National Safety Council

1
National Safety Council

• What is OSHA?
• What is the OSHA Bloodborne Pathogens Standard?
• What steps are necessary to meet the standard?
  (documented training session content, date
  (during workday annually and instructor
  qualifications)
• Who is covered by the standard?
• Good Samaritan Acts are not covered

2
What is a Bloodborne Pathogen?

• Types of Pathogens (HIV, HBV, syphilis)
• Transmission of Pathogens
• Illness symptoms and signs

3
Hepatitis B (HBV)

• Swelling, soreness, and loss of normal liver
  functions
• Common Symptoms
• Weakness
• Fatigue
• Loss of appetite
• Nausea
• Abdominal pain
• Fever
• Headache
• jaundice

4
Human Immunodeficiency Virus (HIV)

• 1 in 250 persons in USA infected with HIV
  affects immune system T4 cells less able to fight
  disease
• Common Symptoms
• None
• Night sweats
• Weight loss
• Fever
• Fatigue
• Gland pain or swelling
• Muscle and joint pain
• Impossible to tell difference between HBV and
  HIV by looking at a person

5
Prevention Strategies

• Engineering controls
• Work practice controls
• Personal Protective Equipment
• Training
• Head, eye face, ear, respiratory, torso, arm
  hand, and foot leg protection
• Universal Precautions

6
Engineering Controls

• Sharps container
• Safety shields
• Self-retracting needle sheaths
• Hand washing facilities
• Antiseptic towelettes
• Safety is designed into the tools and workplace

7
Work Practice Controls

• The behaviors necessary to effectively use
  equipment with engineered safety controls.
• Appropriate use of sharps container
• Use of hand washing facilities
• (PRIMARY MEANS OF PREVENTION)

8
Universal Precautions

• Concept of infection control
• Treating all human blood and bodily fluids as
  infectious

9
Personal Protective Equipment (PPE)

• Face shields
• Masks and goggles
• If eye protection then face mask is needed
• Aprons
• CPR microshields
• Gowns
• Gloves
• Use of personal protective equipment does not
  guarantee protection from bloodborne pathogens
• Remove dirtiest to cleanest

10
Universal Precautions

• OSHA defined
• Other potentially infectious material
• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Pleural fluid
• Saliva from dental procedures
• Any bodily fluid with visible blood
• Any unidentified bodily fluid

11
Universal Precautions

• Precautions not required
• Feces
• Nasal secretions
• Sputum
• Sweat
• Tears
• Urine
• Vomitus
• unless they contain visible blood

12
Immunization

• Vaccine available (Hepatitis B - not 100
  effective)
• No cost to employee/during work hours
• Immunization schedule (3 doses in upper arm over
  6 months)
• Contraindications for immunization (side effects
  are minimal)

13
Exposure Control

• Hand washing and hand washing facilities
• Reducing splash, spray and spattering
• Prohibited use of mouth pipetting or suctioning
• Prohibited in work areas
• Eating, drinking or smoking
• Applying cosmetics or lip balm
• Handling contact lenses

14
Exposure Control

• Personal protective equipment
• Must be provided at no cost
• Must be used
• Must be removed prior to leaving the work area
• Must be laundered and cared for by the employer
• Limited exceptions to PPE use

15
Exposure Control

• Identify surfaces that may become contaminated
• Follow a regular cleaning schedule
• Use reusable latex gloves for cleaning
• Use EPA approved cleaning solutions

16
Labeling

• Define the acceptable containers (closeable,
  leakproof on sides and bottom, puncture resistant
  and labeled or color-coded)
• When is labeling necessary (to protect
  everyone)(on containers to refrigerate/freeze,
  store, dispose of, transport or ship blood)
• Regulate waste (dispose of ASAP)

17
Transmission

• Mode of Transmission
• Mucous membrane
• Non-intact skin
• Contact with contaminated surfaces
• Injections
• Puncture injury (most common mode)

18
Exposure Determination

• If your job requires or might require you to come
  in contact with blood or other potentially
  infectious material then you are covered under
  the OSHA Bloodborne Pathogen Standard
• High risk ex. draw blood, clean sharps, wash
  laundry, assist person in a fight
• Low risk ex. mopping floor, taking throat
  culture, taking BP, eating in hospital cafeteria
• (employees bear no out-of-pocket expense to meet
  requirements developed with the idea of
  protecting employee as much as possible from
  bloodborne pathogens)

19
Post-Exposure Reporting

• Minimizing exposure
• Reporting the exposure incident
• How, when and where
• Whos blood or bodily fluid
• Opportunity for confidential blood testing

20
Post-Exposure Reporting

• Confidentiality
• Your employer is required to collect specific
  information but is not entitled to release this
  information without your expressed written
  consent except as required by law

21
Exposure Determination

• Written exposure control plan
• Employee is to have access to a copy of this plan
• Exposure determination
• List of job classifications with occupational
  exposure
• List of tasks and procedures in which
  occupational exposure occurs
• Schedule and method of implementation