Transcript Biosafety in Crime Scenes and Crime Lab Slide Show

Crime Scene and Crime Lab
Safety
Bloodborne Pathogens
Who is OSHA?
• Occupational Safety and Health
Administration
• Created by Department of Labor by the
Occupational Safety and Health Act of
1970
OSHA Purpose
• To assure so far as possible every working
man and woman in the Nation safe and
healthful working conditions and to
preserve our human resources
Bloodborne Pathogen Standard
PURPOSE
• To limit occupational exposure to blood
and other potentially infectious materials
since any exposure could result in
transmission of BBP which could lead to
disease or death
SCOPE
• Covers all employees who could
reasonably anticipate to face contact with
blood or other potentially infectious
materials
Motivation
• OSHA estimates that 5.6 Million workers in
the Health Care and other facilities are at
risk of Exposures to Bloodborne
Pathogens
Those at Risk
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Law Enforcement Personnel
Firefighters
Paramedics
EMT’s
First Responders
OSHA Requires Training
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Modes of Transmission
Symptoms
Epidemiology
Warning signals indicating exposure
Procedures to follow if exposure occurs
OSHA Requires Training
• Recognizing tasks that may involve
potential exposure
• Practices that reduce exposure
• Use of personal protective equipment
(PPE)
• Emergency procedures following exposure
• Information on biohazard labeling
Modes of Transmission
• Disease transmission is two-way street
• Pathogen is disease-producing
organism that enters the body, basically
a germ
• Most infectious diseases are caused by
one of 6 pathogens - usually bacteria or
virus
• Immune system relies on skin to limit
amount of pathogens that enter the
body
Four ways pathogens enter
body
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Direct contact
Indirect contact
Airborne
Vector borne
Transmission occurs with:
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Presence of pathogen
Sufficient quantity of pathogen
Personal vulnerable to disease
Correct entry site for the pathogen
– Also called portal of entry
Hepatitis
• Several types
• Hepatitis B most serious health threat to
healthcare workers - 200-300 die
annually
• Caused by Hepatitis B virus (HBV)
• Damages liver, causing symptoms from
mild or inapparent to severe or fatal
• 10% become HBV carriers. They
develop liver disease and are infectious
to others
Hepatitis Signs and Symptoms
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Flu-like symptoms
Fatigue
Abdominal pain with nausea/vomiting
Loss of appetite
Jaundice
Liver ailments - cancer, cirrhosis
Hepatitis mode of transmission
• Direct and indirect contact with
– blood
– saliva
– semen
– feces
– food
– water
– other products
HBV Occupational Exposure
• Needlestick - 6-30%
• Broken or nonintact skin
• Mucous membranes of eyes, nose and/or
mouth
• Saliva through a human bite
• HBV can live in dry environment for at
least 7 days. Once virus is dead - it’s
dead!
HIV/AIDS
• AIDS - Acquired Immunodeficiency
Syndrome is caused by HIV
• HIV is Human Immunodeficiency Virus
• Outcome of virus varies:
– Some have no symptoms
– Some have less severe symptoms than
AIDS
– AIDS destroys immune system allowing
life-threatening infections that threaten life
and health
HIV/AIDS Symptoms
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Fever
Night sweats
Weight loss
Diarrhea
Severe fatigue
Shortness of breath
Lesions
HIV/AIDS Transmission
• Direct and indirect contact with:
– blood
– semen
– vaginal fluid
– other fluids possible
HIV transmission in person life
• Anal sex
• Vaginal or oral sex with someone who
uses IV drugs or engages in anal sex
• Sex with someone you don’t know well
• Sex with someone who has multiple sex
partners
• Sex without a condom with an infected
person
• Sharing IV drug needles
Risk of occupational exposure
• Needlestick 0.5% with contaminated
needle
• Chapped/broken skin or mucous
membranes
• Contact with blood or other body fluids
How to protect yourself?
• HBV vaccinations
• Wear Personal Protective Equipment
(PPE) ALWAYS!
• Avoid contact with mouth (use BVM or
pocket mask for mouth-to-mouth)
• Protect yourself from fluids that are
potentially infectious - especially blood
• Practice good hygiene, get plenty of rest
and eat properly
Other diseases of concern
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Herpes
Meningitis
Tuberculosis
Varicella - chicken pox
Mumps
Measles
And other childhood disease
TUBERCULOSIS
Increasing Epidemically
Tuberculosis
• By 1950’s antibiotics had put stop to
epidemic
• Recent comeback
• Caused by:
– Mycobacterium Tuberculosis
– primary a human bacteria
– spread by droplets of fluid being expelled from
infected person then inhaled by uninfected
person - airborne transmission
Risk Factors for TB
• Most significant is living conditions
– cramped - prisons, long term care centers or
homeless shelters
– unsanitary conditions
DRUG RESISTANT STRAINS
OF TB
• OSHA issued mandatory guidelines
• Prevention of Transmission
• Multi resistant strains develop when non
compliance with TB Rx
Since 1985 the incidence of
TB in the general US
population has increased 18
percent reversing a 30 year
downward trend
25,500 cases were reported in the
US in 1990
TUBERCULOSIS SYMPTOMS
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Productive Cough
Coughing up blood
Weight loss
Loss of appetite
Lethargy/weakness/malaise
Night sweats
Fever - usually low grade
Swollen lymph nodes
Tuberculosis Precautions
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Gloves and mask (hepa)
Vigorous hand-washing
Use disinfectant that is tuberculocidal
Mask for patient - if on medication cover
mouth and nose when cough/sneezing
• Have regular PPD tests - positive PPD
indicates person is infected with TB only
EXPOSURE CONTROL PLAN
• Requires employers to identify in writing,
tasks & procedures as well as job
classifications where occupational
exposure to blood occurs
• Must also set a schedule of
implementation
• Plan must be accessible to employees and
to OSHA
METHODS OF COMPLIANCE
• Mandates Universal Precautions
• Emphasizes Engineering and Work Place
Controls
• Procedures for Hand-washing, Minimize
needlesticks, splashing & spraying of
blood
• Ensure appropriate packaging of
blood/specimens
METHODS OF COMPLIANCE
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Regulates Waste
Decontamination Procedures for equipment
Labeling of Infectious or Contaminated Items
Employers must provide at no cost PPE (gloves,
masks, face shields, goggles, safety glasses, lab
coats, full body suits, repirators etc.)
• Written Schedule for Cleaning and method of
decontamination
METHODS OF COMPLIANCE
• Specifies methods of Disposing Sharps
• Sets forth standards for containers
• Sets standard for containers for regulated
waste
• Handling of contaminated laundry
HBV Vaccination
• Requires vaccinations to be made
available to all employees who are at risk
• Procedures for Declination of vaccine.
POST EXPOSURE
EVALUATION & FOLLOW UP
• Procedures for all employees who have
had an exposure
• Laboratory Test at No Cost
• Confidential
• Post Exposure Prophylactics
• Counseling
HAZARD COMMUNICATION
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Warning Labels
Red Bags
Containers
Restricted Areas
Biomedical/Biohazard Symbol
METHODS
• INTERMEDIATE-LEVEL DISINFECTANT
• Use of chemical germicides that are
tuberculocidal (bleach 1:10 dilution)
• LOW-LEVEL DISINFECTING: Laundry
detergents and hot water
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CLEANING AND
DECONTAMINATING SPILLS
OF BLOOD
METHODS
• Put on gloves and clean with disposable
towels. Placed soiled towels in plastic bag
• Wear eye and face protection if there is
splashing
• Wear shoe covers if amount of blood is
great
• Remove contaminated items, gloves last
WASH HANDS AFTER
REMOVING GLOVES
Use soap and water if available,
waterless soap if not until water
can be accessed.