Transcript Slide 1

Bloodborne
Pathogens
Training
Columbus County
Schools
(February 2013)
INTRODUCTION
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Mandatory training for
all CCS employees
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Complies with OSHA
regulations
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Purpose: to eliminate or minimize on-the-job
exposure to blood & other potentially infectious
materials which could cause disease
OBJECTIVES
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Bloodborne pathogens & diseases
Spread of bloodborne diseases
Tasks that may involve bloodborne
pathogen exposure
Ways to reduce the chance of exposure
Hepatitis B Vaccine
Procedure to follow if exposure is
suspected
What are Bloodborne
Pathogens?
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Microorganisms that are present in
human blood and can cause disease.
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Including, but not limited to:
1. Hepatitis B Virus (HBV)
2. Hepatitis C Virus (HCV)
3. Human Immunodeficiency Virus (HIV)
What is Hepatitis B?
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A serious disease that affects the liver caused
by the Hepatitis B virus (HBV)
Can cause acute (short-term) illness
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Loss of appetite
Tiredness
Pain in muscles, joints and stomach
Diarrhea and vomiting
Jaundice (yellow skin or eyes)
(Acute illness is more common among adults)
Hepatitis B (continued)
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HBV can cause chronic (long-term)
infection which can be very serious, and
often leads to:
• Liver damage (cirrhosis)
• Liver cancer
• Death
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About 30% of persons have no signs or
symptoms
How is Hepatitis B spread?
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Hepatitis B virus is spread through
contact with the blood or other body
fluids of an infected person. A person
can become infected by:
• Contact with a mother’s blood and body fluids
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at the time of birth
Contact with blood through breaks in the skin
such as bites, cuts, or sores
Spread of Hepatitis B (continued)
• Contact with objects that could have blood on
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them such as toothbrushes or razors
Having unprotected sex with an infected
person
Sharing needles when injecting drugs
Contact with contaminated tattoo and body
piercing needles
Being stuck with a used needle on the job
HBV is durable and can survive in dried form
on surfaces for at least 7 days (cdc.gov)
Hepatitis B Prevention
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Get vaccinated against Hepatitis B
Wear gloves when touching blood
Cover any broken skin and rashes with
bandages
Do not share razors or toothbrushes
Consider risk involved with tattoo or body
piercing
Practice safe sex
Clean up blood spills with proper disinfectant
Good handwashing
What is Hepatitis C?
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It is a virus that causes inflammation of
the liver
It can cause liver cell damage that can
lead to cirrhosis and cancer
It is a slow-progressing disease that may
take 10-40 years to cause serious liver
damage in some people
How is Hepatitis C spread?
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It is spread when infected blood from an
infected person enters the body of a
person who is not infected by:
• Sharing needles
• Needle sticks or sharps exposure on the job
• Infected mother to newborn
• Contact with contaminated toothbrushes,
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razors, tattoo and body piercing tools
Rarely spread through sexual contact
Hepatitis C Symptoms
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80% of persons have no symptoms
If symptoms are present, they may be
very mild and flu-like:
• Nausea, fatigue, loss of appetite, fever,
headaches, abdominal pain
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Jaundice (yellowing of skin or whites of
eyes)
Dark urine
Prevention of Hepatitis C
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There is NO vaccine to prevent HCV
Wear gloves when touching blood
Use an approved disinfectant for blood
spill clean-up (NABC or Eco-Lyzer)
Never share needles or syringes
Do not share personal care items such
as razors, toothbrushes
Good handwashing
What is HIV?
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HIV is the virus that
causes AIDS
AIDS stands for Acquired Immunodeficiency
Syndrome
AIDS weakens the body’s immune system so
that it cannot fight other deadly diseases.
AIDS is a fatal disease. There is no cure and
no vaccine for AIDS.
How is HIV spread?
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Can occur when blood, semen, vaginal fluid or
breast milk enters the body of an uninfected
person by:
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Having unprotected sex with infected person
Sharing needles or injection equipment with infected
person
From infected mother to unborn child, breastfeeding
Needle stick or sharps injury on the job
Infected blood comes in contact with a persons broken
skin or by splash to mucous membranes of eyes,
mouth, nose
HIV is NOT spread by casual contact.
Symptoms of HIV
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The only way to know if you are infected
with HIV is to be tested for HIV
Many people who are infected with HIV
do not have any symptoms at all for
many years.
HIV symptoms (continued)
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Rapid weight loss
Dry cough
Recurring fever or profuse night sweats
Profound and unexplained fatigue
Swollen lymph glands
Diarrhea that lasts for more than a week
White spots or unusual blemishes on the tongue, in the mouth,
or in the throat
Pneumonia
Red, brown, purplish blotches on skin or inside mouth, nose
Memory loss
Depression
Neurological disorders
Prevention of HIV
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Wear gloves when touching blood
Cover breaks in skin with bandages
Clean up blood spills with approved
disinfectant
Needles and other sharp instruments should
be handled very carefully
Dispose of needles in puncture-proof Sharps
Container
Practice safe sex
Good handwashing
Workplace Transmission
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Bloodborne Pathogens are spread through:
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Infected human blood
Other potentially infectious materials (OPIM):
• Body fluids containing visible blood
• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Synovial fluid
• Pleural fluid
• Peritoneal fluid
• Pericardial fluid
• Amniotic fluid
Basics of Infections
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All of these factors must be present for a
potential exposure to occur:
• Infected source must be present
• Entry site must be present
• Route of transmission must be present – such
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as a contaminated sharp object
Unprotected, susceptible person
Exposure Control Plan
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Designed to prevent BBP exposure
and to protect employees
Provides appropriate treatment and counseling if an
exposure occurs
Copy of plan available:
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School office
CCS website
Copy may be obtained by contacting:
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Pupil Personnel Director
School Nurse
Exposure Control Plan
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Addresses:
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Employee responsibilities
Exposure determination
Safe work practices & engineering controls
Personal protective equipment
Housekeeping
Communication of hazards to employees
The Hepatitis B vaccination
Post exposure follow-up
Record keeping and surveillance
Employee Responsibilities
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To comply with the guidelines of plan
To review the plan at least annually
Any employee who fails to follow the
provisions of the plan:
• May be retrained
• May receive personnel counseling
• May be subject to disciplinary action
How am I exposed at work?
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Potential for transmission exist anytime there
is “blood-to-blood” contact with infected
blood or other potentially infectious materials
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Direct transmission – through open cut, abrasion,
sore, acne, broken skin, mucous membranes of the
eyes, mouth, nose
Indirect transmission – touch contaminant and transfer
to mouth, nose or open skin
Accidental injury – injure yourself with a contaminated
sharp object such as broken glass, sharp metal,
needle, or knife
Exposure Determination
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Work environment is evaluated for actual and
potential hazards for exposure
An identifying list of job classifications that
have actual and collateral risk for occupational
exposure has been made
Tasks have been identified with
recommendations made to reduce the potential
of exposure to blood through use of workplace
controls and personal protective equipment
At-Risk positions (Category I)
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“At-risk employees” means employees
identified as being at risk for occupational
exposure to blood and other potentially
infectious materials (OPIM)
Because of their usual duties, they might be
exposed to blood as an integral part of
performing occupational tasks
It is reasonable to anticipate that exposure
could occur
Category I Positions
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Principals/Assistant Principals
Athletic Trainers
Coaches
Custodians
Diabetic Care Managers
First-Responders
School Nurses
EC Teachers and EC Teacher Assistants
Plumbers
Category II positions (possible
risk of occupational exposure)
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Biology/Chemistry lab teachers
Maintenance workers
Teachers, substitute teachers and teacher assistants
Cafeteria Staff
Pre-K teachers and teacher assistants
Bus Drivers
Secretaries (if responsible for first aid)
Shop/Trade/Industry teachers
Speech Therapists
Examples of tasks causing
risks:
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Emergency first aid
Handling contaminated laundry
Blood spill clean up
Waste disposal
Assisting with blood sugar monitoring
Administering CPR
Repair/handling contaminated
equipment
Examples of Protective
barriers/engineering controls
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Universal precautions
Use of personal protective equipment
(gloves, masks, etc.)
Correct use of approved disinfectants
Use of appropriate disposal containers
Handwashing
Universal Precautions
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Shall be observed to prevent contact
with blood or other potentially infectious
materials
If differentiation between blood and body
fluid types is difficult or impossible, all
body fluids shall be considered
potentially infectious materials.
Handwashing
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When:
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must be performed as soon as possible to flush
contaminated material from the skin adequately
after handling soiled items and equipment,
immediately after gloves are removed
Proper technique (Germ Buster sign)
Antiseptic hand cleanser shall be provided
when hand washing facilities is not feasible
(available from Pupil Personnel Services
Director)
Contaminated Sharps
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Shall be handled with caution
Contaminated needles shall not be bent,
recapped or removed
Shearing or breaking of contaminated needles is prohibited
Immediately after use, contaminated sharps shall be placed in
appropriate container for disposal (Sharps container)
Sharps container shall be easily accessible & located closely
to immediate area where sharps are being used
Container shall be puncture resistant, leak proof and labeled
with biohazard warning symbol
Container shall be maintained upright throughout use and not
be allowed to overfill
In areas of likely exposure:
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Never eat, drink, apply cosmetics/lip
balm, handle contact lenses, or put food
or drink in refrigerators, freezers,
shelves, cabinets or counter tops where
blood or potentially infectious materials
are present
Minimize blood splashing and splattering
in emergency situations
Personal Protective
Equipment (PPE)
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Always protect yourself first before becoming
exposed to blood or body fluids and have a
barrier between you and the potentially
infectious material
Always have PPE readily available and wear in
exposure situations
Remove PPE that is torn, punctured or of poor
quality
Put contaminated PPE in plastic lined
container per waste disposal procedure
Gloves
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Shall be worn when it can be reasonably anticipated that
hand contact may occur with blood or other potentially
infectious materials
Cover open cuts or sores on your hands before gloving
Single use gloves must be replaced ASAP when
contaminated, torn or otherwise not fully protective.
Utility gloves may be decontaminated for reuse if in good
condition.
Powderless, non-allergenic gloves shall be made
available if needed
Keep gloves in top right hand desk drawer to ensure
accessibility for substitute teachers
Glove removal technique
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Remove contaminated gloves carefully – never
touch the outside with bare skin
Dispose of them so that no one else will come into
contact with them
Resuscitation devices
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Mouthpieces, pocket masks or bag-valve
mask devices must be used for CPR.
How do I get PPE items
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Gloves are available from each school office
CPR face shields are available at each school
for designated first responders
Employee must take responsibility for replacing
PPEs as needed (through school office)
Notify a school administrator, school nurse or
Pupil Personnel Services Director if you need
PPE items
Housekeeping
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Immediately call a custodian to clean
up and decontaminate surfaces that
come into contact with blood or other potentially
infectious materials
An EPA-registered disinfectant solution must be
used for blood clean up (NABC or Eco-Lyzer)
Treated surfaces must remain wet for 10 minutes
Gloves should always be worn for cleanup
Small spills –absorb blood with lots of paper towels
or granular absorbent and then clean with approved
disinfectant
Housekeeping
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Large spills – flood area with disinfectant
before cleaning, then clean with fresh
disinfectant.
Mops, pails, sponges, utility gloves must be
decontaminated with approved disinfectant
Broken glassware shall not be picked up
directly with hands. Mechanical means must
be used (broom and dust pan, tongs, etc.) and
items must be placed in a rigid, puncture
resistant container (e.g. sharps container,
cardboard box).
Disposal of waste contaminated
with blood and OPIM
The following procedures shall be
followed for handling and disposal of
such items that include, but are not
limited to bloody bandages, gauze,
dressings, sponges, paper towels,
sanitary pads, swabs and used
gloves or other PPE:
Waste disposal (continued)
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Wear gloves
Place items in a leak proof plastic bag
Remove gloves using proper technique and
place in the plastic bag with the
contaminated items
Securely fasten the bag and place in a
second plastic leak proof bag, also securely
fastened, as an extra precaution
Dispose of as regular trash
When to use red biohazard bags:
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For disposal of regulated waste
including:
• Items that would release blood or other OPIM
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in a liquid or semi-liquid state if compressed
Items that are caked with dried blood or OPIM
and are capable of releasing these materials
during handling
Use of red biohazard bags
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Wear gloves
Place items in a red biohazard bag.
Remove gloves using proper technique and place in the
biohazard bag with the contaminated items.
Secure and close the bag to contain all contents and
prevent leakage of fluids during handling, storage and
transport.
If outside contamination of the bag occurs, it must be
placed in a second bag or container.
The red biohazard bag shall be placed in an outside
trash container to be picked up by the county sanitation
department.
Contaminated Sharps
Disposal
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Shall be discarded immediately in
“Sharps Container”
Sharps container must be maintained upright
throughout use, replaced when necessary
and not be allowed to overfill.
Container shall be closed immediately prior
to removal to prevent spillage or protrusion of
contents
Contact school nurse for disposal of filled
Sharps Containers
Biohazard Warning Label
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Warning labels shall be affixed
to containers used to dispose of and
store regulated waste
Contaminated Clothing
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Wear gloves to handle contaminated clothing
Use universal precautions and minimal
agitation at site where generated
Place clothing in a leak proof plastic bag for
transport home or to laundering area
If degree of contamination meets regulated
waste definition, a red biohazard bag should
be used
Can be washed with regular laundry
What to do if exposed
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Remove PPE
Wash exposed area immediately with soap and
running water
Flush exposed eye or mucous membranes with
water
Immediately report the exposure to your supervisor,
who will inform Pupil Personnel Services Director
The School Safety Officer will complete an Incident
Report form
Take the completed form to Whiteville Urgent Care
for a post-exposure medical evaluation
Hepatitis B Vaccine
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Provides 90% protection against HBV
Given as a series of 3 shots
Gives long-term protection from HBV infection,
possibly lifelong
Very safe vaccine. Mild side effects may include
soreness at injection site, elevated temperature
Severe problems extremely rare
Available at no cost to Category I employees at
Columbus County Health Department(authorization
by Pupil Personnel Services Director required)
Who should NOT get the
HBV Vaccine?
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People who have ever had a lifethreatening allergic reaction:
• To baker’s yeast (the kind for making bread)
• To a previous dose of Hepatitis B Vaccine
Questions
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Contact your School Nurse or Dr.
Heather Wing, Pupil Personnel Services
Director
Employees with jobs listed as Category I
positions, contact your school nurse or
Pupil Personnel Services Director for
Hepatitis B vaccine information