Bloodborne Pathogens

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Bloodborne Pathogens. Edgar Romo , REHS Environmental Health & Biosafety Specialist Janette De La Rosa Ducut , Ed.D. Training Manager. Access the Bloodborne Pathogens Standard Identify epidemiology and symptoms Explain the modes of transmission Locate the Exposure Control Plan at UCR - PowerPoint PPT Presentation

Transcript of Bloodborne Pathogens

  • Bloodborne PathogensEdgar Romo, REHS Environmental Health & Biosafety SpecialistJanette De La Rosa Ducut, Ed.D. Training Manager

  • *Access the Bloodborne Pathogens StandardIdentify epidemiology and symptoms Explain the modes of transmissionLocate the Exposure Control Plan at UCRRecognize tasks/activities Identify methods of preventionDecontaminate and dispose of PPEObjectives

  • *Select proper PPEObtain, or decline, the Hep B vaccineFollow emergency proceduresTake action in an exposure incidentComplete post-exposure evaluationRecognize signs and labelsManage biohazardous waste Obtain answers to your questionsObjectives

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Bloodborne Pathogens StandardThe StandardApply to all work where occupational exposure to bloodborne pathogens is reasonably anticipatedView online at http://ehs.ucr.edu/biosafety

  • *Bloodborne Pathogens StandardBloodborne PathogensMicroorganisms that are carried in bloodthat can cause diseaseHBVHIV

  • Bloodborne Pathogens Standard

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Epidemiology and SymptomsEpidemiologyPlan and evaluate strategies to prevent illness by studying how diseases occur.

  • Hepatitis B

  • HIV

  • Epidemiology and Symptoms

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Modes of TransmissionRoutes of exposure Ways toxins enter the body InhalationAbsorptionInjectionIngestion

  • *Modes of TransmissionMucous MembranesInjectionNon-Intact Skin

  • *Modes of TransmissionPotentially infectious materialsTransmission of a biohazardous agent via body fluid

  • *Modes of TransmissionPotentially infectious materialsurinefecesvomittearssweatsputumnasal secretions

  • Modes of Transmission

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Exposure Control PlanExposure Control Plan

    Review online at http://ehs.ucr.edu/biosafety *

  • Exposure Control Plan*

  • *Exposure Control PlanBiological Use Authorization (BUA)Review the conditions / restrictions for use

  • Exposure Control Plan

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Tasks and ActivitiesDetermine if your tasks, activities, or job description involves exposure and protect yourself.

    *

  • *Tasks and ActivitiesFollow precautions when handlingSyringes, needles, or sharpsEmergency responseBody fluidsSpill clean-ups

  • *Tasks and Activities

    Job DescriptionsPhysicians and NursesAthletic TrainersLifeguardsEmergency Responders (i.e., UCPD)Laboratory workersPhlebotomistsBiohazardous waste workersCustodiansGroundskeepers

  • Tasks and Activities

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Methods of ComplianceMethods ofComplianceUniversal PrecautionsHousekeepingEngineering ControlsWork PracticesPPE*

  • *Methods of ComplianceUniversal PrecautionsHandle as if items were known to be infectious

    Wash hands and use protective barriers (i.e., PPE) for direct contact with blood and other potentially infectious materials.

  • *Methods of ComplianceHousekeepingDecontaminate with a 10% bleach solution (1 part bleach to 9 parts water) or other approved disinfectant for at least 15 minutesSanitize with 1:10 bleach solution

  • *Methods of ComplianceEngineering ControlsEliminate or reduce exposure through use or substitution of machinery or equipment. Dispose of sharps in a puncture-proof containerNeedleless SystemUse aerosols in a Biological Safety Cabinet

  • Biological Safety Cabinets

  • *Methods of ComplianceWork Practices

    Implement safe ways of performing your tasksOne-Hand Technique

  • *Methods of ComplianceHygieneAvoid contactCheck for open wounds Wash hands

  • Wash Your Hands

  • *EatingDrinkingSmokingin the laboratoryMethods of ComplianceNO

  • *Methods of CompliancePPECheck for defects, remove properly, and replace immediately.

    Do not reuse.

  • Methods of Compliance

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Personal Protective Equipment

  • PPESelectionPPE

    Gloves: Latex or NitrileEyes: Safety Glasses, Goggles or Face ShieldBody: Lab CoatFeet: Closed-Toe Shoes*

  • PPE selection

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • PPEDecontamination and DisposalAfter usingDecontaminate (i.e., wash hands after removing gloves)

    Dispose of in biohazard containers*Properly remove PPE

  • Personal Protective Equipment (PPE)

  • PPE Decontamination and Disposal

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Hepatitis B VaccinationHep B Vaccine

    Participate in a free series of three shots (80-95% effective at preventing infection)

  • Hepatitis B VaccinationHep B Vaccine

    You may elect to decline the vaccine

  • Hepatitis B VaccinationHep B Vaccine

    Receive the vaccine, OR Complete the Declination Form

  • Hepatitis B Vaccination

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Emergency ProceduresIn Case of an AccidentObtain medical care and report the injury or illness

  • *Emergency ProceduresSpillsIsolate, decontaminate, and wash hands

  • Blood Spill Cleanup

  • *Emergency ProceduresReview the Emergency Procedures online at http://ehs.ucr.edu/emergency/procedures

  • Emergency Procedures

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • ExposuresExposureContact between eyes, mouth, mucous membranes, skin cuts, or abrasions

  • ExposuresNotificationYou complete an Injury Report Form

    UCR records exposures on a Sharps Injury Log.

  • *ExposuresEmergencyProceduresWash skin immediately.Flush eyes with water for 15 minutes.Call 911 for help.Notify supervisor and EH&S.

  • Exposures

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Post-ExposureEvaluation and Follow-UpMedical EvaluationRoutes of exposureSource individualBlood testingProphylaxis (if applicable)

  • Post-Exposure

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Signs and LabelsBiohazard SymbolFlourescent orange or orange-red in color, with contrasting lettering

  • Signs and LabelsAffix biohazard label

  • Signs and Labels

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • WasteBiohazardous WasteBiologically contaminated waste that could potentially cause harm to human health, animal health, or the environment. Examples: cell cultures, transgenic plants, recombinant DNA, and waste from production of bacteria / virus / fungi / parasites. *

  • *WasteLiquid Waste

    The three types of biohazardous waste generated on campus are contaminated sharps, red bag waste, and liquid waste. Contaminated SharpsRed Bag Waste

  • *

    Contaminated SharpsWasteContaminated Sharps

  • *

    Label with the word Biohazard and the biohazardous symbolWasteContaminated Sharps

  • *

    Store in approved sharps containerWasteContaminated Sharps

  • Labels

    Labels

  • *

    Store until the container reaches the fill line.WasteContaminated SharpsDo not exceed fill line

  • *

    Decontamination is not necessary(unless you plan to dispose as physically hazardous waste)WasteContaminated Sharps

  • *

    Dispose within the appropriate time after generationWasteContaminated SharpsWithin 90 days if stored below 0CWithin 7 days if stored above 0C

  • *

    Submit a waste pickup request online by visiting www.ehs.ucr.edu and clicking on Waste Pickup WasteContaminated Sharps

  • *WasteContaminated Sharps

    Click on the link Biohazardous or Radioactive Waste

  • *WasteContaminated Sharps

    Enter information and click on Submit

  • *WasteRed Bag Waste

    Red Bag Waste

  • *

    Label with:1. Biohazard word2. Symbol3. Building 4. Room NumberWasteRed Bag WasteHinderaker 4108

  • *

    Label with:1. Biohazard word2. Symbol3. Building 4. Room NumberWasteRed Bag WasteHinderaker 4108

  • *WasteRed Bag Waste

    Store in a labeled and leak-resistant secondary container

  • *WasteRed Bag Waste

    Close containers when not in use.

  • Labels

  • *

    Treat within the appropriate time after generation by autoclavingWasteRed Bag WasteWithin 90 days if stored below 0CWithin 7 days if stored above 0C

  • *Red Bag WasteWasteAutoclave tape

    Place indicator tape on the red bag

  • *Red Bag WasteWasteAutoclave

    Follow safe autoclave procedures

  • *Red Bag WasteWaste

    Dispose of autoclaved waste in the building dumpster.

  • *Red Bag WasteWaste

    Submit a waste pickup request online when autoclaving is not possible

  • *

    Go to www.ehs.ucr.edu and click on Waste Pickup WasteContaminated Sharps

  • *WasteContaminated Sharps

    Click on the link Biohazardous or Radioactive Waste

  • *WasteContaminated Sharps

    Enter information and click on Submit

  • *

    Liquid WasteWasteLiquid Waste

  • *

    Label with:1. Biohazard word2. Symbol

    WasteLiquid Waste

  • *WasteLiquid Waste

    Store in a clear, non-breakable, container with positive closure

  • *

    Treat within the appropriate time after generation by disinfectingWasteLiquid WasteWithin 90 days if stored below 0CWithin 7 days if stored above 0C

  • *

    Mix 1 part bleach to 9 parts waterWasteLiquid Waste10987654321

  • *

    Add to liquid waste and wait for 30 minutesWasteLiquid Waste

  • *

    Pour down drain(only if decontaminated)WasteLiquid Waste

  • *Waste

    Mixed waste must be treated in the following order: 1. Radioactive 2. Chemical 3. Biohazardous

  • *Waste

    Mixed WasteWaste that contains radioactive, chemical, and biohazardous components

  • *Waste

    Mixed WasteWaste that contains radioactive and biohazardous components

  • *Waste

    Mixed WasteWaste that contains chemical and biohazardous components.

  • Waste

  • *TopicsBloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control PlanTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation Signs and LabelsWasteQuestions and Answers

  • Questions and AnswersBiosafety Officer

    [email protected] Call (951) 827-5528Visithttp://ehs.ucr.edu/biosafety

  • Questions and Answers

  • *Access the Bloodborne Pathogens StandardIdentify epidemiology and symptoms Explain the modes of transmissionLocate the Exposure Control Plan at UCRRecognize tasks/activities Identify methods of preventionDecontaminate and dispose of PPESummary

  • *Select proper PPEObtain, or decline, the Hep B vaccineFollow emergency proceduresTake action in an exposure incidentComplete post-exposure evaluationRecognize signs and labelsManage biohazardous waste Obtain answers to your questionsObjectives

  • *For more information

    ehs.ucr.edu

    951 827 5528

    [email protected]

    EH&S General Safety OrientationBy, Janette De La Rosa Ducut, Ed.D.**Welcome to the University of California Riverside's online Bloodborne Pathogens training. This training is was developed Environmental Health & Safety (EH&S) for those individuals who have the potential for exposure to bloodborne pathogens. This includes work with blood (and blood products) and other potentially infectious materials. Please note that you must complete annual refresher training in bloodborne pathogens every year, or whenever work practices change.NOTE: Training records must be kept for 3 years, and must be provided by EH&S or other qualified personnel.By the end of this training you should be able to Access the Bloodborne Pathogens standardIdentify epidemiology and symptoms of common bloodborne diseasesExplain the modes of transmissionLocate the Exposure Control Plan at UCRRecognize tasks and activities that may involve exposure Identify methods of preventing or reducing exposureDecontaminate and dispose of PPE You should also be able to...8. Select proper PPE9. Obtain, or decline, the Hep B vaccine10. Follow emergency procedures when involved with blood or OPIM11. Take action in an exposure incident12. Complete post-exposure evaluation and follow-up 13. Recognize signs and labels14. Manage hazardous waste 15. Obtain answers to your questionsTo meet those objectives, we will begin with an introduction to Bloodborne Pathogens StandardEpidemiology and SymptomsModes of TransmissionExposure Control Plan at UCRTasks and ActivitiesMethods of CompliancePPE (Selection)PPE (Decontamination and Disposal)Hepatitis B VaccinationEmergency ProceduresExposuresPost-Exposure Evaluation and Follow-up Signs and LabelsWasteQuestions and Answers

    Lets begin with a discussion of the Bloodborne Pathogens StandardThe Bloodborne Pathogen Standard is a set of regulations passed by the California Occupational Safety and Health Administration (Cal/OSHA). This applies to all work where occupational exposure to bloodborne pathogens is reasonably anticipated. This includes individuals who are trained in First Aid and CPR. Review this standard online at http://ehs.ucr.edu/biosafety.Bloodborne pathogens (BBPs) are microorganisms present in human blood or other potentially infectious materials that can cause disease in persons who are exposed. Many are exotic and relatively rare, such as malaria and syphilis. Others are fairly common such as the hepatitis virus and human immunodeficiency virus (HIV). While CAL-OSHA does not limit the BBP standard to only hepatitis B (HBV) and HIV, these are the most commonly transmitted bloodborne pathogens, and which will be discussed in this training.Epidemiology is the study of how diseases occur in different types of people. Familiarizing yourself with the epidemiology and symptoms of common bloodborne pathogens enables you to plan and evaluate strategies to prevent illness. The next two slides will review the epidemiology and symptoms of two common bloodborne pathogens: Hepatitis B and HIV.Routes of exposure are the various ways that toxins and chemicals enter your body. This includes:Inhalation into the respiratory tractAbsorption through skin contactInjection directly into the bloodstreamIngestion into the digestive tract (via eating)Bloodborne pathogens can be transmitted to you through (accidental) injection with contaminated sharps/needles, and direct skin contact via moist mucous membranes (such as the eyes, mouth, and nose) and non-intact skin (such as open wounds). It's important to note that the HIV virus can not be transmitted through casual contact (because the skin is generally in-tact).Injection or absorption of contaminated blood (and blood products) is one way of getting transmitted with a bloodborne pathogen. But there are other body fluids, known as potentially infectious materials, that also puts you at risk. This includes:Semen secretionsVaginal secretions Cerebrospinal fluid Pleural fluid (lung fluid) Synovial fluid (from a human's joints) Amniotic fluid (uterine fluid) Peritoneal fluid (fluid that fills a human's body cavity) SalivaUnfixed tissues or organs from living or dead humans, other than intact skin Cells or tissue cultures that may contain bloodborne pathogens Organ cultures and culture media or other solutions that may contain bloodborne pathogens Any human body fluid of an unknown origin Other items that would be considered potentially infectious materials includes:Urine Feces Vomit Tears Sweat Sputum Nasal secretions

    To ensure that all bloodborne pathogens are handled safely, Principal Investigators and users of biohazardous materials are required to comply with the provisions of the Exposure Control Plan. This document contains official policies involving biohazardous materials, training requirements, equipment, and procedures for obtaining the Hep B vaccination at no charge to employees. You can view the document online by visiting http://ehs.ucr.edu/biosafety.Once there, you can navigate to the plan documentThe Institutional Biosafety Committee authorizes use of biohazardous materials through a Biological Use Authorization (BUA) permit.There are various tasks and activities that involve reasonably anticipated occupational exposure. Ensure that you determine if your tasks, activities, or job description involves exposure and protect yourself.Therefore, follow precautions whenever handling:Syringes, needles, or sharp objectsEmergency response activitiesBody fluidsSpill clean-upsAdditionally, certain job classifications on campus are predetermined to be at risk of "reasonably anticipated occupational exposure." These include, but are not limited to the following:Physicians and Nurses Athletic Trainers Lifeguards Paramedics or like emergency responders who render first aid as a job function, such as UCPD. Laboratory workers conducting research with HIV and Hepatitis or who handle human blood Phlebotomists Haulers and handlers of biowaste Custodians Groundskeepers __________________NOTE: There are other job classifications at UCR that could also be at risk of reasonably anticipated occupational exposure, but must be determined on an individual basis. Some job classifications that should be analyzed on an individual basis include custodial staff who handle contaminated laundry or clean-up spills of potentially infectious materials and child-care assistants, to name a few. Obtain assistant from Environmental Health & Safety to makes these determinations. Complying with the Bloodborne Pathogens Standard and the campus Exposure Control Plan means that you are following all methods used to eliminate or reduce exposure. These methods include:Observing universal precautionsMaintaining good housekeeping (i.e., Cleaning and Decontamination)Utilizing Engineering Controls Observing Work Practice Controls (i.e., good hygiene)Using Personal Protective EquipmentUniversal Precautions simply means that you should handle all blood and body fluids as if they were known to be infectious with HIV, HBV, or other bloodborne pathogens. This includes washing your hands and using protective barriers (i.e., PPE) for direct contact with blood and other potentially infectious materials.Decontaminate work surfaces before and after use, and immediately after spills of potentially infectious materials with an approved disinfectant (i.e., a 1:10 dilution of household bleach, 70% ethanol, or other disinfectant) for at least 15 minutes prior to clean up or disposal.Engineering controls isolate or remove the bloodborne pathogens hazard from your workplace. This includes use or substitution of machinery or equipment, such as puncture-proof disposal containers for sharps, needleless systems, and working under a biological safety cabinet. You should always use biological safety cabinets when conducting operations on potentially infectious materials that could create aerosols, suspended droplets, or spills. When you cannot use equipment or machines, implement work practices to reduce the likelihood of exposure. Examples of safe ways of performing tasks include prohibiting recapping of needles using a one-hand technique. An important work practice is to maintain good hygiene to reduce your risk of infection. This includes avoiding contact with your face, eyes, mouth, or nose while working with potentially infectious materials. This means that you should never mouth pipette; instead, always use mechanical devices. Additionally, do not handle potentially infectious materials if you have open wounds, burns or abrasions that could serve as a conduit to infection. Finally, you should always washing your hands after handling potentially infectious materials, and after removing gloves.In addition to observing good hygiene, another work practice is to ensure that you do not eat, drink, or smoke in the laboratory. This also means that you should never store food and drink in refrigerators, freezers, on countertops, or in other areas where potentially infectious materials are present. Using Personal Protective Equipment (PPE) is another way of protecting yourself through the use of a physical barrier. PPE is anything that is used to protect a person from exposure including: gloves, safety glasses, CPR mouth barriers, and lab coats. When using PPE:Always check for defects or tears beforehandRemove and replace if it becomes torn or defectiveRemove before leaving a contaminated area (do not wear PPE in public)Do not reuse disposable equipmentWhen you are selecting PPE, consider the type of anticipated exposure, the durability and appropriateness ofthe PPE for the task, and the fit (not too small or too large).When selecting PPE:1. Always wear latex or nitrile gloves when handling potentially infectious materials. Change gloves frequently, never use gloves with compromised integrity (i.e., pinholes, etc.), always wash hands between glove changes, and never reuse disposable gloves. 2. Always protect your eyes with safety glasses, goggles, or face shield, as appropriate when there is the potential for a splash or spill of a potentially infectious material. Clean and disinfect this equipment, as necessary.3. Wear outer protective apparel, such as lab coats or disposable coveralls, when working with or cleaning up spills of potentially infectious materials. More protective gear, such as impervious coveralls and boots may be required, if massive amounts of blood or other body fluids may be encountered (i.e., paramedics responding to a severe automobile accident). If clothing is to be laundered, it should be clearly labeled to indicate it is contaminated.4. Finally, ensure that you protect your feet with closed toed shoes.Decontamination of PPE is also important after use. As a reminder, you should always wash your hands after removing your gloves. Use a soft antibacterial soap whenever possible. A hand sanitizer can be used but wash with soap and water as soon as possible. Carefully remove and dispose of PPE in a biohazard container. If you are at risk of occupational exposure to the Hepatitis B virus, fortunately there are vaccines available that are provided at no cost to you. Your supervisor can arrange for you to receive this vaccine. The vaccine is given in a series of three shots. After the first dose, the second shot is given approximately one month later, and the final dose is given approximately 6 months after the first dose. The vaccine is about 80-95% effective at preventing infection. A small percentage of people may not develop protective levels of antibodies or may lose their immunity after four or more years. Few side effects have been reported, most commonly only discomfort at the site of injection.You may elect to decline the vaccination and continue to work in situations with risk of occupational exposure. If you change your mind you can still receive the vaccination at a later time. Ensure that you either receive the vaccine, or complete the declination form.Receiving the vaccine does not substitute for application of Universal Precautions. The HBV vaccine does not protect against other bloodborne pathogens and it is not 100% effective in 100% of the people. It is simply an added layer of precaution. If an accident happens and there is an injury or illness, ensure that first aid is provided. If necessary send the employee to one of the occupational medicine providers listed on the In Case of an Accident signs (usually posted on laboratory doors). Whenever there is a spill of blood or other potentially infectious materials, ensure that you follow these three general steps: isolate the spill, decontaminate, and wash hands.A list of procedures for common emergencies can be found online at http://ehs.ucr.edu/emergency/procedures Whenever there is direct contact between the eyes, mouth, mucous membranes, skin cuts, or abrasions with blood or other potentially infectious material, it is considered an exposure. Ensure that you take immediate action after an exposure, which includes (as identified before) seeking medical treatment, and reporting it to your supervisor and EH&S. You can notify the campus by completing an Injury Report form, which can be found at http://ehs.ucr.edu/forms. Notification is an important step because the campus is required to record the exposure on a Sharps Injury log.

    For skin exposures:Gently wash contact area with soap and water immediately. When there is an eye exposure involved:Flush eyes with water for 15 minutes using an eye wash, if available. Whenever necessary, call 911 for medical help. Additional Information / Follow Up Activities include notifying your supervisor and EH&S as soon as possible.

    If you elected to participate in the HBV vaccination series prior to your potential exposure, chances are that you are protected from hepatitis. However, you may still be at risk from other bloodborne pathogens. Even if you elected to decline the hepatitis vaccination, it is possible to receive post-exposure preventative (prophylactic) treatment to decrease the chance of infection.If you are exposed, a medical evaluation will be conducted to determine the impact of the exposure, and the best course of action for follow-up. This confidential medical evaluation contains the following elements: Documentation of the route(s) of exposure and the circumstances under which the exposure incident occurred. Identification and documentation of the source individual, unless the campus establishes that identification is not feasible. (With the source individual's consent, the medical provider will also determine that person's HIV and HBV status through blood testing, unless the source is already known to be HIV or HBV positive. The employee who was exposed will be informed of the results of such testing.)If the exposed person consents, the medical provider will test your blood for HBV and HIV. Post-exposure treatment (prophylaxis), when determined appropriate by the medical professional may be applied.Biohazardous agents aren't visible with the naked eye. Although there is no way to visually distinguish infectious materials from non-infectious materials there are certain precautions and warning symbols that can protect or alert you. These labels should be flourescent orange or orange-red in color, with contrasting lettering and the biohazard symbol.Label potentially infectious materials with a biohazard symbol. This includes refrigerators / freezers, waste containers, transportation containers, doors to areas where Biosafety Level 2 or higher agents are handled, and countertops and benches.Also ensure that you label potentially infectious materials or contaminated linens and other debris that have not been determined to be free of bloodborne pathogens, unless such materials are handled with Universal Precautions. Biohazardous waste includes biologically contaminated waste that could potentially cause harm to human health, animal health, or the environment. Examples: cell cultures, transgenic plants, recombinant DNA, and waste from production of bacteria / virus / spores.

    This next section will walk you through the management of biohazardous waste.For the purposes of this training, we will discuss three methods of managing biohazardous waste, based on the type of waste it is. The three types of biohazardous waste generated on campus are contaminated sharps, red bag waste, and liquid waste. Contaminated sharps includes hypodermic needles, knives, and razor blades, pipette tips, slides and cover slips. Lets begin with how to label, store, treat, and dispose of contaminated sharps.All biohazardous waste must be labeled with the word Biohazard and the international symbol for biohazardous waste.Store in approved sharps containers, which are puncture-proof and leak-proof. This containers are provided for free by EH&S. Containers must be closed at all times when not in use.

    EH&S General Safety OrientationBy, Janette De La Rosa Ducut, Ed.D.*The waste storage area must have a sign on the door indicating the room contains hazardous waste. It must also be locked, and remain closed to prevent unauthorized access.When the contents reach the fill line (approximately 2/3 full), seal the container.Decontamination is not necessary (unless you plan to dispose of the waste as physically hazardous waste). Rigid objects such as transfer pipettes are recommended for decontamination by exposure to a 10% bleach solution for at least hour. Refer to the physical hazardous waste module for complete instructions.Dispose within 7 days if stored above 0C or within 90 days if store below 0C Now lets discuss how to label, store, treat, and dispose of red bag waste. This includes infectious agents, contaminated cultures / petri dishes / culture flasks, waste from bacteria / viruses / spores / live & attenuated vaccines. Can also include contaminated wipes and bench paper. Basically anything containing recombinant DNA, plant/animal/human pathogens, and diagnostics must be treated as red bag waste.

    All biohazardous waste must be labeled with the word Biohazard and the international symbol for biohazardous waste and placed into red bags. Label the red bag with the building and room number before filling it. The red bags are for biohazardous waste only (do not use orange bags as they are illegal in the State of California.The one exception is waste that contains plant pathogens. This waste can be placed into a clear bag with the biohazardous label affixed. Store in a labeled leak-resistant container, with a tight-fitting lid before decontamination. Do not use hampers or wire baskets to hold biohazard bags. DO NOT overfill the containers.Containers must be closed at all times when not in use. DO NOT place anything that will puncture the plastic bag. Every year custodians are injured from glass pipettes, or other sharp objects, that are improperly placed in plastic bags.EH&S General Safety OrientationBy, Janette De La Rosa Ducut, Ed.D.*The medical waste storage area must have a sign on the door indicating the room contains hazardous waste. It must also be locked, and remain closed to prevent unauthorized access.When possible, autoclave your red bag waste within the appropriate time frame. Autoclaving must be performed within 7 days if stored above 0C or within 90 days if store below 0C Begin by placing indicator tape on the red bag. This will give you a visual indicator that the appropriate decontamination temperature has been reached.Follow safe autoclave procedures. This includes autoclaving at the proper temperature, pressure, and time. At minimum, this includes autoclaving at 121C and 15 psi for a minimum of 45 minutes. For further operator instructions, refer to the manufacturers guide or your Laboratory Safety Officer.

    Place bags and /or containers in a leak-proof, heat-resistant autoclave pan or tub. Distribute the load as evenly as possible in the pan or tub. Do not over-load the autoclave. The waste should not touch the interior walls of the autoclave. Leave an opening in the bag or loosen tops on the containers to allow steam to penetrate the waste. Place pan or tub of items to be autoclaved inside the autoclave. Close the door and secure it by tightening the handle firmly. Autoclave on the appropriate cycle, liquids or dry, depending on the items being autoclaved. Run the dry cycle for items with a moisture content of 10% or less such as paper, plastics, labware, sharps. Run the liquid cycle for items which may boil and need a slow exhaust. Autoclave the medical waste at 121C and 15 psi for a minimum of 45 minutes. Increase autoclave time by a minimum of 15 minutes for more dense loads or loads with a high liquid content. Wait until the pressure has fallen to zero before opening the autoclave. When opening the autoclave door, take precautions to avoid exposure to steam and hot surfaces or liquids. Stand behind the autoclave door as you open it. Allow liquids to cool several minutes before removing them from the autoclave. Use heat resistant gloves to remove items from the autoclave. Close the autoclave door. Check that the autoclave tape has changed. If the tape has not changed, reautoclave the load. You may need to call Physical Plant to repair the autoclave. Dispose of autoclaved/decontaminated medical waste in the regular trash.

    NOTE: Autoclaves must be spore-tested monthly, and be accompanied by a chart recorder and autoclave log (dated, and kept for 3 years)Once autoclaved, you can dispose of autoclaved waste in the building dumpster. When its not possible to autoclave, place the contaminated red bag waste in a large rigid container (i.e., 44 gallon medical waste tub). DO NOT place in the regular trash.Request a pickup of your non-autoclavable red bag waste by visiting the EH&S website.EH&S General Safety OrientationBy, Janette De La Rosa Ducut, Ed.D.*For more information refer to the Biohazardous & Medical Waste Disposal Requirements poster available at www.ehs.ucr.edu under ResourcesLiquid biohazardous waste includes human / animal blood (and components), bodily fluids, and semi-liquid materials

    All biohazardous waste must be labeled with the word Biohazard and the international symbol for biohazardous waste. Store liquid waste in a clear, non-breakable, container with positive closure. Never use a food container, such as a water bottle, to store this waste.Treat your waste within the appropriate time frame. Decontamination must be performed within 7 days if stored above 0C or with 90 days if store below 0C The most common procedure for disinfecting is to decontaminate in 10% bleach solution for 30 minutes before pouring down drain. To begin, mix 1 part household bleach to 9 parts water. Or, for larger containers ensure that there is 10% bleach contained within.Add to liquid waste and wait 30 minutesAfter appropriate disinfection with a household solution, liquid biohazardous waste can be poured down the drain. Liquid waste decontaminated with non-bleach disinfectants, such as formaldehyde, should NOT be poured down the drain. Instead, dispose of as chemical hazardous waste.

    When generating mixed waste, you must follow the rules of each hazard in order of the most stringent. A good rule to follow is to treat waste in the following order: first as radioactive, second as a chemical, and last as a biohazard.Waste that contains all three hazards (radioactive, chemical, and biohazardous components) must be approached as a radioactive waste first (with appropriate shielding). Then you must identify the chemical waste through a label from the Online Tag Program. Finally, affix a biohazard label to further indicate the contents within.

    NOTE: We strongly urge you to resist mixing biohazardous waste with radioactive and/or chemical waste. Doing so can be dramatically more expensive to dispose of.Waste that contains radioactive and biohazardous components must be approached as a radioactive waste first (with appropriate shielding). Then you must affix a biohazard label to further indicate the contents within. Please note that radioactive biohazardous mixed waste should never be autoclaved. Waste that contains chemical and biohazardous components must be approached as chemical hazardous waste (with a label from the OTP). Then a biohazard label must be affixed. When possible, disinfect the biohazardous part of the mix and then dispose of it as chemical waste.Hazardous chemical and biohazardous waste should never be autoclaved. If you have any comments, questions, or concerns please take the opportunity to contact the Biosafety Officer by sending an email to [email protected] or calling Environmental Health & Safety (951) 827-5528. You can also obtain answers to frequently asked questions by visiting us online at http://ehs.ucr.edu/biosafety.In summary, bloodborne pathogens can cause disease, unless the proper steps are taken to prevent infection. As a reminder, ensure that you are able to...Access the Bloodborne Pathogens standardIdentify epidemiology and symptoms of common bloodborne diseasesExplain the modes of transmissionLocate the Exposure Control Plan at UCRRecognize tasks and activities that may involve exposure Identify methods of preventing or reducing exposureDecontaminate and dispose of PPEEnsure that you also are able to...8. Select proper PPE9. Obtain, or decline, the Hep B vaccine10. Follow emergency procedures when involved with blood or OPIM11. Take action in an exposure incident12. Complete post-exposure evaluation and follow-up 13. Recognize signs and labels14. Manage hazardous waste 15. Obtain answers to your questionsCongratulations! You have completed participation in the University of California Riversides online Bloodborne Pathogens training. For more information visit www.ehs.ucr.edu