Transcript Bloodborne Pathogens

Bloodborne Pathogens
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Natural Defenses
Intact skin and mucous membranes in eyes,
nose and mouth keeps germs out.
Mucous membranes trap & force out germs.
Mucous membrane less effective than skin at
keeping germs out of the body.
Inside body germs detected & surrounded
white blood cells, which release antibodies to
fight infection.
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Natural Defenses
Germs sub-classified as:
- bacteria (tetanus) which are non-dependant
& treated with antibiotics.
- virus (measles) which are dependent & few
medications available.
Germs overwhelm immune system and
infection develops.
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What is a BB Pathogen?
Microorganisms (e.g., bacteria & viruses)
carried in blood and causing diseases:
- Malaria
- Brucellosis
- Syphilis
- Hepatitis B(HBV)
- Hepatitis C(HCV)
- Human Immunodeficiency Virus (HIV)
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Statistics and Standards
Annually millions of workers at risk of
exposure to bloodborne pathogens – human
immunodeficiency virus (HIV – virus causes
AIDS), hepatitis B virus (HBV), & hepatitis C
virus (HCV)
OSHA’s Bloodborne Pathogens standard
(1910.1030) prescribes exposure safeguards to
reduce exposure risks.
Hepatitis A not included, not carried in blood.
No MSHA or OSHA-Construction standard
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Exposure Determination
Employees “reasonably anticipated” in job
performance to contact blood and other
potentially infectious materials.
Designated first-aid and CPR trained
employees
“Good Samaritan” acts such as assisting a coworker with a nosebleed would not be
considered occupational exposure.
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BB Pathogen Spread
All four of the following must be met:
- pathogen Present,
- pathogen Quantity sufficient to cause disease,
- pathogen through correct Entry site, &
- person Susceptible.
PQES
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Infection Risk
Risk of infection from accidental bloodborne
exposure varies with:
- pathogen involved,
- exposure type,
- route of infection,
- immune status of recipient,
- amount of involved blood,
- amount of virus in blood, &
- ability of organism to produce disease.
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Pathogen Transmission
Direct contact with infected human blood,
unfixed tissues, & other potentially infectious
bodily fluids such as:
- Saliva
- Vomit
- Urine
- Semen or vaginal secretions,
- Blood transfusion, &
- Bodily fluid visibly contaminated with blood.
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Pathogen Transmission
Indirect contact with infected human blood,
unfixed tissues, & other potentially infectious
bodily fluids on:
- soiled dressing,
- equipment or working surfaces,
- PPE,
- other first-aid items.
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Pathogen Transmission
HBV, HCV and HIV most commonly
transmitted through:
- sexual contact,
- needles or other sharp instruments,
- mothers to babies at/before birth,
- contact between broken/damaged skin &
infected bodily fluids, &
- contact between mucous membranes &
infected bodily fluids.
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Pathogen Transmission
Infected blood or bodily fluid enters through:
- open sores,
- cuts,
- abrasions,
- acne, or
- any sort of damaged or broken skin (e.g.
sunburn or blisters).
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Pathogen Transmission
Through mucous membrane of:
- eyes,
- nose, &
- mouth.
Example – blood/fluids splash to eyes.
HBV, HCV & HIV share common
transmission mode but risk differs.
Most exposures do not result in infection.
No evidence mosquitoes can transfer virus
from person to person.
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HBV Infection Risk
No risk following receipt of vaccine &
immunity development.
Post exposure treatment 24 hours – 7 days.
Susceptible person after cut exposure to blood:
- single exposure 6-30%, &
- positive antigen status means more virus.
Possible risk from exposure of mucous
membrane or nonintact skin.
No known risk from exposure to intact skin.
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HCV Infection Risk
Susceptible person after cut exposure to blood:
- approximately 1.8%.
Unknown following exposure to eyes, nose or
mouth; believed to be very small.
Reported infection from:
- blood splash to eye, &
- nonintact skin exposure.
No known risk from exposure to intact skin.
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HIV Infection Risk
After cut exposure to blood:
- approximately 0.3%.
After exposure to eyes, nose or mouth:
- estimated on average at 0.1%.
After exposure to nonintact skin:
- less than 0.1%.
From needle stick:
- estimated on average at 0.3 – 0.4%.
No cases with small blood amount on intact skin.
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Vaccinations
HBV:
- available since 1982,
- series of 3 shots over 6 months,
- provides protection for 9 or more years,
- 70-88% effective within 1 week of exposure, &
- 90-95% effective
- chronic infection in 6% persons after age 5.
- death from liver disease in 15-25% of persons.
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Vaccinations
HCV:
- treatment thru medications* and therapy, and
- no vaccine currently available.
HIV:
- treatment thru medications, and
- no vaccine currently available.
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Hepatitis B (HBV)
Durable virus, able to survive in dried blood up
to 7 days.
Initial inflammation of the liver, but can lead to
serious conditions (e.g., cirrhosis & cancer).
1 – 9 months before symptoms are noticeable.
Mild flu symptoms – fatigue, appetite loss,
nausea, joint pain & stomach pain.
Progresses to jaundice & darkening of urine.
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Hepatitis B (HBV)
300,000 U.S. individuals (8,700 health care
workers) infected annually; 1 – 2% fatal
Infection does non prevent infection of HAV
or HCV.
Medications available for chronic HBV; only
work for some patients.
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Hepatitis C (HCV)
Most common chronic bloodborne infection
in the United States.
Acute or Chronic
Chronic – insidious, slow & without
symptoms for 2 or more decades.
Symptoms include: jaundice, fatigue,
abdominal pain, loss of appetite, intermittent
nausea, vomiting.
May lead to chronic liver disease, transplant
& death.
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Human Immunodeficiency
Virus (HIV)
HIV virus leading to AIDS.
Depletes immune system (white blood cells).
Opportunistic infections (e.g., TB, pneumonia).
Very fragile & not survive long outside body.
Primary concern to individuals providing first
air or medical care involving fresh blood or
potentially infectious materials.
No threat of contraction through casual contact.
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Infection Prevention
Universal Precautions:
- Treat all blood and bodily fluids as infectious,
- Use of proper PPE,
- Personal hygiene,
- Proper cleanup and decontamination, &
- Proper disposal of all contaminated material.
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Engineering & work Practice
Controls & PPE
Engineering & work practice controls primary
methods used for transmission control (e.g.,
sharps containers),
Work practices:
- Blood and bodily fluids treated as infectious,
- Remove jewelry,
- Personal hygiene, &
- etc.
PPE used in conjunction with engineering &
work place controls.
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Personal Hygiene
Important factor in minimizing exposure
Confine loose clothing or hair
Maintain nail length < ¼ inch long
Hand washing is one of the most important
practices in transmission prevention.
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Hand Washing
Wash hands immediately
after removing PPE.
Use a soft antibacterial soap
Min. 15 sec. including nails
Rinse thoroughly
Antiseptic cleanser, 70%
ethyl alcohol, but wash with
soap and water ASAP.
Frequently sanitize hands
and exposed skin.
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PPE
Anything protecting a
person from exposure
Gloves (latex, nitrile)
- double glove
Face shields
Eye protection
Mask or Respirator
Mouthpieces &
resuscitation devices
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PPE Rules to Remember
Ensure always available
Always wear in exposure situations or when
there are skin openings (breaks, cuts).
Check for age, defects or tears before using
Remove & replace if torn or defective, or lost
ability to function as barrier.
Remove ASAP to prevent contamination.
Cover skin openings prior to donning.
Remove properly & do not reuse
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Recommended PPE
Recommended PPE Against HBV, HCV & HIV Transmission
Activity/ Task
Disposable
Gloves
Gown
Disposable
Mask
Protective
Eyewear
Bleeding w/
spurting blood
Yes
Yes
Yes
Yes
Bleeding w/
minimal blood
Yes
No
No
No
Handle/Clean
contaminated
items
Yes
No, unless
soiling
No
No
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Glove Removal Technique
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Glove Removal Technique
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Exposure Incident
Flush site of blood or OPIM contact (e.g.,
splash to nose, mouth, or skin).
Irrigate eyes with water or saline
Note specifics of contact with blood or OPIM
Notify supervisor and Safety
No infiltrations of mucous membranes
or open skin surfaces, not considered exposure.
Medical evaluation within 1 to 2 hours
according to current medical guidelines!
Post-exposure medical evaluations
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Post-exposure Evaluation
Confidential medical evaluation
Document route of exposure
Identify source individual
Hepatitis B vaccination status
Test source individuals blood
Provide results to exposed employee
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Summary
OSHA’s Bloodborne Pathogens standard
prescribes safeguards to protect against blood
and OPIM exposures, & reduce their risk from
this exposure.
Implementation will not only will prevent HBV
cases, but also significantly reduce risk of
contracting HIV, HCV, or bloodborne diseases.
Given our line of work, first aid and CRP
responders are potentially exposed.
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Conclusions
BB pathogen rules in place for your health
Precautions use will remove 1 of 4 PEQS
transmission conditions.
Condition missing, infection not occurring
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