OSHA Bloodborne Pathogens Training

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OSHA Bloodborne Pathogens Training

• Washington College

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Introduction

• OSHA training for Resident Hall Advisors
• Developed by
• Dawn Nordhoff, CRNP
• Director, Health Services

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Topics of Discussion

• Bloodborne Pathogens
• HIV
• Hepatitis B and C
• Hepatitis B Vaccination
• Exposure Determination
• Standard Precautions
• Engineering and Work Practice Controls
• Clean-up
• Exposure Emergencies

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Bloodborne Pathogens

• A bloodborne pathogen is a microorganism that is
  carried, replicated and/or transmitted in blood
  or blood products and is capable of causing
  disease.
• All human blood and potentially infectious body
  fluids should be treated as infected.
• Some bloodborne pathogens include HIV, Hepatitis
  B and C, Syphilis, Malaria, Babesiosis,
  Brucellosis, and Creutzfedlt-Jakob disease.

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How are bloodborne pathogens spread?

• By injection, cuts or sticks from contaminated
  sharps and needles or sharing of needles during
  drug use
• Contact between blood and pre-existing skin
  lesions
• Contact with infectious body fluids through the
  eyes, nose, and mouth including sharing of straws
  to snort drugs
• Sexual Contact
• Mother to Baby during pregnancy or during breast
  feeding

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Contaminated

• All body fluids containing visible blood and
  certain other body fluids such as saliva during
  dental procedures, synovial fluid, cerebrospinal
  fluid, pleural fluid, peritoneal and pericardial
  fluid and amniotic fluid, semen, and vaginal
  fluids are considered contaminated.

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Not contaminated

• Feces, nasal secretions, sputum, sweat, tears,
  urine, saliva, breast milk, and vomitus are not
  considered contagious unless blood is present.

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Human Immunodeficiency Virus

• Is the virus known as HIV and the one that causes
  AIDS (Acquired Immunodeficiency Syndrome).
• HIV attacks the bodys immune system, weakening
  it so that it can not fight other infections.

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HIV

• Approximately 45,000 people are infected with HIV
  in the United States every year.
• There are approximately 1 million people living
  with AIDS in the U.S.
• These numbers could be much higher as many people
  who are infected are completely unaware of it.

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HIV

• Unlike the Hepatitis B virus, HIV is very fragile
  and will not survive long outside the human body.
  
• The chances of contracting HIV in the workplace
  are only 0.4.
• However, because it is such a devastating
  disease, all precautions must be taken to avoid
  exposure.

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Symptoms of HIV Infection

• Initially, the person infected with HIV may show
  few or no symptoms. There may be cold or flu
  like symptoms initially that are ignored.
• Later symptoms may include weakness, fever, sore
  throat, nausea, headache, diarrhea, white coating
  on the tongue, weight loss and swollen lymph
  nodes.

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Symptoms of HIV

• Eventually the immune system becomes so depressed
  that the person becomes ill with other diseases
  and infections resulting in death.

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Hepatitis

• Hepatitis is a general term for inflammation of
  the liver. There are several causes including
• Excessive use of alcohol
• Illicit drug use
• Prescription or OTC drug interactions
• Immune Response
• Viral infections including mono

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Hepatitis

• There are several different type of viruses that
  infect the liver.
• Hepatitis A
• Hepatitis B
• Hepatitis C
• Hepatitis D
• Many more have been identified

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Hepatitis B and C

• Hepatitis B and C are transmitted primarily
  through blood and body fluids.

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Hepatitis C

• Hepatitis C is a type of viral infection that
  affects the liver.
• 60-70 of patients have no symptoms
• 75-85 of patients become chronic carriers
• Anti-HCV can usually be detected within 12 weeks
  of exposure

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Hepatitis C

• The leading cause of chronic liver disease and
  the number one indication for liver
  transplantation in the U.S.
• Approximately 4 million people in the U.S. are
  positive for Hepatitis C

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Complications

• Complications of Hepatitis C include
• Liver Cancer
• Cirrhosis
• Chronic Liver Disease
• Death

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Treatment

• Peginterferon alfa 2a or 2b is the newest
  treatment
• Liver Transplant

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Hepatitis C

• You can be re-infected with other strains of
  Hepatitis C
• The HCV antibody remains positive for life but
  does not protect you from future infections
• There is no vaccine for Hepatitis C
• Re-infection after transplant is common because
  it is difficult to filter it from the blood

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Hepatitis B (HBV)

• Hepatitis B is a virus that infects the liver and
  causes inflammation.
• Causes swelling, soreness, and loss of normal
  liver functions
• It can also lead to more serious conditions such
  as cirrhosis of the liver and liver cancer

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• Hepatitis B is transmitted primarily through
  blood to blood contact.
• There is no specific treatment for HBV.

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Hepatitis B

• The Hepatitis B virus is very hardy and can
  survive in dried blood for many days.

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Symptoms of HBV

• Initially there will be Flu like symptoms such
  as
• Fatigue
• Stomach Pain
• Loss of appetite
• Nausea
• Weakness
• Headache
• Fever

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HBV Symptoms

• As the disease continues to develop jaundice or
  yellowing of the skin will occur along with
  darkening of the urine.
• Sometimes people infected with HBV will not have
  any symptoms or will not develop them for up to 9
  months.

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• A person infected with Hepatitis B will usually
  have a positive test for the HBV surface antigen
  within 2-6 weeks from the start of symptoms
• Approximately 85 of infected persons will
  recover in 6-8 weeks
• The other 15 become chronic carriers of the
  disease and can transmit it to others

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Complications of Hepatitis B

• Liver Cancer
• Cirrhosis
• Chronic liver disease
• Death

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Treatment of Hepatitis B

• Symptomatic (rest, fluids)
• Interferon A
• Liver transplant
• Post exposure treatment of
• HBIG and HBV vaccine

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Good News

• There is a way to prevent Hepatitis B infection.
• There is a vaccine for Hepatitis B. It is given
  in a series of 3 shots. The second shot is given
  one month after the first shot and the third shot
  is given 5 months after the second shot.
• This vaccine is free to RAs and it is available
  at the Health Center

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Hepatitis B Vaccine

• The vaccine is contraindicated in people with a
  severe yeast allergy.
• It may cause some side effects such as
  discomfort, bruising or swelling at the injection
  site, headache, fatigue, weakness, malaise, and a
  slight fever. When these sympoms occur they do
  not last long and most people do not have any
  symptoms.

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Should I get the vaccine?

• RAs should have the Hepatitis B vaccine!

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Exposure Determination

• As a RA you have been determined to be in the
  risk category that may occasionally cause you to
  be in a situation that would put you at risk for
  exposure

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Real Life

• You may be the first person to respond to a
  students call for help if they are injured and
  bleeding or you may go to check on someone in
  your hall and find that they have cut wrists and
  are in a pool of blood. You cant get to them
  without coming in contact with the blood.

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If you find yourself in this kind of situation
please stop and protect yourself as much as
possible. Use Standard Precautions and Work
Practice Controls.
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Standard Precautions

• Standard precautions means covering areas of your
  body to prevent contact with potentially
  contaminated blood or body fluids.
• Even if you have had the Hepatitis B vaccine you
  are still at risk for HIV and Hepatitis C as well
  as other bloodborne pathogens

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• Put on protective gloves, gowns, goggles and face
  shields as the situation indicates.
• If you come in contact with any possible
  contaminated fluids, wash your hands and other
  exposed areas ASAP with an antibacterial soap and
  water or a gel cleaner.

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Work Practice ControlsUsing protective
equipment such as gloves and gowns is considered
a work practice control.
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Other controls include

• Use of safer sharps such as disposable needles
  that do not require recapping
• Proper handling and disposal of sharps
• Prevention plan and Post exposure policy

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Prevention

• In addition to avoiding contact with blood and
  body fluids you can also protect yourself and
  others by reporting sharps that are not disposed
  of in a puncture proof container.
• Educating students regarding proper disposal of
  sharps and use of personal protective equipment
  when possible exposure exists.

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Proper clean up

• Finally, if there is blood or body fluids to
  clean up, wear protective equipment and use the
  kit on your hall. A diluted bleach solution of
  110 should be used to clean all surfaces
  affected after the debris has been cleaned.
  Leave the solution on and let the area air dry.
• Always use a brush and dust pan to clean up glass
  or other sharp objects to prevent injury and
  contamination.

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Exposure Emergencies

• If someone must be cared for immediately and this
  results in a possible exposure please follow
  these guidelines.
• 1. Remove clothing that is contaminated.
• 2. Thoroughly wash contaminated area with soap
  and running water.
• 3. Then GO IMMEDIATELY TO THE EMERGENCY
  DEPARTMENT AT CHESTER RIVER HOSPITAL CENTER FOR
  AN EXPOSURE EVALUATION

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Post exposure prophylaxis

• If it is determined that you had a true exposure
  and may be at risk for contracting a bloodborne
  illness you will have blood drawn and be offered
  several medications that may reduce your risk for
  HIV. You may also be given shots to reduce your
  risk of Hepatitis B and C.
• These medications should be given within the
  first 2 hours after exposure.
• It is critical that you go to the Emergency
  Department immediately if exposed.

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Report the incident to college officials

• As soon as possible report the incident to the
  Director of Health Services and the Director of
  Residential Life.
• We will help you with follow up and all the
  required paper work.

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Questions???
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A copy of the Bloodborne Pathogens Compliance
Plan for Washington College can be found in the
following offices Health Services, Public
Safety, Student Affairs and Human Resources