BLOODBORNE PATHOGENS

THE OCCUPATIONAL SAFETY AND HEALTH

ADMINISTRATION (OSHA) STANDARD

OSHA’S EXPECTATIONS

• Employer’s Duties– identify job risks

and classify – provide appropriate

training– provide a plan– provide appropriate

equipment

• Compliance

• Employee’s Duties– follow employer’s

plan– know job

classification– complete training– use equipment

provided by employer

• Compliance

OSHA REQUIRED INFORMATION

• Documents• General explanation of

bloodborne pathogens• Hepatitis B

immunization• Explanation of tasks

that may involve exposure

BLOODBORNE PATHOGENS DEFINED

• Disease-causing microorganisms that may be present in human blood or OPIM (other potentially infectious material)– Viruses– Bacteria– Parasites

MODES OF TRANSMISSION

• Puncture wounds or cuts

• Contact (touch, splash, or spray) with blood or OPIM on:– mucous membrane– non-intact skin

•cuts, abrasions, burns•acne, rashes•papercuts, hangnails

– contaminated sharps

RISK OF EXPOSURE

•Objective of BBP standard is to minimize or eliminate the hazard posed by work that may expose one to blood or OPIM

RISK OF EXPOSURE

• If a risk of exposure exists one should know:– if there is a way to

prevent infection– symptoms and course of

infection– availability of counseling – availability of post-

exposure treatment & follow-up

OCCUPATIONAL EXPOSURE INCIDENTS

• Occupational contact with blood or OPIM is considered an exposure incident

• If an exposure occurs:– wash with soap & water– report incident– document incident– seek “immediate” medical

evaluation– follow employer’s exposure

control plan

IMMEDIATE MEDICAL EVALUATION

• “Immediate” means prompt medical evaluation and prophylaxis

• An exact timeline cannot be stated• Time limits on effectiveness of

prophylactic measures vary depending on the infection of concern

REPORTING AN INCIDENT• Date and time of

incident• Job classification• Location in the

worksite where incident occurred

• Work practice being followed

• Procedure being performed

• PPE in use

Minimal Information to Report

MEDICAL EVALUATION POST EXPOSURE

• Entitled to confidential medical evaluation

• Personal decision about blood testing• Blood may be tested only with

consent• Blood may be stored for 90 days,

while considering testing• Interpretation of any test results

occurs with health care provider

BLOOD TESTING

• Blood may be tested for antibodies to:– Human Immunodeficiency Virus (HIV)– Hepatitis C Virus (HCV)– Hepatitis B Virus (HBV)– Other disease-causing organisms

SPECIFIC BLOODBORNE PATHOGENS

• Definition• Signs and symptoms• Course of infection• Prevention and

control• Post-exposure prophy-

laxis and follow-up care

HIV DEFINED

• HIV is Human Immunodeficiency Virus

• HIV can cause 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 HIV

• Signs and symptoms include:– Weight loss– Night sweats or fever– Gland swelling or pain– Muscle and/or joint pain

• Cannot rely on signs and symptoms to confirm if one is infected

COURSE OF INFECTION WITH HIV

• Incubation period from HIV infection to AIDS can be 8 to 10 years

• Varies greatly among individuals

HIV PREVENTION

• There is no vaccine to prevent HIV infection

• Follow Universal Precautions

HIV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP

• No cure for HIV infection

• Testing schedule for HIV antibodies– at time of exposure– at 3 months – at 6 months

• HIV antibodies usually become detectable within 3 months of infection

• Treatment requires health care provider

• OSHA requires treatment that meets most recent CDC guidelines

HCV DEFINED

• HCV is Hepatitis C Virus• It affects the liver• It is the most common chronic

bloodborne infection in US• Risk 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 HCV

• Jaundice - yellow color to skin and whites of eyes

• Fatigue• Headache• Abdominal Pain• Loss of appetite• Nausea and vomiting

COURSE OF HCV INFECTION

• Incubation period averages 7 weeks

• Chronic liver disease may occur in 70% of those infected with HCV

HCV PREVENTION

• No vaccine exists to prevent HCV infection

• Follow Universal Precautions

HCV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP

• No cure for HCV • No post-exposure pro-

phylaxis recommended• Tests for HCV anti-

bodies & liver function recommended at time of exposure

• Tests should be repeated 4-6 months post exposure

• Treatment of HCV requires a health care provider

• OSHA requires treat-ment that meets most recent CDC guidelines

HBV DEFINED

• HBV is Hepatitis B Virus

• It affects the liver

• Prevalence of HBV infection among healthcare workers is 10 times greater than HCV infection

SIGNS & SYMPTOMS OF HBV

• Jaundice - yellow color to the skin and whites of eyes

•Fatigue•Headache•Abdominal Pain•Loss of appetite•Nausea and vomiting

COURSE OF HBV INFECTION

• Incubation period averages 12 weeks

•Most cases of HBV resolve without complications

•Chronic liver disease may occur in 6 to 7% of those infected with HBV

HBV PREVENTION

• A vaccine does exist to prevent HBV infection

• Employers are required to offer HBV vaccination HBV vaccination to employees covered under BBP standard. Debra Currier at Shiprock Administration Office 368-4984

Ext: 10103• Follow Universal Precautions

HBV POST-EXPOSURE PROPHYLAXIS & FOLLOW-

UP• No cure for HBV

infection• Post-exposure

prophylaxis should begin within 24 hours; no later than 7 days after exposure

• Exposed person should receive HBV vaccine

• Treatment requires health care provider

• OSHA requires treatment meet CDC’s most recent guidelines

HBV IMMUNIZATION

• Employees with routine occupational exposure to blood/OPIM have right to HBV vaccination at no personal expense

• Employee refusal established by signing HBV vaccination declination form

HBV VACCINATION SCHEDULE

• Vaccine given in 3 doses over 6 months– 1st on initial assignment– 2nd one month later– 3rd five months after 2nd dose

• Employer cannot require employee to use health insurance to cover test cost

• Pre-screening is not required• HBV is declining because of vaccine

use!

PREVENTION

• Work Practice Controls

• Personal Protective Equipment

• Universal Precautions

SHARPS CONTAINERS MUST BE:

• closable and puncture resistant

• leak proof• labeled or color-coded• functional• sufficient in number• easily accessible and main- tained in upright position• replaced per agency policy• DO NOT overfilled

HANDWASHING

• Readily available facilities

• Washing after removing PPE

• Using antiseptic hand cleanser when a sink isn’t readily available

HANDWASHING

•First roll out paper towel or have towel readily available so as not to touch other surfaces to reach it

HANDWASHING

•Turn on tap water and adjust temperature

•Use plenty of soap

HANDWASHING

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

HANDWASHING

•Dry hands thoroughly

•DO NOT turn off the water yet

HANDWASHING

•Turn off tap with a dry part of the towel

•DO NOT touch surfaces with clean hands

CLEANING

• Clean work surfaces according to employer’s exposure control plan

• Use PPE and EPA-approved solution

• DO NOT take contaminated materials home to launder!

PERSONAL PROTECTIVE EQUIPMENT (PPE)

• Specialized clothing/equipment used for protection when risk of exposure exists

• Must prevent blood or OPIM from contaminating clothing or skin

• Must be available at no cost to employee

• Must be in appropriate sizes• Must be in good working condition• Must be properly maintained• Employee must be trained in proper use

TYPES OF PERSONAL PROTECTIVE EQUIPMENT

• Gloves• Masks• Eye shields• Gowns/aprons

LATEX GLOVES

• Medical products containing latex must be labeled

• Allergies to latex are increasing

• Substitutes for latex-containing materials must be made available

UNIVERSAL PRECAUTIONS

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

CCSD Policy: GBGC-EExposure Control

PlanContact Payroll for Workman’s Comp

Charlotte Simpson Ext. 10131Contact Debra Currier for Hep B vaccine information. Ext. 10103

EXPOSURE Determination• High Risk – Coaches, physical ed instructors,

custodians, certain special ed program personnel, playground duty personnel, health services personnel, and security personnel.

• Moderate Risk – Regular instructional program personnel, other special ed program personnel, school level office personnel, maintenance personnel, food services personnel, and special assignment personnel (e.g., counselors, librarians).

• Includes record keeping provisions and is reviewed annually

QUESTIONS?