Presentation on theme: "UF Bloodborne Pathogen Training Program 2011"— Presentation transcript:
1UF Bloodborne Pathogen Training Program 2011 *Biological Safety OfficeEnvironmental Health & SafetySharon Judge, PhDAssistant Biosafety Officer*Portions of this presentation were edited and adapted for clinical dentistry applications at UFCD by the Office of Clinic Administration.OSHA requires that printed copy of this training be maintained in the clinic.
2Bloodborne Pathogens (BBPs) ? Pathogenic microorganisms present in blood or other potentially infectious material (OPIM)that are able to cause disease in humans. These pathogens include:Hepatitis B virus (HBV)Human immunodeficiency virus (HIV)Hepatitis C virus (HCV)Less Common disease agents such as Epstein-Barr virus (EBV), human T cell lymphoma virus (HTLV-1), malaria, syphilis, babesiosis, brucellosis, leptospirosis, arboviral diseases (WNV, EEE), Creutzfeldt-jacob disease, rabies, etc
3BBP StandardImplemented in 1991 by the Occupational Safety & Health Administration (OSHA)29 CFRRevised in 2001 – Safe sharps devices, maintain a log of injuries from contaminated sharps.UF follows OSHA requirementGeneral and workplace-specific trainingCompleted BEFORE individual is assigned to tasks with the potential for BBP exposure and ANNUALLY thereafter
4BBP Standard: In addition to training, individuals with potential exposure must also have the following:Access to the regulatory text – required to print a copy for the work (clinic) areaAnd an explanation of it’s contentsA copy of the training material is adequateAccess to a copy of the UF Exposure Control PlanAccess to any site-specific standard operating procedures (SOPs)
5The OSHA BBP Standard Scope & application Definitions Exposure control, exposure control plan, & exposure determination by jobs/tasksComplianceEngineering and work practice controlsPersonal Protective Equipment (PPE)HousekeepingRegulated waste and sharpsHIV/HBV research labs – held to a higher standardHBV vaccination and Post-exposure prophylaxis (PEP)Communication to employees – signs, labels, trainingRecord keeping
6UF BBP Program http://www.ehs.ufl.edu/Bio/BBP/default.htm Chairs/Directors : ensure department’s complianceFaculty/Supervisors : have an exposure control plan in place that is appropriate & being followedEmployees, students, volunteers, etc: follow exposure control plan, report problems/exposuresSHCC/Employee Health: immunizations & post-exposure follow-upEH&S Biosafety: develop & coordinate UF program, track participants
7Who at UF is enrolled in the program? ALL employees, staff, students, volunteers, affiliates with potential exposure to bloodborne pathogens (BBP) from human blood / other potentially infectious material (OPIM)Custodians, medical providers, dentists/dental staff, autopsy staff, clinical laboratory staff, research lab staff & students, biomedical engineers, athletic trainers, event staff, police, emergency responders, physical plant workers,…..etc
8NO* unless visibly contaminated with blood What constitutes OPIM?YESNO* unless visibly contaminated with bloodCerebrospinal fluidTearsSynovial fluidFecesPeritoneal fluidUrinePericardial fluidNasal secretionsPleural fluidSputumSemen/Vaginal secretionsSweatSalivaVomitBreast milkAmniotic fluid
9How are BBPs commonly transmitted at work? Cuts or punctures with contaminated sharp objectsSplashes to mucous membranes (linings of eyes, nose, & mouth)Your mucous membranes are permeable, allow pathogens to pass throughContamination of broken or non-intact or skin (wounds, chapped skin, rashes)
10UF Exposures (2008-2010) Note: 2010 Increase in sharps and splash exposures
112010 Reported Sharps Exposures by Department Dentistry reported 10 exposures
12Cornerstone of exposure prevention “STANDARD PRECAUTIONS” Any and all human blood or other potentially infectious material (OPIM) is treated as INFECTIOUSUse:Safety equipmentEngineering ControlsSafe practicesPersonal Protective Equipment (PPE)To protect yourself & others in the work environment“Standard Precautions” is an alternate, clinical / hospital term= Universal Precautions + “body substance isolation” (standard of care for all patients, all body fluids)
13What to treat with STANDARD PRECAUTIONS: Any human blood or OPIM …..&…..objects/items that may be contaminated by blood or OPIMAny unfixed tissue or organ, other than intact skin, from a living or dead personCell or tissue cultures that may contain BBP agentsBlood/ tissues from animals infected with BBP agents
14Research using human cell lines… Use Universal Precautions for all human cell linesATCC started testing newly manufactured/deposited cell lines for common viral pathogens (HIV, HepB, HepC, HPV, EBV, and CMV) in January 2010Many infectious agents yet to be discovered and for which there is no testRemember HIV?What about XMRV?
15Hepatitis B (HepB, HBV)Spread through direct contact with infected body fluids (blood, semen, vaginal fluids)More transmissible than Hep C virus and HIVInfection may be acute or chronic~ % of Americans have been infected with HepB5-10 % of adults will develop chronic infection; ~1.2 million people with chronic HBV15-25% develop cirrhosis , liver failure, or liver cancer (~ 3000 deaths/year)Many people (~50%) are asymptomatic; if symptoms occur they include:FeverAbdominal painFatigueLoss of appetiteNauseaVomitingJaundiceJoint painDark urine
16Occupational Hepatitis B Exposures Needle sticks a real concern… 30% of susceptible/non-vaccinated individuals exposed to infected blood this way became infectedCan be transmitted by surface contact with dried blood or OPIM! HBV can remain infective in dried room temperature for at least 1 week (MacCannell et al., Clin Liver Dis 2010; 14:23-26)Many people have no idea how they became infectedRisk of infection from blood/OPIM splash onto non-intact skin or mucous membranes… greater risk than other BBPs
17How to prevent Hepatitis B infections at work Get vaccinated!Use Standard PrecautionsCleaning/disinfection is important because the virus can survive on surfacesOSHA BBP standard requires that employees with potential exposure be offered the vaccine at no cost.Occupational infections have decreased 95% since HepB vaccine became available in 1982
18HepB Vaccine Safe Effective Given to newborns, 120 million people in U.S. have received at least one doseEffective>95% develop immunity after full series (3 doses given at 0, 1, 6 months)In Gainesville, free to SHCC ( )Bring completed Acceptance/Declination statement with youIf you decline, can change mind at any timeNOTE: Decline in children and adolescents since implementation of childhood vaccinations.
19Post-vaccination testing Health-care workers or public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids, HBV research lab workersPerformed 1-2 months after dose #3 for recently vaccinated individualsHepB surface antibody (anti-HBs) ≥ 10 mIU/mL - immuneAnti-HBs < 10 mIU/mL – revaccinate (3 doses) and retest anti-HBsStill negative – non-responder, need HBIG after exposurePreviously vaccinated but not tested? Test for anti-HBs after an exposure; if negative, treat as susceptible.
20Hepatitis C (HepC, HCV)Transmitted primarily through contact with infected bloodMany people asymptomatic (symptoms similar to HepB)~1.8 % of Americans have been infected with HepC, 3.2 million chronically infected~ 12,000 deaths/yearLeading indication for liver transplant in U.S.
21Occupational HepC Exposures Percutaneous injury, esp. with deep punctures or extensive blood exposures~2% develop infectionMucosal/non-intact skin exposures rarely documentedProper cleaning/disinfection of surfaces importantHCV in dried blood samples remains infective for at least 16 hours (Kamili et al., Infect Control Hosp Epidemiol 2007; 28: )
22How to prevent Hepatitis C infections at work Universal Precautions for Prevention!NO VACCINEAntivirals (interferon/ribavirin) can have serious side effects, treatment lasts weeks
23HIVCDC: Greater than 1 million people in the United States are currently infected.At least one-fourth of them do not know they are infected, putting them at high risk for transmitting the virus to others.The annual incidence rate of HIV/AIDS in Florida remains more than twice the national average.In 2007, Florida reported 6235 cases HIV, 3896 cases AIDS (Florida DOH HIV/AIDS Annual Report 2007).
24HIV/AIDS - U.S. and Florida > 1 million living with HIV/AIDS~56,000 new infections/year~20% don’t know they are infectedFlorida ranks 3rd among states in the number of reported HIV/AIDS cases
25HIV Attacks immune system destroys white blood cells (CD4+ T cells) Leaves patient immune suppressed & susceptible to infections & certain tumorsMany people show no symptoms for a long time (years)Eventually leads to development of AIDS(acquired immune deficiency syndrome)Early symptoms very similar to flu:FeverHeadacheTirednessEnlarged lymph nodesTreatment focuses on ways to lower blood levels of virus
26Occupational HIV Exposures Risk for HIV transmission after:Percutaneous injury – 0.3%Mucous membrane exposure – 0.09%Non-intact skin exposure – low risk (< 0.09%)57 documented occupationalinfections in U.S. (139 possible infections)84% resulted from percutaneous exposure!
27If HIV is such low risk, why worry? No cure – eventually fatalNO VACCINESome HIV strains resistant to therapyPost-exposure therapy costly & has side effects.Cocktails of three or more antiretroviral drugs given
28How to prevent HIV infections at work Standard precautions ONLY!
29BBPs – comparing the risk of infection Risks of becoming infected with (one of the below listed BBPs) from a needle stick accident:HepB: 30% or 300 people per 1000 needle sticks, if unvaccinatedHepC :2% or 20 people per 1000 needle sticksHIV : 0.3% or 3 people per 1000 needle sticks
30Workplace-specific controls to protect against BBP exposure Engineering controls(Safety Equipment )Work PracticesPersonal protective equipment (PPE)Maximum protection when these controls overlap
31Engineering Controls (Safety Equipment) Task specific - Examples:Sharps boxNon-slip floorsCleanable Work Surfaces & Dental ChairsLeak-proof transport containersSafety devices including needles/syringes and scalpelsSAFETY Sharps DEVICES as available at
32Work practices Controls Safer ways of doing things:Pre-plan your work (unit dose)Decontamination/Disinfection of equipment and surfacesMinimize splashesBarrier covers on equipment and surfacesProper handling of spillsHand HygieneNo food or drink in areas where blood or OPIM is generated/handled/ stored
33Needle Safety: NEVER RECAP NEEDLES USING BOTH HANDS Do Place needles directly into the Sharps BoxClose & replace Sharps Box when it is ¾ fullDo not overfill the sharps box.Never attempt to re-open a closed Sharps Box
34Needle Safety:Know where your needles and other sharps are—AT ALL TIMES!!!!!!!**Never leave a needle uncapped anywhere in your operating field.When possible retract tissue with another instrument (mouth mirror)Recapping NeedlesUse a scoop techniqueUse a cap holder if supplied on the trayNever use two hands when recapping - use the one-handed scoop method.
35Circumstances Associated with Hollow-Bore Needle Injuries NaSH June 1995—December 2003 (n=10,239)35% Clean-up and disposalrelated
36Decontamination/Disinfection of equipment & surfaces: Disinfectants EPA listed tuberculocidal disinfectantCavicide or OpticideFollow manufacturers recommendation for contact time of surface exposure to disinfectantA FRESHLY MADE (w/in 24 hr) solution of household bleach diluted 1:10 with waterEthanol; isopropyl alcohol products evaporate too quickly to be effective. Do not use.
37Indications for Hand Hygiene When hands are visibly dirty, contaminated or soiled, wash with non-antimicrobial or anti-microbial soap and water.Should be washed for at least 20 seconds and dried thoroughly before donning gloves. Pay attention to areas between fingers and around nails.If hands are not visibly soiled, use an alcohol based hand sanitizer for routinely decontaminating hands.Use enough sanitizer to moisten all surfaces of the hands and rub until dry.Less damaging to skin than soapUse before and after wearing gloves or patient contact.Note residue around cuticles & under watchband after thorough hand washing (using “Glo-Germ” )
38Personal Protective Equipment (PPE) Procedure driven - Wear it when & where you’re supposed toPPE must not be worn in any common area, hallway or office = OSHA BBP ruleEmployer responsibilities for PPE: Supplied by employer It must be available It must fit It must be suitable to the task Cleaned or disposed of properly
39Personal Protective Equipment (PPE) Site specific & appropriate to the task - Refer to area’s site specific written standard operating proceduresFace and EyesMaskGlasses (with side shields)GogglesFace ShieldWith maskBody – ExamplesCoatsGownsApronsSleevesHeadShoe Covers
40According to the CDC, the correct order for donning personal protective equipment is:Cover gownFully cover torso from neck to knees , arms to end of wristMaskFit flexible band to nose bridgeFit snug to face and over chin, covering noseGoggles, safety glasses with side shield or face shieldGlovesExtend to cover wrist of cover gown
41According to the CDC, the correct order for removing personal protective equipment is: GlovesOutside of glove is contaminated!When removing, grasp outside of glove with opposite gloved hand and peel offGoggles, safety glasses with side shield or face shieldOutside of goggles is contaminated!Remove by grasping ear pieceCover gownGown front and sleeves are contaminated!Unfasten tiesPull away from neck and shoulders, touching inside of gown onlyTurn gown inside out and roll into a ball then discardMaskFront of mask is contaminated – DO NOT TOUCH!Grasp bottom, then elastics and remove
42Pay attention to how you remove your gloves Grasp the top or wrist of one glove, being careful not to touch anything but the glove.Pull the glove off, turning it inside out. Continue holding the glove.Go under the cuff of the other glove, being careful not to touch its outside surface.Pull the glove off, turning it inside out and pulling it over the first glove. Both gloves should now be inside out, one inside the other.Discard both gloves into an approved waste container.Then wash hands or use hand sanitizer!
43REMEMBER TO USE SAFE WORK PRACTICES TO PROTECT YOURSELF AND LIMIT THE SPREAD OF CONTAMINATION Keep hands away from faceLimit surfaces touchedChange gloves between patients, when worn/torn or heavily contaminatedPerform hand hygiene
44Personal protective equipment (PPE)-Other Considerations: Store, Dispose of, or Clean PPE appropriatelyDo not take PPE home to washDo not wear it out of the clinic area…Wear closed toe shoes !Acid + Flip flops
45GLOVES Latex Nitrile Vinyl – Not recommended - DO NOT hold up well Do not re-use glovesDo not wash glovesSome chemicals (soaps, lotions, & hand sanitizers) you use may breakdown the gloves – use glove compatibility chart
46No gloves outside of the clinic No gloves outside of the clinic! Be aware that the general public does not if know gloves are clean and assumes they are contaminated.These photos should be scary! The potentially contaminated gloves have touched all sorts of things that others may touch without gloves. Anything transferred from the contaminated gloves to the item, may be picked up by the unsuspecting individual!46
47Site specific Exposure Control Plan (ECP) & Standard Operating Procedures (SOPs) Equipment, practices, and personal protective equipment used AT YOUR SITE to protect you & othersWritten down, reviewed, & updated on a regular basis – at least annuallyAccessible to allSee EH&S website for a template to make your SOPs
48HIV & Hepatitis research labs….. More stringent control measuresRegistration of work with EH&SDocumented enrollment in a medical surveillance programCDC/NIH BSL2 guidelines at a minimum
49Steps to Take If An Exposure Occurs Wash the area very thoroughly with soap & water: flush mucous membranes for 15 minutesNotify supervisor/facultyCall , the Needle Stick Hotline, for exposures within 1 hour of Gainesville. Go to nearest medical facility outside of Gainesville area.Get immediate medical attention (1-2 hr max)Allow Medical to follow up with the appropriate testing & the required written opinion
50In Gainesville Vicinity: Also for scalpel cuts, glass cuts, splashes, etc
51If material has splashed into your eyes, immediately use an emergency eyewash or another source of clean running water or saline irrigation to flush them for at least 15 minutes. Hold the eyes open and roll them around to make certain that water reaches their entire surface.Know where the closest eyewash station is located. Staff check to verify station is in working order on a regular basis and maintain a log sheet.
52UFCD OCCUPATIONAL EXPOSURE FLOWCHART Stop the procedure, cleanse the skin with antibacterial soap or flush eyes with clean water.Injured health care worker (HCW); faculty, resident, staff or student calls the Student Health Care Center (SHCC) Needlestick Hotline at Identify yourself as UFCD employee or student and that you’ve had an exposure. Provide information about the event as requested by SHCC.Attending dental faculty confirms permission from source patient to test for Hepatitis B, Hepatitis C and HIV at no expense to them. A written consent is signed by source patient and scanned into in dental electronic record to acknowledge that consent was obtained for testing related to occupational exposure. No further details are included.HCW and source patient go to Shands lab on 3rd floor, room 3152 for lab tests. (Lab forms will be completed by SHCC and faxed to the Shands lab.)The source patient may be verbally informed of their test results by the exposed dental HCW or attending faculty. SHCC must provide the results – as SHCC originally ordered the tests.NOTE: If HCW is faculty or paid resident, they should contact Workers Compensation at to open a claim so expenses will be covered by Workers Comp. Follow-up visits for HCW are scheduled according to SHCC guidelines.NOTE: Exposed HCWs may contact SHCC with any questions or concerns at Ask for Mr. Tony Mennella.
53The Latest Post-Exposure Prophylaxis (PEP) Guidelines for Occupational Exposures to BBP are at: - HIV - HIV, HBV, HCVPost-exposure follow up must be offered by the employer, confidential, & offered at no cost to the employee
54Factors considered in assessing need for PEP Type of exposureType/amount of fluid/tissueInfectious status of sourceSusceptibility of exposed personPercutaneous injury (depth, extent, device)BloodPresence of HepB surface antigen (HBsAg) and HepB e antigen (HBeAg)HepB vaccine and vaccine response statusMucous membrane exposureFluids containing bloodPresence of HepC antibodyImmune statusNon-intact skin exposurePresence of HIV antibodyBites resulting in blood exposure to either personCDC PEP Guidelines:
55Record Keeping Requirements Training records:Retain a minimum of 3 yearsMedical records for immunization or post-exposure follow up:Retain for duration of employment + 30 yrs (includes HepB vaccination records, vaccination declination statement)Confidential sharps injury log (type of device involved, where and how injury occurred):Retain for 5 years from date of exposure
56“Thank you for your continued efforts to comply with the OSHA and BBP standards in your daily work practices. This is the cornerstone for protecting you, your colleagues and your patients in the work place.”Questions may be directed to the Office of Clinic Administration:
582011 UF Biomedical Waste Training *Biological Safety OfficeEnvironmental Health & Safety*Portions of this presentation were edited for clinical dentistry and site-specific applications by the UFCD Office of Clinic AdministrationPhone:
59Biomedical Waste Training State regulations require that all employees who may have contact with BMW receive:initial training at time of hireannual refresher trainingTraining shall cover:Identification, handling, use of protective clothing, segregation, storage, labeling, transport, procedures for decontaminating BMW spills, contingency plan for emergency transport, and procedure for containment and treatment of BMW.Training must be facility and site specificTraining Log/roster must be kept for a minimum of 3 yearsDocumentation of individual employee training is to be kept in their department.
60What is Biomedical Waste (BMW)? Any solid or liquid waste which may present a threat of infection to humansIncludes but is not limited to:Non-liquid human tissue and body partsBlood, blood products and OPIM (as defined in OSHA BBP standard) from humans and other primatesLaboratory/clinical waste containing/contaminated with blood, tissue, cell cultures & other potentially infectious body fluidsLaboratory/veterinary wastes containing human disease-causing agentsDiscarded sharps (medical items intended to cut or puncture skin, e.g. needles, syringe/needle combinations, burs, scalpels)
61Biomedical vs. Biological vs. Hazardous Waste Biomedical waste – specifically regulated by the State of Florida Dept. of HealthBMW is infectious for humans & a subset of biological wasteVarious regulations affect biological waste (NIH, USDA, etc)Biological waste includes rDNA, animal, & plant pathogensHazardous waste is a non-specific term. At UF, most often used to describe chemical waste or chemically-contaminated waste (pharmaceutical waste also handled as chemical waste).
62Examples of BMW?Used, absorbent materials saturated with blood, body fluids, or secretions/excretions contaminated with blood & absorbent materials saturated with blood or blood products that have dried (bandages, gauze, sponges, wound care material).Non-absorbent disposable devices (needles, carpules, disposable gloves, intact glass and hard plastic, etc) contaminated with blood, body fluids, or secretions/excretions contaminated with blood but have not been sterilized or disinfected by an approved method.Extracted teeth and biopsy specimensOther contaminated solid waste which represents a significant risk of infection b/c they are generated in medical facilities which care for persons suffering from diseases requiring isolation criteria.
63State of Florida Requirements Described in Chapter 64E-16 FL Administrative CodeSegregation, handling, labeling, storage, transport & treatment are regulated. Prescribe specific:Sanitary practicesTrainingBiomedical waste plan – provides guidance & describes requirements for proper management of biomedical waste at the generating site or facilityPermits required to generate, store, treat, & transport BMW – UF has permitInspections by the state – has ability to levy finesEnforcement
64Biomedical Waste PlanContent of this presentation closely follows the UF Biomedical Waste Plan which is located in EH&S Biosafety Office. ContactThe BMW plan for Shands UF is located in the Environmental Services Dept., Room G137 (South Tower) and Room B301.8 (North Tower). ContactOther departments at UF/Shands may create and maintain a BMW plan for their area using the following template:
65How is BMW identified?International biological hazard symbol on the containerThe phrase “Biomedical Waste”, “Infectious Waste” or “Biohazardous” must be on the containerBagged waste must be in red bags.
66Segregation of BMW at UF/Shands Segregated at point of origin into its proper container“Point of origin” is the operatory, lab, patient/exam/procedure room or other area where the BMW is generatedChoices for proper BMW container:Red biowaste bagLabeled fiberboard box lined with a biowaste bagSharps container – puncture resistant container specifically designed for sharps
67Biowaste Waste Minimization Cost savings can be significant!New policy for “clean” labware – see - cardboard box labeled “clean lab ware”The following should not be put into the biowaste box unless contaminated:*Paper *Disposable cover gowns *Packaging / wrappings *Paper towels
68For biowaste items that can cut, but are not intended to do so… (broken glass, Pasteur pipettes, pipettes, cotton tip applicators, etc)Dispose of in a way that they can’t do harmOptions:Sharps boxSturdy box in a biohazard bagSleeve/bundle pipettes & place in biohazard bag
69Segregation: Do not mix BMW with radioactive or chemical waste! Chemically or radiologically contaminated gloves, tubes, etc. do not go into a biomedical waste box. They go into their appropriate waste container.Call EH&S ( ) before putting hazardous (chemical) or radioactive warning stickers on biomedical waste containers.Remember – the biomedical waste box is not a universal disposal container! It is more expensive to dispose of than regular trash.
70Segregate medical sharps into sharps containers Do Not Bend or Break Needles or ScalpelsDiscard directly into a leak-proof, puncture resistant containerReplace container when ¾ fullLabel sharps container with facility’s name and address prior to offsite transportUF lab or UFCD Clinic, date, Faculty or Principal Investigator (PI) name, room and phone #
71SharpsContainer should be located where the sharps are used: patient operatories, procedure areas, exam rooms, lab, etc.UF uses disposable containers transported for disposal by StericycleOnly sharps should go into sharps containersSoft items quickly overfill containers and may cause sharps to stick out of the top of the box. Sharps boxes containing items other than sharps and syringes need to be replaced ASAP, but definitely within the 30 days of first use
72What do we do with non-sharp BMW? RED autoclave bags – must meet certain documented standards of State of FL, BBP & DOTe.g. Fisher #01-828E (Medical Action Industries)Red bags are to be available where neededNo liquid waste in red bags!Once sealed, containers must stay sealed. If container breaks or is punctured, put the whole broken container in a new one.Infectious/potentially infectious waste must be stored in a covered, leak-proof container
73Recommend posting a laminated copy of these instructions near biomedical waste box. Write phone number to request additional boxes and red bag liners on copy:
74BMW StorageBMW must be staged in an area away from general traffic & accessible only to authorized personnel. Storage area must be:Labeled with biohazard stickerSecure (locked/non-accessible)Easily cleanable & tidyWaste cannot be stored > 30 days“The 30 day period shall commence when the first non-sharps item of biomedical waste is placed into a red bag or sharps container, or when a sharps container containing only sharps is sealed.”Packages must be labeled as biomedical waste with the biohazard symbol, lab name, location, phone & dateSome locations stage the waste & then transport it to outdoor containers removed for disposal by a designated hauler
75Handling BMWWear appropriate PPE (gloves, clothing cover, safety glasses) when handling non-inactivated wasteUse Universal Precautions – assume all BMW is infectiousTransport waste in leak-proof containersKnow how to handle spills
76Supplies for Handling and Containing BMW At UF: Includes UFCDLabs must furnish their own PPE and red bags (Fisher #01-828E)Sharps containers and BMW boxes are available from Building Services custodians or from AG133 at the Health Science Center (call ) or from Physical Plant Stores, Bldg 705 near the Motor Pool (call )At Shands, staff may obtain any of the supplies by:Contacting Environmental Services at orSpeaking to an Environmental Services staff associate on the unit they are working
77Who Picks Up/Transports BMW for Shands/UF? Transportation of BMW is provided by the following registered BMW transporter:Stericycle, Inc.4245 Maine AveEaton Park, FL 33840State of Florida Permit #
78Contingency PlanStericycle has a number of other sites in the state that they can pull transport equipment from to facilitate emergency situations
79Treatment of BMWBMW shall be treated by heat, incineration, or other equivalent method suitable for hazard inactivation acceptable to the State of Florida.Shands/UF BMW is treated by Stericycle, Inc.Autoclave which sterilizes the waste orIncineration which destroys the wasteNote: CJD BMW must be marked for incineration per hospital policy by the area that has filled the container. See ICP 03-15, Guideline for the Management of Patients with Suspected or Confirmed Creutzfeldt-Jakob Disease (CJD) or other prion disease
80Pretreatment of biological waste from UF labs prior to disposal by Stericycle At UF, all lab waste handled by UF custodial staffUF Policy:Laboratory waste containing infectious, potentially infectious, or rDNA organisms must be inactivated prior to disposalProperly performed autoclave or bleach treatment is acceptableStorage of all non-inactivated waste in this category is restricted to within the generating laboratorySpecific requirements apply for waste containing biological toxins. Contact the Biological Safety Office at
81Autoclaving Requirements: Biological indicator testing every 40 hrs of use (every 6 mos if autoclaving non-infectious material exclusively)Log bookRegular maintenance250°F/121°C, lb pressureLarge loads/resistant pathogens need more timeTypical bag of Biohazardous Waste = 60 minTransport BMW to autoclave in closed bag and leak-proof container
82Bleach Inactivation of BMW Acceptable for liquid material if done correctlyAdd full strength household bleach to final concentration of 10% (5000 ppm available chlorine).Mix. Contact time should be at least 30 minutes.Pour down drain to sanitary sewer.Beware of other disinfectants = “hazardous chemicals”, harmful work with and can’t go down drain, must be picked up by EH&S
83BMW Spills & Surface Disinfection Proper spill handling:Notify people in the areaDon appropriate PPEPlace absorbent material on spillApply appropriate disinfectant – allow sufficient contact time (30 min)Pick up material (watch for glass – use tongs or dust pan); dispose of material into biomedical wasteReapply disinfectant and wipeFor large/high hazard spills, call the Biosafety Office ( )For routine disinfection of surfaces where BMW is handled, use a 1:10 solution of freshly diluted bleach or a tuberculocidal disinfectant (ethanol products evaporate too quickly!)UFCD uses Opticide or Cavicide, disinfectant to clean and disinfect surfaces. Utilize spray,wipe,spray method. If using disinfectant wipes: use wipe, discard, wipe method. Surface must remain wet for the length of time recommended by manufacturer in order for effective disinfection.
84Questions? Contact: The UF Biological Safety Office 352-392-1591