Transcript Bloodborne Pathogens training slides

BLOODBORNE PATHOGENS
THE OCCUPATIONAL SAFETY AND
HEALTH ADMINISTRATION
STANDARD
INTRODUCTION
• What is the bloodborne pathogens standard?
• Who needs bloodborne pathogens (BBP)
training?
• What content needs to be covered?
OSHA’S EXPECTATIONS
• Duties of Employers
– provide a plan
– identify job types and
classifications
– provide appropriate training
– provide appropriate
equipment
• Compliance
• Duties of Employees
– to follow the employer’s plan
– to use equipment provided by
the employer
• Compliance
OSHA REQUIRED INFORMATION
• Documents
• General explanation of
bloodborne pathogens
• Hepatitis B immunization
• Explanation of tasks that may
involve exposure
BLOODBORNE PATHOGENS DEFINED
• Disease-causing
microorganisms that may be
present in human blood or
OPIM (other potentially
infectious material)
– Viruses
– Bacteria
– Parasites
MODES OF TRANSMISSION
• Puncture wounds or cuts
• Contact (Touch, Splash, or Spray)
with blood or OPIM on:
– mucous membrane
– non-tact skin
• cuts, abrasions burns
• acne, rashes
• papercuts, hangnails
– contaminated sharps
RISK OF EXPOSURE
• The objective of the BBP
standard is to minimize or
eliminate the hazard
posed by work that may
expose you to blood or
OPIM
RISK OF EXPOSURE
• If a risk of exposure exists,
you must know:
– if there is a way to prevent
infection
– the symptoms and course of
infection
– that counseling is available
– that post-exposure treatment
& follow-up are available
OCCUPATIONAL EXPOSURE INCIDENTS
• Occupational contact with blood or OPIM is
considered an exposure incident
• If an exposure occurs:
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wash with soap & water
report the incident
document the incident
seek “immediate” medical evaluation
follow employer’s exposure control plan
IMMEDIATE MEDICAL EVALUATION
• Immediate means prompt medical evaluation and
prophylaxis
• An exact time cannot be stated
• Time limits on the effectiveness of prophylactic
measures vary depending on the infection of
concern
REPORTING AN INCIDENT
• Date and time of the
incident
• Job classification
• Location in the worksite
where the incident
occurred
• Work practice being
followed
• Engineering controls in
use
• Procedure being
performed
• PPE in use
Minimal information to report
Medical Evaluation After an Exposure
Incident
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Entitled to confidential medical evaluation
Personal decision about blood testing
Blood may be tested only with consent
Blood may be stored for 90 days, while considering testing
Interpretation of any test results occurs with the health
care provider
BLOOD TESTING
• Blood may be tested for antibodies to:
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Human Immunodeficiency Virus (HIV)
Hepatitis C Virus (HCV)
Hepatitis B Virus (HBV)
Other disease-causing organisms
• Source blood may also be tested with consent
• The results of the tests of source blood will be made
known to you
SPECIFIC BLOODBORNE PATHOGENS
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Definition
Signs and Symptoms
Course of infection
Prevention and control
Post-exposure prophylaxis
and follow-up care
HIV DEFINED
• HIV is the Human Immunodeficiency Virus
• HIV causes acquired immune deficiency syndrome
(AIDS)
• Risk of HIV infection from a puncture injury
exposure to HIV infected blood is very low -- 0.3%
SIGNS & SYMPTOMS OF HIV
• Signs and symptoms include:
– Weight loss
– Night Sweats or fever
– Gland Swelling or pain
– Muscle and/or joint pain
• Cannot rely on signs and symptoms to know if you
are infected
COURSE OF INFECTION OF HIV
• Incubation period from HIV infection to
AIDS may be 8 to 10 years
• Varies greatly among individuals
HIV PREVENTION
• There is no vaccine to prevent HIV
infection
• Follow Universal Precautions
HIV Post-exposure Prophylaxis & Follow-up
• There is no cure for HIV infection
• Testing for HIV antibodies
– at time of exposure
– at 3 months
– at 6 months
• HIV antibodies usually become
detectable within 3 months of
infection
• Treatment of HIV requires visits
with your health care provider
• OSHA requires recommended
treatment meet the most recent
CDC guidelines
• Treatment can include antiviral
medications and a protease
inhibitor
HCV Defined
• HCV is Hepatitis C Virus
• It affects the liver
• It is the most common chronic bloodborne infection in the United
States
• Needlestick injury is the only occupational risk factor that has been
associated with HCV
• Risk of HCV infection after exposure to HCV infected blood is 1.8%
• 70 to 75% of those with acute HCV infection have no symptoms
SIGNS & SYMPTOMS OF HCV
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Jaundice - a yellow color to the skin
Fatique
Headache
Abdominal Pain
Loss of appetite
Nausea & Vomiting
COURSE OF HCV INFECTION
• Incubation period averages 7
weeks
• Chronic liver disease may occur
in 70% of those infected with
HCV
HCV PREVENTION
• There is no vaccine to prevent
HCV infection
• Follow Universal Precautions
HCV Post-exposure Prophylaxis & Followup
• There is no cure for HCV infection
• No recommendation for postexposure prophylaxis
• Tests for HCV antibodies & liver
function tests should be done at
time of exposure
• Tests should be repeated 4 to 6
months after exposure
• Treatment of HCV requires visits
with your health care provider
• OSHA requires recommended
treatment meet the most recent
CDC guidelines
• HCV infection may require liver
transplantation for treatment
HBV DEFINED
• HBV is the Hepatitis B Virus
• It affects the liver
• The prevalence of HBV infection among
healthcare workers is 10 times greater than
HCV infection
SIGNS & SYMPTOMS OF HBV
• Jaundice - a yellow color to
the skin
• Fatique
• Headache
• Abdominal Pain
• Loss of appetite
• Nausea & Vomiting
COURSE OF HBV INFECTION
• Incubation period averages 12 weeks
• Most cases of HBV resolve without further
complication
• Chronic liver disease may occur in 6 to 7%
of those infected with HBV
HBV PREVENTION
• There is a vaccine to prevent HBV infection
• It is required to be offered to anyone
covered by the BBP standard
• Follow Universal Precautions
HBV Post-exposure Prophylaxis & Followup
• There is no cure for HBV infection
• Post-exposure prophylaxis should
begin within 24 hours and no later
than 7 days after exposure
• If not previously vaccinated, the
person should receive the HBV
vaccine
• Treatment of HBV infection requires
visits with your health care provider
• OSHA requires recommended
treatment meet the CDC’s most
recent guidelines
• Chronic HBV infection may require
liver transplantation for treatment
HBV IMMUNIZATION
• All people with routine occupational exposure to blood or OPIM
have the right to receive the HBV vaccine at no personal expense
• Refusal requires signing the Hepatitis B Vaccination declination
form
• Vaccine is Recombivax HB or Energix - B
• Vaccine is prepared from recombinant yeast cultures
• Must be made available within 10 working days of initial
assignment to job
HBV VACCINATION SCHEDULE
• Vaccine is given in 3 doses over 6 months
– 1st on initial assignment
– 2nd one month later
– 3rd five months after 2nd dose
• CDC recommends Hepatitis B antibody testing 1 to 2 months
following the 3rd dose
• Employer cannot require you use your health insurance to cover
the cost
• Pre-screening is not required
• HBV is declining because of vaccine use!
PREVENTION
• Engineering Controls
• Work Practice Controls
• Personal Protective
Equipment
• Universal Precautions
ENGINEERING CONTROLS
• Design safety into the tools and work space
organization
• Engineering controls can:
– Remove the risk of exposure to the hazard
– Eliminate the hazard
– Isolate the hazard
EXAMPLES OF ENGINEERING CONTROLS
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Hand and eyewashing facilities
Sharps containers
Labeling
Self-sheathing needles
Needleless IV systems
LABELING REGULATED WASTE
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Label liquid or semi-liquid blood or OPIM
Label item(s) covered with blood or OPIM
Label sharps contaminated with blood or OPIM
Labels are necessary for containers, storage,
equipment that is contaminated
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exception is certain blood or blood products that have been screened
SHARPS CONTAINERS MUST BE:
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closable
puncture resistant
leakproof
labeled or color-coded
functional
sufficient in number
easily accessible
maintained in an upright position
replaced per policy
NOT be overfilled
SHARPS INJURY PROTECTION
• Reusable sharps require
proper handling
(mechanical means) and
decontamination
• Retractable needles
• Needleless systems
WORK PRACTICE CONTROLS
• Behaviors necessary to use engineering controls
safely & effectively
• Work Practice Controls include:
– using sharps containers
– using an eyewash station
– WASHING HANDS after using PPE
– cleaning work surfaces
– proper laundering
PROHIBITED WORK PRACTICES
• Do not break, shear, bend or recap
needles
• Do not reach into containers of
contaminated sharps
• Do not pick up contaminated items,
such as broken glass, with your bare
hands
• Do not use a vacuum cleaner to clean
up contaminated items
• Do not open, empty or clean sharps
containers
• Do not pipette or mouth suction blood
or OPIM
• Do not eat, drink, smoke, apply
cosmetics, or handle contact lenses in
areas of possible occupational exposure
• Do not store food or beverages in
refrigerators, freezers, shelves, or
cabinets where blood or OPIM are
present
HANDWASHING
• Facilities readily available
• Wash after removing PPE
• Use antiseptic hand cleanser when
necessary (such as when a sink isn’t
handy)
HANDWASHING
• First roll out your paper
towel or have the towel
readily available (so you
don’t touch other
surfaces to get it)
HANDWASHING
• Turn on the tap
water and adjust
temperature
• Use plenty of
soap
HANDWASHING
• Wash your hands
using friction on
all surfaces for at
least 30 seconds
HANDWASHING
• Dry your hands
thoroughly
• DON’T turn off
the water yet
HANDWASHING
• Turn off the tap
with a dry part of
the towel
• Don’t touch
surfaces with
your hands
CLEANING
• Clean work surfaces according to the employer’s exposure control
plan
• Use PPE and EPA-approved solution
• 10% bleach and water, if used must be made daily
• Place contaminated laundry in color-coded laundry bag, use PPE,
and handle as little as possible
• DO NOT take home to launder!
PERSONAL PROTECTIVE EQUIPMENT
(PPE)
• Specialized clothing or equipment used for protection when
risk of exposure exists
• Must prevent blood or OPIM from contaminating clothing or
skin
• Must be readily available at no cost to employee
• Must be in appropriate sizes
• Must be in good working condition
• Must be properly maintained
• Must be trained in proper use
TYPES OF PERSONAL PROTECTIVE
EQUIPMENT
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Gloves
Mask
Eye shields
Gowns/Aprons
Resuscitation
devices
LATEX GLOVES
• Medical products containing latex must be
labeled
• Allergies to latex have been on the rise
• Substitutes to latex-containing materials
must be available
UNIVERSAL PRECAUTIONS
• Infection Control approach that treats
all human blood and certain body fluids
as if they are known to contain
bloodborne pathogens
MATERIALS THAT REQUIRE PRECAUTIONS
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Blood
Semen
Vaginal Secretions
Cerebrospinal, synovial, or pleural fluid
Body fluids with visible blood
Any unidentifiable body fluid
Saliva from dental procedures
MATERIALS THAT DO NOT REQUIRE
PRECAUTIONS
• Universal Precautions do not apply to these fluids
UNLESS blood is visible:
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feces
nasal secretions
sputum
sweat
tears
urine
vomitus
BODY SUBSTANCE ISOLATION (BSI)
• An acceptable alternative to Universal
Precautions
• Treats ALL body fluids and substances as
infectious
EXPOSURE CONTROL PLAN
• Site specific plan provided by employers for the protection of employees
working where the potential for occupational exposure exists
• Lists job classifications and tasks in which exposure may occur
• Identifies engineering controls, work practice controls, PPE, and
Universal Precautions
• Identifies who will be trained and who will do the training
• Includes record keeping provisions and is reviewed annually
QUESTIONS?