2 Bloodborne PathogenBloodborne – carried by and lives in human blood or other bodily fluidsBloodSemenFecesUrineVomitPathogen – a microorganism that can cause disease
3 Types of Pathogens Virus – parasitic microscopic protein AIDS, Hepatitis, Herpes, Bird FluBacteria – one celled organismTetanus, Tuberculosis, Staph InfectionFungus – single or multi-celled organismRingworm, Athlete’s FootProtozoa – primitive single-celled organismMalaria, Giardia
4 How Pathogens Enter the Body IngestionPunctures, cuts, abrasions, and other non-intact skin.Mucous MembranesMouthNoseEyesSexual Contact
5 Your Potential Workplace Exposure Janitorial DutiesFirst Aid Responder
6 First Aid First aid training Good Samaritan Collateral duty* 4/15/2017First AidFirst aid trainingGood SamaritanCollateral duty*Designated responderBBP standardappliesNot covered byBBP StandardBBP standard applies* if First-Aid response is an expected part of the jobDo the BBP requirements apply to first aid trained individuals?The answer depends on the employers expectation of that employee’s application of 1st aid in the course of their job.As you may know, all employers must have 1st aid trained employees at their workplaces.Handout: WRD 11.45, 1st aid certification & BBP requirements.Good Samaritan: If employers have a distinct policy of 1st aid treatment that is only offered on a voluntary basis by the trained individuals, these actions may be classified as “Good Samaritan”. The BBP standards do not apply only under these circumstances. BBP issues and some training would be required under APP.Collateral Duty: The employer made it part of the job duty for an employee to provide 1st aid, but the actual event would be rare. All elements of the BBP standard apply, but HBV vaccinations may be delayed until the first time there is a 1st aid incident involving blood or OPIM (regardless of whether there is an exposure incident). See WRD 92-6, corrective amendment.Designated Responder: The employer makes 1st aid part of the job duty for an employee and exposure would be anticipated. All elements of BBP standard apply.Rev. April, 1997
7 HEPATITIS A Acquired primarily through the fecal-oral route. Causes an infection of the liver.Cannot be distinguished from other forms of Hepatitis without testing.The “restaurant” hepatitis.
8 HEPATITIS B Contracted from contact with blood or other bodily fluids. 100 times more contagious than Human Immunodeficiency Virus (HIV).Can live in a dry environment for at least 7 daysSome people can be carriers and never get sick, but they can infect others.There is no cure, but there is a preventative vaccine.
9 Hepatitis B Very infectious 1/3 no symptoms, 1/3 flu-like, 1/3 severe 6 to 10% of cases infectious for life (carrier state)In the past, 140, ,000 new infections per year5,000-6,000 deaths/yr from chronic liver disease
10 HEPATITIS C Spread by infected blood or other bodily fluids. 85% of Hepatitis C infections persist for lifeOnce contracted, over 70% of cases become chronic.No preventative vaccine.Current risk rate of contraction is 1 in 10,000.
11 HEPATITIS C 4 million Americans infected Only 25% of those infected have been diagnosedCarrier state can develop with or without symptomsCarrier state can lead to chronic liver disease, cirrhosis (10 year latency), or cancer (alcohol is strong co-factor)Leading cause of liver transplant in U.S.
12 HEPATITIS CSigns and symptoms may not appear until 10 years after infectionOnset of symptoms may present with severe liver diseaseNo broadly effective treatmentNo vaccine available
13 HEPATITIS- A,B,&CHeating foods above 1800 F for one minute will kill the virus.Good hygiene (washing hands and face) in the best prevention method.A 10% bleach solution if also an excellent disinfectant.
14 Signs and Symptoms of Hepatitis Flu-like fatigue and loss of appetiteFever, nausea, and joint painHeadachesJaundiceDark colored urineLight colored stool
16 Human Immunodeficiency Virus (HIV) Spread by exchange of blood or other bodily fluids.Attacks the body’s immune system.Can live in a dry environment for only a few hours
17 Human Immunodeficiency Virus (HIV) > 1 million infections in U.S.138 cases of possible occupational transmissionInfected persons may be asymptomatic for years.Usually develops into Acquired Immunodeficiency Syndrome (AIDS)
18 Signs and Symptoms of HIV and AIDS After infection a person will experience flu-like symptoms, then they may become asymptomatic for years.When symptoms do appear they are usually in the form of weight loss, fatigue, night sweats and fever.As the disease progresses the infected person usually dies from an opportunistic infection or cancer due to their weakened immune system.
19 How Do You Protect Yourself? Exposure Control PlanUse the Universal PrecautionWork Practice ControlsEngineering ControlsPersonal Protective Equipment
20 Exposure Control Plan Hepatitis B vaccination Post exposure evaluation & follow-upCommunication and trainingRecordkeeping
21 UNIVERSAL PRECAUTIONTreat all potentially infectious material as if it contained bloodborne pathogens!
22 Work Practice Controls Controls that reduce the likelihood of exposure by altering how a task is performed.Examples:Washing hands after coming into contact with potentially infectious materials.Not eating, drinking, or smoking in areas where potentially infectious materials are located.Decontaminating work surfaces after use.
23 Housekeeping Maintain a clean and sanitary workplace 4/15/2017HousekeepingMaintain a clean and sanitary workplaceWritten cleaning and decontamination scheduleContaminated waste disposal methodsLaundryThe employer has to ensure that the worksite is maintained in a clean and sanitary condition.An appropriate written schedule for cleaning and decontamination must be developed for the program.The written procedures has to include individual locations, how often, what specific cleaners and disinfectants are used and the specific cleaning procedures.The disinfectant must be an EPA approved tuberculocidal or HIV/HBV effective disinfectant. The label on the product will have this information. Check with distributors or EPA maintains a listing of the products.A dilution of household bleach to water of between 1:10 to 1:100 may be used. It should be made daily, older solutions lose potency.Rev. April, 1997
24 Engineering ControlsControls that reduce employee exposure by either removing the hazard, or by isolating the employee.Examples:Using a dust pan or tongs to pick up broken glass.Using biohazard disposal containers to dispose of potentially infectious materials.
26 Personal Protective Equipment Specialized clothing or equipment used for protection against infectious materials.Examples:GlovesProtective EyewearFace shieldsMouthpieces and Resuscitation DevicesAll PPE will be provided to you at no personal cost.
27 PPE Gloves Latex Nitrile Vinyl Utility 4/15/2017 Gloves must be carefully selected for their intended use. Important considerations are permeability to microorganisms, dexterity and durability.Gloves must be frequently changed because the will develop pinhole leaks that are not visible but can allow passage of microscopic organisms.Pictured above is a dispensing rack with gloves of different size. It is important that the glove are located where they are used.Latex gloves are strong allergic sensitizers. It is estimated that up to 8-12% of the users of latex gloves will develop an allergic dermatitis reaction. Some may even have stronger respiratory allergic reactions. Substitute materials must be found to accommodate sensitized individuals. Common substitute materials are nitrile and vinyl. If using latex, chose powderless and those with low-protein or antigen contentThicker utility gloves are needed for tougher jobs where more abrasion is encountered. These gloves must be changed before they start to show wear. They must be disinfected in between uses.Rev. April, 1997
28 VaccinationsThe Hepatitis vaccination is given as a series of three injections, whose schedule will be determined by a doctor.The Hepatitis B vaccine prevents Hepatitis B in 85 – 95% of the people who get all three shots.
29 Hepatitis B Vaccination 4/15/2017Hepatitis B VaccinationMake Hepatitis B vaccination availableDeclination statement requiredAvailable at later date if desiredNo cost to employeesReasonable time and placeIf series is interrupted, continue at any time rather than restart seriesAll employees with occupational exposure must be offered the vaccinationEmployees have the right to refuse the vaccination, but must sign the declination form in Appendix A. They may change their mind at any time in the future.Rev. April, 1997
30 Recordkeeping Medical records HBV vaccination status 4/15/2017RecordkeepingMedical recordsHBV vaccination statusWritten medical opinion of exposure incidentsExposure incident detailsMaintain for length of employment + 30 yearsMedical records that are maintained by the employer may not contain any confidential medical information. The only exception is the HBV vaccination status of the employee. The employer can make arrangements with a healthcare provider to maintain medical recordsA disease that is attained through an exposure incident must be documented on the OSHA 200 log.If 10 or less employees, a record of injuries must be kept even if the OSHA 200 log is not required.A needlestick injury with a contaminated needle must be recorded on the OSHA 200 log if the injury results in loss of consciousness, restricted duties, seroconversion, or medical treatment such as vaccinations or post-exposure prophylaxis (PEP).Rev. April, 1997
31 Recordkeeping Training records Dates Content summary 4/15/2017RecordkeepingTraining recordsDatesContent summaryTrainer name & qualificationsAttendee’s names & job titlesMaintain for 3 yearsRev. April, 1997
32 If you are exposed: Wash cuts with soap and water. Flush splashes to the nose, mouth, or skin with water.Flush out eyes with clean water or saline.
33 If you are exposed Notify your supervisor immediately. Seek medical attention.Fill out a Supervisor’s Injury/Exposure Report.Fill out an Affidavit of Possible Exposure to Reportable Disease/Follow Up Form.