1 Bloodborne Pathogens

2 Standards 29 CFR (Federal) Part 554 Bloodborne Infectious Disease (Michigan)

3 Scope To protect workers against possible contamination from a Bloodborne Infectious Disease.

4 When to comply? If there is an actual or reasonable anticipated risk of an exposure to blood or OPIM during routine tasks.

5 Definitions Bloodborne pathogen  HIV - the virus that causes the autoimmune deficiency syndrome (AIDS) (1-10+ years)  Hepatitis B (HBV) - acute or chronic infection of the liver (incubation 2-3 months)  Hepatitis C (HCV) (incubation 6-9 weeks)  Syphilis (incubation 3 weeks)  Others

6 Definitions Semen Vaginal secretions Amniotic fluid Cerebrospinal fluid Perioneal fluid Pleural fluid Pericardial fluid Synovial fluid Saliva in dental procedures Any bodily fluid that is visibly contaminated with blood. Any body fluid that you cannot recognize if there is blood in it. Other Potentially Infectious Material (OPIM) (State Rule (s))

7 Definitions Sharps - Any item that has a potential to cut or puncture skin. (broken glass, needles, lancets, etc.)

8 Exposure Determination/Categories Category A  Reasonable exposure  Non-routine tasks as a condition of employment. Category B  No anticipated exposure

9 Exposure Control Plan Exposure determination Implementation of the “rules” Training outline Incident reporting and evaluation SOPs Annual review Available to employees

10 Methods of Compliance Universal Precautions Engineering and Work Practice Controls Personal protective equipment Housekeeping

11 Universal Precautions Blood and OPIM treated as Infectious Material.

12 Engineering Controls Reduce exposure by design Self sheathing needles Sharp containers Sinks

13 Engineering Controls On January 18, 2001 OSHA Standard 29 CFR , Bloodborne Pathogens was revised. The major emphasis was "engineering" controls.  Methods to reduce exposure  Built-in safety devices  Annual review  Sharps injury log

14 Engineering and Work Practice Controls: (d) Employers must select and implement appropriate engineering controls to reduce or eliminate employee exposure.

15 Engineering and Work Practice Controls The employer must:  Train employees to use new devices and/or procedures

16 Sharps Container

17 “SESIP” New Definition Non-needle sharp or a needle with a built- in safety feature or mechanism that effectively reduces the risk of an exposure incident. Sharps with Engineered Sharps Injury Protections

18 Hypodermic syringes with “Self-Sheathing” safety feature Self-sheathed protected position

19 Hypodermic syringes with “Retractable Technology” safety feature Retracted protected position

20 Phlebotomy needle with “Self-Blunting” safety feature Blunted protected position

21 “Add-on” safety feature Attached to syringe needle Attached to blood tube holder

22 Retracting lancets with safety features Before During After In use After use

23 Disposable scalpels with safety features Retracted position Protracted position

24 Work Practices Reduce exposure by work habits Wearing gloves Washing hands Using sharp containers NO food, etc.

25 Work Practice SOPs Standard Operating Procedure Each task should have a written procedure to reduce risk of exposure.

26 Personal Protective Equipment (PPE) Choose the correct ones for the task  Gloves, Protective Eyewear, Face Shield, etc. DON & DOFF

27 Housekeeping PPE Recordkeeping

28 Regulated Waste Determination of Regulated Waste Michigan Law  Medical Waste Regulatory Act - Part 138

29 Laundry Employer’s responsibility Personal Procedures (CDC Guidelines)

30 Vaccination When Cost - Employer’s Expense Time Waiver  What does it really mean?

31 Vaccination Efficacy, safety, benefits, administration Availability & Cost Timing Responsibility Waiver

32 Waiver What is it? What does it really mean? Employee has the right not to receive the HBV vaccine: however, must sign a waiver. The employee does have the right to request a HBV vaccine at a later date, at the employer’s expense.

33 Post Exposure Determination Procedure  prophylaxis Confidentiality

34 Labels and Warnings Labels Colors Symbols

35 Recordkeeping Training Post exposure

36 Recordkeeping: (h) Sharps Injury Log  Only mandatory for those keeping records under 29 CFR 1904  Confidentiality  Maintained independently from OSHA 300 log

37 Sharps Injury Log At a minimum, the log must contain, for each incident: Type and brand of device involved Department or area of incident Description of incident

38 Engineering and Work Practice Controls (con’t) The employer must:  Train employees to use new devices and/or procedures  Document in ECP

39 Training Outline Qualifications Law Access to Plan Annual retraining