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1 Bloodborne Pathogens. 2 Natural Defenses !Intact skin and mucous membranes in eyes, nose and mouth keeps germs out. !Mucous membranes trap & force out.

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Presentation on theme: "1 Bloodborne Pathogens. 2 Natural Defenses !Intact skin and mucous membranes in eyes, nose and mouth keeps germs out. !Mucous membranes trap & force out."— Presentation transcript:

1 1 Bloodborne Pathogens

2 2 Natural Defenses !Intact skin and mucous membranes in eyes, nose and mouth keeps germs out. !Mucous membranes trap & force out germs. !Mucous membrane less effective than skin at keeping germs out of the body. !Inside body germs detected & surrounded white blood cells, which release antibodies to fight infection.

3 3 Natural Defenses !Germs sub-classified as: - bacteria (tetanus) which are non-dependant & treated with antibiotics. - virus (measles) which are dependent & few medications available. !Germs overwhelm immune system and infection develops.

4 4 What is a BB Pathogen? !Microorganisms (e.g., bacteria & viruses) carried in blood and causing diseases: - Malaria - Brucellosis - Syphilis - Hepatitis B(HBV) - Hepatitis C(HCV) - Human Immunodeficiency Virus (HIV)

5 5 Statistics and Standards !Annually millions of workers at risk of exposure to bloodborne pathogens – human immunodeficiency virus (HIV – virus causes AIDS), hepatitis B virus (HBV), & hepatitis C virus (HCV) !OSHA’s Bloodborne Pathogens standard (1910.1030) prescribes exposure safeguards to reduce exposure risks. !Hepatitis A not included, not carried in blood. !No MSHA or OSHA-Construction standard

6 6 Exposure Determination !Employees “reasonably anticipated” in job performance to contact blood and other potentially infectious materials. !Designated first-aid and CPR trained employees !“Good Samaritan” acts such as assisting a co- worker with a nosebleed would not be considered occupational exposure.

7 7 BB Pathogen Spread !All four of the following must be met: - pathogen P resent, - pathogen Q uantity sufficient to cause disease, - pathogen through correct E ntry site, & - person S usceptible. !PQES

8 8 Infection Risk !Risk of infection from accidental bloodborne exposure varies with: - pathogen involved, - exposure type, - route of infection, - immune status of recipient, - amount of involved blood, - amount of virus in blood, & - ability of organism to produce disease.

9 9 Pathogen Transmission !Direct contact with infected human blood, unfixed tissues, & other potentially infectious bodily fluids such as: - Saliva - Vomit - Urine - Semen or vaginal secretions, - Blood transfusion, & - Bodily fluid visibly contaminated with blood.

10 10 Pathogen Transmission !Indirect contact with infected human blood, unfixed tissues, & other potentially infectious bodily fluids on: - soiled dressing, - equipment or working surfaces, - PPE, - other first-aid items.

11 11 Pathogen Transmission !HBV, HCV and HIV most commonly transmitted through: - sexual contact, - needles or other sharp instruments, - mothers to babies at/before birth, - contact between broken/damaged skin & infected bodily fluids, & - contact between mucous membranes & infected bodily fluids.

12 12 Pathogen Transmission !Infected blood or bodily fluid enters through: - open sores, - cuts, - abrasions, - acne, or - any sort of damaged or broken skin (e.g. sunburn or blisters).

13 13 Pathogen Transmission !Through mucous membrane of: - eyes, - nose, & - mouth. !Example – blood/fluids splash to eyes. !HBV, HCV & HIV share common transmission mode but risk differs. !Most exposures do not result in infection. !No evidence mosquitoes can transfer virus from person to person.

14 14 HBV Infection Risk !No risk following receipt of vaccine & immunity development. !Post exposure treatment 24 hours – 7 days. !Susceptible person after cut exposure to blood: - single exposure 6-30%, & - positive antigen status means more virus. !Possible risk from exposure of mucous membrane or nonintact skin. !No known risk from exposure to intact skin.

15 15 HCV Infection Risk !Susceptible person after cut exposure to blood: - approximately 1.8%. !Unknown following exposure to eyes, nose or mouth; believed to be very small. !Reported infection from: - blood splash to eye, & - nonintact skin exposure. !No known risk from exposure to intact skin.

16 16 HIV Infection Risk !After cut exposure to blood: - approximately 0.3%. !After exposure to eyes, nose or mouth: - estimated on average at 0.1%. !After exposure to nonintact skin: - less than 0.1%. !From needle stick: - estimated on average at 0.3 – 0.4%. !No cases with small blood amount on intact skin.

17 17 Vaccinations !HBV: - available since 1982, - series of 3 shots over 6 months, - provides protection for 9 or more years, - 70-88% effective within 1 week of exposure, & - 90-95% effective - chronic infection in 6% persons after age 5. - death from liver disease in 15-25% of persons.

18 18 Vaccinations  HCV: - treatment thru medications* and therapy, and - no vaccine currently available.  HIV: - treatment thru medications, and - no vaccine currently available.

19 19 Hepatitis B (HBV) !Durable virus, able to survive in dried blood up to 7 days. !Initial inflammation of the liver, but can lead to serious conditions (e.g., cirrhosis & cancer). !1 – 9 months before symptoms are noticeable. !Mild flu symptoms – fatigue, appetite loss, nausea, joint pain & stomach pain. !Progresses to jaundice & darkening of urine.

20 20 Hepatitis B (HBV) !300,000 U.S. individuals (8,700 health care workers) infected annually; 1 – 2% fatal !Infection does non prevent infection of HAV or HCV. !Medications available for chronic HBV; only work for some patients.

21 21 Hepatitis C (HCV) !Most common chronic bloodborne infection in the United States. !Acute or Chronic !Chronic – insidious, slow & without symptoms for 2 or more decades. !Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting. !May lead to chronic liver disease, transplant & death.

22 22 Human Immunodeficiency Virus (HIV) !HIV virus leading to AIDS. !Depletes immune system (white blood cells). !Opportunistic infections (e.g., TB, pneumonia). !Very fragile & not survive long outside body. !Primary concern to individuals providing first air or medical care involving fresh blood or potentially infectious materials. !No threat of contraction through casual contact.

23 23 Infection Prevention !Universal Precautions: - Treat all blood and bodily fluids as infectious, - Use of proper PPE, - Personal hygiene, - Proper cleanup and decontamination, & - Proper disposal of all contaminated material.

24 24 Engineering & work Practice Controls & PPE !Engineering & work practice controls primary methods used for transmission control (e.g., sharps containers), !Work practices: - Blood and bodily fluids treated as infectious, - Remove jewelry, - Personal hygiene, & - etc. !PPE used in conjunction with engineering & work place controls.

25 25 Personal Hygiene !Important factor in minimizing exposure !Confine loose clothing or hair !Maintain nail length < ¼ inch long !Hand washing is one of the most important practices in transmission prevention.

26 26 Hand Washing !Wash hands immediately after removing PPE. !Use a soft antibacterial soap !Min. 15 sec. including nails !Rinse thoroughly !Antiseptic cleanser, 70% ethyl alcohol, but wash with soap and water ASAP. !Frequently sanitize hands and exposed skin.

27 27 PPE !Anything protecting a person from exposure !Gloves (latex, nitrile) - double glove !Face shields !Eye protection !Mask or Respirator !Mouthpieces & resuscitation devices

28 28 PPE Rules to Remember !Ensure always available !Always wear in exposure situations or when there are skin openings (breaks, cuts). !Check for age, defects or tears before using !Remove & replace if torn or defective, or lost ability to function as barrier. !Remove ASAP to prevent contamination. !Cover skin openings prior to donning. !Remove properly & do not reuse

29 29 Recommended PPE Recommended PPE Against HBV, HCV & HIV Transmission Activity/ TaskDisposable Gloves GownDisposable Mask Protective Eyewear Bleeding w/ spurting blood Yes Bleeding w/ minimal blood YesNo Handle/Clean contaminated items YesNo, unless soiling No

30 30 Glove Removal Technique

31 31 Glove Removal Technique

32 32 Exposure Incident !Flush site of blood or OPIM contact (e.g., splash to nose, mouth, or skin). !Irrigate eyes with water or saline !Note specifics of contact with blood or OPIM !Notify supervisor and Safety !No infiltrations of mucous membranes or open skin surfaces, not considered exposure. !Medical evaluation within 1 to 2 hours according to current medical guidelines! !Post-exposure medical evaluations

33 33 Post-exposure Evaluation !Confidential medical evaluation !Document route of exposure !Identify source individual !Hepatitis B vaccination status !Test source individuals blood !Provide results to exposed employee

34 34 Summary !OSHA’s Bloodborne Pathogens standard prescribes safeguards to protect against blood and OPIM exposures, & reduce their risk from this exposure. !Implementation will not only will prevent HBV cases, but also significantly reduce risk of contracting HIV, HCV, or bloodborne diseases. !Given our line of work, first aid and CRP responders are potentially exposed.

35 35 Conclusions !BB pathogen rules in place for your health !Precautions use will remove 1 of 4 PEQS transmission conditions. !Condition missing, infection not occurring

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