Download - OSHA’s Bloodborne Pathogens Standard-29 CFR 1910.1030

Kentucky Education and Workforce Development Cabinet

Occupational Health and Safety Program

Bloodborne Pathogen Exposure

OSHA’s Bloodborne Pathogens Standard-29 CFR 1910.1030

PURPOSE-Limits occupational exposure to blood and other potentially infectious materials since any exposure could result in transmission of bloodborne pathogens which could lead to disease or death.

OSHA’s Bloodborne Pathogens Standard

SCOPE-Covers all employees with occupational exposure to blood or other

potentially infectious materials as a function of their jobs.

What are Bloodborne Pathogens?

Bloodborne pathogens are micro-organisms in the bloodstream that cause diseases.

What are Other Potentially Infectious Materials (OPIM)?

Human body fluids listed in the standard. Unfixed tissue or organ (other than intact skin)

from a living or dead human. HIV containing cell or tissue cultures, organ

cultures. HIV or HBV containing culture medium or other

solutions. Blood, organs or other tissues from experimental

animals infected with HIV or HBV.

Occupational Exposure

Reasonably anticipated skin, mucous membrane or parenteral contact with blood or other potentially infectious materials that may result from the

performance of an employee’s duties.

29 CFR 1910.1030(b)

803 KAR 2:320


Employers are to evaluate each job task and procedure to determine which employees

may be expected to be occupationally exposed to blood or other potentially

infectious materials.


Exposure determination is made without regard to the use of personal protective

equipment.


OSHA expects an employer to take into account all potential circumstances of

exposure (biting, contact with skin lesions, and/or potentially infectious secretions)

when determining which, if any, employees have occupational exposure.


Based on potential contact with blood and other potentially infectious materials, the

employer is to select the appropriate personal protective equipment in accordance with the standard.

Occupational Exposure-First Aid Trained Employees

First aid trained employees assigned to provide emergency first aid as part of their

specific job duties are covered by the Bloodborne Pathogens Standard.

GOOD SAMARITAN ACTS-Not covered by the standard.


Collateral JobsThose positions that do not have occupational exposure to

blood or other potential infectious body fluids.

Employees in Collateral Jobs Maintenance Workers Good Samaritan Acts

Office Staff Janitorial Employees

Planning and Assessment

• Bloodborne Pathogen Plan for cabinet.• Bloodborne Pathogen Plan for each central

office-Contained in the Safety Plan.• Written assessment of personnel to determine if

there is occupational exposure.

Bloodborne Pathogens

The three most significant bloodborne pathogens found in the workplace:

HIV-Human Immunodeficiency Virus, Hepatitis-B Virus, Hepatitis-C Virus.

Hepatitis B Control

Each employee with occupational exposure will within 10 days of employment shall:

Provide evidence of receiving three doses of Hepatitis B vaccine; or

Provide evidence of a positive Antibody to Hepatitis; or

Sign a form consenting to be vaccinated or to finish an incomplete vaccination series; or

Specifically decline vaccination by signing a Declination Form.

Hepatitis B Control

Provided at no cost to the employee.

Provided at a reasonable time and place and performed by or under the supervision

of a licensed physician or other health care professional.

Staff TrainingProvided at no cost to the employee annually.

Training RecordsA. Dates of each training session.B. Content specific syllabus and any information

distributed to employees.C. The name(s) and qualifications of the person(s)

conducting the training.D. Names and job titles of all persons attending the

training.E. Records shall be retained for 3 years from the date of

training.

Employee Medical Records Retained by Employer

1. Documentation of up-to-date hepatitis B vaccination.2. Incident Reports.3. Results of post exposure testing and follow-up.4. Copy of physician’s written opinion.5. Copy of any written information provided to the

employee.6. Records are confidential and cannot be disclosed

without the employee’s express written consent.7. Records must be retained for 30 years following end of

employment.8. Records must be kept separate from personnel

records.

Blood

Defined as human blood, human blood components, and products made from human

blood.

Other Potentially Infectious Materials (OPIM)

Saliva in dental procedures. Semem. Vaginal secretions. Internal body fluids. Body fluids visibly contaminated with blood. Body fluids in situations where it is difficult or

impossible to identify type of fluid.


Amniotic Fluid-Bacteria and Fungal Germs. Cerebrospinal Fluid-Bacteria, Fungi, Viruses. Feces-Bacteria, Rotavirus, Hepatitis A Virus. Nasal Discharge-Common cold virus, Influenza Virus,

HIV and Hepatitis B Virus. Pericardial Fluid-Organisms that can cause infections. Peritoneal Fluid-Organisms that can cause infections. Pleural Fluid-Organisms that can cause disease. Saliva-Common cold virus, Influenza Virus.


Semen-Gonorrhea, Hepatitis B Virus, Hepatitis C Virus, HIV.

Synovial-Bacteria, Fungi, Viruses, Blood in Fluid. Urine-Cytomegalovirus, Mononucleosis Virus.

How Bloodborne Pathogens are Transmitted

An employee must make contact with contaminated fluids and permit a way to enter

the body.

How Bloodborne Pathogens Enter the Body

Direct blood inoculation-placenta, transfusion, blood products.

Accidental injury which breaks, punctures or cuts the skin or mucous membranes (Parenteral Contact).

Non-sterile technique when tattooing, body piercing, sharing injections.

Open cuts, nicks, and skin abrasions, even dermatitis and acne.

How Bloodborne Pathogens Enter the Body

Mucous membranes (i.e. mouth, eyes (contact lenses), nose.

Sexual intercourse (any type). Indirect transmission (touching something that is

contaminated and then touching an opening in the skin).

Virus Survival

HIV-can survive only a short time outside the body. HBV-can survive up to a week outside the body at

room temperature. HCV-unknown.

Hepatitis-B (HBV)

Hepatitis means “inflammation of the liver.” HBV is the major infectious bloodborne hazard on the

job. Affects approximately 8,700 employees a year,

resulting in more than 400 hospitalizations and 200 deaths.

Flu-like symptoms, becoming so severe as to require hospitalization.

Hepatitis-B (HBV)

• Illness may last 6 months to 2 years. In some cases, HBV damages the liver so severely it leads to cirrhosis and possible death.

• Some people exhibit no symptoms at all and most people recover in time.

• A small percentage of people become carriers.• Blood testing is available.

Hepatitis C (HCV)

• HVC is different from Hepatitis B.• HCV is transmitted directly by blood, but unknown if

other body fluids like sexual fluids or saliva will carry the virus.

• Flu like symptoms can show up within days or years after exposure.

• HCV can be ACUTE requiring liver transplant or death within weeks or months.

Hepatitis C (HCV)

• CHRONIC requiring intensive medical therapy.• 70% of those infected will eventually develop chronic

liver disease, cirrhosis of the liver, and almost certain death.

• Blood test is available.• There is no vaccine for HCV at this time.

Human Immunodeficiency Virus (HIV)

• HIV attacks the immune system and eventually causes AIDS.

• HIV infection is treatable, but not curable.• HIV continues to be infectious in blood and sexual

fluids even during treatment.• Blood testing is available.• There is no vaccine for HIV at this time.

Employees-Providing First Aid

If employees are trained and designated as responsible for rendering first aid or medical

assistance as part of their job duties, they are covered by the OSHA Bloodborne Pathogen

Standard.


Employees, who administer first aid as a collateral dutyto their routine work assignments, need not be offered

the pre-exposure hepatitis B vaccination, provided that a number of conditions are met.


All first aid providers who provide assistance in any situation involving the presence of blood or other

potentially infectious materials, regardless of whether or not a specific exposure incident occurs, must have

the vaccine made available to them as soon as possible, but in no event later than 24 hours after

exposure.


In an exposure incident as defined in the standard has taken place, other post exposure follow-up

procedures must be initiated immediately, per the OSHA Standard.

Other General Industry Employees

While OSHA does not generally consider maintenance and janitorial staff employed in non-health care facilities to have occupational exposure, it is the employer’s responsibility to determine which job

classification or specific tasks and procedures involve occupational exposure.

Universal Precautions

UNIVERSAL PRECAUTIONS is the term used when handling all blood or other potentially infectious material as if it were, in fact, infectious.

Since there is no way of know if an injured person or body fluid is infected, employees in ALL CASES must use universal precautions when exposed to another’s body fluids.

Universal Precautions for Home Visits

Universal Precautions for home visits must be observed.

Employer and employee are to assume that all human blood and human body fluids are infectious for HIV, HBV, and other bloodborne pathogens.

Where differentiation between types of body fluids is difficult or impossible, all body fluids are to be considered potentially infectious.

Universal Precautions for Home Visits

1. Treat all blood and body fluids as being potentially infectious.

2. Use appropriate Personal Protective Equipment.

3. Do not bend, break, shear or recap needles.

4. Wash hands thoroughly before and after each home visit.

5. Do not clean blood spills in a client’s home.

6. Keep mouthpieces and resuscitation equipment readily available if use if likely.

7. No visits if customer has draining sores.

8. No visits if customer has an infection transmissible by the airborne route.

9. Restrict eating, drinking, smoking, apply cosmetics or lip balm, and handling contact lenses during a customer’s home visit.

Universal Precautions

• Wash hands.• Wear gloves (wash hands after glove removal).• Wear impervious apron when splashing is possible.• Wear mask and eye protection.• Handle sharp objects carefully and dispose properly.• Dispose of all spills properly.

Hand Washing• Wash hands with soap and running water.• Rinse hands under running water.• Dry hands well with paper towel.• Use a paper towel to turn off faucet.• Dispose of single use towel.• Wash/disinfect cloth towels.

Hand Washing

Apply hand cream after frequent washing to prevent skin irritation, breakdown, and subsequent infection.

Use waterless soap/wipes when soap and water are not available.

Hand Washing

When antiseptic hand cleansers or towelettes are used, hands will be washed

with soap and running water when the employee returns to a location where hand

washing facilities are available.

Hand Washing

Wash hands immediately or as soon as feasible after removal of gloves or other

protective equipment.

Hand Washing

Employer must ensure that employees wash hands and any other skin with soap and water, or flush mucous membranes with

water immediately, or as soon as feasible, following contact with blood or body fluid.

Personal Protective Equipment

• Employers will provide to employees with occupational exposure PPE appropriate for the risk.

• No cost to the employee.

• PPE will be available for use at each site.

Personal Protective Equipment

PPE will be considered appropriate only if it does not permit blood or other potentially

infectious materials to pass through to reach the employee’s work clothes, street

clothes, undergarments, skin, eyes, mouth, and/or other mucous membranes.

Personal Protective Equipment-Eye Protection

Eye protection is to be worn whenever splashes, spray, spatter or droplets of

blood or other potentially infectious materials may be generated and eye,

nose, and/or mouth contamination can be reasonably anticipated.

Personal Protective Equipment-Gloves

Gloves will be worn when it can be reasonably anticipated that the employee may have hand contact with blood, other potentially infectious materials, mucous

membranes, and/or non-intact skin.


Wear gloves when: Actual or potential touching blood and/or body

fluids; Actual or potential touching mucous

membranes; Actual or potential touching non-intact skin; Actual or potential handling items or surfaces

soiled by blood and/or other body fluids.


Using gloves:Hands should be washed before gloving;Gloves must be changed after each

contact;Hands or other body parts must be

thoroughly washed with soap and water if contaminated with blood or body fluids.

In the Event of an Accident

There is a Hepatitis-B vaccine that can be used post exposure. It is about 90% effective and must be received

as soon as possible.

In the Event of Actual or Potential Exposure

• Stop work and wash the affected body areas thoroughly.

• If eyes or mouth are affected, flood with water at least 10 minutes.

Procedures for Reporting and Managing Exposure Incidents

EmployeeReport the date, time, and type of exposure to

first line supervisor.Treatment in accordance with recommended

guidelines, based on the type of exposure.Adhere to follow-up treatment regimen and/or

testing as prescribed by the physician.Follow-up will be paid for through Worker’s

Compensation.

Procedures for Reporting and Managing Exposure IncidentsEmployee and First Line Supervisor

Initiate a consent form for treatment, if indicated.


First Line Supervisor Complete and submit Cabinet Accident Report. Complete Workers’ Compensation First Report of Injury. Enter appropriate information into OSHA 300 Log. File and retain reports in employee’s medical files. Obtain physician’s written opinion within 15 working days

of the completion of the evaluation. Provide to the physician: 1) copy of the BBP Plan and 2)

description of the affected employee’s duties as they relate to the occupational exposure.


First Line Supervisor Report the incident to the Kentucky Department

for Public Health, Division of Epidemiology and Health Planning.

All employees who are involved in any situation where there was the presence of blood or OPIM, regardless of whether a specific exposure incident occurred, must be offered the full Hepatitis B vaccination series as soon as possible, but no later than 24 hours after the incident.


Time Line

If an exposure incident occurs, all other post exposure follow-up procedures according to the BBP Standard must be initiated immediately.

Employer must ensure that the medical provider is familiar with and follows the recommendations

for post exposure follow-up.

Bloodborne and Body Fluid Cleanup

These procedures are based on OSHA standard 29 CFR 1910.1030 for all employees who have come in contact with infected blood, blood products and/or body fluids at work.

Occurs most often when performing first aid or coming into contact with someone who has been injured on the job.

Clean-Up Procedures When Blood or Body Fluids are Present

Put on disposable gloves and appropriate personal protective equipment.

Remove any broken glass or sharp objects from the area using mechanical means: forceps, needle nose pliers, and/or broom and dust pan.


Never Remove Sharps, Broken Glass, Etc. By Hand.


Contain the area by covering with paper towels and carefully pouring appropriate disinfectant solution around and on the area.

EXAMPLE-1:10 mixture of household bleach and water.


Take care not to splash disinfectant solution or create aerosols while pouring.

Remove the paper towels and repeat the process until all visual material is removed.

Re-wet the cleaned area with disinfectant and air dry until all visual material is removed.


Blood contaminated items used for first aid and care of lacerations, nose bleeds, etc. shall be contained in a plastic lined container, closed, and disposed of with the daily trash in a large, heavy duty plastic bag of sufficient strength to preclude bursting and tearing during handling, storage or transport.

First Aid Site Clean-Up Procedures When Blood or Body Fluids are

Present

Items such as gauze, bandages, band-aids, and/or cotton balls are not required to have special hazard

labels, only double bagging.

First Aid Site Clean-Up Procedures When Blood or Body

Fluids are Present

If the first aid supplies are saturated to the point where liquid can be squeezed in considerable amount, the supplies must be soaked in a disinfectant solution to decontaminate them.

They may be double bagged and included with the normal waste disposal.


Remove all personal protective equipment, dispose, and immediately wash hands and

other contaminated body parts.


Place any soiled linen in a laundry bag. Soiled linen should be handled carefully as if it were contaminated. Pre-soak linen with disinfectant cleaning solution and launder with soap and water.

Linen and clothing contaminated with blood or body fluids must be handled with gloves.

Thank You For Your Participation

For additional assistance contact:

Richard T. Owen

Education Cabinet Safety Coordinator

601 East Main Street

Frankfort, Kentucky 40601

502-564-7346

[email protected]

mailto:[email protected]