1. BLOODBORNE PATHOGENS Presented By Anchorage Fire Department

2. WHY are we doing this training?

3. We can’t ignore it!

4. OSHA BB Pathogen standard “The employer shall provide an annual training for all employees…” OSHA 1910.1030 The more you know, the better you will perform in real situations!

5. Definition “ Bloodborne Pathogen " means any pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to HBV, HIV and HCV.

6. Common BB Pathogen Diseases Malaria Brucellosis Syphilis Hepatitis B(HBV) Hepatitis C(HCV) Human Immunodeficiency Virus (HIV)

7. HEPATITIS

8. Hepatitis A, B, C, D and E: More Serious Than You Think Hepatitis is a disease characterized by inflammation of the liver. Viral hepatitis refers to several common diseases caused by viruses that can lead to swelling and tenderness of the liver.

9. HEPATITIS A Hepatitis A – is known as “Infectious Hepatitis”. This disease is often associated with fecal contamination in water and is spread person-to-person through poor sanitary habits and the intake of uncooked food or unclean water.

10. It takes about 15-50 days to develop symptoms of hepatitis A after exposure. Symptoms usually disappear even without treatment about two weeks later. Symptoms resemble the flu.

11. Hepatitis B What is Hepatitis B? Caused by hepatitis B virus (HBV) Is a disease that damages the liver, causing symptoms that range from mild or unapparent to severe or fatal.

12. Hepatitis B (HBV) Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting HBV can survive for at least one week in dried blood Symptoms can occur 1-9 months after exposure

13. What occupational exposures put a worker at risk for HBV? Contact with blood or potentially infectious body fluids through: 1.Needle-stick 2.Mucous membranes of eyes, nose and mouth 3.Broken or non-intact skin

14. Hepatitis Can Not be spread: breast feeding sneezing hugging or kissing coughing sharing eating utensils or drinking glasses food or water casual contact HBV can live in a dry environment for at least 7 days.

15. HEPATITIS C Hepatitis C is considered to be a more serious threat to fire fighters, paramedics and EMT’s than hepatitis B virus. According to the Center of Disease Control (CDC), hepatitis C is the most common chronic bloodborne infection in the United States.

16. Hepatitis C (HCV) Symptoms include:  jaundice, fatigue,  abdominal pain,  loss of appetite,  intermittent nausea, vomiting May lead to chronic liver disease and death

17. HUMAN IMMUNODEFICIENCY VIRUS (HIV)

18. HIV is the virus that leads to AIDS HIV depletes the immune system HIV does not survive well outside the body There is no threat on contracting HIV through casual contact Human Immunodeficiency Virus (HIV)

19. You cannot “catch” HIV: through the air (like a cold or flu) through casual, everyday contact (sharing bathrooms, kitchens, etc.) through nonsexual social situations through insects or mosquitoes through urine, feces, nasal secretions, sputum, vomitus, saliva, sweat or tears from an infected person.

20. HIV cannot live in dry environment for more than a few hours. Once the virus is dead – it’s dead. You cannot “reactivate” it by adding water.

21. Meningitis Bacterial Meningitis Neisseria meningitidis Streptococcus pneumoniae Haemophilus influenzae type b (Hib) infection Viral Meningitis Fungal Meningitis

22. Shingles “Shingles is a painful localized skin rash often with blisters that is caused by the varicella zoster virus, the same virus that causes chickenpox. Anyone who has had chickenpox can develop shingles because it remains in the body after the chickenpox infection clears Shingles most commonly occurs in people 50 years old or older. ” CDC Posted Jan 2011

23. TUBERCULOSIS AIRBORNE PATHOGEN SIGNS & SYMPTOMS: COUGHING SUDDEN WEIGHT LOSS NIGHT SWEATS

24. TUBERCULOSIS Spread through the air by coughing, sneezing, laughs, or singing. Alaska has a high rate of TB in its rural population.

25. Signs and symptoms High fever Headache Stiff neck Other Symptoms Nausea Vomiting Discomfort looking into bright lights Confusion sleepiness

26. TETANUS A bacterial disease that affects the nervous system. Caused by soil contaminated with manure. Health & Human Services recommends being vaccinated.

27. Vaccinations

28. Hepatitis A Vaccine available

29. Strongly endorsed by medical communities. Offered to all potentially exposed employees. Provided at no cost to employees Declination forms are available for those not wanting the immunization. Vaccinations Hepatitis B (HBV)

30. There is no vaccine to prevent hepatitis C. Vaccinations Hepatitis C

31. There is no vaccine at the present time. Vaccinations Human Immunodeficiency Virus

32. For Bacterial Meningitis Meningococcal conjugate vaccine (MCV4) Ages 2 to 55 years of age Menactra® (2005) Menveo® (2010) Meningococcal polysaccharide vaccine (MPSV4) Older than 55 years of age Menomune® (1981) Vaccinations Meningitis

33. Vaccination MMR (Measles, mumps & Rubella) Varicella (Chickenpox) Influenza Viral Meningitis

34. Vaccinations Shingles CDC recommends Zostavax for use in people 60 years old and older to prevent shingles. This is a one-time vaccination.

35. Tetanus The vaccine is Tetanus toxoid. It is usually given with Diphtheria, & Pertussis vaccine. (DTP) Typically, a booster is given if a wound is dirty and the last Td booster was given more than 5 years previous to the injury. Otherwise, recommendation for Tetanus Booster is every 10 years. Vaccinations

36. Your Exposure Potential Industrial exposure Administering first aid Post-accident cleanup Handling of returned product Janitorial or maintenance work Handling of any waste products P&I 200-2 “Infectious Disease Prevention & Control Program.

37. Standard Precautions Use of proper PPE Treat all blood and bodily fluids as if they are contaminated Proper cleanup and decontamination Disposal of all contaminated material in the proper manner

38. Personal Protective Equipment (PPE) Anything that is used to protect a person from exposure

39. OperationGlovesGlassesMaskImpervious Gown Any medical response Yes Optional Uncontrolled bleeding Yes Controlled bleeding Yes Optional Childbirth Yes Coughing, spitting patient Yes Optional Nebulized Medications Yes Optional Invasive airway procedures Yes Optional Handling/cleaning possibly contaminated equipment Yes Optional Handling/cleaning obviously contaminated equipment Yes Cleaning the patient compartment after a call – without obvious contamination Yes Optional Station Cleaning YesOptionalNo Required PPE Table

40. Always check PPE for defects or tears before using If PPE becomes torn or defective remove and get new Remove PPE before leaving a contaminated area Do not reuse disposable equipment PPE Rules to Remember

41. Decontamination of PPE PPE should be removed and disposed of in biohazard containers. The cleaning of contaminated PPE and work uniforms shall not be done at home. Non-disposable PPE shall be cleaned whenever necessary.

42. Regulated Medical Waste Liquid or semi-liquid blood or other potentially infectious material (OPIM) Contaminated items that would release blood or OPIM when compressed Contaminated sharps Pathological and microbiological waste containing blood or OPIM

43. Signs & Labels Labels must include the universal biohazard symbol, and the term “Biohazard” must be attached to: containers of regulated biohazard waste refrigerators or freezers containing blood or OPIM containers used to store, transport, or ship blood or OPIM

44. Exposure Incident Report all exposures involving blood or bodily fluids to dispatch. Dispatch will contact the on duty Safety Officer. Do not seek treatment without contacting the Safety Officer.

45. Post-exposure Evaluation Confidential medical evaluation Document route of exposure Identify source individual Test source individuals blood (with individuals consent) Provide results to exposed employee

46. Recordkeeping Medical records include: Vaccination status Post-exposure evaluation and follow-up results Training records include: Training dates Contents of the training Name of trainer and trainee

47. Hand Washing Wash hands immediately after removing PPE A hand sanitizer can be used but wash with soap and water as soon as possible thereafter Hand washing is your best defense against exposure.

48. Protection The best defense is a great offense. Recognize and protect yourself Keep up to date with recommended immunizations is the best defense. Maintaining healthy habits, like getting plenty of rest, washing hands.

49. In Conclusion BB pathogen rules are in place for your health and safety Failure to follow them is a risk that does not need to be taken

50. Contact your Safety Officer.