Bloodborne Pathogens Training New York City Department of Education Office of Occupational Safety and Health 65 Court Street, Room 706 Phone #: (718) 935-2319 Fax #: (718) 935-4682 Emerson Greenidge, MS, CSP, Director Carine Jean-Pierre, MS, Research Scientist-Trainer

Bloodborne Pathogens Training New York City Department of Education Office of Occupational Safety and Health 65 Court Street, Room 706 (718) 935-2319 Emerson Greenidge, MS, CSP, Director -Conduct Bloodborne Pathogens, Hazard Communication & Right-To-Know and Laboratory safety training to DOE staff -- Scheduling Hepatitis B vaccinations for DOE staff --Scheduling the pick-up and removal of Regulated Medical Waste --Responds to Indoor Air Quality and other safety and health issues

Regulatory Agencies OSHA– A federal agency created in 1970. Responds to private employees Passed Bloodborne Pathogen Standard 29 CFR 1910.1030 PESH– Public Employees Safety and Health Bureau within NYSDOL Responds to public employees Adopts and enforces OSHA regulations– may be more stringent OOSH – New York City Department of Education office that responds to safety and health issues. Keeps NYCDOE in compliance

Bloodborne Pathogens.-1910.1030 Bloodborne Pathogens means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV). These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

Bloodborne Pathogens Diseases HIV Hepatitis B Hepatitis C Other…

Exposure Control Plan is a written plan which details your employer’s (NYCDOE) response to exposure to blood or other potentially infectious body fluids. should be located at each Department facility and should be easily accessible. has all the necessary forms for the program.

Health Education Program Manager Serves as the district contact regarding safety and health concerns from school staff Coordinates District Safety and Health program Trains and assists Site Administrators in program administration and implementation Liaison between District and OOSH Schedules Hepatitis B Vaccinations with OOSH

Site Administrator Aides the Principal in the coordination of the Bloodborne Pathogen program at your school Assists in identifying those in the exposure group Provides training for staff annually Liaise with district health coordinator

Exposure Determination Each principal/custodian/supervisor who has an employee(s) with occupational exposure must prepare an exposure determination. This exposure determination shall contain the following: A list of all job classifications in which all employees in those job classifications have occupational exposure; A list of job classifications in which some employees have occupational exposure, and

Exposure Determination (cont.’d) A list of all tasks and procedures or groups of closely related task and procedures in which occupational exposure occurs and that are performed by employees in job classifications listed in accordance with the Bloodborne Pathogen standard. This exposure determination shall be made without regard to the use of personal protective equipment.

Occupational Exposure Group Serves as peace officers (deans, AP, Principal) (Intimately) involved in bathroom care Designated first aid responder Social Workers/Guidance Counselors Kindergarten teachers/ Science teachers

Occupational Exposure Group Special Education teachers Deans Physical Education Instructors Designated First Aid Providers Shop and Lab Teachers School Health Aides Paraprofessionals Other

Occupational Exposure Group Site Administrator are not responsible for these groups Custodial employees Medical care provider for students (MD, Nurses, Therapist, Psychologist, etc…) Security staff (NYPD)

Employee Identification Form States that employee is aware of exposure risk due to job tasks Should be distributed and filled out to those in the Occupational Exposure Group who would like to take the Hepatitis B Vaccine for the fist time. Should be filled out in its entirety and collected by the school’s site administrator and returned to District Health Manager

Declination Form States that at-risk employee does not intend to take the vaccine at this time Should be distributed and filled out to those in the Occupational Exposure Group Like the Employee ID Form, a medical record and kept on file The individual may always change their mind Should be filled out each year by employees in exposure group if not previously completed the three dose series

Information and Training Must be done annually for returning employees and new hiring Must train all except the exceptions Must include Q&A Attendance sheet must be kept on file for 3 years

HIV HIV--Human Immunodeficiency Virus– the virus which causes AIDS Breaks down the immune system so that one becomes unable to fight off disease There is no cure but there are drugs that have been proven to extend life and improve its quality Transmitted via: blood, unprotected sex (body fluids), IV needles

Hepatitis C Hepatitis, an inflammation of the liver, caused by the Hepatitis C virus (HCV) Similar to Hepatitis B No vaccine, no cure

Hepatitis B Is an inflammation of the liver caused by the Hepatitis B virus. The virus is transmitted through introduction into an uninfected person from an infected person. Such an introduction must include contact with infected blood, infected blood products, or other potentially infected materials tainted with blood or body fluids.

Hepatitis B– Symptoms Most people do not show any symptoms– asymptomatic It may take from 28-160 days from exposure to symptoms Fatigue, diminished appetite, abdominal discomfort, jaundice, enlarged liver, liver damage, liver cancer

How is Hepatitis B spread: On the job Infected blood + mode of transmission + uninfected person = EXPOSURE Sharing needles Bites Mucus membranes Open wound

How is Hepatitis B spread: On the job Puncture wounds from sharps (needles, broken glass, etc.) Fluid entering nicks or cuts in the skin Touching a contaminated hand to the eyes, nose, mouth or other mucous membranes The only way to tell is a blood test

How is Hepatitis B spread: Outside the workplace Unsafe sex Intravenous drug use Blood transfusions

Hepatitis B may be found in many body fluids: Blood Urine Vaginal secretions Saliva Semen

Hepatitis B may be found in many body fluids: The virus may remain infectious in dried blood, on many different surfaces, for up to two weeks

Hepatitis B You + outside blood + mode of transmission = exposure incident There is no cure for Hepatitis B. There is prevention. Most adults infected with acute Hepatitis B recover.

Persons cannot contracted HBV or HIV from: Drinking fountains Toilet seats Swimming pools Doorknobs Insect bites Shaking hand Using the telephone Eating meals together Being exposed to sneezing or coughing

Questions? What regulation requires employer to protect employees against bloodborne pathogens? A) Right-To-Know Laws B) Hazard Communication Standard C) Bloodborne Pathogens Standard D) New York City Health Code

2) Most People infected with hepatitis B virus do recover Questions? 2) Most People infected with hepatitis B virus do recover and clear the infection? True False

Questions? 3) The written Exposure Control Plan: A) Should be easily accessible to all employees B) Describes how the Department will comply with the OSHA standard C) Should be located at each Department Facility D) All of the above

Personal Protective Equipment Personal protective equipment must be provided by the employer and used by the employee to protect oneself from possible infectious materials (gloves, shoe coverings, aprons, etc.).

Universal Precautions A practice whereas blood and other body fluids other than your own are treated as though they were infectious. Gloves and other physical barriers to protect oneself are utilized.

How can Occupational Exposure be Minimized? Observed Universal Precautions Assume that blood, blood products or materials contaminated with blood are infectious Wash hands immediately after contact with blood or potentially infectious fluids

All three vaccines are needed Hepatitis B– the shot How many vaccinations do I need? The vaccine is given in a three dose series. Dose #1 – Initial dose Dose #2 – 30 days after dose #1 Dose #3 – 4-6 months after dose #2 All three vaccines are needed

More about the vaccine The vaccine is free and on the Department’s time. The vaccine will only be given to those who have been trained. The vaccine has been proven to be 90%+ effective Protected for lifetime No booster shots needed– immune memory The vaccine may not “work” for everyone.

Who is eligible for the Hepatitis B Vaccinations? Special Education teachers Principals/ Assistant Principals/Deans Physical Education Instructors Designated First Aid Providers Shop and Lab Teachers School Health Aides Paraprofessionals Custodial employees Medical care provider for students (MD, Nurses, Therapist, Psychologist, etc…) Security staff (NYPD) Other

More about the vaccine DO NOT TAKE THE VACCINE IF: You are allergic to yeast You are pregnant or planning to become pregnant within the year You are ill (cold, flu, or on medication) on your appointment date You are in doubt due to other medical issues, concerns or complications (see your Physician)

Regulated Medical Waste Regulated Medical Waste– liquid or semi-liquid blood or other potentially infectious materials. Such materials include soiled sharps and saturated materials.

Regulated Medical Waste Red bags and sharps containers are provided for the collection of regulated medical waste. A sharps container, red bag, and storage box should be available in the Nurse’s and/or Custodian’s office.

Regulated Medical Waste Materials soiled and saturated with blood or other potentially infectious materials should be discarded here, unwashed and unsorted. The Nurse or Custodian should contact the Office of Occupational Safety and Health (OOSH) at (718) 935-2319 for removal and replacements.

Other Potentially Infectious Materials Other Potentially Infectious Materials means (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids; (2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and (3) HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

Exposed – what to do? Post Exposure Procedure & Follow-up Policy: MUST KNOW, IF EXPOSED TO BLOOD If you have been contaminated by blood you may have been exposed to Hepatitis B, Hepatitis C, and/or HIV. Protect your health: Wash off the exposed area immediately. Report the incident to your Principal/Custodian/ Site Administrator in order to receive proper post-exposure evaluation and follow-up.

Post Exposure Procedure & Follow-up Policy Employees must be advised to seek medical attention immediately. The exposed employee must be informed that the doctor’s visit is provided free of any charge to him/her. If the employee declines to seek medical attention and evaluation, the employee must provide in writing the reason for the declination and a record of this declination must be kept on file.

Post Exposure Procedure & Follow-up Policy The employee must fill out completely the pertinent forms (Exposure Incident Report) in the appendix B of the NYCDOE Bloodborne Exposure Control Plan. The Principal must provide to the healthcare professional with the requisite information as per OSHA Standard, 29 CFR 1910.1030 (f)(4). The Healthcare professional must provide to the principal/administrator with a copy of his/her written opinion within 15 days of the evaluation. The copy must meet the requirement of OSHA Standard 29 CFR 1910.1030 (f)(5).

Post Exposure Procedure & Follow-up Policy The principal shall establish and maintain an accurate record for each employee with occupational exposure, in accordance 29 CFR 1910.1030 (h)(1). After the post exposure evaluation, the information provided by the physician to the school administrators should reflect the type of treatment and doctor’s opinion. Based on such information, a determination should be made as to whether or not the case is recordable on the Log and Summary of Occupational Injury and Illnesses form (SH 900). If the case is deemed as recordable, then it must be recorded as a privacy case, and the employee’s name must be omitted from all OSHA forms.

Post Exposure Procedure & Follow-up Policy The principal must ensure that all employees who are assigned to task where occupational exposure may place are provided with information and training at the time of initial assignment as per 29 CFR 1910.1030 (g)(2)(ii)(A). Your employer will reimburse medical expenses incurred because of an exposure incident. Forms and supporting documentation must be submitted to the Medical Claims Bureau. Your Site Administrator will be able to assist you in filing the appropriate forms.

EXPOSURE INCIDENT PACKAGE EXPOSURE INCIDENT REPORT IDENTIFICATION AND EVALUATION OF SOURCE INDIVIDUAL EMPLOYEE’S EXPOSURE FOLLOW-UP RECORD EXPOSURE INCIDENT REPORT LOG

SHARPS INJURY INCIDENT PACKAGE SHARPS INJURY REPORT IDENTIFICATION AND EVALUATION OF SOURCE INDIVIDUAL (IF KNOWN) EMPLOYEE’S EXPOSURE FOLLOW-UP RECORD SHARPS INJURY LOG

Questions? 1) Hand Washing is your main protection against the spread of infection? True False

Questions? 2) Hepatitis B virus can survive in dried blood on surfaces for at least one week? True False

3) Most exposure to blood result in infection. True False Questions? 3) Most exposure to blood result in infection. True False

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