1. BLOODBORNE PATHOGENS FOR SCHOOL EMPLOYEES Office of Catholic Schools and Centers The Diocese of St. Petersburg, Florida

2. Introduction In an educational setting, the administration of the school or system is required to identify the personnel whose job duties expose them to blood and potentially infectious body fluids. Not every educator is occupationally exposed to bloodborne pathogens while performing his or her job. However, it is important for everyone in an educational setting to understand the dangers of infection and the safety procedures to minimize risk. Teachers, assistants, office staff, maintenance all have the potential of exposure and it is in the interest of all to use sound safety procedures.

3. Potential Risk of Exposure Jobs Tasks CustodiansCleaning up bloody waste Coaches Caring for sports injuries Support StaffPerforming first aid Clinic aide/nurseIllness/Injury care TEACHERS--- ALL OF THE ABOVE

4. The Facts on Bloodborne Diseases Bloodborne Pathogens are infectious microorganisms that cause disease in humans These microorganisms are carried by human blood and other body fluids. These pathogens include but are not limited to: HBV - Hepatitis B Virus HCV – Hepatitis C Virus HIV – Human Immunodeficiency Virus Syphilis

5. Hepatitis B (HBV) Hepatitis B is a infectious illness of the liver that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness. It results from infection with the Hepatitis B virus. Hepatitis B can be either “acute” or “chronic.” There is no cure for HBV. HBV poses a greater risk than HCV & HIV because it is more easily transmitted.

6. Hepatitis B (HBV) cont. Symptoms include fever, jaundice, fatigue, loss of appetite, abdominal pain, nausea, dark urine, and vomiting but rarely death. People infected with HBV may not know they are infected or may not have symptoms; however they can still infect others. The tests, “assays”, for detection of HBV involves serum and blood tests

7. Hepatitis B Vaccine HBV can be prevented What to do? Receive the Hepatitis B vaccine and take appropriate safety precautions. The vaccine can also be started within 24 hours of exposure and can be part of a post exposure evaluation and follow up plan.

8. Hepatitis C (HCV) Hepatitis C is a viral disease that leads to the swelling (inflammation) of the liver and presents with symptoms similar to Hepatitis B. Frequently people infected with Hepatitis C may not know or do not have any symptoms. If the is present for years, the liver becomes permanently scarred. (cirrhosis) Hepatitis C can lead to death. About 1 in 10 people have yellowing of the skin (jaundice) that gets better. If detected, many patients benefit from treatment with medications.

9. Hepatitis C cont. Hepatitis C is the leading cause of liver transplants. Although vaccines exist for Hepatitis A and B, there is not a vaccine available for Hepatitis C

10. Human Immunodeficiency Virus(HIV) HIV attacks the person’s immune system and causes it to break down. HIV infection is generally a slowly progressive disease with three stages. The first two stages include a primary infection and chronic asymptomatic infection. In the third stage, the infected person becomes seriously ill when the immune system loses its ability to fight infection. The goals of drug therapy are to prevent damage to the immune system by the HIV virus. There is not a preventative vaccine for HIV but studies are occurring which could pave the way. HIV symptoms are treatable.

11. Syphilis Bacterial Infection Can be treated with antibiotics Virus is fragile, surviving only briefly on surfaces Transmitted sexually 4 different stages

12. Transmission of Bloodborne Diseases Bloodborne pathogens are transmitted when contaminated blood or body fluids enter the body of another person. In the workplace setting, transmission is most likely to occur through: An accidental puncture by a sharp object, such as a needle, broken glass, or other "sharps", contaminated with the pathogen. Contact between broken or damaged skin and infected body fluids

13. Transmission of Bloodborne Pathogens Contact between mucous membranes and infected body fluids. Unbroken skin forms an impervious barrier against bloodborne pathogens. However, infected blood or body fluids can enter your system percutaneously through: Open sores, cut, abrasions, acne, any sort of damaged or broken

14. Non-Transmitted Ways Ways that bloodborne pathogens are not transmitted. Touching an infected person Coughing or sneezing Air

15. Transmission - Indirectly Contaminated surfaces are a major cause of the spread of hepatitis. HBV can survive on environmental surfaces, dried and at room temperature, for at least one week. HCV virus does not survive well outside of the body Syphilis virus is very fragile and survives only briefly on surface

16. Proper Cleaning Proper cleaning of any blood spills- including dried blood should be cleaned using 1:10 dilution of household bleach to 10 parts water. Gloves should be used when cleaning up any blood spills.

17. Personal Protective Equip. (PPE) Continued The Personal Protective Equipment must fit properly, especially gloves. All Personal Protective Equipment must be free of physical flaws that could compromise safety. You must use appropriate Personal Protective Equipment each time you perform a task involving potentially infected materials.

18. Personal Protective Equipment(PPE) Equipment that protects you from contact with blood or other potentially infected material (PIM) include: Gloves Gowns, Aprons, Lab Coats Face Shields, Protective Eye Wear Masks, Mouthpieces, Resuscitation Bags

19. Personal Protective Equipment (PPE) - Gloves Gloves should be removed when they become contaminated or damaged or immediately after finishing the task. You must follow a safe procedure for glove removal, being careful that no pathogens from the soiled gloves contact your hands. Properly dispose of the gloves Wash hands as soon as you can after removing gloves

20. Personal Protective Equipment (PPE) – Glove Removal Glove Removal With both hands gloved, peel one glove off from top to bottom and hold it in the gloved hand. With the exposed hand, peel the second glove from the inside, tucking the first glove inside the second. Dispose of the entire bundle promptly. Never touch the outside of the glove with bare skin. Every time you remove your gloves, wash your hands with soap and warm running water as soon as you possibly can.

21. Hand Washing Hand washing is the #1 protection against infection. Wash hands after coming in contact with blood, body fluids, excretions, and secretions even if you were wearing gloves. Hand Washing Steps Use soap and warm running water for 20 seconds.

22. Hand Washing cont. Rub vigorously over all surfaces, including above your wrists and under fingernails. Rinse thoroughly and dry with a clean paper towel and discard. Use a clean paper towel to turn off the faucet and discard.

23. Standard Precautions Research shows that proper safety precautions greatly reduce the risk of coming in contact with bloodborne pathogens. To reduce your risk: Handle all blood and body fluids as if they are infectious. Dispose of sharps (needles) safely. Wear personal protective equipment (PPE) when exposed to blood and body fluids.

24. Standard Precautions Clean and disinfect areas possibly contaminated with infectious materials with the proper cleaning agent or with a mixture of bleach and water (one part household bleach to 10 parts water). Get the Hepatitis B vaccine.

25. Standard Precautions – Signs & Labels Watch for fluorescent orange-red labels, red bags, and containers with a biohazard symbol. This symbol will warn you when the contents of containers are used for waste, storage, or shipping contain blood or other potential infectious material.

26. Safety Guidelines Follow safety methods that can help prevent you from becoming infected with bloodborne viruses. OSHA highly recommends receiving the immunization for HBV. Remember, there are no vaccines for HCV and HIV, so it is important to follow all safety precautions.

27. Safe Practices to Follow Clean all blood and bodily fluid spills promptly according to the Exposure Control Plan. Always put a barrier between you and possible exposure Remember safety procedures are for the benefit of all within the school community

28. What to do if Exposed? Do not panic if you are exposed to blood or other body fluids. Immediately wash the skin area with soap and water. If blood or other potentially infectious material comes in contact with your eyes, immediately flush them with large amounts of clean, running water.

29. What to do if exposed ? Do not use caustic agents, such as bleach to clean contacted skin areas. They can damage the skin. Report the exposure incident to your administrator or school nurse so post-exposure evaluation can begin.

30. Housekeeping Effective housekeeping strategies include: Clean and decontaminate all material with the appropriate disinfectant / cleaner. Use a broom and dust pan to pick up broken glass instead of your hands. Dispose of sharps and other potential infectious material in appropriately marked containers. Handle contaminated laundry as little as possible.

31. Scenario 1 Blood borne pathogens A primary student suddenly becomes ill in class and vomits on the floor of the classroom. Specific procedures must be followed to eliminate the possible hazard of body fluid exposure. The procedures include: Teacher keeps students……. Teacher contacts….. Teacher sends……… Main office…… Custodian is responsible ……………………… Custodian uses ………………………… Custodian …………………. Custodian ………………………. Custodian ……………………………. Custodian ………………………………… Custodian ……………………………….

32. Scenario 1 responses Teacher keeps students away from potential hazard Teacher contacts main office Main office removes student to nurses office and contacts lead custodian Custodian is responsible for cleaning up all body fluid spills Custodian uses protective equipment such as gloves, apron, protective eyewear, etc. Custodian removes body fluid from floor Custodian sanitizes floor Custodian cleans and decontaminates all equipment and environmental working surfaces exposed to body fluids Custodian removes gloves and disposes in appropriate biohazard container Custodian washes hands with antibacterial soap

33. Scenario 2 A teacher is out on the playground with her class and a young student falls and hits their mouth on the side of the slide. Teacher address………… Teacher addresses……………. Teacher contacts…………… Main office………………. Main office…………… Custodian …………………. Teacher………………….. Main office ………….

34. Scenario 2 responses Teacher should immediately address the student who is hurt using the child’s shirt or another piece of clothing to hold against wound. Teacher should be cognizant of the other children in the area. Ask them to gather and move to a visible area in the playground away from the hurt child. Look for adult assistance within a close proximity. Teacher should send two children to notify the office of the child’s injury and ask for assistance. How can this be different if a minor scratch or cut?

35. Scenario 2 con’t Main office should send assistance—one to supervise the children in the group and if a clinic aide/nurse present send for support. Main office should contact parents immediately. Determine extent of injury, report accurately to parents and if in doubt of severity, call 911. Why? Custodian will clean area, use protective equipment, decontaminate equipment, remove gloves, dispose of material appropriately and wash hands with bacterial soap.

36. Stay Safe! Protecting yourself from bloodborne diseases on the job requires knowing the facts and taking sensible precautions.

37. Resources The Center for Disease Control www.cdc.govwww.cdc.gov American Academy of Orthopaedic Surgeons www.aaos.org www.aaos.org Board of Regents of the University System of Georgia www.usg.eduwww.usg.edu Occupational Safety & Health Administration (OSHA) www.osha.govwww.osha.gov July 2014