Transcript Bloodborne Pathogens (BBP) Exposure Control Program

Bloodborne Pathogens (BBP)
Exposure Control Program
For
Laboratory Workers
At UNC Chapel Hill
In accordance with
Occupational Safety and Health
Administration (OSHA)
Bloodborne Pathogen Standard
29 CFR 1910.1030
1
In case of emergency…
Knowing the right steps to take after an exposure incident is critical to reducing the
likelihood of acquiring a bloodborne pathogen. Immediately after any exposure
incident:
•
Wash the exposed area with soap and water; if the exposure involves the eyes, you
should flush with tap water
•
Immediately report the incident to your supervisor and/or immediately call the
University Employee Occupational Health (UEOHC) at 6-9119.
Emergency Contact Numbers
UEOHC Clinic:
966-9119
Emergency:
9-911
Questions regarding this training:
962-5507
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
2
INTRODUCTION
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& 5 p.m.
3
BBP Training: Why should we do it?
1. It’s the law
2. It’s UNC’s
responsibility
3. Knowing this
information can
protect your health
and the health of
others
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
4
BBP Training: Why should we do it?
1.
2.
3.
It’s the law
It’s UNC’s responsibility
Knowing this information can protect your
health and the health of others
The complete OSHA Bloodborne
Pathogens Standard is available at the
OSHA website.
•
On March 6, 1992, OSHA created the
Bloodborne Pathogen (BBP) Standard to make
sure all employers strive to keep their workers
safe from bloodborne pathogens.
•
OSHA considers the Senior Scientist or Principal
Investigator (PI) of each laboratory to be an
employer. You work under the guidance of your
PI for some benefit; be it knowledge,
experience, or monetary compensation.
•
Most hazardous laboratory tasks are covered
under the OSHA Laboratory Standard and, at
UNC, these are tracked in your lab’s Laboratory
Safety Plan.
•
Some laboratory tasks are more likely to come
into contact with bloodborne pathogens.
•
OSHA regulates potential bloodborne pathogen
exposure separately from the Laboratory
Standard. The OSHA Standard requires annual
training and a vaccination or declination for
Hepatitis B virus.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
5
BBP Training: Why should we do it?
1.
2.
3.
It’s the law
It’s UNC’s responsibility
Knowing this information can protect your health and
the health of others
•
Employers demonstrate to OSHA that they are
following the Bloodborne Pathogens Standard
by implementing an Exposure Control Plan.
•
At UNC, every Principal Investigator adopts the
UNC Laboratory Exposure Control Plan.
•
The UNC Laboratory Exposure Control Plan lists
the steps UNC is taking to keep lab workers safe.
It is the plan to control every lab worker’s
exposure to bloodborne pathogens.
•
Annual training on the Exposure Control Plan is
one requirement of the OSHA BBP Standard.
The other requirement is a
vaccination/declination for Hepatitis B virus.
•
As a lab worker, this training fulfills your training
requirement.
•
The complete UNC Laboratory Exposure Control
Plan is available on the EHS website.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
6
BBP training: Why should we do it?
1.
2.
3.
It’s the law
It’s UNC’s responsibility
Knowing this information can protect your
health and the health of others
•
For lab workers, the potential for exposure to
some bloodborne pathogens may exist during
certain procedures, using particular devices, or
when encountering spilled human material such
as cell lines, blood , or body fluids, or improperly
handling waste from your laboratory.
•
Bloodborne pathogens and material potentially
containing bloodborne pathogens are handled
at Biosafety Level 2 (BSL-2).
•
The OSHA Standard requires the use of the
biohazard symbol to allow for communication of
potential biological hazards.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
7
EXPOSURE DETERMINATION IN THE UNC
LABORATORY
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
8
Exposure Determination
Each Principal Investigator is responsible for
ensuring the completion of the exposure
determination for each employee who works
with blood and/or Other Potentially
Infectious Material (OPIM) including human
cell lines.
This should be completed upon orientation and
“no later than 10 days after the date of
employment” (OSHA). The exposure
determination is documented via:
• The Laboratory Safety Plan Schedule A
(updated annually);
• The employee Lab Worker Registration Form;
and
• Followed-up during laboratory safety audits
conducted by UNC EHS.
This determination must made
without regard to use of PPE.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
9
I work in a lab, how do I determine
“Occupational Exposure”?
The OSHA definition of Occupational Exposure is
Reasonably anticipated skin, eye, mucous membrane or parenteral
contact with blood or other potentially infectious materials that may
result from the performance of an employee’s job duties.
Parenteral contact is:
piercing mucous membranes
or the skin by needlesticks,
human bites, cuts and
abrasions.
…for definitions f
blood or OPIM other
potentially infectious
materials), read on
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
10
For the purpose of making an
Exposure Determination,
OSHA defines blood as:
Blood:
Human blood, human blood
components, products made
from human blood
…so if you work with this
material in a lab setting,
you need to be enrolled
in the Bloodborne
Pathogens program.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
11
For the purpose of making an
Exposure Determination,
OSHA defines OPIM as:
Other Potentially Infectious Material
This includes:
• Certain human body fluids
• Any unfixed tissue or organ except
intact skin from human (living or
dead)
• Human cell lines
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
12
OPIM: Other Potentially Infectious Material
Certain human body fluids include:
•
•
•
•
•
•
•
•
•
•
Semen
Vaginal secretions
Cerebrospinal fluid
Synovial fluid
Pleural fluid
Pericardial fluid
Peritoneal fluid
Amniotic fluid
Saliva in dental procedures
Any body fluid visibly contaminated with
blood
• All body fluids when it is difficult to
differentiate between body fluids
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
13
Human Cell Lines
• OSHA's position has always been that
workers handling human cell cultures
(primary or characterized) fall under
the Bloodborne Pathogen (BBP)
Standard unless the cells have been
tested and proven to be free of
bloodborne pathogens.
• Because it is difficult to have cells
tested for all bloodborne pathogens
and ensure that they are never
contaminated with bloodborne
pathogens during research, UNC has
taken the position that work with ALL
human cell lines (including established
lines) fall under the requirements of the
BBP standard.
A HeLa Cell Line named after Heinratta Lacks, one of the
earliest human cell lines
•OSHA’s interpretation of the
BBP Standard that includes
human cell lines is available
here: Applicability of 1910.1030
to established human cell lines
(06/21/1994)
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
14
GENERAL RISKS AND TRANSMISSION
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& 5 p.m.
15
What are Bloodborne Pathogens?
Many diseases are linked to bloodborne pathogens, but few
bloodborne pathogens are frequently responsible for infections in
the workplace.
OSHA defines bloodborne pathogens as:
Pathogenic microorganisms that are present in human
blood that can cause disease in humans.
The risks and transmission of the following bloodborne
pathogens will be discussed in this training:
• hepatitis B virus (HBV)
• hepatitis C virus
• human immunodeficiency virus (HIV)
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
16
Other Bloodborne Pathogens Include:
•
•
•
•
•
•
•
•
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Non-A, non-B hepatitis
Treponema pallidum
(syphilis)
Plasmodium spp. (malaria)
Brucella spp.
Leptospira interrogans
Arboviruses
Borreliae
Creutzfeldt-Jakob disease
agent
Hemorrhagic fever viruses
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
17
Occupational transmission of HIV
among health care workers.
As of December 2001,
occupational exposure to
HIV has resulted in 57
documented cases of HIV
among healthcare
personnel in the United
States.
(Source: CDC 2003)
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
18
Laboratory Acquired HIV
Two workers in different laboratories producing large quantities of highly
concentrated HIV were documented to have laboratory-acquired HIV
infections.
One worker's infection was presumed to have been caused by "undetected skin
contact with virus culture supernatant". The most probable cause for this infection
was inapparent parenteral exposure. Gloves of questionable integrity, skin cuts and
abrasions, and one episode of a dermatitis-like condition represented portals for
possible exposure and routes of infection.
The other worker's infection followed "an injury with a potentially contaminated
needle". The most probable cause for the second worker's infection was parenteral
inoculation. This worker recalled incurring an injury with a blunt cannula
approximately 6 months before the first seropositive sample.
Source: MMWR 37(S-4);19-22, Publication date: 04/01/1988
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
19
Clinical Manifestations of HIV Infection
The clinical symptoms of HIV
infection ranges from those who have
no symptoms to those with severe
immunodeficiency or Acquired
Immune Deficiency Syndrome (AIDS).
Initial infection can be followed by an
acute flu-like illness with non-specific
symptoms such as fever, swollen
lymph nodes, rash, malaise, sore
throat, and headache.
Other symptoms can include
anorexia, chronic diarrhea, weight
loss, and fatigue.
Opportunistic infections and
malignant diseases without a known
cause for immune deficiency can also
be indicative.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
20
HIV Infection
Without treatment, the natural history of HIV infection can vary
considerably from person to person. The risk for disease progression
increases with the duration of infection. Approximately 20-25% of HIVinfected adults will develop AIDS within 6 years after infection and 50%
within 10 years. When an HIV-infected person develops certain diseases
or conditions, they are then classified as having AIDS. Three of the most
common clinical conditions are P. carinnii pneumonia, HIV wasting
syndrome and candidiasis of the esophagus.
Wasting Syndrome
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
21
Hepatitis B in the U.S.
Annually, there are 10,000 new cases of Hepatitis B virus (HBV) reported in the
U.S., with an estimated one to two million carriers of HBV. The prevalence of
serologic markers for present or past Hepatitis B infection is approximately
5%.
Studies have found a prevalence of Hepatitis B to be approximately
2% in the general U.S. population.
(Source: www.cdc.gov)
Viral hepatitis infects the liver
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
22
Estimated number of occupational Hepatitis B infections among
U.S. health care workers, 1983–1999
(Source: CDC [2002a].)
In the mid-1980s, health care facilities began adopting “universal precautions” against exposure to body
fluids. These were followed in 1992 with the OSHA BBP Standard.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
23
Clinical Manifestations of Hepatitis B Virus Infection
1.
67% to 75% of infected persons have no symptoms or mild flu-like
illness
25% to 33% have a more severe clinical course:
2.
•
•
•
Extreme fatigue, anorexia, nausea, abdominal and joint pain, rash,
fever
Symptoms last for 3-10 days. This is followed by onset of jaundice or
dark urine.
Severe acute liver failure with Hepatic encephalopathy (brain
dysfunction directly due to liver dysfunction) can occur within 8
weeks of the onset of jaundice.
Hepatitis B virus
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
24
Hepatitis B Vaccination
Employees who have reasonably anticipated exposure to blood or OPIM will
be offered the Hepatitis B vaccination free of charge through the
University Employee Occupational Health Clinic (UEOHC) located at 145 N.
Medical Drive.
This vaccination must be made
within 10 working days
assignment or the Hepatitis B
declination form must be signed.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
available
of initial
25
General Hepatitis B Vaccination
Information
Recombinant vaccines for HBV were licensed in the US in 1986. Given as a
series of three injections, the vaccine produces a high antibody titer in
over 90% of the population.
The vaccine is safe and well tolerated by recipients. In about 1 out of 4
adults, soreness where the shot was given, lasting a day or two was noted
and mild to moderate fever was noted in 1 out of 100 adults.
Employees with life threatening allergies to baker’s yeast should not
receive the Hepatitis B vaccination.
For more information about the Hepatitis B vaccination series, view the CDC fact sheet.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
26
Hepatitis B Vaccination Requirement
Do you still need to schedule or decline the Hepatitis B vaccine?
This requirement needs to be met within 10 working days after your exposure determination is made.
The vaccine is offered by UNC at no cost to you.
To obtain the Hepatitis B vaccination, complete these steps:
1. Fill out the Hepatitis B vaccination consent form available here.
2. If you don't have a medical record number, call 966-2555 to get one.
3. Schedule your appointment with the University Employee Occupational Health Clinic at 966-9119.
To Decline the Hepatitis B vaccination: Complete this form and follow the directions on the form to submit it
to the University Employee Occupational Health Clinic.
Go on, do
it now.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
27
Clinical Manifestations of Hepatitis C Virus
Infection
Hepatitis C is the most common chronic bloodborne infection in the US
and is the leading indication for liver transplantation.
• 25-30% of infections are asymptomatic
• 55-85% of infected persons develop long-term infection
• 70% of infected persons develop chronic liver disease
• 5-20% of infected persons develop cirrhosis over a period of 20 to
30 years
• 1-5% of infected persons die from the consequences of long term
infection (liver cancer or cirrhosis)
Symptoms include jaundice, loss of appetite, fatigue, intermittent
nausea, abdominal pain and vomiting.
There is no vaccine for Hepatitis C.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
28
Transmission
In the lab setting, bloodborne pathogens are transmitted by:
• Percutaneous exposure such as needlesticks, cuts with sharp objects
contaminated with blood/OPIM
• Direct contact of blood/OPIM with non-intact skin.
• Mucous membrane exposure such as splashes of blood/OPIM to the
eyes, nose and mouth.
HIV and HBV can also be transmitted from mother to unborn child. If you
are pregnant or intend to become pregnant, please contact EHS at 9625507 for information about the UNC conceptus protection policy.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
29
Health Care Worker BBP Exposures
3%
1%
Percutaneous
14%
Contact with mucous
membranes
Exposure of broken or
abraded skin
82%
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
Human bites
30
Percutaneous Injuries
Up to 800,000 percutaneous
injuries may occur annually
among all U.S. health care
workers (both hospital-based
workers and those in other health
care settings).
After percutaneous injury with a
contaminated sharp instrument,
the average risk of infection is
0.3% for HIV and ranges from 6%
to 30% for hepatitis B.
Distribution of 10,378 reported
percutaneous injuries among hospital
workers by medical device associated with
the injury, 1995-2000 (Source: CDC 2002)
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
31
Laboratory Associated Infections
A study conducted by Pike in 1979 found that only a small proportion of all
lab acquired infections (not just BBP) were associated with an identifiable
accident. This study was updated in 1999 (Harding and Byers) and they
also found a small percentage of lab acquired infections were linked to a
specific accident.
Accidents Associated with Lab Acquired
Infections (Pike 1979)
Needle and syringe
14%
6%
25%
Broken glass, other sharp
Spills, sprays
13%
Aspiration through pipette
16%
26%
Animal bite or scratch
Other
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
32
PREVENTING INCIDENTS AT UNC
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
33
PREVENTING INCIDENTS AT UNC
Now that we’ve
discussed how to
respond in the event of a
potential exposure, let’s
look at how to protect
ourselves and others
from exposure.
Make sure you know what’s expected to keep your lab safe according to the
OSHA BBP Standard:
(1) To prevent exposures to lab workers and
(2) To protect infrequent visitors to the lab (such as UNC Facilities Services
workers, etc.) against exposures
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
34
Universal Precautions
• Universal Precautions is an approach to infection control to prevent contact
with blood or "other potentially infectious materials". These laboratorians
practice Universal Precautions by safely handling all human blood and
OPIM research material as if they are infected with HIV, HBV, and other
bloodborne pathogens.
• Universal Precautions is a simple approach toward protecting yourself in
the laboratory environment.
• With Universal Precautions, you wear PPE when you anticipate contact with
any and all human blood, body fluids, or OPIM.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
35
Biosafety Level 2 (BSL-2)
•
To implement proper Universal Precautions
under the OSHA BBP Standard at UNC, the
lab worker is required to have basic
knowledge of BSL-2 practices as described
by the CDC/NIH.
•
Unlike the Bloodborne Pathogens training
that is required annually, the BSL-2 training
is a one-time requirement. BSL-2 training is
available online.
•
Training history can be reviewed online to
determine if you’ve met the requirement.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
36
Bloodborne Pathogens Spills
Spills may occur when containers of blood or other potentially infectious
materials (OPIM) are dropped in the clinic or laboratory.
Employees designated to participate in emergency and decontamination
procedures are exposed to blood or OPIM; they are to be thoroughly
familiar with proper cleaning and decontamination procedures so that the
contamination is contained and exposure to other people is minimized.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
37
Response to a BBP Spill
1:10 dilution of household
bleach
1.
2.
3.
4.
5.
6.
7.
8.
20 minute contact time
Evacuate laboratory and alert people in the immediate
spill area
Remove any contaminated clothing and wash exposed
skin with disinfectant
Notify PI and EHS (962-5507)
Wait 30 minutes before reentering. During this time the
aerosol will be removed from the laboratory by the
exhaust air ventilation system.
Re-enter wearing PPE --Lab coat with long sleeves,
disposable gloves and shoe covers, eye/face protection
Clean-up
Use mechanical means to provide barrier from broken
glass
Cover with paper towels or other absorbent materials
9.
10.
11.
12.
13.
14.
15.
16.
Disinfect
Pour appropriate disinfectant (i.e. diluted bleach)
around and in spill area. Avoid splashing.
Allow 20 minutes contact time.
Use paper towels to wipe up spill working from the
edges into the center
Place materials used to clean up spill, including PPE,
in orange biohazard bag
Wash hands
Tape “X” on autoclave symbol with autoclave tape
Autoclave materials
Wash hands
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
38
Remember Your Sharps Precautions
During a Spill
Contaminated broken glassware is cleaned up by mechanical means (e.g.
tongs, forceps, pieces of cardboard).
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
39
Biohazard Waste Disposal
North Carolina Medical Waste Rules describes
biological waste as:
Blood and body fluids in individual containers
in volumes greater than 20 ml
20 ml liquid ~ ½ shot glass
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
40
Biohazard Waste
Researchers are responsible for properly treating Biohazard waste and
sharps generated in their labs. Waste is to be treated according to
procedures outlined in the UNC Biological Waste Disposal Policy.
Most researchers treat their waste in
an autoclave. Autoclaving is the
most dependable procedure for
the destruction of all forms of
germs including bloodborne
pathogens.
For more information, Autoclave
Usage and Safety training is
available online.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
41
Biohazard Labels
Biohazard labels are used to alert
others of the potential presence of
biohazardous materials such as
human blood, body fluids, and
OPIM.
These labels are fluorescent
orange or red/orange with
contrasting letters and have the
universal biohazard symbol.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
42
Biohazard Labels
At UNC, biohazard labels are used on:
•
•
•
•
Containers of biohazard waste
Refrigerators and freezers used to store human specimens
Containers used to store, transport and ship human specimens
Any equipment that could be potentially contaminated with human blood,
OPIM, and other material that could allow bloodborne pathogens to live or to
grow.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
43
Engineering and Work Practice
Controls
To eliminate or minimize employee exposure
The BBP Standard requires the
implementation of engineering and work
practice controls.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
44
Engineering and Work Practice
Controls
Engineering controls are equipment or devices
used to control exposures and at UNC include
sharps disposal containers, safer needle
devices, and biological safety cabinets.
Work Practice Controls specifically reduce the
likelihood of exposure by altering the manner
in which a task is performed.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
45
Disposal of Biohazard Waste: SHARPS
Because percutaneous exposure (through the skin) is a primary route of
transmission at BSL-2, extreme caution should be taken with contaminated
needles or sharp instruments.
Needles/contaminated sharps:
• Must never be bent, recapped
or removed unless there is no
alternative
• May only be recapped using a
mechanical device or one
handed technique
• Must never be sheared or
broken
46
Needles & Sharps Precautions
Contaminated sharps must be
placed in red, hard walled plastic
containers labeled with the
biohazard symbol as shown.
When the container is no more
than 2/3 full, place autoclave
indicator tape over the biohazard
symbol in an “X” pattern as
shown.
Containers must be placed in
biohazard bag prior to
autoclaving.
47
Safer Needle Devices
• When possible, safer needle
devices should be used in the
laboratory.
• Examples of safer devices,
including interactive animations,
can be found on the OSHA
website at the Safer Needles
Section.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
48
Biological Safety Cabinets
Biological Safety Cabinets are used in
laboratories when conducting
procedures with a potential for creating
aerosols or splashes of blood/OPIM.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
49
Work Practice Controls
Minimize Splashes. Your technique is important. Germs can spread more
readily when we cause splashing, spraying, spattering, and airborne
droplets of blood or other potentially infectious materials.
Hand washing. Hands are to be washed
immediately or as soon as feasible after
removal of gloves or other personal
protective equipment.
Do not use sinks in food preparation
areas. If hand washing facilities are not
immediately available use antiseptic hand
cleanser and/or disposable wipes.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
50
Work Practice Controls
Prevent Ingestion. Eating, drinking,
smoking, applying cosmetics or lip
balm, and handling contact lenses
are prohibited during duties where
there is reasonable likelihood of
occupational exposure to blood or
other potentially infectious
material.
Storage of food and drink is prohibited
in refrigerators, freezers, shelves,
cabinets or on countertops or
bench tops where blood or other
potentially infectious materials are
present.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
51
Personal Protective Equipment
• Specialized clothing or
equipment worn by an
employee for protection
against a hazard
• General work clothes
(including uniforms) are not
PPE
• It is UNC’s responsibility as
an employer to provide PPE
in the appropriate sizes that
is readily accessible to your
worksite or issued to you as
a properly trained
employee.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
52
Personal Protective Equipment
Whenever your duties
create the potential for
exposure to blood or
OPIM, personal
protective equipment
such as gloves and eye
protection for cleaning
spills must be available
and utilized.
If a garment(s) is
penetrated by blood or
OPIM, the garment(s)
must be removed
immediately or as soon
as feasible.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
53
LAUNDRY
What to do if clothing becomes soiled
with blood or OPIM?
1. Handle uniforms soiled with blood
as little as possible, using gloves
and appropriate protective
clothing.
2. Place garment soiled with blood in
bags that prevent leakage.
3. Contaminated uniforms cannot be
taken home for cleaning. Facilities
Services employees should contact
Mark Baker (2-1261) so that
arrangements can be made for
laundering.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
54
RESPONDING TO AN INCIDENT IN YOUR
LAB
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
55
RESPONDING TO AN INCIDENT IN
YOUR LAB
Now that we’ve discussed
what it means to be
exposed, let’s look what
to do in the event of a
potential exposure.
An important part of this training program is to make sure all lab workers
know the following:
(1) if they have had an exposure incident and
(2) what to do after they have an exposure incident.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
56
What is a BBP Exposure?
The OSHA BBP Standard Definition:
“A specific eye, mouth, other mucous membrane, non-intact skin or
parenteral contact with blood or OPIM that results from the
performance of an employee’s duties.”
BBP Exposure = Blood, OPIM
contact with: Eye,
Nose,
Mouth,
Shaving cut,
Also, remember:
rash, etc.
UNC requires you to report ANY
incident resulting in injury from
the performance of your duties.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
57
What is a BBP Exposure?
• When blood or OPIM enter an unprotected break in your
skin such as an open wound, scratch, acne, rash; or
• When blood or OPIM
splashes or gets into your
eyes, nose, or mouth; or
• If you are cut or stuck by an
object (it must break the
skin) that is contaminated
with blood or OPIM.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
58
Immediate Precautions
What to do for needlesticks, cuts from contaminated objects, animal bites or
scratches:
1.
Remove contaminated gloves and if possible, allow the wound to
bleed freely for a minute.
2.
Wash the wound with soap
and water for 5 minutes and
apply sterile gauze or a
bandage, if necessary.
3.
Decontaminate and remove
protective lab clothing and
proceed immediately to
UEOHC or call HealthLink. If
the injury requires
immediate medical
attention, go to the
Emergency Room.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
59
Immediate Precautions
What to do for mucous membrane exposure (eyes, nose, or mouth):
1.
2.
3.
Rinse tissue surface with
copious amounts of water.
Eyes should be irrigated for
at least 5 minutes using the
emergency eyewash station.
Decontaminate and remove
protective lab clothing and
proceed immediately to
UEOHC or call HealthLink.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
60
Report Exposures Immediately
Immediately report the incident to your supervisor and/or call the University
Employee Occupational Health (UEOHC) at 6-9119.
Emergency Contact Numbers
UEOHC Clinic:
966-9119
Emergency:
9-911
After any exposure event during work hours, employees must be seen by
the University Employee Occupational Health Clinic (UEOHC) for
treatment and documentation of exposure.
After hours, all calls to the UEOHC are routed to HealthLink (966-7890)
through UNC Hospitals. You should request that the MD on call for UEOHC
after hours bloodborne pathogen exposures be called. The on-call MD will
determine the need for immediate prophylaxis and if needed, direct the
worker to meet him/her in the ER, or otherwise arrange for appropriate
blood tests to be drawn and medications to be dispensed.
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
61
Post-Exposure Evaluation
Following the incident, UNC will
provide you with a post exposure
medical evaluation.
This evaluation may include:
• Documenting routes of exposure
• Documenting circumstances of
the incident
• Identifying sources of
contamination
• Blood tests for HIV, HBV with
consent from employee
• Post exposure prophylaxis and
counseling
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
62
Post Exposure Evaluation
1.
2.
The Principal Investigator and EHS must be notified of all exposures.
A NCIC Form 19 must be completed by the employee at UEOHC
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
63
Safety Resources
Below is a list of Safety Resources that can provide you with
more safety information.
How to Protect Yourself from Needlestick Injury (NIOSH)
http://www.cdc.gov/niosh/docs/2000-135/pdfs/2000-135.pdf
Selecting, Evaluating, and Using Sharps Disposal Containers
http://www.cdc.gov/niosh/sharps1.html
Bloodborne Infectious Diseases
HIV/AIDS, Hepatitis B Virus, and Hepatitis C Virus
http://www.cdc.gov/niosh/topics/bbp/
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
64
CDC & OSHA Standards
OSHA on Bloodborne Pathogens
Topics Page
http://www.osha.gov/SLTC/bloodbornepathogens/index
.html
OSHA's Bloodborne Pathogens Standard
http://www.osha.gov/pls/oshaweb/owadisp.show_docu
ment?p_table=STANDARDS&p_id=10051
Exposure to Blood: What Health Care Workers Need to Know
(CDC)
http://www.cdc.gov/ncidod/dhqp/pdf/bbp/exp_to_bloo
d.pdf
Sharps Safety: Workbook for Designing, Implementing, and
Evaluating a Sharps Injury Prevention Program (CDC
http://www.cdc.gov/sharpssafety/
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
65
Questions??
• If you have any questions, please contact
Environment, Health and Safety at 962-5507
between 8 am and 5 pm.
Don’t forget to
take the exam to
get credit for this
course!
To begin the exam, go to
https://itsapps.unc.edu/SelfStudyUnits/?testid=38
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
66
END
Questions?? Call 962-5507 between 8 a.m.
& 5 p.m.
67