2. 4/21/20151 Great Plains Technology Center Presents BLOODBORNE PATHOGENS

3. 4/21/20152 Objectives Upon completion of this class, you should be able to: 1 Define what bloodborne pathogens are and how they are transmitted. 2 Describe OSHA’s regulations for minimizing exposure to bloodborne pathogens. 3 Describe procedures to follow if an exposure incident occurs. 4 Discuss OSHA’s requirements for an Exposure Control Plan and it’s impact.

4. 4/21/20153 OSHA 1910.1030(a) Scope and Application “This section applies to all occupational exposure to blood or other potentially infectious material….”

5. 4/21/20154 What are Bloodborne Pathogens? “Bloodborne pathogens are micro- organisms present in blood that cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV)”

6. 4/21/20155 What is Needed to Spread Bloodborne Pathogens? Potentially Infectious Materials a route of entry into the body. In direct or indirect contact with

7. 4/21/20156 Methods of Transmission l Contact with contaminated blood or surfaces l Blood transfusions and other blood products l Inhalation and ingestion l Sexual contact l Contaminated needles, tattoos, or body piercing l Some diseases may be vector borne, but there are no proven cases of this for HIV or HBV

8. 4/21/20157 MOST COMMON BLOODBORNE PATHOGENS Hepatitis B and C Human Immunodefiecency Virus HBV HIV HCV

9. 4/21/20158 HBV, HCV & HIV/AIDS l Hepatitis affects the liver. l HIV affects the body’s immune system. l Both diseases can be fatal.

10. 4/21/20159 Hepatitis B HBV

11. 4/21/201510 Hepatitis B Statistics l Annual estimates in the U.S. : –1-1.25 million chronically infected –140,000-320,000 new infections –5,000-6,000 deaths l HBV can remain viable in a dried state on surfaces for up to 1 week and possibly longer but is unable to reproduce outside the human body.

12. 4/21/201511 HBV Symptoms l The virus can incubate for 40- 120 days after infection but symptoms may occur earlier. l You could have the virus and not show symptoms (asymptomatic). l Severe symptoms resemble the flu and includes: jaundice, dark urine, fatigue, nausea, abdominal pain, and loss of appetite.

13. 4/21/201512 HBV Treatment l The drug interferon reduces the chance of a return of the disease and can be effective in about 30-40% of patients. l A vaccine has been available since the 1980s and is considered to be 90% effective.

14. 4/21/201513 OSHA Requirements - HBV l People who are in high risk occupations must be offered the opportunity to obtain the vaccination at no cost. l The vaccine may be taken at any time, even within 7-14 days post-exposure.

15. 4/21/201514 HBV Vaccine l This is a 3- injection series. l The second injection is given one month after the first, with the third six months later. l To insure immunity, you must receive ALL three injections.

16. 4/21/201515 Hepatitis C HCV

17. 4/21/201516 Hepatitis C l HCV is less infectious but harder to kill than HBV. l HCV is more infectious and just as hard to diagnose and to treat as HIV. l HCV is the most common chronic bloodborne infection in the U.S. affecting 1.8% of the population. l 25-30% of infections are symptomatic, 70- 75% are asymptomatic.

18. 4/21/201517 HCV Symptoms l Severe symptoms include jaundice, fatigue, abdominal pain, loss of appetite, nausea, and vomiting. l Diagnosis may be made during blood testing done for donating blood.

19. 4/21/201518 HCV Symptoms l Most people never experience severe symptoms until many years after infection when they are diagnosed with chronic liver damage, cirrhosis of the liver or liver cancer. l 70% of infected persons have chronic liver disease and 8- 10,000 die each year.

20. 4/21/201519 HCV Treatment l There is no effective vaccine yet. l Interferon and/or ribavirin therapy is only 10-40% effective.

21. 4/21/201520 HIV

22. 4/21/201521 HIV….AIDS l Human Immunodeficiency Virus (HIV) became widely known to man in the early 80’s. l Attacks the immune system and can cause Acquired Immune Deficiency Syndrome (AIDS).

23. 4/21/201522 HIV/AIDS Is a fragile virus. Has no known vaccine. Declines in new infection rate and deaths provide evidence of the widespread beneficial effects of new treatment regimens. HIV cannot reproduce or survive well outside the body and must be grown in large amounts to be studied in laboratories.

24. 4/21/201523 HIV/AIDS Statistics l Annual estimates in the U.S.: 900,000 cumulative HIV cases reported 774,467 cumulative AIDS cases reported 40,000 new infections each year 322,865 living with AIDS 448,060 cumulative AIDS deaths reported.

25. 4/21/201524 You Cannot Get HIV: The Truth l By sharing food or drinking after someone else. l From sinks or toilets. l From casual contact with an HIV-infected person. l By insects such as mosquitoes.

26. 4/21/201525 Symptoms l Has an incubation period of 2-10 years. l Rapid weight loss, dry cough, recurring fever, fatigue, swollen lymph glands, diarrhea, unusual blemishes in mouth area or skin blotches, pneumonia, memory loss, depression, etc.

27. 4/21/201526 Treatment l There is no vaccine l Many different drugs are being tried. l Most effective treatment appears to be a “cocktail” of protease inhibitors taken with two reverse transcriptase inhibitors.

28. 4/21/201527 Other Infectious Diseases

29. 4/21/201528 Other Infectious Diseases l Two other prevalent infectious diseases that are not Bloodborne that anyone working in the public sector should be aware of are: –E Coli –Tuberculosis

30. 4/21/201529 E. Coli Bacteria l It is food borne. l Can be transmitted in human feces. l Found in unpasturized fruit juices, on unwashed fruits and vegetables. l Thought to be caused by transporting fruits/vegetables in the same transports previously carrying animals.

31. 4/21/201530 Contaminated Meat l E-coli can live in the intestines of healthy cattle. Meat becomes contaminated during slaughter and mixed into beef when ground. l Bacteria present on cow’s udders or on equipment can contaminate unpasturized milk.

32. 4/21/201531 Prevention l Wash all fruits and vegetables thoroughly l Wash hands frequently, especially after touching raw meat. l Cook hamburger until well done (to 160 degrees Fahrenheit). l Avoid drinking unpasturized juices or milk. l Drink water that has been treated with chlorine or other effective agents. l Avoid swallowing lake or pool water.

33. 4/21/201532 Treatment l There is no evidence that antibiotics improve the course of e-coli and may precipitate kidney complications. l Anti-diarrheal agents should be avoided. l Blood transfusions and kidney dialysis may be required.

34. 4/21/201533 Tuberculosis l Tuberculosis is a disease caused by bacterial infection l These germs are carried through the air in infectious airborne droplets less than 5 microns in size. l Hepa-filters catch only material over 5 microns.

35. 4/21/201534 Who Is Most Likely To Develop Clinical TB? l 10% of those exposed will develop clinical TB during their lifetimes. l Susceptibility is greater during first two years of life, puberty and adolescence.

36. 4/21/201535 Tuberculosis Testing l The TB skin test is required of day care and health care and is recommended for all who prepare or handle food. l It is not 100% accurate. l Reactions may begin as soon as 5 hours after testing and usually are at maximum at 48-72 hours.

37. 4/21/201536 Treatment l TB can be treated with various antimicrobials. l Not all strains will respond to the first line drugs, referred to as multi-drug resistant.

38. 4/21/201537 Universal / Standard Precautions Treat any body fluid as potentially infectious material.

39. 4/21/201538 Preventive Control Measures l Standard good hygiene practices –Use universal measures. –Wash hands often. –Wipe surfaces down with disinfectant. –Keep surfaces dry. –Discourage sharing of personal items.

40. 4/21/201539 Preventive Control Measures l Limit your exposure to germs and viruses. l Exercise regularly. l Listen to your body. l Eat better. l Battle stress. l Get immunized. Take nutrition supplements. Don’t overuse antibiotics.

41. 4/21/201540 Personal Protective Equipment l Includes the use, when needed, of: –Gloves and safety glasses –Gowns, aprons, laboratory coats, clinic jackets, surgical caps, or shoe covers –Surgical mask in conjunction with goggles or eye glasses with solid side shields or, alternatively, a chin length face shield

42. 4/21/201541 Contaminated Laundry l Contaminated clothing or uniforms must be laundered by using specific guidelines. l You should not take contaminated laundry home to your families.

43. 4/21/201542 Containers Proper Disposal is required. If objects could puncture container, then a puncture-resistant container is required.

44. 4/21/201543 How can I tell who is infected? The answer is…… you cannot!!! The best thing that you can do is to assume that any/all blood is contaminated and take preventive measures.