Bloodborne Pathogens Edgar Romo, REHS Environmental Health & Biosafety Specialist Janette De La Rosa Ducut, Ed.D. Training Manager

2 1. Access the Bloodborne Pathogens Standard 2. Identify epidemiology and symptoms 3. Explain the modes of transmission 4. Locate the Exposure Control Plan at UCR 5. Recognize tasks/activities 6. Identify methods of prevention 7. Decontaminate and dispose of PPE Objectives

3 8. Select proper PPE 9. Obtain, or decline, the Hep B vaccine 10. Follow emergency procedures 11. Take action in an exposure incident 12. Complete post-exposure evaluation 13. Recognize signs and labels 14. Manage biohazardous waste 15. Obtain answers to your questions Objectives

4 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Bloodborne Pathogens Standard The Standard Apply to all work where occupational exposure to bloodborne pathogens is reasonably anticipated View online at

6 Bloodborne Pathogens Standard Bloodborne Pathogens Microorganisms that are carried in blood that can cause disease HBV HIV

8 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Epidemiology and Symptoms Epidemiology Plan and evaluate strategies to prevent illness by studying how diseases occur.

13 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Modes of Transmission Routes of exposure Ways toxins enter the body Inhalation Absorption InjectionIngestion

15 Modes of Transmission Mucous Membranes InjectionNon-Intact Skin

16 Modes of Transmission Potentially infectious materials Transmission of a biohazardous agent via body fluid

17 Modes of Transmission Potentially infectious materials urine feces vomit tears sweat sputum nasal secretions

19 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Exposure Control Plan Exposure Control Plan Review online at 20

Exposure Control Plan 21

22 Exposure Control Plan Biological Use Authorization (BUA) Review the conditions / restrictions for use

24 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Tasks and Activities Determine if your tasks, activities, or job description involves exposure and protect yourself. 25

26 Tasks and Activities Follow precautions when handling… Syringes, needles, or sharps Emergency response Body fluids Spill clean-ups

27 Tasks and Activities Job Descriptions Physicians and Nurses Athletic Trainers Lifeguards Emergency Responders (i.e., UCPD) Laboratory workers Phlebotomists Biohazardous waste workers Custodians Groundskeepers

29 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Methods of Compliance Methods of Compliance Universal Precautions Housekeeping Engineering Controls Work Practices PPE 30

31 Methods of Compliance Universal Precautions Handle as if items were known to be infectious Wash hands and use protective barriers (i.e., PPE) for direct contact with blood and other potentially infectious materials.

32 Methods of Compliance Housekeeping Decontaminate with a 10% bleach solution (1 part bleach to 9 parts water) or other approved disinfectant for at least 15 minutes Sanitize with 1:10 bleach solution

33 Methods of Compliance Engineering Controls Eliminate or reduce exposure through use or substitution of machinery or equipment. Dispose of sharps in a puncture- proof container Needleless SystemUse aerosols in a Biological Safety Cabinet

35 Methods of Compliance Work Practices Implement safe ways of performing your tasks One-Hand Technique

36 Methods of Compliance Hygiene Avoid contact Check for open wounds Wash hands

38 Eating Drinking Smoking …in the laboratory Methods of Compliance NO

39 Methods of Compliance PPE Check for defects, remove properly, and replace immediately. Do not reuse.

41 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

PPE Selection PPE Gloves:Latex or Nitrile Eyes:Safety Glasses, Goggles or Face Shield Body:Lab Coat Feet:Closed-Toe Shoes 43

45 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

PPE Decontamination and Disposal After using Decontaminate (i.e., wash hands after removing gloves) Dispose of in biohazard containers 46 Properly remove PPE

49 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Hepatitis B Vaccination Hep B Vaccine Participate in a free series of three shots (80-95% effective at preventing infection)

Hepatitis B Vaccination Hep B Vaccine You may elect to decline the vaccine

Hepatitis B Vaccination Hep B Vaccine Receive the vaccine, OR Complete the Declination Form

54 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Emergency Procedures In Case of an Accident Obtain medical care and report the injury or illness

56 Emergency Procedures Spills Isolate, decontaminate, and wash hands

58 Emergency Procedures Review the Emergency Procedures online at

60 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Exposures Exposure Contact between eyes, mouth, mucous membranes, skin cuts, or abrasions

Injury Report Form Exposures Notification You complete an Injury Report Form UCR records exposures on a Sharps Injury Log. Sharps Injury Log

63 Exposures Emergency Procedures Wash skin immediately. Flush eyes with water for 15 minutes. Call 911 for help. Notify supervisor and EH&S.

65 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Post-Exposure Evaluation and Follow-Up Medical Evaluation Routes of exposure Source individual Blood testing Prophylaxis (if applicable)

68 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Signs and Labels Biohazard Symbol Flourescent orange or orange-red in color, with contrasting lettering

Signs and Labels Affix biohazard label

72 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Waste Biohazardous Waste Biologically contaminated waste that could potentially cause harm to human health, animal health, or the environment. Examples: cell cultures, transgenic plants, recombinant DNA, and waste from production of bacteria / virus / fungi / parasites. 73

74 Waste Liquid Waste The three types of biohazardous waste generated on campus are contaminated sharps, red bag waste, and liquid waste. Contaminated Sharps Red Bag Waste

75 Contaminated Sharps Waste Contaminated Sharps

76 Label with the word “Biohazard” and the biohazardous symbol Waste Contaminated Sharps

77 Store in approved sharps container Waste Contaminated Sharps

Labels

79 Store until the container reaches the fill line. Waste Contaminated Sharps Do not exceed fill line

80 Decontamination is not necessary (unless you plan to dispose as physically hazardous waste) Waste Contaminated Sharps

81 Dispose within the appropriate time after generation Waste Contaminated Sharps Within 90 days if stored below 0˚C Within 7 days if stored above 0˚C

82 Submit a waste pickup request online by visiting and clicking on “Waste Pickup” Waste Contaminated Sharps

83 Waste Contaminated Sharps Click on the link “Biohazardous or Radioactive Waste”

84 Waste Contaminated Sharps Enter information and click on “Submit”

85 Waste Red Bag Waste Red Bag Waste

86 Label with: “Biohazard” word 2. Symbol 3. Building 4. Room Number Waste Red Bag Waste Hinderaker 4108

87 Label with: 1. “Biohazard” word 2. Symbol 3. Building 4. Room Number Waste Red Bag Waste Hinderaker 4108

88 Waste Red Bag Waste Store in a labeled and leak-resistant secondary container

89 Waste Red Bag Waste Close containers when not in use.

Labels

91 Treat within the appropriate time after generation by autoclaving Waste Red Bag Waste Within 90 days if stored below 0˚C Within 7 days if stored above 0˚C

92 Red Bag Waste Waste Autoclave tape Place indicator tape on the red bag

93 Red Bag Waste Waste Autoclave Follow safe autoclave procedures

94 Red Bag Waste Waste Dispose of autoclaved waste in the building dumpster.

95 Red Bag Waste Waste Submit a waste pickup request online when autoclaving is not possible

96 Go to and click on “Waste Pickup” Waste Contaminated Sharps

97 Waste Contaminated Sharps Click on the link “Biohazardous or Radioactive Waste”

98 Waste Contaminated Sharps Enter information and click on “Submit”

100 Liquid Waste Liquid Waste

101 Label with: “Biohazard” word 2. Symbol Waste Liquid Waste

102 Waste Liquid Waste Store in a clear, non-breakable, container with positive closure

103 Treat within the appropriate time after generation by disinfecting Waste Liquid Waste Within 90 days if stored below 0˚C Within 7 days if stored above 0˚C

104 Mix 1 part bleach to 9 parts water Waste Liquid Waste

105 Add to liquid waste and wait for 30 minutes Waste Liquid Waste

106 Pour down drain (only if decontaminated) Waste Liquid Waste

107 Waste Mixed waste must be treated in the following order: 1. Radioactive 2. Chemical 3. Biohazardous

108 Waste Mixed Waste Waste that contains radioactive, chemical, and biohazardous components 32 P

109 Waste Mixed Waste Waste that contains radioactive and biohazardous components 32 P

110 Waste Mixed Waste Waste that contains chemical and biohazardous components.

112 Topics 1. Bloodborne Pathogens Standard 2. Epidemiology and Symptoms 3. Modes of Transmission 4. Exposure Control Plan 5. Tasks and Activities 6. Methods of Compliance 7. PPE (Selection) 8. PPE (Decontamination and Disposal) 9. Hepatitis B Vaccination 10. Emergency Procedures 11. Exposures 12. Post-Exposure Evaluation 13. Signs and Labels 14. Waste 15. Questions and Answers

Questions and Answers Biosafety Officer Call (951) Visit

Access the Bloodborne Pathogens Standard 2. Identify epidemiology and symptoms 3. Explain the modes of transmission 4. Locate the Exposure Control Plan at UCR 5. Recognize tasks/activities 6. Identify methods of prevention 7. Decontaminate and dispose of PPE Summary

Select proper PPE 9. Obtain, or decline, the Hep B vaccine 10. Follow emergency procedures 11. Take action in an exposure incident 12. Complete post-exposure evaluation 13. Recognize signs and labels 14. Manage biohazardous waste 15. Obtain answers to your questions Objectives

117 For more information ehs.ucr.edu