Presentation on theme: "Bloodborne Pathogens Training"— Presentation transcript:
1 Bloodborne Pathogens Training University of Michigan-Flint.Environment, Health and Safety (EHS)
2 Course InformationThis bloodborne pathogens training program is required annually for UM employees who may reasonably anticipate contact with blood or other potentially infectious materials (OPIM), during the performance of their duties.
3 Course TopicsBloodborne Pathogens Standard (copy available from EHS and online)Bloodborne PathogensMode of TransmissionExposure Control PlanMethods of Prevention (Universal Precautions)UM Hepatitis B Immunization ProgramEngineering ControlsSharps DisposalPersonal Protective Clothing and Equipment (PPE)Spill ResponseBBP WasteCommunicable Diseases
4 Bloodborne Pathogens Standards and Regulations This program was designed to meet the requirements of:Occupational Safety and Health Administration (OSHA) Occupational Exposure to Bloodborne Pathogens29 CFR (1990).Michigan Occupational Safety and Health Administration (MIOSHA) Bloodborne Infectious DiseasesR R (1993).Needle stick Safety and Prevention Act (2000)Exposure Source Testing MI Act 368 of 1978These standards apply to workers who are at risk of exposureto pathogenic microorganisms associated with human blood.
6 Pathogenic Microorganisms Bloodborne Pathogens: are pathogenic microorganisms that are present in human blood or other potentially infectious materials (OPIM) and can cause disease. Pathogenic microorganisms include, but are not limited to:HBVHCVHIVWest NileMalariaSyphilisBrucellosis
7 Other Potentially Infectious Materials (OPIMs) Blood products, semen, vaginal secretionsSaliva in dental settingsAny body fluid that is contaminated with bloodAny body fluid of unknown sourceUnfixed tissues or organsHIV or HBV containing cells or culturesBlood, organs or other tissues from experimental animals infected with BBPIntroduction of human-derived materials (i.e. tumor cells) into animals.
8 Mode of TransmissionTransmitted when infected blood or bodily fluid enters the opening of mucosal membrane.Mucous Membranes are wet, thin tissue found in certain openings of the human body. These openings include the mouth, eyes and nose.Breaks in the skin are an ideal way for the contaminate to enter:CutsPuncturesAbrasionsRashesAcneHang NailsBandage affected area and wear double gloves to prevent transmission through breaks in skin.
9 Hepatitis B (Hep B)Infection of the liver which may lead to liver disease, liver cancer and possibly death. It is the leading occupational disease in the United States.12,000 cases of HBV were identified annually (up to the year 1992). Numbers have decreased to approximately 800 cases annually since the introduction of the immunization.HBV is extremely stable.It may survive 10 days outside of host!
10 Hepatitis B (cont’d)Approximately 10% of infected individuals may become "carriers“.This means that they may suffer from infection at a later time. They can also be infectious to others for the rest of their lives while not demonstrating any symptoms of HBV.Symptoms may occur 2-6 months after exposure and include:FeverVomitingJaundice (yellowing) of the eyes and/or skinLoss of appetiteDark-colored urineAches in muscles and joints
11 Hepatitis C (HCV)Viral infection of the liver that can be transmitted via blood or other potentially infected materialsSymptoms similar to those caused by HBVAlthough 80% of individuals may have no symptoms, these infected individuals may be lifelong carriers. No vaccine is available.Very difficult for body’s immune system to recover from HCV infectionLeading indication for liver transplants in the U.S.
12 Human Immunodeficiency Virus (HIV) Virus that causes Acquired Immunodeficiency Syndrome (AIDS)May be passed through infected blood or OPIMs that come in contact with broken skin or mucous membranesSome infected individuals will develop AIDS as a result of their HIV infection.Some individuals develop flu-like symptoms within 7-21 days after exposure.Recent studies suggest the best independent predictors of primary HIV infection are rash and fever among individuals recently exposed to HIV.HIV will not survive long outside host (~90-99% reduction within several hours).
13 Controlling the Risk of Exposure Here are the ways to reduce your likelihood of exposure to blood or other potentially infectious materials:Universal PrecautionsExposure Control plan (ECP)Hepatitis B VaccinationEngineering ControlsWorkplace ControlsSafe Work PracticesPersonal Protective Equipment (PPE)Proper Hand-washing TechniqueReporting exposures immediately and seeking medical follow-up treatment as soon as possible
14 Universal Precautions An infection control method where ALL human blood and other potentially infectious materials are treated as if known to be infectious.
15 Exposure Control Plan (ECP) The ECP must be made available to all employees who are determined to be at risk.Employees must be familiar with the ECP and know where it is located.ECP reviewed/revised ANNUALLY with input from employees.ECP is readily available to employees.
16 Reporting an Exposure Incident Is it work related?Date and time of exposureDetails of the procedure being performed, including where and how the exposure occurred. If related to a sharp device, the type and brand of device and how and when in the course of handling the device the exposure occurred must be included in the reportDetails of the exposure, including the type and amount of fluid or material and the severity of the exposureDetails about the exposure source if knownDetails about the exposed person… vaccinated?May need to attach sheet of paper with details to work connection form
17 Hepatitis B Vaccination Available to Category A employees at no costSeries of 3 injections:1st: given at anytime2nd: 1 month after first injection3rd: 5 months after 2nd injectionProvides protective levels of antibody in 97% of healthy individualsYou cannot get HBV from the vaccineNo booster shot required (lifelong immunity)According to the FDA, the current shot is one of the safest availableSide effects may include: soreness, redness and swelling at injection siteFor further information, EHS encourages you to contact your primary care physician/practitioner
18 Hepatitis B (cont’d) Vaccination need not be offered if… Individuals have previously received the complete seriesAntibody testing has revealed the individual is immuneThe vaccine is contraindicated for medical reasonsThe vaccine is NOT mandatory.Employer must offer the vaccine, however, you do not have to accept the vaccine.You may decline the vaccination series, in which you will be asked to sign a declination form.To receive the Hepatitis B Vaccine, please contact: UM-Flint (810)
20 No Vaccines for HCV and HIV There is no vaccine against HCV and no treatment after exposure that will prevent infection.There is no vaccine against HIV.The Public Health Service, under recommendations from the CDC, suggests a 4-week course of administration of the antiretroviral drugs depending upon the risk of transmission (exposures involving a larger volume of blood with larger amount of HIV). This should begin within hours after exposure.
21 Engineering ControlsAre used to isolate or remove the potential hazard from the workplace. Controls are used in combination with safe work practice controls.Sharps disposal containersHand washing facilities &waterless soap dispensersBiohazard bags/waste containersSpill/clean-up kitsUse tongs for picking up hazardous objectSharps disposal containersHand washing facilitiesBiological Safety CabinetsAutoclaveFacilitiesMechanical means to remove broken sharps items
22 SharpsDepartments generating sharp waste are responsible for proper disposal.Must use a puncture resistant plastic containerMust be located in area where sharps are usedSharp containers can only be filled to indicator line or ¾ full. Call EHS (810) for removal.Do NOT OVERFILL sharps container. Overfilled sharps container pose a risk to all workers.
23 Sharps (cont’d) Examples of sharps are: Needles Scalpels Razor blades LancetsContaminated glass Pasteur pipettesGlass capillary tubesContaminated broken glassContaminated microscope slides and cover slipsExposed ends of dental wires
24 Workplace ControlsWash hands after contacting body fluids or contaminated surfacesKeep fingernails shortScrub nail areaClean surfaces regularlyKeep disinfectant solution and waterless hand disinfectant nearby.Keep PPE in stock and readily available.
25 Safe Work PracticesPersonal Protective Equipment (PPE) must be removed before leaving the work areaClothing penetrated with blood or OPIM must be removed immediatelyFollow proper protocol for cleaning blood/bodily fluid spillsWash hands immediately after removing gloves or other protective clothing.Wash hands after contact with blood or OPIM.
26 ECDC Soiled Clothing Remove clothing immediately Place in a labeled plastic bag (To Be Washed) and separate from normal laundry and use proper laundering techniques. (Make sure water is hot, 82oC, and is on the hot cycle for at least 10 mins)Child’s clothing should be placed in a labeled plastic bag (Soiled) and should be sent home with parents
27 DPS/Medical Staff Soiled Clothing Remove clothing immediatelyPlace in a labeled plastic bag (Biohazard)Have clothing be sent to proper laundering facilities that will decontaminate the uniform
28 BBP Exposures Eyes: Flush with water Skin: Wash thoroughly with soap and water for 15 mins.IMMEDIATELY notify Supervisor & EHS.Go to UM Medical Providerfor post-exposure follow-up ASAP
29 Protective Work Clothing and Equipment (PPE) PPE shall be provided at no cost to the employee.Examples: GLOVES, goggles, apron, “booties”Assure appropriate PPE is readily accessible and fits properlySupervisor will monitor and ensure employee uses PPE.Provide for cleaning, laundering, or disposal of PPE.
30 Protective Work Clothing and Equipment (PPE) Hand Protection:Ensure equipment is availableNon-latex products must be available for individuals with latex allergiesDisposable gloves should be replaced if they are peeling, cracked, discolored, or if they have punctures, tears, or other evidence of deteriorationGloves of appropriate size must be availableDo not re-use disposable glovesRemove gloves before leaving the work areaAlways wash hands after removing gloves
31 Blood/Body Fluid Spills All spills must be safely cleaned as soon as possible.Wear gloves, gowns or lab coats and eye protection during clean up.A solution of 1:10 bleach and water or an EPA- approved disinfectant should be used.If broken glass is involved, it should be carefully removed using a mechanical device such as tongs or forceps and the broken glass placed in the sharps container.Never pick up broken glass by hand!
33 Spill Clean-up Procedure Cover and saturate with disinfectant. Let stand minutes. Clean and Dispose of Paper TowelRe-spray area with disinfectantRe-wipe with paper towelDecontaminate materials used to clean spillPut on personal protective equipmentRemove sharp objects carefully with forceps/tongsCircle spill with disinfectant. Use bleach (1:10 dilution), Lysol, Virex, or EPA registered tuberculocidal disinfectant
34 Disinfectant Procedure Information Take the necessary precautions when handling disinfectants because of them are caustic and hazardous chemicalsAlways prepare all disinfectants daily. Some prepared diluted mixtures, like bleach and water, are not stable and lose it’s efficacy as a disinfectant when not made dailyWhen using, spray on and allow to air dryIf area is heavily soiled, clean with detergent and water firstImpervious (waterproof) surfaces are cleaned differently than porous/fabric surfaces.Do not use commercially pre-saturated wipes to sanitize surfaces as their efficacy has not been testedThe contamination of the wipe during use may not be sufficiently controlled by the bleach solution in the wipe
35 Hand-washing First line of defense against infectious disease Hands and other skin surfaces must be washed immediately, and thoroughly, after handling potentially infectious materialsWash hands and lather, rubbing front and back for at least 20 seconds with soapRinse under running warm water from wrists to fingertipsDry with paper towel and turn faucet off with paper towelAfter watching the video, if there is one thing you could change, what would that be?
36 Employee Responsibilities Know and understand your department’s ECPWhat PPE should be worn? When?What do you do if you are not sure if a substance is a BBP or not?Who in your department is authorized to clean up blood? Category A or B? What are you?ALWAYS Follow SAFE Work Practices… maintain a clean and sanitary environment.Wash hands.Get HBV Vaccine or sign declination form. Discuss other vaccinations that are available for you with your family physician.Report all exposure incidents immediatelyParticipate in your department’s annual ECP review.
37 Other Communicable Diseases West NileMeningitisNorovirusH1N1Tuberculosis (TB)
38 West Nile Derived from being bitten by an infected mosquito The most serious form of WNV is FatalEncephalitis: inflammation of the brainIncubation period is 2-15 daysSymptoms include:High feverNeck stiffnessDisorientationComaTremorsConvulsionsMuscle weaknessParalysisAccording to the CDC, 1 in 150 people get infected, however, 4 out of 5people infected with the virus express asymptomatic infections. This meansthat they do not show any signs of sickness.
39 West NileAccording to the CDC, 1 in 150 people get infected, however, 4 out of 5 people infected with thevirus express asymptomatic infections. This means that they do not show any signs of sickness.There are 3 possible outcomes from beinginfected with WNV:Asymptomatic: you do not show any signs of infection (most people fall into this category)Develop West Nile Fever: experience symptoms (expressed in 20% of infected individuals)Severe West Nile Disease, West Nile Meningitis, West Nile Encephalitis: experience severe symptoms and possibly die (expressed in 1% of infected individuals)
40 MeningitisInflammation of the membrane (meninges) that covers the brain and spinal cordCaused by either:Viral Meningitis(Aseptic) Bacterial Meningitis
41 Viral Meningitis Caused by Enteroviruses Less severe and is healed without any specific treatmentSymptoms include:High feverSevere HeadacheStiff neckSensitivity to bright lightSleepiness or trouble waking upNausea, vomitingLack of appetiteSymptoms last between 7-10days with full recoveryNo specific treatment
42 Bacterial Meningitis Highly severe and some forms are contagious 2 strains of the leading cause of Bacterial Meningitis are Streptococcus pneumoniae and Neisseria meningitisSymptoms include:High feverHeadacheStiff neckDiscomfort looking into bright lightsNauseaVomitingConfusionSleepinessBrain damageHearing lossLearning disabilityDisability
43 Bacterial Meningitis (cont’d) Transmitted via respiratory and throat secretionsModes of transmission include:CoughingKissingSneezingNot as contagious as the flu, therefore, you cannot become infected through casual contactExample: You will not become infected if you breathe in the same air that someone with meningitis breathedIncubation period ranges from several hours to 2 daysThere are vaccines against some forms of meningitis.According to the CDC, the current vaccines available are safe and effective
44 NorovirusA type of Gastroenteritis: inflammation of the stomach and small and large intestinesCaused by a host of viruses that produces the outcome of vomiting and diarrheaAccording to the CDC, it is the leading cause of foodborne-disease outbreaks in the United StatesCommon name: Stomach Flu, but not caused by Influenza
45 NorovirusSymptoms:Watery diarrheaVomitingHeadacheFeverAbdominal crampsSymptoms begin 1 to 2 days after infection and lasts for 1 to 10 days depending on the strain of virus.Transmitted through contaminated food and beverages via the oral-fecal pathway
46 H1N1 (Variant Influenza Virus) Respiratory disease normally affecting pigs, caused by a specific strain that affects human beingsSpread through the direct contact of infected pig or infected personAccording to the CDC, human to human transmission is not as easily spreadSymptoms are similar to those of the human flu
47 Tuberculosis (TB)It is an airborne disease caused by bacterium, Mycobacterium tuberculosis, which attacks the lungs. It can also attack the kidneys, spine and brain. If untreated it can be fatal.There are 2 forms of TB:Latent TB: when the bacteria lives in the host’s body without making the person sick. They test positive for the TB skin test, however, they are not infectiousActive TB: when the bacteria is active in the host’s body and makes the person sick and is infectious.People can become infected if some one with active TB sings, speaks, coughs or sneezes in the nearby area.
48 Tuberculosis (TB) If infectious, there is a treatment. TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens include:isoniazid (INH)rifampin (RIF)ethambutol (EMB)pyrazinamide (PZA)Regimens for treating TB disease have an initial phase of 2 months, followed by a choice of several options for the continuation phase of either 4 or 7 months (total of 6 to 9 months for treatment).Treatment regimen must be fully completed to fully cured. If not taken as prescribed and correctly, infected person’s TB bacteria will become resistant to medication and would require a stronger and expensive medication.