Presentation on theme: "Senior Loss Control Consultant"— Presentation transcript:
1 Senior Loss Control Consultant Bloodborne PathogensPresentation By:Mike Pettit,Senior Loss Control ConsultantTallahassee, FloridaWelcome, everyone My name is Mike Pettit, and I am a Senior Loss Control Consultant based in Tallahassee, FL I greatly appreciate the opportunity to present to you today. Should you have any questions, the opportunity to ask questions will be provided at the end of the presentation. This Webinar will be available on the Summit website, within the next few weeks to allow future training of your employees.
2 Bloodborne Pathogens: Protecting Yourself & Your Co-WorkersToday, we will be discussing Bloodborne Pathogens, focusing on Protecting Yourself and Your Co-Workers . . .
3 What We Will Cover What are Bloodborne Pathogens? Facts and StatisticsTypes of Bloodborne PathogensHow is it Transmitted?How Do I Protect Myself?TrainingPersonal Protective EquipmentDecontaminationHygieneKnowing your BBP KitSo, what are we going to cover today?What are BloodBorne Pathogens?Facts and StatisticsTypes of BloodBorne PathogensHow is it Transmitted?How Do I Protect Myself?Personal Protective EquipmentDecontaminationHygieneKnowing your BBP KitIdentifying and Handling Sharps
4 What Are Bloodborne Pathogens (BBP)? Bloodborne Pathogen are microorganisms such as viruses or bacteria that are carried in blood and can cause disease in people.Types of BBP:MalariaSyphilisBrucellosisHepatitis B (HBV)Human Immunodeficiency Virus (HIV)The two diseases specifically addressed by the OSHA Bloodborne Pathogen Standard.So, What exactly are bloodborne pathogens?By definition, Bloodborne Pathogens are microorganisms such as viruses or bacteria that are carried in blood and can cause disease in people.There are many different types of BBP but there are 2 types that OSHA specifically has in mind in regards to the Bloodborne Pathogen Standard. They are:Hepatitis B (HBV)Human Immunodeficiency Virus (HIV)The reason for the focus here of course is because of the severity of these 2 diseases.
5 Hepatitis B (HBV)Over 300K people are infected with Hepatitis B each year in the USThis virus is transmitted primarily through “blood to blood” contactThere is no cure for this diseaseLet’s take the time to look at these two bloodborne pathogens.As far as statistics are concerned, over 300,000 people are infected with Hepatitis B each year in the US alone. That is far too many people.The primary way that this disease is transmitted is through “blood to blood” contact. If you have ever had your blood drawn or received a shot, this is why the nurses take such caution with the used needles. It is not because they are afraid of getting stuck. It is because they are working to avoid coming into contact with a bloodborne pathogen. There have been many advances in the medical field with “Safe” needle devices that enclose the needle before and after an injection. A great deal of time and money has been spent coming up with products that help minimize this hazard.Most importantly, and as the 3rd bullet point indicates, there is no cure or specific treatment for Hepatitis B. Again, this is the reason for OSHA’s focus.
6 Need To Know Facts of HBV This virus is very durable...it will survive in dried blood for up to seven (7) days.Based on the duration of 7 days, employees such housekeepers and custodians should wear personal protective equipment (gloves, mask, etc).There are some things that everyone needs to know when talking about Hepatitis B.First of all, this virus is very durable - it will survive in dried blood for up to seven (7) days. That is why, no matter what, when attempting to clean up or disinfect an area that has been possibly exposed to a bloodborne pathogen, you must use extreme caution.Responders should wear personal protective equipment (such as gloves, mask, etc.) that has been provided, as well as the safe work practices we will talk about today.
7 HBV Symptoms: Fatigue Stomach pains Nausea Symptoms are like mild “flu”.Note - It can take 1 to 9 months beforesymptoms become noticeableSo what are the symptoms of Hepatitis B exposure?FatigueStomach painsNauseaSymptoms of a hepatitis B exposure act like a mild “flu” bug.Now these are just basic symptoms. Any employee that believes they have come into contact with a blood borne pathogen should consult a physician immediately for proper diagnosis:After exposure, it can take 1 to 9 months before symptoms even become noticeable. If you wait for symptoms to appear, it may be too late for treatment. That is why you have to seek medical attention after any exposure to make sure you receive the necessary treatment, if necessary.
8 HEPATITIS B … IS PREVENTABLE Prevention – safe practices and IMMUNIZATIONPre exposure – series of 3 vaccinations90% effective for up to7 YEARSHepatitis B is preventable before and after exposure.You can be immunized before exposure with a series of 3 shots which, as you can see here, is 90% effective for up to 7 years.
9 HEPATITIS B … POST-EXPOSURE Initiate vaccination series (70-88% effective)Give immune globulin within 1 WEEK of exposure90% effective if given incombinationHepatitis B can also be combated after exposure with a 2 step process.The first step is the vaccination seriesThe second step is the immune globulin, which must be administered within one week of exposure.This is another example of why you must seek medical attention right away if exposed.Together, these steps are 90% effective in controlling the disease.
10 What Is Human Immunodeficiency Virus (HIV)? AIDS is caused by a virus called HIVIt may take many years to develop AIDS.HIV attacks the body’simmune systemThe other main bloodborne pathogen that OSHA is concerned with is HIV.AIDS, or immune deficiency syndrome, is caused by the virus HIV. Once a person is infected with HIV, it may take many years before they develop AIDS. The way that HIV works is that it attacks the body’s immune system and weakens it to the point it cannot fight other diseases.
11 Human Immunodeficiency Virus (HIV) Over 35K people are infected every year.There is no known cure.Seek Medical attention immediatelyHere are some facts associated with HIVOver 35,000 people are infected every year in the United States.AIDS is a fatal disease because there is no known cure at this time - there have been a great deal ofadvancements made to extend your life span, but, again, there are no cures.9939 universal blvd 32819Seek Medical attention immediately if you believe you may have contracted this virus.
12 HIV INFORMATION:HIV virus is very fragile and will not survive very long outside of the human body.The primary concern to employees providing first aid or medical care in situations involving fresh blood or other potentially infectious materials.It is estimated that the chances of contracting HIV in the workplace is only 0.4%. However, all precautions must still be taken.Unlike Hepatitis B, HIV is very fragile and cannot survive very long outside the human body. Remember, Hepatitis B can last up to 7 days outside the human body.Providing medical care such as first aid is a situation where the HIV virus could be transmitted should the person in need or even the person administering the treatment have HIV.It is not likely for aids transmission to occur in the workplace. As you can see there is only a .4% chance of this happening. However, given the consequences, all precautions must be taken.
13 HIV SYMPTOMS:These are basic symptoms and all employees should consult a physician for proper diagnosis:Symptoms can vary but often include weakness, fever, sore throat, nausea, headaches, diarrhea, a white coating on the tongue, weight loss, and swollen lymph glands.CONSULT YOUR DOCTOR IMMEDIATELY IF YOU BELIEVE YOU MAY HAVE HIV.Some of the basic symptoms from HIV infection include:weakness, fever, sore throat, nausea, headaches, diarrhea, a white coating on the tongue, weight loss, and swollen lymph glands.If you remember from Hepatitis B, they sound very similar - almost flu-likeAgain, these symptoms may take weeks to show. Only a doctor can determine whether or not you have been infected.
14 MEANS OF TRANSMISSIONHBV, HIV and other blood borne pathogens may be present in:Blood, vaginal secretions, semen and certain other body fluids;Body tissues or organs.So what are some of the ways these bloodborne pathogens can be transmitted?First of all, HBV, HIV, and other blood borne pathogens may be present in Blood andother body fluids, as well as body tissues or organs
15 MEANS OF TRANSMISSIONTo cause infection, the virus must enter your body. Some likely ways are:Sexual contact with an infected partner;Sharing infected needles;Cutting yourself with a sharp object that is contaminated with infected blood or fluidsBut, in order to cause infection, the virus must have a way to enter your body. Some likely ways are:Sexual contact with an infected partner;Sharing infected needles;Cutting yourself with a sharp object that is contaminated with infected blood or fluidsGetting infected blood or fluids on your skin if you have open sores, nicks or cuts;Getting contaminated blood or fluids in the mucous membranes in your eyes, nose or mouth. (This is where proper hygiene comes into play in avoiding these exposures)Your skin is normally a protective barrier to keep viruses out, but if you have dermatitis, acne, chapped hands or broken cuticles, you have ways for the HIV or HBV to enter your body
16 TRAINING 29CFR1910.1030 (g)(2)(i) states training is to be provided: At the time of initial assignment to tasks where occupational exposure to blood or other potential infectious materials (OPIM) may take placeAnnually, thereafterAs we see in this slide, the OSHA Standard requires trainingAt time of initial assignment were exposure to blood or other potential infectious materialsmay take placeRetraining efforts should then be provided every year, thereafterTraining must also (next slide) . . .
17 TRAINING 29CFR1910.1030 (g)(2)(vii) states training is to include: Hepatitis B vaccine informationExplanations of symptomsPost-Exposure follow-up proceduresMeans of transmissionLocation and handling of PPEHepatitis B vaccine information - Explanation of related symptoms – post-exposure follow-upprocedures - means of transmission – the location and handling of personalprotective equipmentWe have already reviewed HIV and Hepatitis B information, symptoms, and post-exposurefollow-up procedures, and will include the remaining and additional aspects during theremainder of this presentation
18 PREVENTION Always take time to put on a pair of leak-proof gloves Make sure you are wearing eye protection to prevent the transmission of blood borne pathogens through the eyes.If you get blood or other potentially infectious materials on your skin, immediately wash with soap and water.Now we will discuss some of the ways for preventionIf you choose to help an injured co-worker, always take time to put on a pair of leak-proof gloves and wear them under your regular work gloves. Also, make sure you are wearing eye protection to prevent the transmission of blood borne pathogens through the eyes.If you get blood or other potentially infectious materials on your skin, immediately wash with soap and water
19 PREVENTIONIf potentially infectious materials get in your eyes, nose or mouth, immediately flush with running water at a sink or eyewash fountainAny unprotected contact with blood or other bodily fluids to your supervisor so proper medical follow-up can be made.If potentially infectious materials get in your eyes, nose or mouth, immediately flush with running water at a sink or eyewash fountain.You should report any unprotected contact with blood or other bodily fluids to your supervisor so proper medical follow-up can be made.
20 CLEAN-UP When blood or body fluids are cleaned up after an accident: Restrict access to the areaWear two pairs of leak-proof gloves;avoid tearing glovesWear a leak-proof apron to protect your clothesDo not pick up contaminated sharp objects (glass, nails, sharp metal, etc.) with your hands--sharp objects might cut both your glove and your hands.Use disposable towels to soak up most of the bloodWhen blood or body fluids are being cleaned up after an accident:Restrict access to the area – this is to keep others from becoming exposedWear two pairs of leak-proof gloves – do everything possible to avoid tearing the glovesWear a leak-proof apron to protect your clothesDo not pick up contaminated sharp objects (glass, nails, sharp metal, etc.) with your hands--sharp objects might cut both your glove and your hands. Use brooms and dust pans or tongs to pick up these objects.Use disposable towels to soak up most of the blood – you must also (next slide) . . .
21 CLEAN-UP When blood or body fluids are cleaned up after an accident: Place all contaminated towels and waste in sealed, color-coded or labeled leak-proof containerDispose of as a regulated waste.Clean with an appropriate disinfecting solution.After cleaning, promptly disinfect mops and any other cleaning equipment.Place all contaminated towels and waste in sealed, color-coded or labeled leak-proof container - these areincluded in BBP kitsDispose of as a regulated waste - Don’t just toss it in the dumpster, as you may need to contact you sanitation provider on how they would want you to handle this effortClean with an appropriate disinfecting solution - A solution of 10 parts water to 1 part bleach will kill both HIV and HBV;After cleaning, promptly disinfect mops and any other cleaning equipment – otherwise, you may spread viruses to other areas of the facility.
22 “UNIVERSAL PRECAUTIONS” METHODS OF COMPLIANCE“UNIVERSAL PRECAUTIONS”All human blood and certain human body fluids are to be treated as if KNOWN to be infected.So, How do I know if what I am cleaning is infected with a BBP.The best rule of thumb is to use Universal PrecautionsSince you don’t know who might be infected, the safe thing to do is to use Universal Precautions: That is to treat all blood and body fluids as if they are infected.It only takes one exposure to become infected--Don’t Take Chances.Fortunately, HIV and HBV aren’t spread through the air like cold or flu germs. You can’t get either disease from working alongside someone who is infected or from casual contact.Also, assume the worst when cleaning and properly protect yourself during these efforts
23 PERSONAL PROTECTIVE EQUIPMENT You must do the following:Always wear PPE in exposuresituationRemove and/or Replace PPE thatis damaged (torn or punctured).Remove PPE before leaving thework area.Now let’s talk about the various types of PPEYou must do the following:Always wear PPE in exposure situation - this could be gloves, goggles, aprons and so onRemove and/or Replace PPE that is damaged (those torn, punctured, showing signs of wear, etc.).Removed PPE before leaving the work area - don’t risk exposing other areas or people
24 PPE ITEM - GLOVESGloves should be made of latex, nitril, rubber, or other water impervious materials – the fluid must not come into contact with your skinDouble gloving can provided an additional layer of protection.Bandage any known cuts prior to putting on glovesInspect your gloves for tears or punctures before putting them on.The first thing to do to protect yourself is to wear personal protective equipment such as latex or protective gloves. This prevents blood from coming in contact with your skin.Before putting on latex gloves, it is also important to make sure that whoever is putting on the gloves does not have a latex allergy. In this case, another type of glove besides latex must be used.GLOVES should be made of an impervious material - if gloves are thin or flimsy, double gloving can provided an additional layer of protection. Also, if you know you have cuts or sores on your hands, you should cover with a bandage or similar protection as an additional precaution before donning your gloves.Also, inspect your gloves for tears or punctures before putting them on - If gloves are damaged, DO NOT USE THEM!Take special precaution when removing gloves. Do not touch the outside of the gloves with any bare skin – you can carefully grasp the glove at the cusp, and then use the inside of the first glove to carefully remove the 2nd gloveAnd, be sure to dispose of them in proper container so that no one else will be exposed to them, either.
25 REMOVING CONTAMINATED GLOVES Disinfect gloves in solution if possibleGrasp palm of glove with other handRemove that glove inside outSlide finger at wrist of gloved handRemove second glove inside outDispose of both properly
26 PPE ITEM – EYE PROTECTION Eye Protection: If there is a risk of splashing contaminated fluids, you should wear eye protectionSplashing can occur while:cleaning up a spillwhile providing first aid or medical assistanceThe next type of PPE we will discuss concerns eye protectionEye Protection - If there is a risk of splashing contaminated fluids, you should wear eye protection.As you can see from this slide, splashing can occur while:cleaning up a spillwhile providing first aid or medical assistance.Consideration should also be made to only allow trained employees to provide first aid to other employees.
27 PPE ITEMS—MASK & APRONS Face Shields/MaskAprons/GownsFace shields, masks and gowns are other forms of PPEFace Shields/Mask should be worn in addition to goggles/eye protection mask to provide additional face protections - these willprovide additional protection against splashes to the nose and mouth.Aprons/Gowns may be worn to protect your clothing and to keep blood or other contaminated fluids from soaking through to your skin. If your clothes become contaminated, they should be laundered immediately. Contaminated laundry should be handled as little as possible and should be placed in an appropriate labeled bag or container until it is decontaminated, dispose of, or laundered.With the exposures any employee could face, the extensive use of PPE will more than likely never occur. But, for educational reasons, we will still cover it.
28 DON’T TRUST IN LUCK ! PPE MUST BE … Appropriate to the task Readily availableReadily accessibleProperly maintainedUSED!!!When it comes to PPE, it must be:Appropriate to the task – don’t wear safety glasses when you need goggles, don’t wear cotton gloves that could soak up fluids when you should be wearing latex.Readily available – You must have the equipment at your locationReadily accessible - If you can’t get to it to use it, what good is it.Properly maintained – Damaged PPE provides no protection.IS FREE TO OUR EMPLOYEES – Free is free; efforts have been made to keep everyone safe at work.USED!!! – all the training in the world and all of the gloves and goggles you could find do no good if it is not used. Given what has been provided, there is no excuse for anyone to become infected.
29 DECONTAMINATE YOURSELF! Wash thoroughly with soap and water.Flush eyes for 15 MINUTESAfter removing PPE, wash hands with soap and waterHygiene is crucial when dealing with bloodborne pathogens!Wash any area of the body that comes into contact with infectious materials thoroughly with soap and water.For splashes into the eyes, flush eyes with running water for 15 MINUTESAfter removing PPE, wash hands with soap and water – FOR AT LEAST 20 SECONDS!Proper hygiene will help keep you from exposing yourself after the fact.
30 DECONTAMINATE THE AREA Work surfacesPails, bins, receptaclesLabware(decontaminate broken glassware BEFORE DISPOSAL)Use plastic-backed absorbent paper; dispose of as biohazard wasteSo now we must decontaminate the area.What exactly needs to be decontaminated?Any exposed Work surfaces - floors, counters, etc.Any Pails, bins, receptacles that have come into contact(decontaminate broken glassware BEFORE DISPOSAL)Why do we clean it before we dispose of it? Remember, Hepatitis B can live for 7 days. We must make sure that in the event someone else down the road comes into contact with it, they are not at risk of becoming infected.
31 HOW TO DECONTAMINATEHousehold bleach FRESHLY MADE; 10% V/V (¼ cup bleach to 1 gallon water)Allow sufficient time (At least minutes; depends on surface/material)Use after spills, at completion of task, and at the end of shiftSo how do we decontaminate?Here is a simple recipe that you can even use in your own home to decontaminate surfaces.Add ¼ cup bleach to 1 gallon of water. Notice we are adding the bleach to the water. Why do we do it in that order? If we add the bleach first, we risk splashing bleach on ourselves. Always add the concentrate to the water, not the water to the concentrate.Give the solution time to work - 10 minutes should do is a good rule of thumbYou should always decontaminate after spills, and at the completion of the task
32 OTHER HYGIENE PRACTICES Never eat, drink, smoke, apply cosmetics, or handle contact lenses if you are working in an area where there is possible exposure.No food or drink is permitted in laboratories or lab refrigerators designated for lab use.Never eat, drink, smoke, apply cosmetics, or handle contact lenses if you are working in an area where there is possible exposure. Why is this?You can become infected through the mucus membranes, such as the eyes and the mouth.No food or drink is permitted in laboratories or lab refrigerators designated for lab use. Same as the other point - it can be spread and enter the body through our mouths
33 HAZARD COMMUNICATION Use warning labels Post the biohazard symbol Use red bags / containersPost signage – agent, entry requirement, contact infoProvide trainingUse warning labelsPost the biohazard symbolUse red bags / containersPost signage – agent, entry requirement, contact infoAll of these are included in BBP kitsProvide training – inform everyone of the hazards of BBP, and how to protect themselves and others
34 Where is your BBP Kit located? If I were to visit your workplace and ask, “Where is your BBP kit located?,” could everyone provide an accurate answer?Remember, it must be available and it must be accessible. Those performing the assistance must know where it is located.
35 What is available in your BBP Kit? So, what all is available in the BBP Kit?Gloves?Bio hazard bags?Antiseptic cleaners?Are there goggles?What else is available?
36 BROKEN GLASSWAREBroken glassware that has been visibly contaminated with blood must be sterilized with an approved disinfectant solution before it is disturbed or cleaned up.It must be disposed of in anappropriate sharps container.**ONLY EMPLOYEES WHO ARE CONSIDERED TRAINED RESPONDERS SHOULD BE HANDLING ANY OF THESE ITEMS.**Broken glassware that has been visibly contaminated with blood must be sterilized with an approved disinfectant solution before it is disturbed or cleaned up. This can be the solution we spoke of earlier with the 10% bleach and 90% water mix.It must be disposed of in an appropriate sharps container.Please keep in mind, ONLY Those Considered Trained Responders should be handling these items.
37 SIGNS, LABELS, & COLOR CODING Look for warning labelsThe labels should be florescent red, orange, and/or orange-redSee your supervisor or the EPA for additional informationorLOOK for warning labels to be affixed to containers of regulated waste, refrigerators, and/or freezers containing blood or other potentially infectious material.The labels should be florescent red, orange, and/or orange-red.For additional information, you are encouraged to contact the EPA at the listed phone number or websiteAgain, this pertains more to OSHA’s standard for BBP training, and not necessarily something you would come across on a routine basis.
38 FOR ANY POTENTIAL BLOODBORNE PATHOGEN EXPOSURE … Seek IMMEDIATE medical attentionGo to the NEAREST medical facilitySo let’s start recapping what has been discussed . . .If you suspect that you have potentially been exposed to any BBP, you mustSeek medical attentionGo to the nearest medical facilityThe quicker you take action, the better you chances are of avoiding any life-long consequences.
39 RESPONDING TO AN EXPOSED WORKER Arrange for immediate and confidential medical evaluationDocument how the exposure occurredIdentify and test the source individual, if possibleArrange for an immediate and confidential medical evaluationDocument how the exposure occurred – this is for both medical needs, as well as future preventative measuresIdentify and test the source individual, if possible – this is the person who is bleedingYou must also (next slide) . . .
40 RESPONDING TO AN EXPOSED WORKER Test the exposed employee’s blood, if consent is obtainedProvide counselingEvaluate any reported illnessHave the exposed employee’s blood tested - some of the medical attention received by the person exposed to the blood will depend on whether or not there has been an infectious exposureProvide counselingEvaluate any reported illness
41 POST-EXPOSURE EVALUATION & FOLLOW-UP A confidential medical evaluation andfollow-up is available to employeesA confidential medical evaluation and follow-up is available – only the affected individual, the medical provider, and an assigned company representative have access to the information – it is not shared with other employees
42 Must be made available to employee MEDICAL RECORDSMust be made available to employeeMedical records are available to employees at all times, and can be provided to the employee at the conclusion of employment
43 MEDICAL RECORDS All medical records should include: Employee name and social security numberStatus of Hepatitis BvaccinationResults of all exams,testing, and follow-upsThe medical records provided to an employee must include the listed information- Employee name and social security #- Status of Hep B vaccination- Results of all exams, testing, and follow-up effortsThe medical records should also include (next slide) . . .
44 MEDICAL RECORDS Should also include: Copy of physician’s professional opinionCopy of informationprovided to healthcareprofessionalMedical records should also include:- A copy of the physician’s professional opinion, which would include diagnosis, treatment, etc.- A copy of the information provided to the healthcare professional
45 REGULATORY COMPLIANCE 29 CFR (c)(1)(iii)Exposure control plansDue to the hazards recognized by OSHA in regards to BBP exposures, OSHA Standardsrequire exposure control plans for every employerThese plans must include (next slide) . . .
46 EXPOSURE CONTROL PLANS Exposure control plans include:Policy statementSteps to the determination of employee exposureImplementation of control methods including:Universal PrecautionsEngineering and work practice controlsPersonal Protective Equipment (PPE)HousekeepingExposure Control Plans must include:- Policy statement- The steps needed to be taken to determine employee exposure- The implementation of control measures, such as- Universal Precautions (again, this is treating all blood as though it is contaminated / infectious)- Engineering and work practice controls (eliminating, when possible, all potential contamination)- Personal Protective Equipment- Housekeeping and post-exposure clean-up proceduresThe Plans must also include (next slide) . . .
47 EXPOSURE CONTROL PLANS Exposure control plans include:Hepatitis B VaccinationPost-exposure evaluation and follow – upCommunication of hazard to employees and trainingRecordkeepingProcedures for evaluating circumstances surrounding exposure incidents.Exposure Plans Must Also Include:- The offer to provide the Hep B vaccination (the employee has the option to decline vaccination, and should berequested to sign a form of declination)- The post-exposure evaluation and follow-up efforts- Communicating the hazards to employees through training- Maintaining required recordkeeping efforts- The procedures for evaluating circumstances surrounding exposure incidents such as accident investigations
48 EXPOSURE CONTROL PLANS At this website, a sample Exposure Control plan is available through OSHA
49 REMEMBER … For Successful Post-Exposure Treatment TIME IS OF THE ESSENCE !Remember, for an individual to receive the treatment necessary following an exposure, Time is of the Essence!An employee should immediately inform his or her supervisor of a potential exposure, and the sequenceof events previously provided must be initiated
50 Mike Pettit, Senior Loss Control Consultant Tallahassee, Florida Thank YouMike Pettit,Senior Loss Control ConsultantTallahassee, Florida