Infectious Disease and Bloodborne Pathogens Training St. Michael-Albertville Public Schools

Questions? Any time throughout the slide show or throughout the school year: Contact Rachel Koehler at IEA Phone: 763.315.7900 rachel.koehler@ieasafety.com

What’s in it for me? Reminder on how to protect yourself from infectious diseases, including Bloodborne Pathogens (BBPs) Satisfy OSHA requirement for annual training of affected employees Question: Who is responsible for your safety? Answer: YOU ARE! Lead in to next slide with a statement of “Yes, OSHA requires training. And the district will provide all the tools and training to make sure you can be safe while on the job. But it is YOUR responsibility to use the PPE and follow the procedures. We do this so we can go home at the end of each day to this….” and then click to next slide.

Infectious Diseases A disease caused by a microorganism or other agent, such as a bacterium, fungus, or virus, that enters the body of an organism

Common Infectious Diseases Common Cold Chickenpox Measles Conjunctivitis (Pink eye) Influenza (flu) Head & Body Lice Pertussis (whooping cough) Meningitis (Bacterial or Viral)

The Infection Chain Infectious Agent (flu) Reservoir (you) Modes of Escape (sneeze) Modes of Transmission (airborne) Modes of Entry (hand to mouth) Host Susceptibility (immune system) Just need to break one link in the chain to prohibit infection from spreading! See or use infectious disease handout. Infectious Agents –hazardous biological materials that present a risk or potential risk to the health of humans or animals. Reservoir – This is where the disease lives inside your body. Modes of Escape – This is how the disease is spread from the infected person.   Modes of Transmission – This is how the disease moves from one person to another.   Modes of Entry – This is how a person becomes infected with a disease.   Host Susceptibility – This depends on the individual’s bodily reaction to the disease in question.

Break the Infection Chain Modes of Escape Cough and sneeze into your “sleeve,” not your hands! Modes of Entry Wash your hands Housekeeping Proper cleaning and disinfecting of high contact surfaces

Definition of Bloodborne Pathogen Pathogenic microorganism Present in human blood Can cause disease in humans Most common BBPs are: Hepatitis B Hepatitis C HIV

Infectious Body Fluids Blood Other Potentially Infectious Materials (OPIMs) Semen Vaginal Secretions Cerebrospinal Fluid Pleural Fluid (or Lung Fluid) Synovial Fluid (or Fluid from Your Joints) Amniotic Fluid (or Uterine Fluid) Peritoneal Fluid (or Fluid that fills your body cavity) Saliva in Dental Procedures Any Body Fluid that is Visibly Contaminated with Blood

BBPs Are NOT Spread By… Urine Feces Vomit Saliva Nasal Secretions Air Food Water ….Unless Visibly Contaminated with Infectious Blood!!!

Purpose of OSHA Standard To reduce or eliminate occupational exposure to potentially infectious materials which could cause disease or death. Designed to protect 5.6 million workers in healthcare and related occupations.

Who Does it Cover? All employees for whom exposure can be “reasonably anticipated” as part of their normal job duties Health care occupation primary focus Employer responsible for evaluating potential for exposure Excludes Good Samaritan activities (e.g. A teacher breaking up a fight)

BBP Program Requirements Evaluation of employee activities Develop Exposure Control written plan Practice Universal Precautions Hepatitis B vaccinations and titers Post exposure procedures Personal protective equipment Training Annual review Recordkeeping Plan - Identifies jobs/tasks where occupational exposure occurs Schedule of implementation Procedures for evaluating exposure incidents Accessible to all employees & OSHA Review/update annually

Exposure Control Written Plan A written plan in which potential exposures are listed along with appropriate responses The BBP program coordinator is Julie Winkelman, District Nurse Accessible to all employees & OSHA Reviewed/updated annually

Types of Bloodborne Diseases

Human Immunodeficiency Virus Virus that causes AIDS. HIV affects the immune system, slowing destroying white blood cells. Virus is killed easily outside of body (once blood is dry, HIV considered no longer communicable) There is no vaccine to prevent HIV From the Public Health Image Library – Center for Disease Control and Prevention

Symptoms of HIV Weakness/Fatigue Fever Sore throat Nausea Headaches Swollen lymph glands Sometimes no immediate symptoms

Hepatitis B Virus (HBV) Attacks liver 90% of infected adults are acute carriers Death occurs in 15-25% of chronically infected people Vaccine preventable Virus is only killed by high-level bactericides From the Public Health Image Library – Center for Disease Control and Prevention

Symptoms of Hepatitis B Fatigue Possible stomach pain Loss of appetite Nausea Jaundice Darkened urine Sometimes asymptomatic (~30%)

Hepatitis C (HCV) Attacks liver No vaccine 80 of infected people are chronic carriers 50-55% develop chronic liver disease Treatment with interferon but has side effects

Symptoms of Hepatitis C Fatigue Joint pain Stomach pain Itchy skin Sore muscles Dark urine 80% of carriers are asymptomatic and may be for 20-30 years

Modes of Transmission Sexual contact Infected mother to child Exposure to another person’s blood Contaminated needle sharing (drug use) Accidental poke by used needle or other contaminated sharp (e.g. broken glass) Blood contact with non-intact skin Blood contact with mucous membranes (i.e. eyes, nose, mouth) Blood transfusions

Common Occupational Transmissions Needle-sticks (80% - mostly in healthcare) Contaminated sharps/glass/ceramics Mucous membranes (eyes, nose, mouth) Open wound that is exposed to someone else’s blood (includes skin rash, dermatitis broken cuticles, cut)

Methods of protection  

Universal Precautions Treat ALL blood/body fluids as potentially infectious!!! Avoid skin exposure to blood and OPIM Use a barrier to keep fluids from contacting skin Dispose of sharps in a puncture resistant container Dispose of soiled items in leak –proof bags/containers Wash Hands for 20 seconds with friction/soap/water Contact custodian to clean/disinfect spill ASAP!

Vaccinations HIV Hepatitis B Virus Hepatitis C Virus There is NO vaccine for HIV. Some treatments can improve length of life dramatically. Hepatitis B Virus The HBV vaccination is administered in a series of 3 injections Given at 0, 1, and 4-6 month intervals Effective in 95% of people who complete series of all three shots Series may continue if exceeded interval (i.e. do not have to start over even if 1st shot was 2 years ago) Hepatitis C Virus There is NO vaccine. Treatment is only effective in 40% of cases.

Hepatitis B Vaccination Available at no cost to all St. Michael-Albertville Public School employees who are “covered” under the BBP Program. Titer test (blood draw) required for new “health care worker” after receiving the HBV vaccination If you would like to receive the HBV vaccination at no cost, contact Julie Winkelman.

Engineering Controls Sharps containers Self-Sheathing Needles Closable, leak proof, puncture resistant Used for disposal of used needles and other contaminated sharp objects (e.g. broken glass) Located in school health offices Self-Sheathing Needles Avoid having to re-cap needles!

Administrative Controls No food or application of cosmetics in the area where blood or other body fluids are present! Direct victims in self-care where possible Hand-washing facilities present throughout our schools

Personal Protective Equipment Gloves shall be worn when it can be reasonably anticipated that you may: Have hand contact with blood or other infectious materials Have hand contact with mucous membranes Have hand contact with non-intact skin Handle or touch contaminated items or surfaces Please speak with your supervisor if you need PPE

Gloves Don prior to contact with blood Check for proper fit Check for punctures Wash hands before/after Pull snug to insure good fit Peel off from wrist to fingers Dispose of in waste container Do not reuse

First Aid Procedures Assess the situation - call nurse for assistance or send injured to nurse’s office Use personal protective equipment Instruct injured person on self-care – if they can hold a tissue to their nose or apply a band aid themselves, have them do it! Wash hands immediately afterwards Don’t exceed your level of training!

Disinfectants High level commercial germicides Products effective against HBV and HIV are approved by EPA Follow label instructions PPE Disposal Kill time Make Sure You Have a Proper Disinfectant!

Infectious Waste Materials used to clean up blood spills (e.g. absorbent material, gloves) typically can go in general trash as long as they are bagged separately first Contaminated sharp objects (e.g. used needles and broken glass) should always go in sharps container Red biohazard bags require special disposal procedures. Use only if absorbent material is: Saturated or dripping Pourable Avoid blood pooling in waste container

Post exposure procedures

What qualifies as a blood exposure? “Exposure Incident” means a specific eye, mouth, other mucous membrane, non-intact* skin, or parenteral** contact with blood or other potentially infectious materials that results from the performance of an employee’s duties. *Non-intact skin includes skin with dermatitis, hang-nails, cuts, abrasions, chafing, acne, etc. **Parenteral means piercing mucous membranes or the skin barrier though such events as needle sticks, human bites, cuts, and abrasions. When an employee experiences an “exposure incident”, the employer must institute the required follow-up procedures in their plan. Read slide contents directly. Then, Summarize by saying: “Exposure incident” means that an actual event has occurred where a route of exposure has been established in the affected worker. When reading and implementing the requirements set forth in the bloodborne pathogens standard, it is important to understand the difference in meaning between “occupational exposure” and “exposure incident”.

Post-Exposure Procedures Wash exposed area IMMEDIATELY! Flush splashes to nose, mouth, or skin with water. Irrigate eyes with water or saline. Report the exposure to supervisor and District Nurse. Fill out a first report of injury and a copy of the Post Exposure Follow-up Packet(obtain from Health Services) Seek assistance of health care professional to determine follow-up actions (if necessary).

Additional Post-Exposure Procedures If possible, identify source individual Attempt to get permission for a blood test from source individual (if authorized) Blood testing for exposed individual (if authorized) Findings & diagnosis must be kept confidential Treatment and counseling by a physician available if needed

Training Offered to all employees covered in district’s BBP plan Annual Includes the following: Background of Standard Activities which may result in exposure Safe work practices/PPE How to handle clean-ups Signs & symptoms of disease Hepatitis B vaccination Post exposure procedures

Recordkeeping Medical Training Exposure Incident duration of employment + 30 years Training 3 years Exposure Incident

Quiz and Questions Please click on the link below for the BBP Quiz. That will be your documentation of training for this year. https://www.surveymonkey.com/s/QG5M2SQ If you have any questions throughout the quiz, please contact Rachel Koehler with IEA at 763.315.7900 or rachel.koehler@ieasafety.com