Bloodborne Pathogens In the School Setting Julie A. Strunk, RN BSN

Why do we need to do this each year? OSHA requires annual training for employees who are at occupational risk of exposure to bloodborne pathogens The purpose of the regulation is to protect employees against exposure to bloodborne pathogens which could lead to disease or death

Bloodborne Pathogens Definition Bloodborne Pathogens are microorganisms (such as viruses) transmitted through blood, or other potentially infectious material such as certain bodily fluids (semen, breast milk, etc.) or tissues.

Bloodborne Pathogens Body fluids, especially those visibly contaminated with blood, are capable of causing disease. Pathogens can enter your body through a cut or break in the skin, through your eyes or mucus membranes. Can also be transmitted sexually Main diseases of concern are Hepatitis B and C viruses and HIV (AIDS virus)

HIV Human Immunodeficiency Virus HIV attacks your body’s ability to protect itself against disease Initially there are no visible signs of having the virus Most people with HIV develop AIDS There is no vaccination for HIV

HIV The HIV Virus can live outside of the body for only a few hours 10-50 virus particles per ml of blood There are 4 modes of transfer: Blood Semen Vaginal secretions Breast milk

Hepatitis: Inflammation of the Liver Types of Viral Hepatitis Hepatitis A (HAV) fecal / oral Hepatitis B (HBV) bloodborne Hepatitis C (HCV) bloodborne

Hepatitis B and C Up to 100 times easier to catch than HIV Unlike HIV, the Hepatitis virus can live outside of the body for several days 1,000,000 – 1,000,000,000 virus particles per ml of blood

Concentration of Hepatitis B Virus in Various Body Fluids Low/Not ___High Moderate Detectable_ Blood Semen Urine Serum Vaginal Fluid Feces Wound exudates Saliva Tears Breast milk

HIV vs. Hepatitis B

Reasons Not To Receive the Hepatitis B Vaccine Previous infection with HBV Yeast sensitivity Thimerosal sensitivity Pregnancy Immunosuppressive therapy

Hepatitis C 3-4 million carriers, most common bloodborne infection in US Disease can incubate for decades and most people have no symptoms By 2010 may affect more Americans each year than AIDS HCV is not related to the viruses that cause Hepatitis A or B No Vaccine or effective post-exposure prophylaxis 85% develop chronic infection Leading indication for liver transplants

Sources of Infection for persons with Hepatitis C

The “OTHER” sources of infection Hepatitis C The “OTHER” sources of infection Contact with infectious body fluids to broken skin Contact with infectious body fluids to mucous membranes Puncture wounds with used needles

Symptoms of Hepatitis B or C Flu-like symptoms Fatigue Jaundice Severe pain in joints Lung disease Inflammation of the liver Inflammation on and ulcers of the colon May be asymptomatic (no symptoms)

There is no cure for Hepatitis B or C There is a vaccine for Hepatitis B

How are Bloodborne Pathogens Spread on the Job? By a sharp object that is contaminated by the virus when it cuts or punctures the skin When a contaminated object touches inflamed skin, acne, skin abrasions When a contaminated surface is touched, then eyes, nose, mouth, open wounds or inflamed skin is touched

UNIVERSAL PRECAUTIONS How to Reduce Your Risk UNIVERSAL PRECAUTIONS STANDARD PRECAUTIONS "Universal precautions," as defined by CDC, are a set of precautions designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens when providing first aid or health care. Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious for HIV, HBV and other bloodborne pathogens.

If It’s Warm, Wet, and Not Yours, DON’T Touch It!

How to Reduce Your Risk Needles and other sharps must be discarded in rigid, leak-proof, puncture resistance containers When emptying trash containers, do not use your hands to compress the trash in the bag Lift and carry the trash bag away from your body                                                             

How to Reduce Your Risk Do not eat, drink, smoke, apply cosmetics or handle contact lenses in areas where there is the possibility of exposure to BBP

How to Reduce Your Risk Personal Protective Equipment (PPE) Gloves Masks Eye protection CPR microshields

Clean-up Procedures

Cleaning Up Body Fluid Spills Please call the office or custodial staff for a body fluid spill. Keep students away from the contaminated area until cleaned.

Gloves Glove removal and disposal technique Grip one glove near the cuff and peel it down until it comes off inside out. Ball it up in the palm of your gloved hand. Place two fingers of your bare hand inside the cuff of the remaining glove and peel glove down so that it also comes off inside out with the first glove tucked inside. Never touch the outside of the glove with your bare hands. Properly dispose of the gloves. Wash hands immediately.

Hand washing THE SINGLE MOST EFFECTIVE WAY TO PREVENT THE TRANSFER OF GERMS is to WASH YOUR HANDS using soap and running water. Scrub for at least 30 seconds, rinse well, dry with a paper towel.

What Should I Do If I Have Accidental Contact With Body Fluids? Wash area thoroughly with soap and warm water Contact School Nurse or Supervisor of Health Services Right Away! Report to your supervisor

Remember! Risk of exposure to BBP in the school setting is low Risk of HBV transmission in schools is rare There have been no cases of HIV transmission in school

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