BLOODBORNE PATHOGENS

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BLOODBORNE PATHOGENS

• Training for Medical Reserve Corp Volunteers

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Bloodborne Pathogens (BBPs)

• Exposure to and infection from BBPs is
  preventable. This presentation outlines the
  means by which exposure to these pathogens will
  be prevented and outlines measures for responding
  to an exposure incident when it occurs.

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Learning Objectives

• By the completion of this training, you will be
  able to
• Define a bloodborne pathogen
• Name three body fluids capable of spreading BBPs
• Describe personal protective that may be used to
  protect against BBPs
• Know what to do if you have an exposure to a BBP

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Bloodborne Pathogen Training Model

• This training model will cover
• Definition of bloodborne pathogens
• Diseases caused by BBPs
• Risk of infection
• Engineering and work practice controls
• Personal protective equipment
• Post-exposure evaluation and follow-up

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What is a Bloodborne Pathogen?

• BBPs are pathogenic microorganisms that are
  present in human blood and can cause disease in
  humans.
• Of primary concern are Human Immunodeficiency
  Virus (HIV), hepatitis B virus (HBV), and
  hepatitis C virus (HCV)

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Modes of Transmission

• BBPs can be transmitted through contact with
  infected blood or other potential infectious
  materials (OPIM) such as
• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Synovial fluid
• Pleural fluid
• Amniotic fluid
• Saliva (in dental procedures only)
• All body fluids that are of undetermined nature
  or where blood is present

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Body Fluids that dont spread BBPs (unless
contaminated with blood)

• Urine
• Feces
• Tears

• Vomitus
• Sweat
• Saliva (except during dental procedures)

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How BBPs are Spread

• An exposure occurs when the pathogen is
  introduced directly into the body through a break
  in the skin, by a needle stick, or through a cut
  with a contaminated object.
• Needle sticks are the most common means of
  exposure to bloodborne pathogens.
• Other exposures occur with contact to mucous
  membranes or non-intact skin.

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How BBPs are NOT spread

• NOT spread by
• Splashing on intact skin
• touching, hugging, kissing
• arthropods (i.e., mosquitoes, ticks)
• shared eating, drinking, cooking utensils
• Airborne routes
• Casual contact in the workplace

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Hepatitis B (HBV)

• Hepatitis means inflammation of the liver
• Primarily transmitted through blood-to-blood
  contact
• May lead to serious liver conditions such as
  cirrhosis or liver cancer
• Virus can live in dried blood for up to several
  days
• Risk of HBV infection after a single positive
  needle stick is 30 (CDC, 1996)

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Hepatitis B

• Incubation period 2 weeks 6 months
• Average incubation is 60-90 days
• Symptoms
• Fatigue
• Loss of appetite
• Abdominal pain
• Nausea
• Rash
• Jaundice
• Dark colored urine

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Hepatitis B disease

• Acute phase Time when a person becomes infected
  and for a few weeks to several months later only
  1/3 are symptomatic
• Chronic phase While some individuals recover
  after the acute phase, others remain infected for
  the rest of their lives. Nearly 10 of adults
  who contract hepatitis B become chronic carriers

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Hepatitis B Vaccine

• Series of 3 injections given over 6 months
• After the series is completed, a sample of blood
  may be tested to see if antibodies have formed to
  protect you from the virus

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Hepatitis B Vaccine

• If antibodies are positive, you are considered a
  responder and have protection from the virus
• If antibodies are negative, you are considered a
  nonresponder and a 2nd series may be given
• If no response to 2 series, you are a
  nonresponder and are not protected against
  hepatitis B.

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Hepatitis C Virus (HCV)

• Primarily transmitted through needle sticks or
  cuts and breaks in the skin
• Risk after a single needle stick is 3-10 (CDC,
  1996)
• Incubation period ranges from 2 weeks to 6
  months, most commonly 6-9 weeks
• Symptoms
• Anorexia, vague abdominal discomfort, nausea and
  vomiting

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Hepatitis C

• Initial infections are asymptomatic 90 of time
• 50-80 develop chronic infection, about half
  leading to cirrhosis or liver cancer
• Not vaccine-preventable

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HIV

• Human Immunodeficiency virus (HIV) is the virus
  that causes acquired immune deficiency syndrome
  (AIDS)
• Virus attacks the bodys immune system,
  destroying the bodys ability to fight infections
• Routes of exposure include sexual contact, IV
  drug use, mother-to-child transmission during
  pregnancy, and blood-to-blood contact

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Environmental Resistance of Viral Particles

• Hepatitis B Virusvery sturdy virus in the
  environment. Probably infective for days, even
  in dried blood.
• HIV--extremely fragile in the environment.
  Probably only infective for minutes outside body
  fluids or upon drying.
• Hepatitis C Virus--not well documented. Probably
  more like HBV than HIV.

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Universal/Standard Precautions

• a system which assumes that every direct contact
  with blood and other potentially infectious
  materials is infectious AND
• requires every worker exposed to these materials
  to be protected as though such materials were
  HBV, HCV and/or HIV infected.

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Engineering Controls

• Defined as
• Technology and devices used to isolate and remove
  hazards from the worker
• Used to eliminate or minimize worker exposure to
  blood or OPIM

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Examples of Engineering Controls

• Needle guards/retractable syringes
• Puncture-resistant sharps containers
• Splash guards/goggles
• Mechanical pipetting

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Sharps Containers shall be

• Puncture resistant and closable no pop bottles
  allowed!
• Labeled as Biohazard or color-coded red
• Leak proof
• Available wherever blood is drawn or injections
  given
• Kept upright
• Replaced when full Dont overfill!
• Lid closed and locked when filled

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Work Practice Controls

• Defined as alterations in the way a task is
  performed to reduce the possibility of exposure
  to blood or OPIM
• Gloves
• Handwashing
• Using Personal Protective Equipment
• Handling sharps according to manufacturer
  directions
• Limiting personal activities in work areas

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Glove Use

• Will be worn by workers when performing tasks
  where exposure to blood or other potentially
  infectious materials may occur
• After use, gloves shall be removed, disposed of,
  and hands washed as soon as possible.

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Hand Washing

• Handwashing is the single most important means of
  preventing the spread of infection.
• Hands must be washed before and after all client
  contact.
• When hand washing facilities are not available,
  hands may be cleansed with an antiseptic cleanser
  and washed with soap and water as soon as
  possible.

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Personal Protective Equipment

• Defined as specialized clothing or equipment used
  by workers to protect themselves from direct
  exposure to blood or OPIM
• Gloves
• Lab coats
• Face masks
• Eye protection
• CPR pocket masks
• Disposable coveralls
• Stick pick

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Personal Activities

• Eating, drinking, smoking, and applying
  cosmetics, lip balm, or contact lenses are
  prohibited in work areas where there is a
  potential for exposure to infectious materials.
• Food and drink will not be stored in areas where
  potentially infectious materials are stored.

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Clean-Up of Spills

• Wear gloves
• Use Isolyzer, especially when broken glass is
  involved.
• Use a dustpan and broom to complete clean-up.
• Discard the broom and dustpan into a biohazard
  waste receptacle (i.e. red bag).

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OR

• Wear gloves
• Wipe up as much of the fluid as possible with
  paper towels. Put the towels in a plastic bag,
  seal, label properly, and dispose of in a
  biohazard waste container.

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THEN

• Flood the area with a commercial disinfectant or
  use a freshly prepared bleach solution, diluted 1
  part bleach to 10 parts water.
• Clean the area thoroughly
• Remove and dispose of gloves in biohazard waste
  container.
• Wash hands

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Post-Exposure Evaluation and Follow-Up

• Initial evaluation and any indicated prophylaxis
  should ideally occur within 2 hours of exposure
  to minimize the chance of BBP transmission.
• The exposed worker should report the injury to a
  supervisor and be seen by a medical consultant
  for evaluation as quickly as possible.

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Training

• All volunteers who may be exposed to BBPs during
  deployment will participate in this training.
• Training will be provided before assigning tasks
  where exposure might occur.
• Training must be completed annually and within 1
  year of the previous training.

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WAC 296-823

• A copy of WAC 206-823, Occupational Exposure to
  Bloodborne Pathogens (effective date 9/1/2004) is
  available at http//www.lni.wa.gov

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THINK PREVENTION
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BBP Quiz

• Now you have a short quiz to take
• Click on the link to Bloodborne Pathogen Quiz
• Print out the test
• Complete the test and mail or deliver the test to
  the MRC coordinator