Bloodborne Pathogens

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Bloodborne Pathogens

• Lander University Employee Training

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Introduction

• To progress through the presentation simply use
  the directional arrows at the bottom left of the
  screen.
• At the end of this presentation click on the quiz
  link on the home page. Please print the quiz,
  complete it and forward to your supervisor.

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Introduction

• This training module is designed to provide a
  basic understanding of bloodborne pathogens,
  common modes of their transmission, methods of
  prevention, and other pertinent information.
  This program is designed to meet the requirements
  of the Occupational Safety and Health
  Administration's (OSHA's) Bloodborne Pathogen
  Standard, 29 CFR 1910.1030.

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Introduction

• The Federal OSHA Bloodborne Pathogen Standard was
  published in 1991. It was designed to reduce and
  minimize the potential for occupational exposure
  to the Human Immunodeficiency Virus (HIV), the
  Hepatitis B Virus (HBV) and other human
  bloodborne pathogens.
• This training program is a direct result of the
  requirements of this regulation.

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Introduction

• All Lander University employees with the
  potential for exposure to bloodborne pathogens in
  their workplace environment must by law receive
  special training. 
• For the purposes of this training anyone who
  receives payment from the University and who is
  exposed as part of their job is an employee.
• In this training program, you will learn methods
  of protecting yourself from potential exposure to
  blood borne pathogens in your workplace. It also
  covers the very important procedures that must be
  carried out should accidental exposure occur.

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Introduction Methods of Compliance

• Exposure Control Plan
• The OSHA Standard requires that Lander prepare an
  Exposure Control Plan which is designed to
  document procedures that minimize employee
  exposure to bloodborne pathogens.
• The Plan contains two parts
• Exposure Determination
• Methods of Compliance
• The plan must be updated annually or when new
  tasks are added.

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Introduction Methods of Compliance

• Exposure Determination Lander University
  conducted a survey of all departments to
  determine which employees were at a risk for
  exposure. That survey resulted in three
  categories of risk depending on daily tasks that
  would place the employee at risk of occupational
  exposure.

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Exposure Determination

• Category I Tasks that involve exposure to
  blood, body fluids, or tissues.
• Category II Tasks that involve no exposure to
  blood, body fluids, or tissues but employment may
  require performing unplanned Category I tasks.
• Category III Tasks that involve no exposure to
  blood, body fluids, or tissues, and Category I
  tasks are not a condition of employment.

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Exposure Determination

• The following is a listing of employees within
  each class.
• Category I Athletic Trainers, Nursing Faculty,
  Staff Nurses, University Police Officers
• Category II Faculty Laboratory Instructors,
  Physical Plant Custodians and Plumbers, PEES
  Faculty, Athletics Dept. Coaches, Campus
  Recreation Employees, and Resident Assistants
• Category III All other employees

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Common Tasks and Procedures

• The following is a list of tasks and procedures
  in which occupational exposure may occur at the
  University and that are performed by categorized
  employees.
• Cleaning of blood or OPIM
• Collecting, handling or disposing of blood or
  OPIM
• Rendering first aid or CPR
• Finger Sticks
• Assisting in emergency situations
• Oral Assessments

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Introduction

• In order to fully understand the Bloodborne
  Pathogens Standard and Landers policy you will
  need to know some common terms. These terms are
  regulatory definitions, not necessarily common
  words.

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Vocabulary

• Universal Precautions
• An approach to infection control that involves
• Assuming that all blood, blood products, and body
  fluids are contaminated. 

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Vocabulary

• Blood
• Blood 
• Blood Components 
• Products made from Human Blood
• Bloodborne Pathogen  Pathogenic microorganisms
  present in human blood that can cause disease in
  humans. These pathogens include, but are not
  limited to, Hepatitis B Virus (HBV), Hepatitis C
  Virus (HCV), and Human Immunodeficiency Virus
  (HIV). Hepatitis B can survive in dried blood
  specimens for several days.

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Vocabulary

• Other Potentially Infectious Materials (OPIM)
• Human Body Fluids
• Semen 
• Vaginal Secretions 
• Cerebrospinal Fluid 
• Synovial Fluid 
• Pleural Fluid 
• Pericardial Fluid 
• Peritoneal Fluid 
• Amniotic Fluid 
• All body fluids that are of undetermined nature
  or are visibly contaminated with blood are also
  considered to be as OPIM.

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Vocabulary

• OPIM also refers to
• Unfixed tissue or organs. 
• HIV-containing cells, tissue, or organ cultures. 
  
• HIV- or HBV-containing culture medium. 
• Blood, organs, etc. from animals with HIV or
  HBV. 

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Vocabulary

• Contaminated
• Blood or OPIM on a Surface 
• Blood or OPIM on Clothes, Equipment, etc. 
• Decontamination
• To remove, inactivate, and destroy infectious
  material. 
• To make surface or equipment safe for handling,
  use, or disposal. 

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Vocabulary - Diseases

• Hepatitis B (HBV)
• In the United States, approximately 300,000
  people are infected with HBV annually. Of these
  cases, a small percentage are fatal.
• "Hepatitis" means "inflammation of the liver,"
  and, as its name implies, Hepatitis B is a virus
  that infects the liver. While there are several
  different types of Hepatitis, Hepatitis B is
  transmitted primarily through "blood to blood"
  contact. Hepatitis B initially causes
  inflammation of the liver, but it can lead to
  more serious conditions such as cirrhosis and
  liver cancer.
• There is no "cure" or specific treatment for HBV,
  but many people who contract the disease will
  develop antibodies which help them get over the
  infection and protect them from getting it again.
  It is important to note, however, that there are
  different kinds of hepatitis, so infection with
  HBV will not stop someone from getting another
  type.

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Vocabulary - Diseases

• The Hepatitis B virus is very durable, and it can
  survive in dried blood for up to seven days. For
  this reason, this virus is the primary concern
  for employees such as housekeepers, custodians,
  laundry personnel and other employees who may
  come in contact with blood or potentially
  infectious materials in a non first-aid or
  medical care situation.
• Symptoms The symptoms of HBV are very much like
  a mild "flu". Initially there is a sense of
  fatigue, possible stomach pain, loss of appetite,
  and even nausea. As the disease continues to
  develop, jaundice (a distinct yellowing of the
  skin and eyes), and a darkened urine will often
  occur. However, people who are infected with HBV
  will often show no symptoms for some time. After
  exposure it can take 1-9 months before symptoms
  become noticeable. Loss of appetite and stomach
  pain, for example, commonly appear within 1-3
  months, but can occur as soon as 2 weeks or as
  long as 6-9 months after infection.

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Vocabulary - Diseases

• Human Immunodeficiency Virus (HIV)
• AIDS, or acquired immune deficiency syndrome, is
  caused by a virus called the human
  immunodeficiency virus, or HIV. Once a person has
  been infected with HIV, it may be many years
  before AIDS actually develops. HIV attacks the
  body's immune system, weakening it so that it
  cannot fight other deadly diseases. AIDS is a
  fatal disease, and while treatment for it is
  improving, there is no known cure.
• Estimates on the number of people infected with
  HIV vary, but some estimates suggest that an
  average of 35,000 people are infected every year
  in the US (in 2000, 45,000 new infections were
  reported). It is believed that as of 2000,
  920,000 persons were living with HIV/AIDS in the
  United States. These numbers could be higher, as
  many people who are infected with HIV may be
  completely unaware of it.

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Vocabulary - Diseases

• The HIV virus is very fragile and will not
  survive very long outside of the human body. It
  is primarily of concern to employees providing
  first aid or medical care in situations involving
  fresh blood or other potentially infectious
  materials. It is estimated that the chances of
  contracting HIV in a workplace environment are
  only 0.4. However, because it is such a
  devastating disease, all precautions must be
  taken to avoid exposure.
• AIDS infection essentially occurs in three broad
  stages. The first stage happens when a person is
  actually infected with HIV. After the initial
  infection, a person may show few or no signs of
  illness for many years. Eventually, in the second
  stage, an individual may begin to suffer swollen
  lymph glands or other lesser diseases which begin
  to take advantage of the body's weakened immune
  system. The second stage is believed to
  eventually lead to AIDS, the third and final
  stage, in all cases. In this stage, the body
  becomes completely unable to fight off
  life-threatening diseases and infections.

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Modes of Transmission

• It is important to know the ways exposure and
  transmission are most likely to occur in your
  particular workplace, be it providing first aid
  to an athlete, handling blood samples in the
  laboratory, or cleaning up blood from a hallway.
• HBV and HIV are most commonly transmitted
  through
• Sexual Contact
• Sharing of hypodermic needles
• From mothers to their babies at/before birth
• Accidental puncture from contaminated needles,
  broken glass, or other sharps
• Contact between broken or damaged skin and
  infected body fluids
• Contact between mucous membranes and infected
  body fluids

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Modes of Transmission

• In most work or laboratory situations,
  transmission is most likely to occur because of
  accidental puncture from contaminated needles,
  broken glass, or other sharps contact between
  broken or damaged skin and infected body fluids
  or contact between mucous membranes and infected
  body fluids. For example, if someone infected
  with HBV cut their finger on a piece of glass,
  and then you cut yourself on the now infected
  piece of glass, it is possible that you could
  contract the disease. Anytime there is
  blood-to-blood contact with infected blood or
  body fluids, there is a slight potential for
  transmission.

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Modes of Transmission

• 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 blisters

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Modes of Transmission

• Bloodborne pathogens may also be transmitted
  through the mucous membranes of the
• Eyes
• Nose
• Mouth
• For example, a splash of contaminated blood to
  your eye, nose, or mouth could result in
  transmission.

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Personal Protective Equipment

• It is extremely important to use personal
  protective equipment and work practice controls
  to protect yourself from bloodborne pathogens.

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Personal Protective Equipment

• Universal Precautions a prevention strategy
  where blood and all OPIM is treated as if it is
  infectious.
• This strategy is used in all situations where
  exposure to blood or potentially infectious
  materials is possible. This also means that
  certain engineering and work practice controls
  shall always be utilized in situations where
  exposure may occur.

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Personal Protective Equipment

• Employees should always utilize PPE when working
  with blood or OPIM.
• PPE is provided to employees at no cost to them.
• Training in the use of appropriate PPE for
  specific tasks or procedures is provided by your
  supervisor.

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Personal Protective Equipment

• The types of PPE available to employees are as
  follows
• Safety glasses
• Face shields
• Gowns and foot coverings

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Personal Protective Equipment

• All employees should observe the following
  precautions
• Wash hands immediately or as soon as feasible
  after removing gloves or other PPE
• Remove PPE after it becomes contaminated and
  before leaving the work area.
• Used PPE must be disposed of in the appropriate
  Biohazard container, not with common trash.
• Never wash or decontaminate disposable gloves for
  reuse.
• Wear appropriate face and eye protection when
  splashes, sprays, splatters, or droplets of blood
  or OPIM pose a hazard to the eye, nose, or mouth.

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Personal Protective Equipment

• Wear appropriate gloves when it is reasonably
  anticipated that there may be hand contact with
  blood or OPIM, and when handling or touching
  contaminated items or surfaces replace gloves if
  torn, punctured, or contaminated, or if their
  ability to function as a barrier is compromised.
• Remove immediately or as soon as feasible any
  garment contaminated by blood or OPIM, in such a
  way as to avoid contact with the outer surface.

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Engineering Controls

• Lander University employees will utilize sharps
  containers as a means of an engineering control
  to prevent workplace exposure.
• Contaminated sharps are discarded immediately in
  containers that are closable, puncture resistant,
  leak proof and appropriately labeled or color
  coded.

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Engineering Controls

• Sharps disposal containers must be easily
  accessible and located as close as feasible to
  the immediate area where sharps are used.
• Broken glassware that may be contaminated is only
  picked up by using mechanical means, such as a
  brush and dustpan.

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Engineering Controls

• Example of Sharps Containers

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SHARPS

• "Contaminated Sharps" means any contaminated
  object that can penetrate the skin including, but
  not limited to, needles, scalpels, broken glass,
  broken capillary tubes, and exposed ends of
  dental wires

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SHARPS INJURIES

• NIOSH recommends if you experienced a needlestick
  or other sharps injury or were exposed to the
  blood or other body fluid during the course of
  your work, immediately follow these steps
• Wash needlesticks and cuts with soap and water
• Flush splashes to the nose, mouth, or skin with
  water

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SHARPS INJURIES

• Irrigate eyes with clean water, saline, or
  sterile irritants
• Report the incident to your supervisor
• Immediately seek medical treatment

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Housekeeping

• Regulated waste is to be placed in containers
  which are closable, constructed to contain all
  contents and prevent leakage, appropriately
  labeled or color-coded and closed prior to
  removal to prevent spillage or protrusion of
  contents during handling.

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Signs and Labels

• Regulated waste is to be placed in containers
  which are designated for use in biohazard
  disposal.
• These containers may be bags, sharps containers,
  or bins.
• All containers should be color coded red or
  labeled with the universal biohazard symbol

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Signs and Labels

• Examples of Biohazard symbol.

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Hepatitis B Vaccination

• The Hepatitis B Vaccination is available at no
  cost to employees after initial employee training
  and within 10 days of initial assignment to all
  employees identified in the exposure
  determination section of this plan.
• Vaccination is encourage unless
• Documentation exists that the employee already
  received the vaccine.
• Antibody testing reveals the employee is immune.
• Medical evaluation shows that vaccination is
  contraindicated.

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Hepatitis B Vaccination

• If an employee declines the vaccination, the
  employee must sign a declination form. Employees
  who decline may request and obtain the
  vaccination at a later date at no cost.
• Vaccination on campus is provided by the staff
  nurse.

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Workplace Exposure Procedures

• An exposure incident occurs if the employee has
  eye, mouth, or other mucous membrane, non-intact
  skin or percutaneous (penetrating the skin)
  contact with blood or other potentially
  infectious material in a work situation, or in
  the performance of their job duty.

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Workplace Exposure Procedures

• Post-exposure evaluation or follow-up will be
  conducted for all employees who have had an
  exposure incident, and will be conducted in
  accordance with Landers Exposure Control Plan
  and Centers for Disease Control guidelines.

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Workplace Exposure Procedures

• Following an occupational exposure to blood or
  body fluids through sharp object injury or
  mucuous membrane contact
• Immediate Site Management
• Skin/sharp object injury cleanse immediately
  with warm soapy water.
• Mouth Rinse mouth well with copious amounts of
  water or rinse well with mouth wash.

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Workplace Exposure Procedures

• Report Injury to Supervisor
• Complete written report of the injury (use
  Appendix D of Exposure Control Plan)
• Report to appropriate medical facility for
  follow-up. This should be done immediately as
  time is critical.
• The supervisor will contact the Office of Human
  Resources, and the Infection Control Officer.

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Workplace Exposure Procedures

• Following a report of an exposure incident, the
  employee will immediately be given a confidential
  medical evaluation and follow-up.

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Post Training Quiz

• The online module is now complete. To complete
  the session please return to the home page and
  select quiz. Please print the quiz, complete it,
  and forward to your supervisor along with the
  online training documentation form.