Transcript Bloodborne Pathogens

Bloodborne Pathogens
Training for BIOL 1020
Human Physiology
Liston Campus
Sources
• Oklahoma State University
– http://www.pp.okstate.edu/ehs/Training.htm
• Wisconsin Department of Health and Family Services
– http://dhfs.wisconsin.gov/webcast/dph/bbp.htm
• Dr. Denise Yordy
– http://faculty.ccri.edu/dyordy
Bloodborne Pathogens
• Bloodborne pathogens
are microorganisms
(“small living things”)
carried in blood (or
other body fluids) that
can cause disease in
humans
• Usually bacteria and
viruses
“Germ”
Diseases
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Malaria
Syphilis
Brucellosis
Hepatitis B (HBV)
Human Immunodeficiency
Virus (HIV)
• Hepatitis C (HCV)
All of these are examples of diseases caused by bloodborne
pathogens. We are primarily concerned with HBV, HIV and HCV.
Hepatitis B (HBV)
• “Hepato” = “liver”
and “itis” =
inflammation, so
hepatitis is an
inflammation of the
liver
• HBV, therefore, is a
virus that infects the
liver
Hepatitis B
• Given what you already know about the
specialization and functions of the liver, do
you think that hepatitis B is potentially a
major problem or a just minor nuisance?
MAJOR PROBLEM! Inflammation of the
liver can interfere with normal liver function.
Cirrhosis of the liver and liver cancer are
potential consequences of HBV infections.
Hepatitis B Symptoms
• May feel like you have
something like the flu
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fatigue
abdominal pain
decreased appetite
nausea
• jaundice (yellow
discoloration of the skin and
whites of the eyes)
• dark-colored urine
Note: Symptoms
are highly variable
and can even be
absent! Symptoms
may occur right
after exposure or it
might take as long
as 1-9 months for
them to develop.
Treatment of Hepatitis B
• No cure
• No specific treatment
• Vaccine available for
prevention of disease
Hepatitis C (HCV)
• Infection of the liver
caused by exposure to
the hepatitis C virus
(HCV), a virus that is
not related to HBV
Hepatitis C Symptoms
• Asymptomatic (no
symptoms)
• Jaundice
• Malaise (a nonspecific
sensation of just not
feeling well)
Note: Though initial
symptoms are often mild
and can even be absent,
one-half of patients
infected with HCV go on
to develop chronic
disease. Cirrhosis of the
liver and liver cancer are
possible consequences.
Treatment of Hepatitis C
• No vaccine available
for prevention of
disease
• New treatments can
provide a cure!
Human Immunodeficiency Virus (HIV)
• AIDS or Acquired
Immune Deficiency
Syndrome
• Weakens body’s
immune system
leaving it incapable of
fighting off other
diseases
• Fatal
HIV Infection Stages/ Symptoms
1. Initial flu-like illness may occur shortly after exposure
2. Later
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Weakness
Fever
Sore throat
Nausea
Headaches
Diarrhea
Weight loss
Swollen lymph nodes
3. Full-blown AIDS
Treatment of AIDS
• No cure
• No vaccine available
for prevention of
disease
• Available treatment
focuses on slowing
progression of disease
and managing
complications
Risks of HBV, HCV and HIV
• It should now be obvious that people
may be infected with HBV, HCV,
and/or HIV without being aware of it.
These viruses cause diseases that can
be fatal, so we need to focus on
_______________.
PREVENTION
Transmission of Pathogens
• Semen
• Vaginal secretions
• Serous fluid
– Pleural fluid
– Pericardial fluid
– Peritoneal fluid
While it is obvious that HBV,
• Amniotic fluid (fluid
HCV and HIV can be transmitted
surrounding developing
by exposure to contaminated
fetus)
blood, other body fluids also pose
a risk…
Transmission of Pathogens
• Cerebrospinal fluid
(surrounding brain and
spinal cord)
• Synovial fluid (in joints)
• Saliva (in dental
procedures)
• Any body fluid that is
While it is obvious that HBV,
HCV and HIV can be transmitted
visibly contaminated with
by exposure to contaminated
blood.
blood, other body fluids also pose
a risk…
Questions
• What body fluids are not considered to be
infected with bloodborne pathogen unless
they contain visible blood?
feces
nasal secretions
saliva (except in dental settings)
sputum
sweat
tears
urine
vomitus
Questions
• Why is saliva considered to be
contaminated during dental procedures?
There is a risk of bleeding during dental procedures so
saliva would be contaminated with blood.
• When would urine be considered
contaminated?
Urine is considered to be risky if it is visibly
contaminated with blood.
Modes of Transmission
• HBV, HCV and HIV can be transmitted:
– Through sexual contact
• Remember that pathogens can be found in semen
and in vaginal secretions
– Through shared hypodermic needles
• A used needle is contaminated with blood
– From mothers to babies before birth or at the time of
delivery
Modes of Transmission
• In the laboratory setting, we must be concerned
about possible:
– Broken or damaged skin exposed to infected
body fluids
– Mucous membranes exposed to infected body
fluids
– Accidental punctures from contaminated
needles, broken glass, or other sharps
Therefore…..
• Our goals in the laboratory setting will be to:
– Prevent body fluids from coming into contact with
skin
– Prevent body fluids from coming into contact with
mucous membranes
– Dispose of all laboratory wastes in the appropriate
ways so that no one is accidentally punctured. If this
is not done, we risk injuring students, instructors,
custodial staff, and laboratory staff.
Body Defenses
• The body has many defenses in place to
protect it against infection. The immune
system is a complex defense system.
Simpler defenses include physical barriers
such as the skin and mucous membranes.
Intact skin essentially shields the body from
pathogens, but if the skin is broken, that
physical barrier is lost.
Skin at Risk
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Cuts
Open wounds
Abrasions or scrapes
Acne
Blisters
Basically, anywhere
that the skin is not
perfectly intact,
pathogens can gain
entry into the body.
Mucous Membranes at Risk
• In the lab, we are at risk if
body fluids are splashed
into the face because
pathogens can enter
through the mucus
membranes of the
– Mouth
– Nose
– Eyes
• You are likely starting to think of ways that
you can protect your skin and mucous
membranes when you are in lab. What are
your ideas?
Universal Precautions
•
The first thing you need to do is
to assume that all of the body
fluids we listed before are
potentially infectious, no matter
who they came from.
• Remember that people:
1. May not be aware that they are
infected or
2. May be embarrassed to admit
that they are infected.
Personal Protective Equipment (PPE)
• Needed in an environment
where exposure to body
fluids is possible
• Protective equipment made
of nonporous material so
that fluids cannot soak
through
• Protect clothing, skin, eyes,
nose and mouth
Rules for Using PPE
• Always use the appropriate PPE in situations
that put you at risk for exposure.
• Do not use PPE that has in any way lost its
ability to function as a barrier. Torn and/or
punctured equipment is not effective.
• If PPE becomes torn or punctured during use, it
must be replaced.
• PPE must be removed before leaving the
laboratory.
Gloves
• Made of rubber, latex,
vinyl, nitrile, etc.
• Check them before wearing
to make sure that they are
not damaged. A torn glove
does not provide protection!
• Remove them carefully to
avoid having the
contaminated outside of the
glove come into contact
with your skin.
Goggles
• Protect the mucous
membranes of the eyes
from splashed or
vaporized fluids
Face Shield
• Protect the mucous
membranes of the
nose and mouth from
splashed or vaporized
fluids
Apron
• Protect clothing
• Help to prevent fluids
from soaking through
clothes and reaching
skin
• Should be made of a
nonporous material. A
standard kitchen apron
is not going to provide
protection.
Hand Washing
• Hands should be thoroughly
washed after any exposure
to body fluids and
immediately after protective
equipment is removed.
• Use a hand sanitizer if hand
washing facilities are not
immediately available, then
wash hands at the earliest
opportunity.
• You should now understand why CCRI’s
laboratory policy prohibits the following
activities:
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Eating
Drinking
Smoking
Gum chewing
• Should you apply cosmetics in lab? No!
• Should you put in contact lenses or take
them out? No!
When Bad Things Happen
• We live in an imperfect world, and
accidents will happen.
• If you have a skin exposure, wash the area
thoroughly with an antibacterial soap and
running water.
• If you have an eye splash, use the eyewash
station and flush the affected eye for 15
minutes.
• If you have any other mucous membrane
splash, flush the affected area with running
water for 15 minutes.
When Bad Things Happen
• Notify your instructor
immediately!
• File an incident report with
Campus Police and send a
copy to CCRI’s Chemical
Safety Coordinator.
• Get a post exposure medical
evaluation.
Decontamination
• All surfaces, tools, equipment and other objects that
come in contact with potentially infectious materials
must be decontaminated and sterilized as soon as
possible.
• Equipment being decontaminated should be soaked in
disinfectant for at least 10 minutes before continuing
the cleaning process.
• Equipment used to clean up a spill of potentially
infectious material, i.e. mops, sponges, etc., must be
decontaminated immediately.
Disinfectants
• A 10% solution of household
bleach can be used for
decontamination. The usual
recommendation is to use at
least ¼ cup of bleach per 1
gallon of water.
• Lysol
• Other EPA-registered
disinfectant.
http://www.mediacampaign.org/mg/images/bleach_full.jpg
Clean Up of Potentially Infectious Spills
• Carefully cover the spill
with paper towels, then
gently pour 10% bleach
solution over the towels.
Leave it for at least 10
minutes before you begin
wiping the material up.
• Wear appropriate PPE
when cleaning up spills.
Cleanup
• Remember that accidental punctures
from contaminated needles, glass
and other sharps can be a way that
pathogens are transmitted.
• Inappropriate cleanup, therefore
jeopardizes the health of students,
instructors, custodial staff and
laboratory staff.
Handling of Sharps & Regulated Wastes
• Sharps are NEVER
disposed of in
ordinary trash
receptacles.
• Regulated wastes are
NEVER disposed of in
ordinary trash
receptacles.
Sharps
• According to OSHA, contaminated sharps
are "any contaminated object that can
penetrate the skin, including but not limited
to, needles, scalpels, broken glass, broken
capillary tubes, and exposed ends of dental
wires,“
• In our lab, sharps can include glass slides,
cover slips and lancets.
Regulated Waste
• Any liquid or semi-liquid blood or other
potentially infectious materials
• Contaminated items that would release blood or
other potentially infectious materials in a liquid
or semi-liquid state if compressed
• Items that are caked with dried blood or other
potentially infectious materials and are capable
of releasing these materials during handling
• Contaminated sharps
Handling of Sharps
• Needles and other sharps
should not be bent, broken or
recapped
• Needles and other sharps
should be moved only by
using forceps, pliers, or
broom and dust pan.
• Needles shall be disposed of
only in labeled sharps
containers.
Sharps Disposal
• Sharps containers
must be closable,
puncture-resistant, and
leak-proof on sides
and bottom. The
container must be
labeled and/or colorcoded.
http://web.princeton.edu/sites/ehs/biosafety/livevirusworker/21-Sharpscontainer.jpg
Biohazard Labels
• Sharps containers display the
biohazard symbol
• Bags for regulated waste also
display the biohazard symbol
and are orange or red in
color. Double-bagging
should be used.
• Other containers used to store
or transport hazardous wastes
must also display this symbol
Biohazard Labels
• Refrigerators/freezers used
to store blood, body fluids
or other potentially
infectious material display
the biohazard symbol.
• Food and drinks are
NEVER stored in a
biohazard refrigerator or in
cupboards or on counters
where specimens are
located.
Summary
• To protect yourself and prevent
transmission of bloodborne pathogens
– Use Universal Precautions
– Follow the appropriate practice
recommendations and clean up procedures
– When in doubt, ASK!
Quiz
• Remember that in order to take participate in
laboratory, you must pass the following quiz with
a grade of 80% or better.
• Print, complete, sign the quiz, and return it to your
lab instructor.
• QUIZ
• If this hyperlink does not work for you, copy and
paste this address into your browser.
– http://faculty.ccri.edu/chansen1/Physiology/Bloodborne
_Pathogens_Quiz.doc