1. Bloodborne Pathogens Horace McCorvey Epidemiologist Disease Surveillance Coordinator Health Service Region 4/5, Tyler

2. Objectives Review Modes of Disease Transmission List the Major Bloodborne Pathogens Review Controls and Work Practice Recommendations Review Exposure Procedures Short Film, Bloodborne Pathogens, Protection in the Educational Environment

3. Modes of Transmission

4. BBP transmitted through contact with blood or O ther P otentially I nfectious M aterial –S–Semen –V–Vaginal Secretions –C–CSF –S–Synovial Fluid –P–Pleural Fluid –S–Saliva –A–Any body fluid that is visibly contaminated with blood

5. Routes of Entry Likely workplace transmission –Accidental needle stick –Broken glass or other sharps –Contact between broken skin and body fluids –Contact between mucus membranes and body fluids

6. Routes of Entry Infected blood can enter the body through: –Open sores –Cuts –Abrasions –Acne –Any damaged or broken skin

7. Routes of Entry Entry via mucus membranes –Eyes –Nose –Mouth

8. Bloodborne Pathogens of Concern Hepatitis C HIV Hepatitis B

9. Can live for 7+ days in dried blood 100 times more contagious than HIV Approximately 78,000 new infections per year (2001) 1.25 million carriers 5,000 deaths/year HBV - Hepatitis B General Facts Normal Jaundice

10. HCV - Hepatitis C The most common chronic bloodborne infection in the U.S. 3.9 million (1.8%) Americans infected; 2.7 million chronically infected 25,000 new infections per year (2001) Leading cause of liver transplantation in U.S. 8,000-10,000 deaths from chronic disease/year No broadly effective treatment No vaccine available General Facts Healthy human liver Hepatitis C liver

11. Fragile – few hours in dry environment Attacks the human immune system Cause of AIDS >1 million infected persons in U.S. Human Immunodeficiency Virus General Facts

12. Controls and Work Practice Recommendations

13. Exposure determination Exposure controls Training and Hazard Communication Hepatitis B Vaccine Post exposure evaluation & follow-up Exposure Control Plan Exposure Control Plan To eliminate/minimize your risk of exposure

14. – A system of infection control: TREAT ALL HUMAN BLOOD AND OPIM AS IF KNOWN TO BE INFECTIOUS WITH A BLOODBORNE DISEASE. Exposure Controls

15. Gloves Gowns Shoe covers Exposure Controls Personal Protective Equipment (PPE) Face shields or masks and eye protection Resuscitation devices

16. Exposure Controls Always wear PPE in exposure situations Remove and replace damaged PPE Remove PPE before leaving the work area Wear goggles when splashing is possible Face shields provide added protection Gloves should be made of latex, nitril, rubber or other impervious material Cover sores on the hands prior to gloving Aprons should be worn to prevent soaking

17. Hygiene Practices Hand Washing –Immediate washing after exposure –Use soft antibacterial soap –Immediate washing after removal of gloves or other PPE What “Not” to do in soiled or exposed work areas: –Eat, Drink, Smoke –Apply cosmetics or lip balm –Handle contact lenses

18. Decontamination Decontaminate tools, surfaces and other objects coming in contact with blood and body fluids Use a 5% or 10% solution of household bleach or commercial EPA-registered disinfectant SPILLS –Cover spills with paper towel or rags, then soak with solution –Leave disinfectant in place for 10 minutes

19. Decontamination SHARPS –Dispose of needles in sharps containers –Do not handle broken glass with bare hands –Broken glassware that has been contaminated with blood must be decontaminated prior to proper disposal

20. Signs, Labels & Coding Warning labels should be affixed to: –Regulated waste –Refrigerators and freezers containing blood or other potentially infectious materials –Containers used to store, transport or ship infectious material Regulated Waste Refers to: –Any liquid or semi-liquid blood or other material –Contaminated items that would release blood or OPIM if compressed –Contaminated sharps

21. Work Practice Controls Hepatitis B vaccination should be made available to all Class I employees including –School Nurses –Coaches (as designated by the AD) –Physical Education Teachers –Athletic Trainers –Teachers, TA’s, and bus drivers of multi-handicapped children –Custodians (as designated by Director of Maintenance) –Designated maintenance

22. What to Do in the Event of an Exposure Incident

23. Exposure Incident If you have an exposure incident with blood or OPIM, immediately do the following:  Thoroughly clean the affected area Wash cuts, and skin with soap and water Flush with water splashes to the nose and mouth Irrigate eyes with clean water, saline, or sterile irrigants  Report exposure to supervisor

24. Questions