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BLOODBORNE PATHOGENS. THE OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION STANDARD. INTRODUCTION. What is the bloodborne pathogens standard? Who needs bloodborne pathogens (BBP) training? What content needs to be covered?. Duties of Employers provide a plan - PowerPoint PPT Presentation



  • INTRODUCTIONWhat is the bloodborne pathogens standard?Who needs bloodborne pathogens (BBP) training?What content needs to be covered?

  • OSHAS EXPECTATIONSDuties of Employersprovide a planidentify job types and classificationsprovide appropriate trainingprovide appropriate equipmentComplianceDuties of Employeesto follow the employers planto use equipment provided by the employerCompliance

  • OSHA REQUIRED INFORMATIONDocumentsGeneral explanation of bloodborne pathogensHepatitis B immunizationExplanation of tasks that may involve exposure

  • BLOODBORNE PATHOGENS DEFINEDDisease-causing microorganisms that may be present in human blood or OPIM (other potentially infectious material)VirusesBacteriaParasites

  • MODES OF TRANSMISSIONPuncture wounds or cutsContact (Touch, Splash, or Spray) with blood or OPIM on:mucous membranenon-tact skincuts, abrasions burnsacne, rashespapercuts, hangnailscontaminated sharps

  • RISK OF EXPOSUREThe objective of the BBP standard is to minimize or eliminate the hazard posed by work that may expose you to blood or OPIM

  • RISK OF EXPOSUREIf a risk of exposure exists, you must know:if there is a way to prevent infectionthe symptoms and course of infectionthat counseling is availablethat post-exposure treatment & follow-up are available

  • OCCUPATIONAL EXPOSURE INCIDENTSOccupational contact with blood or OPIM is considered an exposure incidentIf an exposure occurs:wash with soap & waterreport the incidentdocument the incidentseek immediate medical evaluationfollow employers exposure control plan

  • IMMEDIATE MEDICAL EVALUATIONImmediate means prompt medical evaluation and prophylaxisAn exact time cannot be statedTime limits on the effectiveness of prophylactic measures vary depending on the infection of concern

  • REPORTING AN INCIDENTDate and time of the incidentJob classificationLocation in the worksite where the incident occurred

    Work practice being followedEngineering controls in useProcedure being performedPPE in use

    Minimal information to report

  • Medical Evaluation After an Exposure IncidentEntitled to confidential medical evaluationPersonal decision about blood testingBlood may be tested only with consentBlood may be stored for 90 days, while considering testingInterpretation of any test results occurs with the health care provider

  • BLOOD TESTINGBlood may be tested for antibodies to:Human Immunodeficiency Virus (HIV)Hepatitis C Virus (HCV)Hepatitis B Virus (HBV)Other disease-causing organismsSource blood may also be tested with consentThe results of the tests of source blood will be made known to you

  • SPECIFIC BLOODBORNE PATHOGENSDefinitionSigns and SymptomsCourse of infectionPrevention and controlPost-exposure prophylaxis and follow-up care

  • HIV DEFINEDHIV is the Human Immunodeficiency VirusHIV causes acquired immune deficiency syndrome (AIDS)Risk of HIV infection from a puncture injury exposure to HIV infected blood is very low -- 0.3%

  • SIGNS & SYMPTOMS OF HIVSigns and symptoms include:Weight lossNight Sweats or feverGland Swelling or painMuscle and/or joint painCannot rely on signs and symptoms to know if you are infected

  • COURSE OF INFECTION OF HIVIncubation period from HIV infection to AIDS may be 8 to 10 yearsVaries greatly among individuals

  • HIV PREVENTIONThere is no vaccine to prevent HIV infection

    Follow Universal Precautions

  • HIV Post-exposure Prophylaxis & Follow-upThere is no cure for HIV infectionTesting for HIV antibodiesat time of exposureat 3 monthsat 6 monthsHIV antibodies usually become detectable within 3 months of infectionTreatment of HIV requires visits with your health care providerOSHA requires recommended treatment meet the most recent CDC guidelinesTreatment can include antiviral medications and a protease inhibitor

  • HCV DefinedHCV is Hepatitis C VirusIt affects the liverIt is the most common chronic bloodborne infection in the United StatesNeedlestick injury is the only occupational risk factor that has been associated with HCVRisk of HCV infection after exposure to HCV infected blood is 1.8%70 to 75% of those with acute HCV infection have no symptoms

  • SIGNS & SYMPTOMS OF HCVJaundice - a yellow color to the skinFatiqueHeadacheAbdominal PainLoss of appetiteNausea & Vomiting

  • COURSE OF HCV INFECTIONIncubation period averages 7 weeksChronic liver disease may occur in 70% of those infected with HCV

  • HCV PREVENTIONThere is no vaccine to prevent HCV infection

    Follow Universal Precautions

  • HCV Post-exposure Prophylaxis & Follow-upThere is no cure for HCV infectionNo recommendation for post-exposure prophylaxisTests for HCV antibodies & liver function tests should be done at time of exposureTests should be repeated 4 to 6 months after exposureTreatment of HCV requires visits with your health care providerOSHA requires recommended treatment meet the most recent CDC guidelinesHCV infection may require liver transplantation for treatment

  • HBV DEFINEDHBV is the Hepatitis B VirusIt affects the liverThe prevalence of HBV infection among healthcare workers is 10 times greater than HCV infection

  • SIGNS & SYMPTOMS OF HBVJaundice - a yellow color to the skinFatiqueHeadacheAbdominal PainLoss of appetiteNausea & Vomiting

  • COURSE OF HBV INFECTIONIncubation period averages 12 weeksMost cases of HBV resolve without further complicationChronic liver disease may occur in 6 to 7% of those infected with HBV

  • HBV PREVENTIONThere is a vaccine to prevent HBV infectionIt is required to be offered to anyone covered by the BBP standardFollow Universal Precautions

  • HBV Post-exposure Prophylaxis & Follow-upThere is no cure for HBV infectionPost-exposure prophylaxis should begin within 24 hours and no later than 7 days after exposureIf not previously vaccinated, the person should receive the HBV vaccine

    Treatment of HBV infection requires visits with your health care providerOSHA requires recommended treatment meet the CDCs most recent guidelinesChronic HBV infection may require liver transplantation for treatment

  • HBV IMMUNIZATIONAll people with routine occupational exposure to blood or OPIM have the right to receive the HBV vaccine at no personal expenseRefusal requires signing the Hepatitis B Vaccination declination formVaccine is Recombivax HB or Energix - BVaccine is prepared from recombinant yeast culturesMust be made available within 10 working days of initial assignment to job

  • HBV VACCINATION SCHEDULEVaccine is given in 3 doses over 6 months1st on initial assignment2nd one month later3rd five months after 2nd doseCDC recommends Hepatitis B antibody testing 1 to 2 months following the 3rd doseEmployer cannot require you use your health insurance to cover the costPre-screening is not requiredHBV is declining because of vaccine use!

  • PREVENTIONEngineering ControlsWork Practice ControlsPersonal Protective EquipmentUniversal Precautions

  • ENGINEERING CONTROLSDesign safety into the tools and work space organizationEngineering controls can:Remove the risk of exposure to the hazardEliminate the hazardIsolate the hazard

  • EXAMPLES OF ENGINEERING CONTROLSHand and eyewashing facilitiesSharps containersLabelingSelf-sheathing needlesNeedleless IV systems

  • LABELING REGULATED WASTELabel liquid or semi-liquid blood or OPIMLabel item(s) covered with blood or OPIMLabel sharps contaminated with blood or OPIMLabels are necessary for containers, storage, equipment that is contaminatedexception is certain blood or blood products that have been screened

  • SHARPS CONTAINERS MUST BE:closablepuncture resistantleakprooflabeled or color-codedfunctionalsufficient in numbereasily accessiblemaintained in an upright positionreplaced per policyNOT be overfilled

  • SHARPS INJURY PROTECTIONReusable sharps require proper handling (mechanical means) and decontaminationRetractable needlesNeedleless systems

  • WORK PRACTICE CONTROLSBehaviors necessary to use engineering controls safely & effectivelyWork Practice Controls include:using sharps containersusing an eyewash stationWASHING HANDS after using PPEcleaning work surfacesproper laundering

  • PROHIBITED WORK PRACTICESDo not break, shear, bend or recap needlesDo not reach into containers of contaminated sharpsDo not pick up contaminated items, such as broken glass, with your bare handsDo not use a vacuum cleaner to clean up contaminated itemsDo not open, empty or clean sharps containersDo not pipette or mouth suction blood or OPIMDo not eat, drink, smoke, apply cosmetics, or handle contact lenses in areas of possible occupational exposureDo not store food or beverages in refrigerators, freezers, shelves, or cabinets where blood or OPIM are present

  • HANDWASHINGFacilities readily available

    Wash after removing PPE

    Use antiseptic hand cleanser when necessary (such as when a sink isnt handy)

  • HANDWASHINGFirst roll out your paper towel or have the towel readily available (so you dont touch other surfaces to get it)

  • HANDWASHINGTurn on the tap water and adjust temperatureUse plenty of soap

  • HANDWASHINGWash your hands using friction on all surfaces for at least 30 seconds

  • HANDWASHINGDry your hands thoroughlyDONT turn off the water yet

  • HANDWASHINGTurn off the tap with a dry part of the towel Dont touch surfaces with your hands

  • CLEANINGClean work surfaces according to the employers exposure control planUse PPE and EPA-approved solution10% bleach and water, if used must be made dailyPlace contaminated laundry in color-coded laundry bag, use PPE, and handle as little as possibleDO NOT take home to launder!

  • PERSONAL PROTECTIVE EQUIPMENT (PPE)Specialized clothing or equipment used for protection when risk of exposure existsMust prevent blood or OPIM from contaminating clothing or skinMust be readily available at no cost to employeeMust be in appropriate sizesMust be in good working conditionMust be properly maintainedMust be trained in proper use

  • TYPES OF PERSONAL PROTECTIVE EQUIPMENTGlovesMaskEye shieldsGowns/ApronsResuscitation devices

  • LATEX GLOVESMedical products containing latex must be labeledAllergies to latex have been on the riseSubstitutes to latex-containing materials must be available

  • UNIVERSAL PRECAUTIONSInfection Control approach that treats all human blood and certain body fluids as if they are known to contain bloodborne pathogens

  • MATERIALS THAT REQUIRE PRECAUTIONSBloodSemenVaginal SecretionsCerebrospinal, synovial, or pleural fluidBody fluids with visible bloodAny unidentifiable body fluidSaliva from dental procedures

  • MATERIALS THAT DO NOT REQUIRE PRECAUTIONSUniversal Precautions do not apply to these fluids UNLESS blood is visible:fecesnasal secretionssputumsweattearsurinevomitus

  • BODY SUBSTANCE ISOLATION (BSI)An acceptable alternative to Universal PrecautionsTreats ALL body fluids and substances as infectious

  • EXPOSURE CONTROL PLANSite specific plan provided by employers for the protection of employees working where the potential for occupational exposure existsLists job classifications and tasks in which exposure may occurIdentifies engineering controls, work practice controls, PPE, and Universal PrecautionsIdentifies who will be trained and who will do the trainingIncludes record keeping provisions and is reviewed annually


    *In 1991, OSHA issued regulations on occupational exposure to bloodborne pathogens.These requirements are to ensure employee safety when there is occupational exposure to disease causing microorganisms in blood or other potentially infectious materials.BBP training is required for any employee with the potential for occupational exposure to blood or other potentially infectious materials, whether you are part time, full time, temporary, or a volunteer! Annual training is required to keep up with changes in the standard. This includes any employee who might clean and dress wounds, provide emergency first aid, provide care to students where exposure to blood or other potentially infectious material (OPIM) is possible, custodial workers who clean up spills of blood or OPIM, law enforcement or correctional officers, and maintenance workers that cover healthcare facilities or clinics..Training needs to cover: OSHAs expectations; Bloodborne pathogens and their transmission; Occupational exposure; Immunization; Engineering controls; Work practice controls; Personal protective equipment (PPE); Universal Precautions; APS Exposure Control Plan.*Meeting OSHAs expectations is accomplished by:TrainingProviding OSHA required informationProviding site specific required informationDocumentationOngoing observed practiceSystematic review of practice

    Training must be provided by qualified personnel.Site specific training must be provided.The timing of the training is important and documentation is required.Training must be appropriate to the education and reading level of the participants.A qualified person must be available to answer questions during training.

    TIP: Training records assist the employer and OSHA in determining whether the training program adequately addresses the risk in each job.**TIP: Puncture wounds most often occur when:Disposing of needlesAdministering injectionsDrawing bloodRecapping needlesHandling trash or dirty linens**You may change your mind at a later time and receive the vaccine as long as you are in a job covered by the standard