Transcript Bloodborne Pathogens

Bloodborne Pathogens
for the Lay Rescuer and
First Responder
Instructor
Barry Ponder
Introduction
• Approximately 5.6 million workers in
health care and other facilities are at risk
of exposure to bloodborne pathogens
such as human immunodeficiency virus
(HIV – the virus that causes AIDS), the
hepatitis B virus (HBV), and the hepatitis
C virus (HCV)
• OSHA’s Bloodborne Pathogens standard
prescribes safeguards to protect workers
against the health hazards from exposure
to blood and other potentially infectious
materials, and to reduce their risk from this
exposure
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Methods of Compliance
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Universal Precautions
Engineering and Work Practice Controls
Personal protective equipment
Housekeeping
• More information at www.cdc.gov
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Who is covered by the standard?
• All employees who could be “reasonably
anticipated”, as the result of performing their
job duties, to face contact with blood and
other potentially infectious materials
• “Good Samaritan” acts such as assisting a
co-worker with a nosebleed would not be
considered occupational exposure
• Designated first aid and/or CPR/AED
responders are subject to the standard
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Some Workers Who are at Risk
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Physicians, nurses and emergency room personnel
Orderlies, housekeeping personnel, and laundry workers
Dentists and other dental workers
Laboratory and blood bank technologists and technicians
Medical examiners
Morticians
Law enforcement personnel
Firefighters
Paramedics and emergency medical technicians
Anyone providing first-response medical care
Medical waste treatment employees
Home healthcare workers
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Bloodborne Pathogens
• Bloodborne Pathogens
are microorganisms
(such as viruses)
transmitted through
blood, or other
potentially infectious
material such as certain
bodily fluids (semen,
breast milk, etc.) or
tissues.
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Bloodborne Pathogens
• Bodily fluids, especially those
visibly contaminated with
blood, are capable of causing
disease.
• Pathogens can enter your
body through a cut in the skin,
through absorption through
membranes of the eyes or
mouth.
• Can also be transmitted
sexually.
• Main diseases of concern are
Hepatitis B (and C) virus, and
HIV (AIDS virus).
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Human Immunodeficiency Virus (HIV)
• HIV attacks your
body’s ability to
protect itself against
disease
• Initially no visible
signs of having the
virus
• There is no
vaccination for HIV
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HIV Transmission
• Virus lives outside the body only
a few hours
• 5 modes of transfer:
1 blood
2 semen
3 vaginal secretions
4 breast milk
5 amniotic fluid
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HIV Transmission
• NOT BY
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Door knobs
Drinking fountains
Mosquitoes
Oral secretions
Sneezes
Toilets
Shaking hand
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Hepatitis B
Hepatitis B Virus
• Up to 100
times easier to
catch than HIV
• Unlike HIV, can
live outside of
body for
several days
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HBV
• Liver is located behind
the lower ribs on the
right side of your
abdomen
• Weighs about 3
pounds and is roughly
the size of a football.
• If infected with HBV,
the liver often
becomes tender and
enlarged
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Some signs and symptoms of HBV
and HCV include:
• Flu-like symptoms
• fatigue
• jaundice
• severe pain in joints
normal
Yellow
from
jaundice
• lung disease
• inflammation of liver
• inflammation on and ulcers of the colon
• may be asymptomatic (i.e. no symptoms indicated)
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Concentration of Hepatitis B Virus in
Various Body Fluids
High
Moderate
Low / Not Detectable
Blood
Semen
Urine
Serum
Vaginal fluid
Feces
Wound exudates
Saliva
Sweat
Tears
Breastmilk
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Hepatitis B
• “Approximately 10% of those infected
become chronic carriers who can infect
their families and friends. They have up to
300 times greater than normal risk of
developing liver cancer.”
• “Every year, approximately 5,000
Americans, die of HBV or its complications.
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Hepatitis B
Acute:
6-8 weeks, 90%
– 30-40% with acute HBV have no idea how or when
they became infected
– 10% of infected carry virus for longer than 6 months
(carriers)
Chronic:
Life, 10%
– Hepatitis B carriers are people infected with HBV and
never fully recover. They carry the virus and can infect
others for the rest of their lives
– Approximately one million people in the US carry HBV
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Hepatitis B Vaccination
• Available since 1981
• Recombinant DNA technology- no
human materials used so no risk of
HIV or HBV
• 85%-95% effective for healthy adults
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Hepatitis B Vaccination
• Three doses at 0, 1, 6
months
• Must receive all three
doses
• Free to collateral duty
employees after an
incident where blood or
OPIM is present
• Division’s procedure in
offering vaccinations
• May decline vaccine (but
must sign waiver)
• May receive vaccine later
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HIV vs. Hepatitis B
HIV
Hepatitis B
Transmitted through blood, semen,
vaginal secretions, and breast milk
Transmitted through blood, semen,
and vaginal secretions
10-50 virus particles per ml of blood 1,000,000 – 1,000,000,000 virus
particles per ml of blood
Virus lives outside the body only a
few hours
Virus lives outside the body for up
to 7 days
Up to 100 times easier to catch
than HIV
No vaccination available
Vaccinations available – 3 doses
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Hepatitis C
• 3-4 million carriers
• Disease can
incubate for
decades
• By 2010 may affect
more Americans
each year than AIDS
• HCV not related to
the viruses that
cause HBA and HBV
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Hepatitis C
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Hepatitis C
• Risk Factors:
– Long-term kidney dialysis
– Sex with multiple partners
– Tattooing or body piercing with
shared needles or unsterilized
equipment
– Intranasal cocaine use with shared
straws
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How to Handle Needles
• You can be
exposed to a
BBP if a
sharp object
cuts or
punctures
your skin.
• Never re-cap
a needle
Employees who self-administer medication may have needles in the workplace.
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How to Dispose of Needles
Needles and other
sharps must be
discarded in rigid,
leak-proof, puncture
resistance
containers
Do not dispose of needles in regular garbage
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How Bloodborne Pathogens Spread
on the Job
• During a first aid or CPR/AED response
incident, the potential for exposure to
bloodborne pathogens exists if there is
blood or other potentially infectious
material (OPIM) present
• If blood or OPIM is present in the
workplace from an unreported accident
or illness, there’s potential for exposure
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How Bloodborne Pathogens Spread
on the Job
• When a contaminated
object touches inflamed
skin, acne, skin abrasions
• When you touch a
contaminated
surface and then
touch your eyes,
nose, mouth, or
open wounds or
inflamed skin
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How to Reduce Your Risk
When emptying trash
containers, do not use
your hands to
compress the trash in
the bag.
Red biohazard bags
cannot be disposed of
in regular garbage.
Contact your EHS
coordinator for
guidance.
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How to Reduce Your Risk
Do not eat, drink,
smoke, apply
cosmetics or handle
contact lenses in
areas where there is
the possibility of
exposure to BBP
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How to Reduce Your Risk
UNIVERSAL PRECAUTIONS
– A system of infection control which
assumes that all human blood and certain
body fluids are treated as if known to be
infectious.
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Personal Protective Equipment
Gloves, eye protection, CPR mouthpiece or
pocket mask, face shields, lab coats, coveralls…
Know how to use and limitations
Mask with One-Way Valve
Kit with each AED
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Personal Protective Equipment
• PPE needed for CPR is located with each
AED
• Additional PPE is available through the EHS
Coordinator (i.e. for First Aid)
• Responders shall use PPE
• Replace PPE if contaminated, torn,
punctured, or barrier is compromised
• Most PPE is disposable and must be
disposed of properly (Biohazard)
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CPR Response Scenario
• Is the scene safe?
• What are the dangers at the scene?
• What can you do to help this person and still
be protected? Use your PPE.
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Glove Removal and Disposal
Grip one glove near
the cuff and peel it
down until it comes
off inside out. Cup
the removed glove
in the palm of your
other gloved hand.
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Glove Removal and Disposal
•Place two fingers of
your bare hand
inside the cuff of the
remaining glove.
•Peel that glove
down so that it also
comes off inside out
and over the first
glove.
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Glove Removal and Disposal
Dispose of gloves
in labeled
biohazard bag or
give to EMS for
disposal
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Proper Hand Washing
•Wash hands well with
antibacterial soap
•May use antiseptic
cleansers or
towelettes until soap
and water are
available
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Clean-Up Procedures
If Blood or Other Potentially Infectious Material (OPIM)
is present after an emergency, special clean-up
procedures must be followed.
Special Clean-up Procedures
FYI:
• Special kit required
• Special PPE
required
• Specific disinfection
procedure
Your actions:
• Secure the area
• Contact your EHS
Coordinator
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Our Facility Exposure Control Plan
(available from EHS Coordinator)
• Exposure
Determination
• Universal
Precautions & Work
Practices
• Engineering
Controls
• PPE
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Housekeeping
Regulated Waste
Labels & Signs
Reporting
Procedure
• HBV Vaccinations
• Post Exposure
Evaluation
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Our Facility Exposure Control Plan
Example Reporting Procedure
• Employees must promptly report any
potential exposure to blood, OPIM, or
contaminated materials to the EHS
Coordinator. This shall occur
immediately if medical attention is
needed, and always before the end
of the work shift.
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Our Facility Exposure Control Plan
Example Reporting Procedure (cont.)
• The EHS Coordinator must record
specifics of the occurrence and
determine if blood or OPIM was
present.*
• If it is determined that blood or OPIM
was present, a confidential medical
evaluation will be provided under the
supervision of a licensed physician
* Procedure for collateral duty employees
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Our Facility Exposure Control Plan
Example Post Exposure Evaluation
Process
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Done in accordance with CDC guidelines
Review of exposure incident details
Testing of source individual after consent
Results of testing provided to exposed
employee
• Provisions for testing and treating exposed
employee
• Maintain patient confidentiality
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Prompt Reporting is Key
• Immediate post-exposure follow-up
further reduces risk
• Highly effective post-exposure
procedures for HIV and Hepatitis C
exposure can virtually eliminate risk
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