1. PRESENTED AND DESIGNED BY: KATHERINE LYNN, RN, BSN WRITTEN BY: JASON SPRIGGS, UNIVERSITY OF VERMONT AND THE OFFICE OF OCCUPATIONAL SAFETY AND HEALTH Bloodborne Pathogens

2. **WHY ARE WE HERE?** **WHY ARE WE HERE?** Why are we here? OSHA’s Bloodborne Pathogen Standard 29 CFR 1910.1030 took effect in March 1992. Its purpose is to limit occupational exposure to blood and other potentially infectious materials and covers all employees who can “reasonably expect” to come into contact with these materials as part of their job.

3. What is a Bloodborne Pathogen? Bloodborne pathogens are microorganisms that are carried in blood and can cause disease in humans.

4. Common Bloodborne Pathogen Diseases Malaria Syphilis Brucellosis Hepatitis B (HBV) Hepatitis C (HCV) Human Immunodeficiency Virus (HIV)

5. HIV attacks the body’s immune system and weakens the body’s ability to fight infection. Acquired Immune Deficiency Syndrome (AIDS) is caused by HIV but may not develop until years after initial infection with HIV. There is no cure but treatment options are improving.

6. HIV Transmission HIV is spread when infected blood, semen, vaginal fluids, or breast milk gets into the bloodstream of another person This can happen through:  Sexual contact  Sharing needles  Pregnancy, childbirth and breastfeeding  Workplace exposure to blood and/or body fluid  Blood transfusions

7. Symptoms of HIV Symptoms: Symptoms of HIV infections vary; there may be no signs of illness until the immune system weakens. As the body’s defenses weaken:  swollen lymph glands  susceptibility to other infections  weakness  fever  sore throat  white coating on the tongue  weight loss

8. HIV in the United States CDC has estimated that more than 1 million (1,106,400) adults and adolescents were living with HIV infection in the United States at the end of 2006. According to the most recent incidence estimates, approximately 56,000 persons have been infected with HIV annually during the past decade. The rate of new HIV infection for black/African American women is nearly 15 times as high as that of white women, and nearly four times that of Hispanic women. At some point in their life, 1 in 16 black/African American men will receive a diagnosis of HIV, as will one in 30 black women. 24-27% of people with HIV do not know their status. Source: CDC

9. Hepatitis B (HBV) HBV is a virus that infects the liver. The Hep B virus can remain infectious in dried blood for up to seven days. There is no specific treatment or cure for HBV and it can lead to cirrhosis and liver cancer, but some people develop antibodies and recover quite well.

10. In infected persons, HBV can be found in: It can enter the body through:  Blood  Body tissue  Saliva  Semen  Vaginal secretions  Urine  Breast milk  Puncture wounds from sharps  Contaminated body fluids  An opening or break in the skin  Splashing into mucous membranes –eyes, nose, mouth  Unprotected sex  Intravenous drug use  Blood transfusions Hepatitis B Transmission

11. Hepatitis B Symptoms:  Fatigue, stomach pain, loss of appetite, nausea….similar to the “flu”.  Jaundice, darkening of the urine. Exposure to onset of symptoms: 1-9 months.

12. Hepatitis C (HCV) Hepatitis C starts as a mild or asymptomatic infection, it can go undetected for years before the onset of jaundice and malaise. Over 50% of patients with hepatitis C develop chronic liver disease, including cirrhosis, liver, chronic hepatitis infections. The virus was identified in 1989.

13. Hepatitis C Transmission Most commonly occurs in people who have:  received blood transfusions before 1992  shared needles  had tattoos  had body piercing Risk of sexual transmission appears to be small No evidence that it can be transmitted by casual contact, through foods, or by coughing or sneezing Transmission from mother to child appears to be uncommon

14. HCV in the United States One of the most common causes of chronic liver disease, cirrhosis and cancer Over four million people have hepatitis C in the USA with 180,000 new infections annually 8,000-10,000 deaths annually from HCV Globally ~ 170 million chronic infections

15. Your Potential Exposure Here at school the most common exposure hazards are involved with administering first aid, accident cleanup and janitorial/maintenance work.

16. Universal Precautions Universal Precautions is a prevention strategy in which all blood and other body substances are treated as if they are, in fact, infectious, regardless of the perceived status of the source individual. This approach is used in all situations where exposure to blood or other body substances is possible.

17. Personal Protective Equipment (PPE) To protect yourself, you must have a barrier between yourself and any potentially infectious material. Gloves, masks, and gowns are examples of PPE.

18. PPE Rules to Remember If you have cuts or sores on your hands, cover them with a bandage before putting on your gloves. When taking contaminated gloves off, make sure you don't touch the outside of the gloves with any bare skin. Dispose of soiled gloves properly so that somebody else won't come in contact with them. If a glove is damaged, don't use it!

19. Decontamination When cleaning up surfaces use a disinfecting spray or 10% bleach solution Do an initial wipe up Spray and allow it to stand for ten minutes then wipe up Properly dispose of all wipes PPE should be removed properly disposed

20. Hand washing Wash your hands as soon as possible following an exposure to bodily fluids – even if you used gloves!! Use soft antibacterial soap if possible – no harsh, abrasive soaps because they may open fragile sores on the skin.

21. Regulated Medical Waste Regulated medical waste includes blood, other potentially infectious materials, items that would release either of these when compressed, contaminated sharps, and pathological and microbiological waste containing blood or other potentially infectious material.

22. Sharps Sharps include needles and broken glass which must be disposed of properly in a sharps container which in under the sink in my office. Broken glass should be swept into a dustpan, not picked up by hand.

23. Signs and Labels All containers of regulated waste must be labeled with the biohazard symbol and the term “biohazard”. You may get a red biohazard bag from in the health room or from maintenance.

24. Exposure Incident A specific incident of contact with potentially infectious bodily fluid. If you are exposed to blood or other bodily fluids wash the exposed area thoroughly with soap and water. If blood is splashed in the eye or mucous membrane, flush the affected area with running water for at least 15 minutes. Report the exposure to the nurse and administration as soon as possible. Stay calm!!

25. Post-Exposure Evaluation A post-exposure evaluation is a confidential medical evaluation which includes:  Documentation of the route of exposure.  Identification of the source individual.  Testing of the source individual’s blood if consent is given, and providing the results to the exposed employee.  Testing of the employee if necessary.

26. Hepatitis B Vaccine All employees can receive the vaccine from their physicians and receive reimbursement from the school. The Hepatitis B vaccination is given in a series of three shots. The second shot is given one month after the first, and the third shot follows five months after the second. This series gradually builds up the body's immunity to the Hepatitis B virus. The vaccine itself is made from yeast cultures; there is no danger of contracting the disease from getting the shots, and, once vaccinated, a person does not need to receive the series again.

27. In Conclusion Bloodborne pathogen rules are in place for your health and safety, as is the requirement for annual training.

28. Questions?