers must maintain a sharps inury log for the

recording of inuries from contaminated sharps

9he log must be maintained in a way that ensures

employee privacy and must contain% at a minimum4 9ype and brand of device involved in the incident

1ocation of the incident

"escription of the incident


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SummarySummary

#HA)s &loodborne *athogens standard prescribes

safeguards to protect workers against the health

ha+ards from exposure to blood and other potentially

infectious materials% and to reduce their risk from thisexposure

Implementation of this standard not only will prevent

hepatitis & cases% but also will significantly reduce the

risk of workers contracting AI"#% Hepatitis '% or otherbloodborne diseases

21 Bloodborne

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