Protection From Bloodborne Protection From Bloodborne PathogensPathogens

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A question of validity:A question of validity:

Why do I need to know this stuff?Why do I need to know this stuff?

Why Bloodborne Pathogen Why Bloodborne Pathogen Prevention TrainingPrevention Training

What is the chance of an employee getting What is the chance of an employee getting a scrape, cut, or a heart attack at worka scrape, cut, or a heart attack at work

What is the chance of an employee having What is the chance of an employee having to provide CPR or First Aid to a victimto provide CPR or First Aid to a victim

What to do when an employee sees some What to do when an employee sees some blood on a surface from a cut or a scrape of blood on a surface from a cut or a scrape of another personanother person

Bloodborne Pathogens do not have to be Bloodborne Pathogens do not have to be one of the many mysteries of lifeone of the many mysteries of life

OutlineOutline RegulationsRegulations DefinitionsDefinitions Transmission & Symptoms Transmission & Symptoms Bloodborne DiseasesBloodborne Diseases Methods of ComplianceMethods of Compliance

Federal and State RegulationsFederal and State Regulations OSHA 29 CFR OSHA 29 CFR

1910.1030 1910.1030

TDH: Health and TDH: Health and Safety Code, Chapter Safety Code, Chapter 81, subchapter H81, subchapter H

Regulations state Regulations state Employers must have an Employers must have an

Exposure Control Plan Exposure Control Plan (ECP)(ECP) and and traintrain employees employees to use it.to use it.

Employees must follow Employees must follow applicable rules to protect applicable rules to protect themselvesthemselves

Employees can access Employees can access TAMUCC’s ECP at TAMUCC’s ECP at http://safety.tamucc.edu..

It is a written document outlining what the It is a written document outlining what the employer does to protect workers from employer does to protect workers from bloodborne pathogen exposure by using bloodborne pathogen exposure by using methods of compliance to include, but not methods of compliance to include, but not limited to:limited to: Training to communicate hazardsTraining to communicate hazards Control the exposureControl the exposure Safe Operating Procedures Safe Operating Procedures Hepatitis B vaccination programHepatitis B vaccination program

What is an Exposure Control Plan?What is an Exposure Control Plan?What is an Exposure Control Plan?What is an Exposure Control Plan?

OSHA/TDH Bloodborne Pathogen OSHA/TDH Bloodborne Pathogen StandardStandard

The standard is designed to The standard is designed to protect workers whose job protect workers whose job might expose them to might expose them to bloodborne diseases.bloodborne diseases. Physicians, nurses, paramedicsPhysicians, nurses, paramedics Public safety workersPublic safety workers Public service workersPublic service workers Sport Facility workersSport Facility workers

DefinitionsDefinitionsBloodborne Pathogens:Bloodborne Pathogens: microorganisms that are microorganisms that are present in blood or other present in blood or other potentially infectious materials potentially infectious materials (OPIM) and can cause disease.(OPIM) and can cause disease.

Blood:Blood: includes human blood, includes human blood, human blood components, human blood components, products made from human products made from human blood, and also medications blood, and also medications derived from blood (e.g., derived from blood (e.g., immune globulins, albumin, immune globulins, albumin, etc.)etc.)

Bloodborne Pathogens:Bloodborne Pathogens: microorganisms that are microorganisms that are present in blood or other present in blood or other potentially infectious materials potentially infectious materials (OPIM) and can cause disease.(OPIM) and can cause disease.

Blood:Blood: includes human blood, includes human blood, human blood components, human blood components, products made from human products made from human blood, and also medications blood, and also medications derived from blood (e.g., derived from blood (e.g., immune globulins, albumin, immune globulins, albumin, etc.)etc.)

Other Potential Infectious MaterialsOther Potential Infectious Materials

Include blood and:Include blood and:Human body fluids such as saliva in dental Human body fluids such as saliva in dental procedures, semen, vaginal secretion, fluid procedures, semen, vaginal secretion, fluid surrounding the brain and spinal cord, fluid surrounding the brain and spinal cord, fluid surrounding the bone joint, fluid in lungs.surrounding the bone joint, fluid in lungs.Fluid surrounding a fetus, and any fluid Fluid surrounding a fetus, and any fluid that is visibly contaminated with blood, and that is visibly contaminated with blood, and all body fluid that is difficult to differentiate all body fluid that is difficult to differentiate between body fluids.between body fluids.

Include blood and :Include blood and :Any unfixed tissue or organ (other Any unfixed tissue or organ (other than intact skin) from a human than intact skin) from a human living or deadliving or deadHIV-containing cells or tissue HIV-containing cells or tissue cultures, organ cultures, HIV-, HBV-, cultures, organ cultures, HIV-, HBV-, or HCV-containing cultureor HCV-containing culture

Other Potential Infectious MaterialsOther Potential Infectious Materials

Regulated Waste Vs. Non Regulated Regulated Waste Vs. Non Regulated WasteWaste

Regulated Waste must be Regulated Waste must be disposed of properly through disposed of properly through Bio Haz. waste or sterilized Bio Haz. waste or sterilized thoroughly by autoclavethoroughly by autoclave

Non-Regulated Waste can be Non-Regulated Waste can be disposed of as solid wastedisposed of as solid waste

Regulated WasteRegulated Waste

Contaminated items that would release Contaminated items that would release blood or OPIM in liquid or semi-liquid blood or OPIM in liquid or semi-liquid state if compressedstate if compressed

Items that are caked with dried blood or Items that are caked with dried blood or OPIM and are capable of releasing these OPIM and are capable of releasing these materials during handlingmaterials during handling

Contaminated sharpsContaminated sharpsPathological and microbiological Pathological and microbiological

waste containing blood or OPIMwaste containing blood or OPIM

Non-Regulated WasteNon-Regulated Waste

Mucus, sweat, tears, Mucus, sweat, tears, Urine, fecesUrine, feces Nasal secretions Nasal secretions vomitvomit

Unless the above material Unless the above material is visibly contaminated is visibly contaminated with blood or is difficult to with blood or is difficult to differentiate.differentiate.

Blood Borne Pathogen TrainingBlood Borne Pathogen Training

Segregating Medical Waste

Occupational Bloodborne Occupational Bloodborne Pathogen TransmissionPathogen Transmission

Through direct contact Through direct contact between infected blood andbetween infected blood and

Open soresOpen sores CutsCuts Chapped skinChapped skin Mucus membranes in eyes, Mucus membranes in eyes,

nose, mouthnose, mouth

Infection from a Infection from a bloodborne bloodborne pathogen can pathogen can result in chronic result in chronic infection, serious infection, serious illness, and illness, and deathdeath..

Courtesy of Owen Mumford, Inc.

Occupational Bloodborne Pathogen Occupational Bloodborne Pathogen TransmissionTransmission

If you experienced a needle stick or sharps If you experienced a needle stick or sharps injury or were exposed to the blood or other injury or were exposed to the blood or other body fluid of a patient during the course of body fluid of a patient during the course of your work, immediately follow these steps: your work, immediately follow these steps:

Wash needle sticks and cuts with soap and Wash needle sticks and cuts with soap and water water

Flush splashes to the nose, mouth, or skin Flush splashes to the nose, mouth, or skin with waterwith water

Irrigate eyes with clean water, saline, or Irrigate eyes with clean water, saline, or sterile solutionsterile solution

Report the incident to your supervisorReport the incident to your supervisor Immediately seek medical treatmentImmediately seek medical treatment

Source: CDC

Occupational ExposureOccupational Exposure

Employees who may have occupational Employees who may have occupational exposures to bloodborne pathogens will:exposures to bloodborne pathogens will:

Receive a Bloodborne Pathogen Prevention Receive a Bloodborne Pathogen Prevention trainingtraining

Receive additional training on specific Receive additional training on specific procedures from their department if required procedures from their department if required (ex. Blood or Potential Body Fluid Clean Up (ex. Blood or Potential Body Fluid Clean Up Procedures)Procedures)

Be offered a series of HBV vaccination. Be offered a series of HBV vaccination.

HepatitisHepatitis

DefinitionDefinition: A liver disease caused by a hepatitis : A liver disease caused by a hepatitis virus. - hepatitis means “inflammation of the virus. - hepatitis means “inflammation of the liver”liver”

Types: A,B,C,D,ETypes: A,B,C,D,E Symptoms: Symptoms: JaundiceJaundice, fatigue, abdominal pain, , fatigue, abdominal pain,

loss of appetite, nausea, dark urine, vomiting, loss of appetite, nausea, dark urine, vomiting, joint pain.joint pain.

Hepatitis B - HBVHepatitis B - HBV Hep B: Liver disease caused by the Hep B: Liver disease caused by the

hepatitis B virus. hepatitis B virus. Occupational Transmission: Through direct Occupational Transmission: Through direct

contact with infected blood or certain bodily contact with infected blood or certain bodily fluids (OPIM)fluids (OPIM)

Occupational Risk Groups: Occupational Risk Groups: Healthcare workersHealthcare workers Public safety workersPublic safety workers Public services workersPublic services workers

Hepatitis B - HBVHepatitis B - HBV CharacteristicsCharacteristics: :

There are no medications available for There are no medications available for hepatitis B. hepatitis B.

Hepatitis B vaccine is available for prevention.Hepatitis B vaccine is available for prevention.There are antiviral drugs available for the There are antiviral drugs available for the

treatment of chronic HBV infection.treatment of chronic HBV infection. HBV virus is very durable and can survive in HBV virus is very durable and can survive in

dried blood for up to 7 days.dried blood for up to 7 days.Hepatitis carrier: infected person who never Hepatitis carrier: infected person who never

fully recovers from infection can carry the fully recovers from infection can carry the virus that may infect others - about 1M in the virus that may infect others - about 1M in the US US Source: cdcSource: cdc

Hepatitis C (HCV)Hepatitis C (HCV) Hep C: Liver disease caused by the hepatitis C Hep C: Liver disease caused by the hepatitis C

virusvirus Occupational Transmission: Needlestick or sharp Occupational Transmission: Needlestick or sharp

injuries (not common)injuries (not common) Risk Groups: Healthcare workers after Risk Groups: Healthcare workers after

needlesticks, recipients of blood or organs from a needlesticks, recipients of blood or organs from a donor who later tested positive for HCV.donor who later tested positive for HCV.

No Hep C vaccineNo Hep C vaccine

Source: cdcSource: cdc

Fragile – few hours in dry Fragile – few hours in dry environmentenvironment

Attacks the human Attacks the human immune systemimmune system

Cause of AIDSCause of AIDS More than 1 million More than 1 million

infected persons in U.S.infected persons in U.S. No cure; no vaccine No cure; no vaccine

available yetavailable yet

Human Immunodeficiency Virus Human Immunodeficiency Virus (HIV)(HIV)

HIV - seen as small spheres on the surface of white blood cells

Source: cdcSource: cdc

HIV & AIDSHIV & AIDS

Occupational Risk Group: Occupational Risk Group: Healthcare workers Healthcare workers

being stuck with being stuck with infected needle infected needle

First Aid Providers First Aid Providers getting infected blood getting infected blood into an open cut or into an open cut or mucus membranemucus membrane

Source: cdcSource: cdc

Hepatitis B VaccinationHepatitis B Vaccination

First shot

321

Second shot: 1 month after the first shot

Third shot: 5 months after the second shot

BBP Methods of ComplianceBBP Methods of Compliance

1) Isolate the blood borne pathogen 1) Isolate the blood borne pathogen hazards. Example: sharps disposal hazards. Example: sharps disposal containers, autoclave, Biological cabinet, containers, autoclave, Biological cabinet, etc. etc.

2) Use “Universal Precautions”: Treat all 2) Use “Universal Precautions”: Treat all blood & bodily fluids as if they are blood & bodily fluids as if they are infected.infected.

3) Use PPE: Barriers between workers 3) Use PPE: Barriers between workers and potentially infected materialsand potentially infected materials

Hygiene Practice ControlsHygiene Practice Controls

Hand washing: One of the most important (and Hand washing: One of the most important (and easiest) practices used to prevent transmission easiest) practices used to prevent transmission of blood borne pathogensof blood borne pathogens Wash hands with soap & water immediately or ASAP Wash hands with soap & water immediately or ASAP

after removal of gloves or other PPEafter removal of gloves or other PPE If you are away from the hand-washing facilities, use If you are away from the hand-washing facilities, use

antiseptic cleanser in conjunction with clean antiseptic cleanser in conjunction with clean cloth/paper towels. Then wash hands with soap and cloth/paper towels. Then wash hands with soap and water as soon as feasiblewater as soon as feasible

Eating/Drinking/Smoking/Applying make Eating/Drinking/Smoking/Applying make up/Handling contact lenses are prohibited in up/Handling contact lenses are prohibited in exposure areasexposure areas

Hazard Communication: Hazard Communication: Signs/LabelsSigns/Labels

Logo & Warning required to communicate the hazard

Disinfecting Surfaces or ToolsDisinfecting Surfaces or Tools Clean and disinfect contaminated Clean and disinfect contaminated

surfaces or tools ASAP with a bleach surfaces or tools ASAP with a bleach solution or an OSHA approved solution or an OSHA approved disinfectantdisinfectant

If using bleach, mix 10% solution (1 If using bleach, mix 10% solution (1 part of household bleach, 9 parts of part of household bleach, 9 parts of water or 3/4 cup of bleach in a gallon water or 3/4 cup of bleach in a gallon container and fill it up with water) . container and fill it up with water) . Leave solution on contaminated Leave solution on contaminated surface for at least 15 minutessurface for at least 15 minutes

If using OSHA approved disinfectant, If using OSHA approved disinfectant, follow manufacturer’s directionsfollow manufacturer’s directions

Example of a Safe Operating Procedure - Blood Example of a Safe Operating Procedure - Blood Droplets Clean UpDroplets Clean Up

Cleaning up/disinfecting blood in droplets: Put gloves on Spray disinfectant over blood droplets

until they are saturated Wipe the contaminated surface dry with

paper towels Dispose of paper towels in solid waste

container Spray the contaminated surface

thoroughly with disinfectant Wait 10 minutes for disinfectant to work Wipe the surface dry with paper towels Dispose of paper towels and gloves in

solid waste container Wash hands with soap and warm water

thoroughly

SharpsSharps Needles, scalpels, razor Needles, scalpels, razor

blades, broken glassblades, broken glass Dispose of sharps in a sharps Dispose of sharps in a sharps

containercontainer NEVER PICK UP BROKEN NEVER PICK UP BROKEN

GLASSWARE DIRECTLY GLASSWARE DIRECTLY WITH THE HANDS. SWEEP WITH THE HANDS. SWEEP OR BRUSH THE MATERIAL OR BRUSH THE MATERIAL INTO A DUSTPAN INTO A DUSTPAN

Sharps Injury LogSharps Injury Log

TAMUCC is required to establish TAMUCC is required to establish and maintain a sharps injury log for and maintain a sharps injury log for the recording of percutaneous the recording of percutaneous injuries from contaminated sharps. injuries from contaminated sharps. The information in the sharps injury The information in the sharps injury log shall be recorded and log shall be recorded and maintained in such manner as to maintained in such manner as to protect the confidentiality of the protect the confidentiality of the injured employee.injured employee.

TAMUCC is required to report sharp TAMUCC is required to report sharp injury to the Public Health Dept.injury to the Public Health Dept.

Copy of Sharps Injury Log should be Copy of Sharps Injury Log should be kept at TAMUCC EH&S officekept at TAMUCC EH&S office

If You are Exposed to BBPIf You are Exposed to BBP Eye & mucus membrane: Eye & mucus membrane:

Flush out with water for Flush out with water for 15 minutes, then report 15 minutes, then report to your supervisorto your supervisor

Skin: wash skin with Skin: wash skin with soap and non-abrasive soap and non-abrasive antibacterial soap, then antibacterial soap, then report to your supervisorreport to your supervisor

Medical EvaluationMedical Evaluation

If you think that you If you think that you have been in direct have been in direct contact with potentially contact with potentially infectious materials, infectious materials, report it immediately to report it immediately to your supervisoryour supervisor

You will be offered a You will be offered a confidential medical confidential medical evaluation and follow-upevaluation and follow-up

BBP Emergency Procedures BBP Emergency Procedures In case of an emergency involving blood or OPIM In case of an emergency involving blood or OPIM

If you are not trained to deal with it, call E,H&S If you are not trained to deal with it, call E,H&S immediatelyimmediately

If you are trained to deal with it, make sure to:If you are trained to deal with it, make sure to:Use Use Universal Precautions Universal Precautions Wear proper PPE Wear proper PPE If incident involves sharps, use broom and If incident involves sharps, use broom and

dustpan to pick up. Never pick up sharps dustpan to pick up. Never pick up sharps directly with the handsdirectly with the hands

If there is an injury from contaminated sharps, If there is an injury from contaminated sharps, fill out form “fill out form “Sharps Injury Log” from Sharps Injury Log” from EH&S EH&S dept. within 24 hoursdept. within 24 hours

Assist EH&S in accident investigation if neededAssist EH&S in accident investigation if needed