Controlling Communicable Diseases. OSHA Bloodborne Pathogens Standard 1910.1030

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Transcript of Controlling Communicable Diseases. OSHA Bloodborne Pathogens Standard 1910.1030

  • Controlling Communicable Diseases

  • OSHA Bloodborne Pathogens Standard 1910.1030

  • Bloodborne Pathogens:Pathogenic microorganisms present in human blood that can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV).

  • Bloodborne Pathogen Standard Exposure Control Plan Universal Precautions Engineering & Work Practice Controls Personal Protective Equipment (PPEs) Housekeeping Hepatitis B Vaccination Labels & Signs Record Keeping

  • Exposure Control Plan

  • Occupational Exposure = Reasonably Anticipated Contact With Blood and OPIMs Via:

    SkinEyeMucous MembraneParenteral

  • Updating the Exposure Control PlanAt Least AnnuallyWhenever Tasks are ModifiedIntroduction of New Procedures or TasksWhen a Revised Employee Position Affects Occupational ExposureTo Reflect Changes in Technology

  • Other Potentially Infectious Materials (OPIMs)SemenVaginal SecretionsCerebrospinal FluidSynovial FluidPleural FluidPericardial FluidPeritoneal Fluid

    Amniotic FluidSaliva in Dental WorkAny Body Fluid Visibly Contaminated with BloodAll Body Fluid That is Difficult to DifferentiateUnfixed Tissue or Organs (Except Intact Skin)

  • Universal Precautions

  • Engineering and Work Practice ControlsPersonal Protective Equipment (PPEs)Handwashing Facilities (or Antiseptic Hand Cleaner)Sharps and Laundry DisposalPersonal Hygiene

  • Personal Protective Equipment (PPEs)GlovesAprons & Gowns Resistant to FluidFace Shields and MasksShoe Covers

  • HousekeepingKeep Work Area CleanAccess to Reusable SharpsDisposal of Contaminated SharpsContaminated Laundry

  • Hepatitis B VaccinationAvailable to Employees with Occupational ExposureAvailable After Initially Declined by Employee at Time of EmploymentEmployee Must Sign Declination That Appears in Appendix A of Bloodborne Pathogen Standard

  • Labels & SignsAffixed to Refrigerators Containing Blood or OPIMs & Receptacles of Regulated WasteFluorescent Orange or Red-OrangeRed bags with Biohazard Symbol May be Used for ContainersLabels Consist of Three Interlocking Circles

  • Employee Information & TrainingProvided During Working HoursNo Cost to EmployeeDuring Initial EmploymentAt Least Annually After Initial Employment

  • Record KeepingMedical Records for Bloodborne PathogensTraining RecordsSharps Injury Log

  • Information About Bloodborne Pathogens

    Protecting Public Health a Primary Responsibility of the Funeral Service Profession

    A. Control the Spread of Communicable Diseases1. Precautionary measures

    B. Not Becoming Infected Carriers Ourselves1. Bring Illnesses to our families, friends, and associatesMedical & Scientific Community Believe Serious Danger Posed A. Government Obligates Funeral Establishments to OSHAs Bloodborne Pathogens Standard 1. Rules established to protect employees with exposure risk

    What Are Bloodborne Pathogens?A. Disease causing microorganismsB. In Blood and Other Body FluidsC. Include HBV, HCV, and HIV, Inter AliaD. A Plethora of Bugs We May Not Know Exist YetFuneral Home Compliance with Bloodborne Pathogens Standard Prevents Spread of Communicable Disease Primary Reference for Inspectors Consists of Eight Overlapping Areas:1. Exposure Control Plan2. Universal Precautions3. Engineering & Work Practice Controls4. Personal Protective Equipment (PPEs)5. Housekeeping6. Hepatitis B Vaccination7. Labels & Signs8. Record Keeping

    Funeral Homes Must Develop Exposure Control PlanMajor Piece of Bloodborne Pathogens StandardEncompasses Most of the Bloodborne Pathogens Standard Directly or IndirectlyReviewed at Least AnnuallyDocuments Measures to Reduce Exposure Incidents Workplace Practice (i.e., cleaning hands and using PPEs) Engineering (use of puncture resistant sharps container)Documents Consideration of Safer Control Devices i.e., new drain tube reduces blood splattering i.e., new suture needle that prevents sticksF. Documents Employer Solicitation of Input from TrenchesG. Determines Occupational Exposure by Job Classification What Comprises Occupational Exposure?Job Classification Reasonably Anticipated Contact with Blood and OPIMsSkin (abrasions and cuts)Eye (splashes)Mucous Membrane (splash in mouth or nose)Parenteral (needle stick on HCV and many years ago)VII.Exposure Control Plan Changing, Not StaticA. Updated At Least AnnuallyB. When Tasks Modified (not very often in 19th Century profession but possible)C. Introduction of New Procedures and Tasks (switching from chemical disinfectants to autoclave)D. Revised Employee Position (make the funeral directors go on removals or administrative person clean prep room)E. Changes in Technology (crazy guy switching from arterial injection to filling casket with inert gas)

    A Cornucopia of Other Potentially Infectious Materials (OPIMs)A. Semen (story of priest with panties, painted toe nails and condom)B. Vaginal Secretions (lets not discriminate only against males)C. Cerebrospinal Fluid (autopsy)D. Synovial Fluid (joints, bone donors, accident victims)Pleural Fluid (lungs during aspiration; trocars can backup and reverse producing unpleasant shower)Pericardial Fluid (sac around heart, autopsy)G. Peritoneal Fluid (abdominal sac)H. Amniotic Fluid (pregnancies & fetal deaths) I. Saliva in Dental Work (becomes mixed with blood)J. Body Fluid Contaminated with Blood & Difficult to Differentiate (almost always the case with funeral service)K. Unfixed Tissue or Organs (not embalmed, hence my idea of embalming first)

    Universal Precautions 2nd Major Part of OSHAs BBP Personnel with Occupational Exposure As If Every Person, All Blood, Body Fluids Contain Ebola Many Unknowing Carriers (all age groups, social and economic backgrounds, geographical location, rural and urban) Like Playing Ball Under Shell Game (impossible to know which cases contain disease) Or Like Trying to Cross an Old Mine FieldX. Engineering & Work Practice Controls Another Important Element of BBPA. Employers Required to Provide Exposed Employees with PPEs1. Make sure theyre available bad sign if notB. Handwashing Facilities If Possible or Antiseptic Hand Cleaner (i.e., removals)1. If Antiseptic Handcleaner, Wash Hands ASAPC. Used Sharps in Puncture Resistant Container 1. scalpals, hypodermic needles, wire used shutting mouth, razors2. Can Puncture Regular Biohazard Box3. In Trash Can Infect Unwitting Janitor or Rumagers (vagrants going through Dumpster for deads soiled clothing)D. Biohazard Box for Non SharpsE. Labeled Container or Non Absorbant Sac for Contaminated Laundry (dont want laundry personnel to unwittingly become infected handling with sores or cuts)F. Personal Hygiene1. Not regular bathing although coworkers will appreciate2. Minimized spraying and splashing3. No eating, drinking, smoking, cosmetizing, lip balm applications handling contacts where exposure probable4. Lunches and drinks not in cooler with dead bodies or anywhere in preparation room around infectious materials (dont forget to remove gloves at lunch time like an old embalmer I saw) PPEs A Shield Against InfectionA. GlovesB. ApronsC. GownsD. Face ShieldsE. Masks (my encounter with MRSA)F. Shoe Covers (my 3 year old loves playing with my shoes when I get home; better keep 2 pairs)G. Employers Should Ensure UseH. Discarded When Leaving Work Area (should not be hanging up covered in blood for reuse)I. Gloves Worn if Blood Contact Possible Home RemovalsJ. Ensure Funeral Homes Have All These for EmployeesGood Housekeeping Prevents InfectionA. Wipedowns After Working with Remains1. Counters, cabinets, walls with disinfectants2. Instruments and items touched with bloody gloves cleaned & disinfected3. Mop Floors with Disinfectant After Procedures B. Written Schedule for Cleaning with Decontamination Method DescribedC. Accessing Reusable Sharps Does Not Require Reaching Into Container (reduces potential to get stuck/cut)D. Disposal of Contaminated Sharps1. Closable container2. Leakproof on sides and bottom3. Maintained Upright During Use4. Labeled and/or color coded5. Placed in Biohazardous Box When Fulla. Bio Box Dated When First Usedb. Labeled and color codedc. Closed prior to removald. Expires after 30 daysE. Contaminated Laundry in Labeled, Leak Resistant SacF. Examples of Poor Housekeeping: 1. Dried blood in sink and on prep table or splatters on walls, floor, counters, etc.2. Sternum Found in Autopsy Compound HBV Great ThreatA. Virulent & Viable in Dried Blood at Least One Week (Eventual hepatic cancer and unpleasant death)B. Infected Individual May Develop Symptoms or Become Unknowing CarrierC. Employers Offer Exposed Employees Vaccine1. Free of charge2. At reasonable time and place3. Employee can decide any time to receive free vaccine4. Vaccine Refusal Requires Signature of Specific OSHA Declination Form Labels & Signs Maintain VigilanceA. Flourescent orange or red-orangeB. Three Interlocking CirclesC. Placed on Containers of Regulated WasteD. Placed on Refrigerators Containing Blood or OPIMsE. On Biohazardous Waste Bags and Boxes Containing Non-Sharps Contaminants Employee Training Required By OSHAs BBP StandardA. Employees with Occupational ExposureB. Free of ChargeXVI. Anything Dealing with the Government Requires Records; OSHAs BBP Standard No ExceptionA. Medical Records Preserved for Employees with Occupational Exposure 1. Name & SSN of Employee2. HBV Vaccination Status 3. Exam Results4. Maintained Duration of Employment +30 years B. Training Records1. Summarize session and date2. Instructor name & qualifications3.