Transcript Bloodborne Pathogens - ProvidencePanthersSportsMedicine

Bloodborne Pathogens
What Are Bloodborne Pathogens?
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Microorganisms such
as viruses or bacteria
that are carried in
blood and can cause
disease in people
Transmitted through
contact with blood or
other bodily fluids
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Mode of transmission:
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Human blood
Semen
Vaginal secretions
Cerebrospinal fluid
Synovial fluid
Bloodborne Pathogen Transmission
Bloodborne pathogens are transmitted
through contact with infected human blood
and other body fluids such as
 Semen
 Vaginal
secretions
 Cerebrospinal fluid
 Synovial fluid
 Pleural fluid
 Peritoneal fluid
 Amniotic fluid
 Saliva
Skin Provides a Barrier
Unbroken skin forms an impervious barrier
against bloodborne pathogens. However,
infected blood can enter your system through
 Open
sores
 Cuts
 Abrasions
 Acne
 Any
sort of damaged or broken skin such as sunburn
or blister
Mucous Membranes
Bloodborne pathogens may also be
transmitted through the mucous membranes
of the
 Eyes
 Nose
 Mouth
Types of Bloodborne Pathogens
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Most significant—
Hepatitis B (HBV)
 HIV
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Also—
Hepatitis C (HCV)
 Hepatitis A & D
 Syphilis
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If you are exposed…
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Wash the exposed area thoroughly with soap and
running water
Use non-abrasive, antibacterial soap
Flush mouth, nose, eyes for 15 minutes if blood is
splashed in mucous membranes
Remove clothing that is contaminated as soon as
possible & place in approved container
Report exposure to your supervisor
Fill out an exposure report form
Request blood testing & Hepatitis B vaccination
Hepatitis B Virus
Hepatitis B Virus
is a virus that causes infection and
inflammation of the liver
 is transmitted primarily through “blood to
blood” contact
 can lead to serious conditions such as
cirrhosis & liver cancer
 can survive in dried blood for up to seven
days
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HBV Transmission
Infected blood and body fluids
 In infected persons, HBV can be found in:
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 Blood
 Body
tissue
 Saliva
 Semen
 Vaginal secretions
 Urine
 Breast milk
HBV Transmission in the Workplace
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Puncture wounds from
sharps
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Contaminated body fluids
entering:
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An opening or break in the
skin
Splashing into mucous
membranes—eyes, nose,
mouth
HBV Transmission Outside the
Workplace
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Unprotected sex
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Intravenous drug use
(sharing needles)
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Blood transfusions
HBV Symptoms
 Mild
flu-like symptoms
 Fatigue
 Weakness
 Nausea
 Abdominal pain
 Headache
 Fever
 Possible jaundice
 Darkened urine
Hepatitis B Vaccinations
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There is no cure or specific treatment
Many people develop antibodies to fight the
disease which may prevent future infection
Employees who have routine exposure to
bloodborne pathogens (doctors, nurses, first aid
responders, etc) shall be offered the Hepatitis B
vaccine series at no cost to themselves unless:
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They have previously received the vaccine series
Antibody testing has revealed they are immune
The vaccine is contraindicated for medical reasons
Vaccination Process
 Series
of three shots
 Second shot is given one month after the
first
 Third shot follows five months after the
second
 This series gradually builds up the body’s
immunity to the Hepatitis virus
 Given in the deltoid muscle of upper arm
Do not take the vaccine if:
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You are allergic to yeast
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You are pregnant or planning to become pregnant
within the year
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You are ill (cold, flu, or on medication) on your
appointment date
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You are in doubt due to other medical issues,
concerns, or complications (see your physician)
HIV/AIDS
Human Immunodeficiency Virus
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HIV is the virus that leads to AIDS
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HIV depletes the immune system
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HIV does not survive well outside the body
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There is still no vaccine available
Transmission of HIV
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HIV is spread when infected blood, semen,
vaginal fluids, or breast milk gets into the
bloodstream of another person:
 Sexual
contact
 Sharing needles
 Pregnancy, childbirth and breastfeeding
 Workplace exposure to blood and/or body
fluids
Transmission of HIV
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HIV is NOT spread through:
 Casual
 Saliva
 Sweat
 Spit
 Tears
 Air
 Insects
contact
HIV Symptoms
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Symptoms of HIV infection can vary, but
often include:
 Weakness
 Fever
 Sore
throat
 Nausea
 Headaches
 Diarrhea
 White coating on tongue
 Weight loss
 Swollen lymph glands
Acquired Immunodeficiency
Syndrome (AIDS)
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Development of opportunistic infections that do not usually
infect people with a healthy immune system
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The signs and symptoms depend on the type of infection
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Swollen lymph glands in the neck, underarm, and groin area
Recurrent fever
Persistent headaches and night sweats
Constant fatigue
Persistent diarrhea
Without treatment, a person could die from a simple
infection
Hepatitis C (HCV)
General Facts About
Hepatitis C
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Identified in 1989
One of most common
causes of chronic liver
disease, cirrhosis, and
cancer
Most commonly occurs in
people who have
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received blood transfusions
before 1992
shared needles
had tattoos
had body piercing
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Risk of sexual
transmission appears to be
small
No evidence that it can be
transmitted by casual
contact, through foods, or
by coughing/sneezing
Transmission from mother
to child appears to be
uncommon
Hepatitis C
The virus is very robust
 The virus can remain undetected in the body
for years
 Most Hepatitis C infections become chronic
and lead to liver disease and liver failure
 There is no vaccine for Hepatitis C
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Symptoms of HCV
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Appetite loss
Fatigue
Nausea
Vomiting
Vague stomach pain
Muscle and joint pain
Jaundice
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yellowing of skin
yellowing of the whites of the eyes
dark urine
Hepatitis A and D
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HAV
Most common in children
 Often spread by close personal contact or poor
hygiene
 Unprotected sexual intercourse
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HDV
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Occurs from complications from HBV
Bloodborne Pathogens Standards
CDC
Centers for Disease Control
 Organization within federal government
 Monitors outbreaks of infections
 Advises affected groups on how to handle
situations
 Control the spread of diseases
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OSHA
Occupational Health and Safety
Administration
 Federal agency develops regulations for
employees whose jobs may put them at risk
of bloodborne pathogen exposure
 Requires each workplace to develop and
keep hands on exposure control plan
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Defines staff duties, documentation of
exposure, personal protective equipment, etc
OSHA Mandates
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Exposure control plan be
on hand
Training of staff about
bloodborne pathogens
Documentation and
reporting of all exposures
Personal protective
equipment be available to
staff
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Hepatitis B vaccine be
offered to all at-risk staff
Special containers be
used for biohazardous
materials and sharps
Staff follow standard
precautions
Proper disinfection
techniques be used to
clean tools and work
surfaces
Bloodborne Pathogens Rule
Published 1992
 Clear provisions for employers regarding
infection control practices
 Intent to eliminate or minimize occupational
exposure to blood or other potentially
infectious materials
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Methods of Compliance
Training
of
Employees
Work
Practice
Controls
Universal
Precautions
Vaccines
Where
Possible
Employee
Protection
Administrative
Controls
Personal
Protective
Equipment
Engineering
Controls
Observe Universal Precautions
Infection control guidelines designed to
protect workers from exposure to diseases
spread by blood and certain body fluids.
 All patients should be assumed to be
infectious for bloodborne diseases such as
AIDS and hepatitis B.
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Universal Precautions
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Wash hands before and
after all patient or
specimen contact
Treat the blood of all
patients as potentially
infectious
Treat all linen soiled with
blood or body secretions
as potentially infectious
Wear gloves if contact with
blood or body fluids is
possible
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Immediately place used
syringes in a nearby
impermeable container; do
not recap or manipulate
needles or sharps in any
way
Wear protective eyewear
and mask if splatter with
blood or body fluids is
possible
Wear a mask if there is a
risk of infection by TB or
other airborne organisms
Personal Protective Equipment
Personal Protective Equipment
(PPE)
PPE provides protection against exposure to
infectious materials and must be routinely
used when contact with blood or body fluids
is anticipated
 Selection of PPE is task oriented
 PPE is appropriate when under normal
conditions it prevents blood and body fluids
from reaching an employee’s
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work clothes, street clothes, undergarments
 skin, mouth, eyes, other mucus membranes
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Examples of PPE
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Gloves
Gowns, aprons,
sleeves
Laboratory coats
Face shields or masks
Eye protection
Mouthpieces
Resuscitation bags,
pocket masks
Foot protection
Gloves
Gloves should be made of latex, nitril,
rubber, or other water impervious material
 Inspect gloves before use
 Double gloving can provide an additional
layer of protection
 If you have cuts or sores on your hands, you
should cover these with a bandage or
similar protection as an additional
precaution before donning your gloves
 Don’t touch the outside of used gloves
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Removing Contaminated Gloves
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PINCH one glove back by the cuff until it comes
off inside out.
Discard or cup in the palm of your gloved hand.
Removing Contaminated Gloves
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HOOK a finger of your bare hand inside the cuff of
the remaining glove
PULL BACK so this glove also comes off insideout with the first glove tucked inside it
WASH HANDS!
Rules to Follow
Treat all blood or potentially infectious body
fluids as if they are contaminated
 Always wear personal protective equipment
in exposure situations
 Replace PPE that is torn or punctured
 Remove PPE before leaving work area
 Properly disinfect or dispose of used PPE
 Wash hands immediately after removing
PPE
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Hand Washing Technique
Bloodborne Pathogens in
Athletics
Chances of transmitting HIV among athletes
is low
 Minimal risk of on-field transmission of HIV
from one player to another – less than 1 per
1 million games
 High risk sports for transmission due to
close contact: martial arts, wrestling and
boxing
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Policy Regulation
 Many organizations have developed policies
to help prevent the transmission of
bloodborne pathogens, and have also
initiated programs to help educate athletes
 All institutions should take the responsibility
for educating their student athletes about
transmission of bloodborne pathogens
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HIV and Athletic Participation
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Americans with
Disabilities Act of 1991
states that infected
athletes with HIV
cannot be
discriminated against
and may be excluded
from participation only
on a medically sound
basis
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Testing Athletes for HIV
should not be used as a
screening tool to
determine participation
status
Mandatory testing is not
allowed for legal reasons
related to the ADA of 1991
Athlete’s who engage in
high-risk activities should
be encouraged to seek
voluntary anonymous
testing for HIV
Athletics
Preparing the Athlete
 Cover all open wounds or other skin lesions
with occlusive dressing
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When Bleeding Occurs
 Athlete’s with active bleeding must be
removed from contest and returned only
when deemed safe by medical staff
 Uniforms saturated with blood must be
changed
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Protecting the Athlete from
Exposure
USOC supports required use of
mouthpieces in high-risk sports
 Also recommended all athletes shower
immediately after practice or competition
 Athletes should receive the HBV
immunization
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Wash Hands
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When visibly soiled
After using the bathroom
After removing gloves
After blowing your nose
After sneezing in your hands
Before and after eating,
handling food, drinking or
smoking
Wash Hands
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Before and after assisting
a child in using the toilet
After diaper changes
After contact with runny
noses, vomit, or saliva
Before feeding children
After handling pets,
animals, or animal waste
After handling garbage
Technique for Hand Washing
Remove rings and watches before washing
 If hands-free dispenser is not available,
dispense paper towels before washing
 Hand should be positioned lower than the
arms to avoid contamination
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Decontamination Procedures
Decontamination & Sterilization
All surfaces, tools, equipment and other
objects that come in contact with blood or
potentially infectious materials must be
decontaminated and sterilized as soon as
possible.
 Equipment and tools must be cleaned and
decontaminated before servicing or being
put back to use
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Decontamination
Solution of 5.25% sodium hypochlorite
(household bleach)
 Diluted between 1:10 and 1:100 with water
 Standard recommendation is to use at least
a quarter cup of bleach per one gallon of
water
 Use Lysol or some other EPA-registered
tuberculoid disinfectant. Check the label of
all disinfectants to make sure they meet this
requirements
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Medical Waste
Signs & Labels
Warning labels must be
placed on containers
of regulated waste,
refrigerators and freezers
containing blood or other
potentially infectious material
and other containers used to
store, transport, or ship blood
or other potentially infectious
material
Regulated Medical Waste
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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
Regulated Medical Waste
Red bags and sharps containers are
provided for the collection of regulated
medical waste
 A sharps container, red bag,
and storage box should be
available in the Nurse’s
and/or Custodian’s office
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Biohazard Containers
Requirements for Handling Laundry
Handle contaminated laundry as little as
possible, with minimal agitation
 Place wet contaminated laundry in leakproof labeled or color-coded containers
before transport; use red bags or bags
marked with biohazard symbol
 Wear appropriate PPE when handling
and/or sorting contaminated laundry
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Employee Determination
Exposure Determination
Each principal/custodian/supervisor who has
employees with occupational exposure must
prepare an exposure determination.
 Must contain:
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A list of all job classifications in which all
employees in those job classifications have
occupational exposure
 A list of job classifications in which some
employees have occupational exposure
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All Employees at Risk of Exposure
School nurses
 School Aides who work with the
developmentally disabled
 Lifeguards
 Security Guards
 Health Aides
 Custodial Cleaners
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Some Employees at Risk of
Exposure
Principals
 Assistant Principals
 Laboratory Teachers
 Custodians
 Designated CPR/First Aid Responders
 Physical Education Teachers
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Occupational Exposure Employees
Will receive specialized training annually
 Will be offered the Hepatitis B vaccination
series
 Will be provided with post-exposure
evaluation and follow-up in the case of an
exposure incident
 Will be provided with personal protective
equipment
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