1. Crime Scene and Crime Lab Safety
Bloodborne Pathogens

2. Who is OSHA? Occupational Safety and Health Administration
Created by Department of Labor by the Occupational Safety and Health Act of 1970

3. OSHA Purpose
To assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources

4. Bloodborne Pathogen Standard PURPOSE
To limit occupational exposure to blood and other potentially infectious materials since any exposure could result in transmission of BBP which could lead to disease or death

5. SCOPE
Covers all employees who could reasonably anticipate to face contact with blood or other potentially infectious materials

6. Motivation
OSHA estimates that 5.6 Million workers in the Health Care and other facilities are at risk of Exposures to Bloodborne Pathogens

7. Those at Risk Law Enforcement Personnel Firefighters Paramedics EMT’s
First Responders

8. OSHA Requires Training
Modes of Transmission
Symptoms
Epidemiology
Warning signals indicating exposure
Procedures to follow if exposure occurs

9. OSHA Requires Training
Recognizing tasks that may involve potential exposure
Practices that reduce exposure
Use of personal protective equipment (PPE)
Emergency procedures following exposure
Information on biohazard labeling

10. Modes of Transmission Disease transmission is two-way street
Pathogen is disease-producing organism that enters the body, basically a germ
Most infectious diseases are caused by one of 6 pathogens - usually bacteria or virus
Immune system relies on skin to limit amount of pathogens that enter the body

11. Four ways pathogens enter body
1. Direct contact
2. Indirect contact
3. Airborne
4. Vector borne

12. Transmission occurs with:
1. Presence of pathogen
2. Sufficient quantity of pathogen
3. Personal vulnerable to disease
4. Correct entry site for the pathogen
Also called portal of entry

13. Hepatitis Several types
Hepatitis B most serious health threat to healthcare workers die annually
Caused by Hepatitis B virus (HBV)
Damages liver, causing symptoms from mild or inapparent to severe or fatal
10% become HBV carriers. They develop liver disease and are infectious to others

14. Hepatitis Signs and Symptoms
Flu-like symptoms
Fatigue
Abdominal pain with nausea/vomiting
Loss of appetite
Jaundice
Liver ailments - cancer, cirrhosis

15. Hepatitis mode of transmission
Direct and indirect contact with
blood
saliva
semen
feces
food
water
other products

16. HBV Occupational Exposure
Needlestick %
Broken or nonintact skin
Mucous membranes of eyes, nose and/or mouth
Saliva through a human bite
HBV can live in dry environment for at least 7 days. Once virus is dead - it’s dead!

17. HIV/AIDS AIDS - Acquired Immunodeficiency Syndrome is caused by HIV
HIV is Human Immunodeficiency Virus
Outcome of virus varies:
Some have no symptoms
Some have less severe symptoms than AIDS
AIDS destroys immune system allowing life-threatening infections that threaten life and health

18. HIV/AIDS Symptoms Fever Night sweats Weight loss Diarrhea
Severe fatigue
Shortness of breath
Lesions

19. HIV/AIDS Transmission
Direct and indirect contact with:
blood
semen
vaginal fluid
other fluids possible

20. HIV transmission in person life
Anal sex
Vaginal or oral sex with someone who uses IV drugs or engages in anal sex
Sex with someone you don’t know well
Sex with someone who has multiple sex partners
Sex without a condom with an infected person
Sharing IV drug needles

21. Risk of occupational exposure
Needlestick 0.5% with contaminated needle
Chapped/broken skin or mucous membranes
Contact with blood or other body fluids

22. How to protect yourself?
HBV vaccinations
Wear Personal Protective Equipment (PPE) ALWAYS!
Avoid contact with mouth (use BVM or pocket mask for mouth-to-mouth)
Protect yourself from fluids that are potentially infectious - especially blood
Practice good hygiene, get plenty of rest and eat properly

23. Other diseases of concern
Herpes
Meningitis
Tuberculosis
Varicella - chicken pox
Mumps
Measles
And other childhood disease

24. Increasing Epidemically
TUBERCULOSIS
Increasing Epidemically

25. Tuberculosis By 1950’s antibiotics had put stop to epidemic
Recent comeback
Caused by:
Mycobacterium Tuberculosis
primary a human bacteria
spread by droplets of fluid being expelled from infected person then inhaled by uninfected person - airborne transmission

26. Risk Factors for TB Most significant is living conditions
cramped - prisons, long term care centers or homeless shelters
unsanitary conditions

27. DRUG RESISTANT STRAINS OF TB
OSHA issued mandatory guidelines
Prevention of Transmission
Multi resistant strains develop when non compliance with TB Rx

28. 25,500 cases were reported in the US in 1990
Since 1985 the incidence of TB in the general US population has increased 18 percent reversing a 30 year downward trend
25,500 cases were reported in the US in 1990

29. TUBERCULOSIS SYMPTOMS
Productive Cough
Coughing up blood
Weight loss
Loss of appetite
Lethargy/weakness/malaise
Night sweats
Fever - usually low grade
Swollen lymph nodes

30. Tuberculosis Precautions
Gloves and mask (hepa)
Vigorous hand-washing
Use disinfectant that is tuberculocidal
Mask for patient - if on medication cover mouth and nose when cough/sneezing
Have regular PPD tests - positive PPD indicates person is infected with TB only

31. EXPOSURE CONTROL PLAN
Requires employers to identify in writing, tasks & procedures as well as job classifications where occupational exposure to blood occurs
Must also set a schedule of implementation
Plan must be accessible to employees and to OSHA

32. METHODS OF COMPLIANCE Mandates Universal Precautions
Emphasizes Engineering and Work Place Controls
Procedures for Hand-washing, Minimize needlesticks, splashing & spraying of blood
Ensure appropriate packaging of blood/specimens

33. METHODS OF COMPLIANCE Regulates Waste
Decontamination Procedures for equipment
Labeling of Infectious or Contaminated Items
Employers must provide at no cost PPE (gloves, masks, face shields, goggles, safety glasses, lab coats, full body suits, repirators etc.)
Written Schedule for Cleaning and method of decontamination

34. METHODS OF COMPLIANCE Specifies methods of Disposing Sharps
Sets forth standards for containers
Sets standard for containers for regulated waste
Handling of contaminated laundry

35. HBV Vaccination
Requires vaccinations to be made available to all employees who are at risk
Procedures for Declination of vaccine.

36. POST EXPOSURE EVALUATION & FOLLOW UP
Procedures for all employees who have had an exposure
Laboratory Test at No Cost
Confidential
Post Exposure Prophylactics
Counseling

37. HAZARD COMMUNICATION Warning Labels Red Bags Containers
Restricted Areas

38. Biomedical/Biohazard Symbol

39. METHODS INTERMEDIATE-LEVEL DISINFECTANT
Use of chemical germicides that are tuberculocidal (bleach 1:10 dilution)
LOW-LEVEL DISINFECTING: Laundry detergents and hot water

40. CLEANING AND DECONTAMINATING SPILLS OF BLOOD

41. METHODS
Put on gloves and clean with disposable towels. Placed soiled towels in plastic bag
Wear eye and face protection if there is splashing
Wear shoe covers if amount of blood is great
Remove contaminated items, gloves last

42. WASH HANDS AFTER REMOVING GLOVES
Use soap and water if available, waterless soap if not until water can be accessed.