1. Bloodborne pathogens James R. Ginder, MS, NREMT,PI,CHES,NCEE
Health Education Specialist
Hamilton County Health Department

2. The Reader Will Be Able To...
List three bloodborne pathogens.
Explain how bloodborne pathogens are transmitted.
Identify three ways to prevent development of a bloodborne pathogen.

3. Introduction…
Bloodborne Pathogen Standard applies to all employees with occupational exposure to blood and other potentially infectious materials (OPIOM)

4. Bloodborne pathogen standard 1910.1030
Covers all employees who could “reasonably anticipate" as the result of performing their job duties, to face contact with blood and other potentially infectious materials.

5. Risk of Infection… Risk of infection depends on several factors:
The pathogen involved
The type/route of exposure
The amount of virus in the infected blood at the time of exposure
The amount of infected blood involved in the exposure
Whether post-exposure treatment was taken
Specific immune response of the individual

6. Bloodborne Pathogens…
Bloodborne pathogens are microorganisms present in human blood which can infect and cause disease in people who are exposed to blood containing the pathogen.
These microorganisms can be transmitted through contact with contaminated blood and body fluids.

7. Who is at Risk… Sheriff, Police, Jail Staff • Health Care Staff
Physicians, Nurses • First Responders
EMS • Therapists
Life Guards
Coroner & Morticians
Teachers/Child Care Providers
Housekeepers

8. How are diseases transmitted…
Direct Contact
Body Fluids
Indirect Contact
Objects With Body Fluids
Airborne
From The Air
Vector Borne
Animals And Insects

9. How You become sick.. Is the disease present
Must have entry into the body
How much of the disease is present
How strong is your immune system

10. Where are Bloodborne Pathogens Found?
Blood products
Semen
Vaginal secretions
Cerebrospinal fluid
Pleural fluid (or lung fluid)
Synovial fluid (or fluid from your joints)
Amniotic fluid (or uterine fluid)
Peritoneal fluid (or fluid that fills your body cavity)
Saliva in dental settings
Any body fluid that is visibly contaminated with blood

11. Main bloodborne pathogens and diseases of concern
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)
Human Immunodeficiency

12. Modes of Transmission Of All Bloodborne Pathogens…
Sexual contact
Sharing of needles
From mothers to their babies at/before birth
Accidental puncture from contaminated needles, broken glass, or other sharps
Contact between broken or damaged skin and infected body fluids
Contact between mucous membranes and infected body fluids
Anytime there is blood-to-blood contact with infected blood or body fluids

13. HIV Fragile – survives only a few hours in dry environment
Attacks the immune system
CDC estimates that more than one million people are living with HIV in the United States
Approximately one in five (20 %) of those people living with HIV is unaware of their infection. (CDC)
Most people will develop AIDS
No cure; no vaccine available yet

14. Transmission Of HIV Sexual contact Sharing needles or drug equipment
Pregnancy, childbirth and breast feeding
Contact with other body fluids
Body Piercing and Tattooing

16. HIV Is NOT Spread Through…
Casual Contact
Saliva
Sweat
Spit
Tears
Air
Insects

17. Acquired Immunodeficiency Syndrome (AIDS)
Having Two Of The 23
Opportunistic Infections
&
White Blood Cell Below 200
AIDS
Acquired
Develops after contact with HIV
Immunodeficiency
A weakening of the immune system
Syndrome
A group of signs and or symptoms caused by a disease

18. Liver
Healthy Liver
Liver Infected With Hep. B

19. Hepatitis b A virus that infects the liver
HBV can live outside the body for 7 days
90% of adults contracting the disease will recover and develop immunity
Up to 10% of adults who contract the disease will not recover but have chronic Hepatitis
May lead to chronic liver disease, liver cancer, and death

20. Symptoms of Hepatitis B
Fever
Fatigue
Loss of appetite
Nausea
Vomiting
Abdominal pain
Dark urine
Clay-colored bowel movements
Joint pain
Jaundice

21. Hepatitis B Transmission
Sex with an infected partner
Injection drug use that involves sharing needles, syringes, or drug equipment
Children born to mothers who have Hepatitis B
Contact with blood or open sores of an infected person
Needle sticks or sharp instrument exposures
Sharing items such as razors or toothbrushes with an infected person

22. Hepatitis B Vaccine No risk of developing Hepatitis B from the vaccine
The vaccine is 90%+ effective
The vaccine is given in three doses
Dose # 1- Initial dose
Dose # Days after dose 1
Dose #3- 4 months after dose 2

23. Hepatitis C
The most common chronic bloodborne infection in the United States
Approximately 3.2 million persons are chronically infected
80% of people have no signs or symptoms
May remain undetected in the body for years

24. Hepatitis C Most commonly occurs in people who have:
Received blood transfusion before 1992
Shared needles/drug equipment
Tattoos/body piercing
HIV +
Children born to mothers who have Hepatitis C
Shared nail clippers and toothbrushes
Risk of sexual transmission appears to be low

25. Signs and Symptoms of Hepatitis C
Fever
Fatigue
Dark urine
Clay-colored stool
Abdominal pain
Loss of appetite
Nausea
Vomiting
Joint pain
Jaundice
In those persons who do develop symptoms, the average time period from exposure to symptom onset is 4–12 weeks (range: 2–24 weeks).

26. Co-Infection… Person is infected with both HIV and Hepatitis C
CDC estimates that 3,000,000 people are co-infected in the U.S.
50%-90% of injection drug users are infected with Hepatitis C and HIV (CDC)
A person who is co-infected may develop liver damage faster

27. Transmission Potential
Contact with another person’s blood or bodily fluid that may contain blood
Mucous membranes: eyes, mouth, nose
Non-intact skin
Contaminated sharps/needles

28. Your Exposure Potential
Accidental Release
Post-Accident Cleanup
Administering First-Aid
Handling of Returned Product
Janitorial or Maintenance Work
Handling of any Waste Products

29. Universal Precautions
Use of proper Personal
Protective Equipment (PPE)
Treat all blood and bodily fluids as if they are contaminated
Proper cleanup and decontamination
Disposal of all contaminated material in the proper manner

30. Personal Protective Equipment (PPE)
Anything that is used to protect a person from exposure
Latex or Nitrile gloves
Goggles
CPR mouth barriers,
Aprons
N95 mask & respirators

31. PPE Rules to Remember
Always check PPE for defects or tears before using
If PPE becomes torn or defective remove and get new
Remove PPE before leaving a contaminated area
Do not reuse disposable equipment

32. Decontamination
When cleaning up surfaces use diluted bleach solutions or other suitable commercial disinfectant (1:10)
Do an initial wipe up
Spray and allow it to stand for ten minutes, then wipe up
Dispose of all wipes in biohazard containers
PPE should be removed and disposed of in biohazard containers

33. Decontamination Procedures
Use appropriate personal protective equipment
Absorb grossly bloody materials with absorbent materials and place in a tied, red bag
Decontaminate mop, broom or dust pan in a bleach solution

34. Hand Washing Wash hands immediately after removing PPE
Use a soft antibacterial soap
A hand sanitizer can be used, but wash with soap and water as soon as possible afterward

35. How to Remove Gloves

36. 1. Wet hands
2. Use soap
3. Lather, rub Sing Happy Birthday
twice ( seconds)
4. Rinse
5. Towel or air dry hands
6. Turn off water with
towel or sleeve

37. Regulated Medical Waste…
Liquid or semi-liquid blood or other potentially infectious materials and sharps.

38. Regulated Waste…
Must be placed in closable leak-proof container built to contain all content during handling, storing, transporting or shipping and be appropriately labeled or color-coded

39. Signs and Labels
Labels must include the universal biohazard symbol, and the term “Biohazard” must be attached to:
Containers of regulated biohazard waste
Refrigerators or freezers containing blood or OPIM
Containers used to store, transport, or ship blood or OPIM

40. Exposure Incident… A specific exposure to the Eyes Mouth
Mucus membrane
Or broken skin
As well as contact with blood or other potentially infectious material that results from the performance of an employee’s duties.

41. Exposure Incident… Keep Calm Tell a supervisor ASAP
If body fluid enters eyes or mouth, wash with water for 20 minutes
If body fluid comes in contact with broken or chapped skin or needle stick, wash with water and soap for 20 minutes
What do you do?

42. Injury report
EXAMPLE

43. Worker’s Compensation

44. Known Source
If you know the
source
EXAMPLE

45. UNKNOWN Source
If you do not know
who the source is
EXAMPLE

46. Sharps Log
Any needle sticks

47. Ryan White Law
The Ryan White Law, mandates that the source patient test results be provided to the designated infection control officer of the employee involved in an exposure incident.

48. IF IT IS WET AND NOT YOURS DO NOT TOUCH IT WITHOUT GLOVES!

49. Question If you have any questions, contact:
Christie Clare

50. Course confirmation
Print, sign and return slide # 51 to Christie Clare

51. BLOODBORNE PATHOGEN COURSE CONFIRMATION
Lanesville Community School Corporation
I have viewed the bloodborne pathogen course. I understand that if I have any questions about the course or have an exposure to blood or body fluids, I should contact the school nurse at extension 205.
_______________________ (Printed Name)
_______________________ (Job Title)
_______________________ (Signature)
_______________________ (Date)
*You must print, sign and return this confirmation to Christie Clare after viewing the course.