1. Occupational Infection Human disease cause by work associated exposure Bacteria : anthrax brucellosis Viruses : hepatitis B AIDS Fungi : candidiasis Parasite : hook worm toxoplasmosis

2. OCCUPATIONS Contact with Human or Animal Waste DISEASES Child care worker Lab animal worker Veterinarian Care for children or primates infected with hepatitis A Hepatitis A Farm worker Farmer & Rancher Sewer worker Work in water contaminated by wastes of infected humans or animals in endemic area Leptospirosis *Schistosomiasis Animal handler (cattle) Child care worker Care for children or animals infected with cryptosporidiosis Cryptosporidiosis Farmer & Rancher Farm worker Associate with dogs in endemic area Echinococcosis

3. OCCUPATIONS Contact with Infected Patient or Blood DISEASES Dental worker Embalmer Healthcare worker Handle contaminated needles or surgical instruments AIDS Hepatitis B Hepatitis C Healthcare worker Care for sick patients (droplet/airborne pathogens) Adenovirus Diphtheria Influenza Measles Meningococcus Mumps Parvorvirus Pertussis Rubella Tuberculosis Varicella Healthcare worker Care for sick patients (bloodborne pathogens) AIDS hemorrhagic fever *Ebola -Marburg

4. Prevention of occupational exposure to blood is the cornerstone of healthcare worker (HCW) protection When exposure occurs, all efforts should be directed to minimize the risk of transmission of HIV, HBV and HCV.

5. Barrier-Protection should be standard for all patient care This includes gloves, gloves masks lab coats surgical liquid-resistant gowns face and/or eye protection

6. Hepatitis B Prophylaxis Exposed personHBS Ag +HBS Ag -Not tested UnvaccinatedHBIG x 1 HB vaccine HB vaccine Previously vaccinated responder Adequate anti- HBS no treatment in adiquate anti – HBS HBvaccine No treatment Known non responder HBIG x 2 HBIG + vaccine No treatmentHigh risk HBIG+vaccine Response unknown Inadiquate HBIG+ vaccine Adequate no treatment No treatment Inadequate anti HBSAg vaccine booster

7. Precautions (1) use of personal protective equipmen (2) use of safe disposal waste containers for potentially infected needles, sharps, and other materials (3) not recapping needles (4) appropriate handling of needles and sharp instruments during surgery and other medical procedures involving blood or blood products (5) transportation of blood samples, syringes and needles in safe waste disposal containers

8. Post-Exposure Management Procedures (1)How to respond in the event of exposure to potentially- infected blood or blood products (2) Counseling and testing the high-risk patient and the exposed HCW (3) Use of rapid HIV tests, when available (4) The risks, benefits, and efficacy of antiretrovirals and HBIG for PEP (5) The need for immediate counseling of and physician referral for HCWs who seroconvert after exposure to infection

9. Healthcare worker occupational safety programs (1)Provision of effective barrier-protection and waste disposal for infected needles and sharps (2) Education on the need for and appropriate use of barrier protection and waste disposa (3) Strict guidelines on the reporting of exposures to bloodborne pathogens (4) Responsive post-exposure prophylaxis (PEP) programs that include counseling, testing, and provision of effective PEP drugs and vaccines.