1. Bloodborne Pathogens Mandated Training
Sitka School District
Bloodborne Pathogens Mandated Training

2. FYI
School employees need to be aware of the potential danger of bloodborne diseases and how to protect themselves from them. Most school employees are NOT exposed to bloodborne diseases while performing their jobs 

3. The OSHA Bloodborne Pathogens Standard
The purpose of the law is to protect employees who have reasonably anticipated exposure to blood or other potentially infectious material (OPIM)

4. The OSHA Bloodborne Pathogens Standard
Our Exposure Control Plan describes who is covered under the Standard, what prevention and control measures we use, and what protective equipment we will provide to you. It also describes our housekeeping procedures, training information procedures, and record keeping.

5. Examples of Illnesses Pathogens Cause
a microorganism that can cause disease
Examples of Illnesses Pathogens Cause
Viruses
AIDS, Hepatitis B, colds, flu, Herpes
Bacteria
Intestinal diseases, Tuberculosis, Gonorrhea
Fungi
Athlete’s foot, Farmer’s lung, Asthma/allergies
Parasites
Giardiasis, Malaria, Trichinosis
“Microorganisms that cause diseases are generally referred to as pathogens. They are generally classified into four main groups:
“Viruses: Are extremely small infectious agents that are basically packages of genetic material. They can reproduce only within cells of living hosts by taking over and forcing the host cells to reproduce the virus. Some examples of illnesses they cause include AIDS (caused by HIV); Hepatitis B; a variety of colds and flus; and Herpes.
“Bacteria: Are one-celled living organisms that do not require a living host cell to reproduce. E.coli and salmonella are a couple of examples that cause intestinal diseases; tuberculosis and gonorrhea are other examples.
“Fungi: Fungi include yeasts and molds. They are single or multi-celled plants that live by decomposing and absorbing the organic material in which they grow. They can cause diseases such as athlete’s foot, ring worm, and farmer’s lung, and also cause asthma and allergies.
“Parasites: Are single or multi-celled plants or animals that live upon, or within, other living organisms (hosts) from which they obtain some advantage, like nutrients. Some examples include giardia (beaver fever); malaria; and trichinosis. Trichinosis is caused by eating raw or undercooked pork and wild game products infected with the larvae of the Trichinella worm.”
Trichinella (parasite)
E. coli (bacteria)
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6. Transmission of Diseases
Organisms can enter the body via
Inhalation
Air
Inhalation
Air
Ingestion
Contaminated
food or water
Contact
Bloodborne
“Routes of Transmission: The first step in preventing disease is to keep the organism from entering the body. There are three primary routes of entry:
“Inhalation: a pathogen is usually carried on respiratory droplets in the air and enters the respiratory system; for example, colds, flu, and tuberculosis are transmitted when an infected person coughs or sneezes and spreads the microorganism through the air to others.
“Ingestion: the pathogen is ingested, usually via contaminated hand or food. For example, in food-borne outbreaks of Hepatitis A, the virus is shed in the feces of an infected restaurant worker who doesn’t wash his/her hands properly after going to the bathroom, and then spreads the virus by handling or preparing uncooked foods or foods after cooking.
“Bloodborne contact: This is the focus of today’s training. In the following slides, I will explain how bloodborne diseases are transmitted, which diseases are of primary concern, their incidence and prevalence, and the symptoms of these diseases.”
NOTE: this slide is animated

7. Bloodborne Pathogens (BBPs)
Other Potentially Infectious Materials
Present in
Blood or
“Bloodborne Pathogens are microorganisms that are present in blood or other potentially infectious materials (OPIM) and can cause disease.
“’Blood’ includes human blood, human blood components, products made from human blood, and also medications derived from blood (e.g., immune globulins, albumin, etc.).”

8. Bloodborne Pathogens (BBPs)
OPIM
any unfixed tissue or organ (other than intact skin) from a human (living or dead)
HIV- or HBV-containing cultures (cell, tissue, or organ), culture medium, or other solutions
blood, organs, & tissues from animals infected with HIV, HBV, or BBPs
semen
vaginal secretions
body fluids such as pleural, cerebrospinal, pericardial, peritoneal, synovial, and amniotic
saliva (if blood is present)
any body fluids visibly contaminated with blood
body fluid where it is difficult to differentiate
“OPIM include certain body fluids or tissues that may contain bloodborne pathogens, such as”
(Run through the list.)
“Other body fluids and materials, such as saliva, tears, urine, and feces, are not considered OPIM unless they are contaminated with blood or with the OPIM body fluids or tissues listed on this slide.”

9. Modes of transmission of bloodborne pathogens
Blood borne pathogens can cause infection by entering your body in a variety of ways, including:
Open cuts
Nicks or sticks by sharp objects (broken glass, sharp metal, needles, knives, exposed ends of orthodontic wires)
Skin abrasions
Dermatitis
Acne
The mucous membranes of your mouth, eyes or nose (through splash or splatter of blood or other body fluids)
Illegal intravenous drug use
Sexual contact
An infected mother to her baby

10. Modes of transmission of bloodborne pathogens
rendering medical treatment
performing life-saving activities
providing first-aid
handling of potentially infected persons
performing clean-up and decontamination
procedures involving blood or other potentially infectious material
Tasks or procedures performed by employees that could potentially expose an employee to blood or other body fluids are:

11. Basic Precautions
There are basic precautions you can take to reduce your risks of
contracting bloodborne disease such as HBV or HIV. One of the
most effective work practice controls is also the most basic.
WASH YOUR HANDS. If a body fluid gets on your hands, wash immediately
NEVER touch anyone else’s blood
ALWAYS wear vinyl gloves when you anticipate that you might have had contact with blood or other potentially infectious material, mucous membranes or non-intact skin, and when handling or touching contaminated items or surfaces
ALWAYS refer bleeding children to health office personnel
If a child VOMITS in class, call the custodian for clean up
If you perform CPR, always use a disposable resuscitation device 

12. Actions to take and persons to contact in an emergency involving blood or other potentially infectious material
An exposure incident is defined by OSHA as a specific eye, mouth, other mucus membrane, non-intact skin, or contact with blood or other potentially infectious material that results from the performance of an employee’s duties. If you have an exposure during the course of your job, immediately report the incident to your supervisor.
Once you have reported an exposure incident, an investigation will be launched immediately. You, and possibly others at the scene, will be asked to provide information describing the incident. This information will be documented on a written Exposure Incident Evaluation Form. At your request, a copy of this documentation will be provided to you. 
WASH YOUR HANDS. If a body fluid gets on your hands, wash immediately.
NEVER touch anyone else’s blood.
ALWAYS wear vinyl gloves when you anticipate that you might have had contact with blood or other potentially infectious material, mucous membranes or non-intact skin, and when handling or touching contaminated items or surfaces.
ALWAYS refer bleeding children to health office personnel.
If a child VOMITS in class, call the custodian for clean up.
If you perform CPR, always use a disposable resuscitation device. 

13. Actions to take and persons to contact in an emergency involving blood or other potentially infectious material
Reporting an exposure incident immediately is very important. Medical
evaluation and follow-up are available to you once you are exposed. If you
consent, you will be provided, at no cost, with:
Blood tests to screen for HBV and HIV
A confidential medical evaluation
Post-exposure preventive treatment and counseling, as medically indicated
WASH YOUR HANDS. If a body fluid gets on your hands, wash immediately.
NEVER touch anyone else’s blood.
ALWAYS wear vinyl gloves when you anticipate that you might have had contact with blood or other potentially infectious material, mucous membranes or non-intact skin, and when handling or touching contaminated items or surfaces.
ALWAYS refer bleeding children to health office personnel.
If a child VOMITS in class, call the custodian for clean up.
If you perform CPR, always use a disposable resuscitation device. 

14. Exposure Controls Housekeeping Maintain a clean and sanitary workplace
Cleaning and decontamination schedule and procedures
Approved disinfectant – bleach, EPA-approved
Contaminated waste disposal methods
Laundry
DISINFECTANT
“All work areas are to be maintained in a clean and sanitary condition.
“A written schedule and detailed procedures for cleaning and decontamination is posted/located at (state location where maintenance schedule is placed in the work areas or in procedure manuals, policies, etc.)”
“Decontaminate all work surfaces with the appropriate disinfectant after completion of procedures, when surfaces are contaminated, and at the end of each work shift. The appropriate disinfectant is an *EPA-approved tuberculocidal or HIV/HBV-effective disinfectant, or a diluted (1:10 for spills, 1:100 for routine cleaning) bleach solution made daily.
(Lists of disinfectants are available from the EPA Office of Pesticides, antimicrobial pesticides website at

15. Communication of Hazards
Biohazard Labels and Signs
Predominantly fluorescent orange or orange/red background
Lettering and symbol in contrasting color to background
Must have biohazard symbol
Labels attached securely to any containers or items containing blood/OPIM
Red bags/containers may substitute for labels
Signs posted at entrance to specified work areas
“Containers containing blood or OPIM, or equipment contaminated with blood/OPIM must have this orange/red label with the biohazard symbol. The following must be labeled:
- regulated waste disposal
- sharps containers
- containers used to store, transport or ship (e.g., freezers)
- laundry
- contaminated equipment
- etc.
“The labels must be attached with string, wire, adhesive, or other method so they can't become lost or accidentally removed.
“Red bags or red containers may be substituted for labels. We use red bags for (list, e.g., laundry, etc.))

16. Regulated Waste - Containers
Exposure Controls
Regulated Waste - Containers
Easily accessible
Labeled or color-coded
Leak-proof, closeable
Puncture-resistant for sharps
Replaced routinely (do no overfill!)

17. Bloodborne Pathogens Employee Fact Sheet Hepatitis B Virus
Hepatitis B Virus (HBV) is a liver disease, initially resulting in possible inflammation of the liver, and frequently leading to more serious conditions, including cirrhosis and liver cancer. In the United States, there are approximately 300,000 new cases every year of HBV. 
Healthcare workers are 20 times more likely to contract Hepatitis B than the normal population. It is estimated that there are as many as 18,000 new cases of HBV each year among healthcare workers, resulting in deaths.
HBV is most often transmitted through breaks in the skin or mucous membranes. This usually occurs through needle sticks, human bites, or having blood or other infectious material get into existing cuts or abrasions. Hepatitis B can also be transmitted through caked, dried blood and from contacting contaminated surfaces.

18. Bloodborne Pathogens Employee Fact Sheet Hepatitis B Virus
The symptoms of HBV infection are flu-like. Initially, there is a sense of fatigue, possible stomach pain, loss of appetite, and nausea. As the disease develops, jaundice (a distinct yellowing of the skin) and a darkened urine will often occur. However, some people will show no symptoms and about 10% of infected people become “symptomless” chronic carriers of the virus.
While there is no cure for Hepatitis B, a vaccine does exist that can prevent infection.  
After exposure, it can take 2-6 months for Hepatitis B to develop. This is extremely important, since vaccinations begun immediately after exposure to the virus can often prevent infection. 

19. Bloodborne Pathogens Employee Fact Sheet Human Immunodeficiency Virus
Human Immunodeficiency Virus (HIV) is the “newest” of the major bloodborne diseases. HIV is spreading rapidly, and it is estimated that by the end of 1992 over two million people in the U.S. were infected. 
HIV is transmitted primarily through sexual contact and contact with blood and some body fluids. HIV is NOT transmitted by touching or working around people who carry the virus.

20. Personal Protective Equipment (PPE)
Task or Activity
Disposable
Gloves
Gown
Mask
Protective Eyewear
CPR (no bleeding)
Yes No
Pocket Mask, One-way  valve
Cuts and scrapes  
Simple Band-Aid placement  
Bleeding control with spurting blood
Yes (surgical mask)
Bleeding control with minimal bleeding 
Bloody nose    
Oral/nasal suctioning, manually cleaning airway  
No, unless splashing is likely
Handling and cleaning instruments with microbial contamination 
No, unless soiling is expected
Measuring blood pressure  
Measuring temperature  
Giving an injection  
Personal Protective Equipment (PPE)
Recommended For Protection Against Blood borne Pathogens
Adapted from: Guidelines for
Prevention of Transmission of HIV
And HBV to Health Care and Public
Safety Workers, U.S. Department
Of Health & Human Services,
Table 4, page 28, 1989.