Bloodborne Pathogen Safety

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Bloodborne Pathogen Safety
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Could You Contract a Disease at Work?

• Administering first aid?
• Cleaning the restrooms?
• Using a tool covered with dried blood?
• A co-worker sneezes on you?
• Changing diapers?
• Tube feeding?
• Catheterization?

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What is a Bloodborne Pathogen

• A micro-organism that lives in your blood and
  causes disease. Some bloodborne pathogens
  include
• Hepatitis B
• Hepatitis C
• HIV-AIDS
• Other diseases of concern for educators
• Hepatitis A
• Tuberculosis (TB)
• Common Cold

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What is Hepatitis A?

• Hepatitis A is a liver disease caused by
  Hepatitis A virus.
• 33 of Americans have evidence of past infection
  (immunity)
• Cases increasing slightly during past several
  years.
• Estimated 125,000-200,000 total infections/yr in
  United States

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How is Hepatitis A Virus Transmitted?

• Hepatitis A virus is spread from person to person
  by putting something in the mouth that has been
  contaminated with the stool of a person with
  hepatitis A.  This type of transmission is called
  "fecal-oral.
• The virus is more easily spread in areas where
  there are poor sanitary conditions or where good
  personal hygiene is not observed.

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What are the Signs and Symptoms of Hepatitis A?

• Persons with hepatitis A virus infection may not
  have any signs or symptoms of the disease.
• Older persons are more likely to have symptoms
  than children. 
• If symptoms are present, they usually occur
  abruptly and may include
• fever,
• tiredness,
• loss of appetite,
• nausea,
• abdominal discomfort,
• dark urine, and
• jaundice (yellowing of the skin and eyes). 
• Symptoms usually last less than 2 months a few
  persons are ill for as long as 6 months.
• The average incubation period for hepatitis A is
  28 days.

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Hepatitis B (HBV)

• 11.25 million Americans are chronically infected
• Symptoms include jaundice, fatigue, abdominal
  pain, loss of appetite, intermittent nausea,
  vomiting

• May lead to chronic liver disease, liver cancer,
  and death
• 300,000 new cases every year
• 90 Infection rate
• HBV can survive for at least two weeks in dried
  blood

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HEPATITIS B SYMPTOMS

• Jaundice,
• fatigue,
• abdominal pain,
• loss of appetite,
• intermittent nausea,
• vomiting

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Hepatitis B Vaccination

• Offered to all potentially exposed employees
• Provided at no cost to employees
• Declination form

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Viral Hepatitis C

• Hepatitis C is a disease of the liver caused by
  the hepatitis C virus. You should contact your
  medical care provider for a blood test if you
• were notified that you received blood from a
  donor who later tested positive for hepatitis C.
• have ever injected illegal drugs, even if you
  experimented a few times many years ago
• received a blood transfusion or solid organ
  transplant before July, 1992
• received a blood product for clotting problems
  produced before 1987
• have ever been on long-term kidney dialysis
• have evidence of liver disease

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Hepatitis C (HCV)

• Hepatitis C is the most common chronic bloodborne
  infection in the United States
• Symptoms include jaundice, fatigue, abdominal
  pain, loss of appetite, intermittent nausea,
  vomiting.
• 85 Infection rate only 25 will show symptoms
  upon infection. The Stealth Disease some may
  have no symptoms for 20 years or more.
• May lead to chronic liver disease and death

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Hepatitis C virus (HCV)

• 25-30 of infections are symptomatic
• Chronic infection gt85 of infected persons
• Chronic liver disease 70 of infected persons
• Deaths from chronic liver disease
  8,000-10,000/yr
• Leading indication for liver transplantation
• Estimated 3.9 million (1.8) Americans have been
  infected with HCV of whom 2.7 million are
  chronically infected

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Hepatitis D and Hepatitis E

• Hepatitis D is a co-virus associated with
  Hepatitis B (HBV).
• Patients with HBV and HDV have an increased
  chance of developing liver cancer or cirrhosis of
  the liver.
• IV drug use or unprotected sex with multiple
  partners.

• HEV is transmitted primarily by the fecal-oral
  route and fecally contaminated drinking water is
  the most commonly documented vehicle of
  transmission
• Virtually all cases of acute Hepatitis E in the
  United States have been reported among travelers
  returning from high HEV-endemic areas

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Human Immunodeficiency Virus (HIV)

• HIV is the virus that leads to AIDS
• HIV depletes the immune system
• HIV does not survive well outside the body

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of AIDS Cases by Age at Diagnosis
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Trends in AIDS Epidemic

• Today, 42 million people are estimated to be
  living with HIV/AIDS. Of these, 38.6 million are
  adults. 19.2 million are women, and 3.2 million
  are children under 15.
• An estimated 5 million people acquired the human
  immunodeficiency virus (HIV) in 2002, including 2
  million women and 800,000 children under 15.
• During 2002, AIDS caused the deaths of an
  estimated 3.1 million people, including 1.2
  million women and 610,000 children under 15.
• Women are becoming increasingly affected by HIV.
  Approximately 50, or 19.2 million, of the 38.6
  million adults living with HIV or AIDS worldwide
  are women.

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RISK GROUPS

• Low socioeconomic level
• Sexual/household contacts of infected persons
• Infants born to infected mothers
• Health care workers

• Injection drug users
• Sexually active heterosexuals
• Men who have sex with men
• Infants/children of immigrants from
  disease-endemic areas
• Hemodialysis patients

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Potentially Infectious Bodily Fluids

• Blood
• Saliva, vomit, urine (with visible blood)
• Semen or vaginal secretions
• Skin, tissue, cell cultures
• Other body fluids

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PREVENTION OF TRANSMISSION OF BLOODBORNE PATHOGENS

• UNIVERSAL PRECAUTIONS
• Wear Personal Protective Equipment, like Gloves
• Good hygiene and
• sanitation

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Universal Precautions

• Proper cleanup and decontamination
• Treat all blood and bodily fluids as if they are
  contaminated
• Wash your hands

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First Aid

• Wear gloves if you might come in contact with
  blood.
• Have first aid supplies handy on the playground
  by keeping a zip-lock plastic bag stocked with
  disposable gloves, sterile wipes, gauze wrap, and
  bandaids in your pocket.

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Protective Equipment

• Gloves (Latex, Vinyl, or Plastic)
• Apron
• Face shield
• CPR mask
• Whatever you need must be provided by the
  district

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Safe Work Practices

• Remove contaminated PPE or clothing as soon as
  possible
• Clean and disinfect contaminated equipment and
  work surfaces
• Thoroughly wash up immediately after exposure
• Properly dispose of contaminated items

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HOW TO WASH HANDS (CONTINUED)

• Turn the faucet off using the towel.
• Discard the used towel in a trash can lined
• with a fluid-resistant (plastic) bag.
• Consider using hand lotion to prevent chapping of
  hands.
• When assisting a child in handwashing, either
  hold the child (if an infant) or have the child
  stand on a safety step at a height at which the
  child's hands can hang freely under the running
  water.
• Assist the child in performing all of the above
  steps and then wash your own hands.

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How to Wash Hands

• Always use warm, running water and a liquid,
  soap. Antibacterial soaps may be used, but are
  not required.
• Wet the hands and apply a small amount of liquid
  soap to hands.
• Rub hands together vigorously until a soapy
  lather appears and continue for at least 15
  seconds. (Sing a tune to pass the time!!) Be
  sure to scrub between fingers, under fingernails,
  and around the tops and palms of the hands.
• Rinse hands under warm running water. Leave the
  water running while drying hands.
• Dry hands with a clean, disposable towel.

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When Hands Should Be Washed

• Upon arrival at work.
• Immediately before handling food, preparing
  bottles, or feeding children.
• After using the toilet, assisting a child in
  using the toilet, or changing diapers.
• After contacting a child's body fluids, including
  wet or soiled diapers, runny noses, spit, vomit,
  etc.
• Whenever hands are visibly dirty or after
  cleaning up a child, the room, bathroom items, or
  toys.
• After removing gloves used for any purpose.
• Before giving or applying medication or ointment
  to a child or self.
• Before going home.

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Decontamination

• Wear protective gloves
• Disinfectant/cleaner provided in bodily fluid
  disposal kit
• Solution of 1/4 cup bleach per gallon of water
• Properly dispose of contaminated PPE, towels, rags

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Labels and Signs

• Labels must include the universal biohazard
  symbol, and the term Biohazard must be attached
  to
• containers of regulated biohazard waste
• refrigerators or freezers containing blood or
  OPIM
• containers used to store, transport, or ship
  blood or OPIM

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Exposure Incident

• A specific incident of contact with potentially
  infectious bodily fluid
• If there are no infiltrations of mucous membranes
  or open skin surfaces, it is not considered an
  occupational exposure
• Report all accidents involving blood or bodily
  fluids
• Post-exposure medical evaluations are offered

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Potential Transmission

• Contact with another persons blood or bodily
  fluid that may contain blood
• Mucous membranes -- eyes, mouth, nose
• Non-intact skin
• Contaminated sharps/needles

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Potential Exposure

• Administering first aid
• Post-accident cleanup
• Custodial or maintenance work

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Post Exposure Evaluation

• Confidential medical evaluation
• Document route of exposure
• Identify source individual
• Test source individuals blood (with consent)
• Provide results to exposed employee

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What is an exposure?What do I do?

• If you are exposed
• Wash the exposed area thoroughly with soap and
  water.
• Report it to your supervisor, IMMEDIATELY
• Seek immediate medical
• attention

• An exposure is
• When someone elses blood gets into your blood
  through a cut or open wound.
• Needle stick
• Human bite that breaks the skin

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Things to Remember

• A person could be HIV or HBV positive and have no
  symptoms at all.
• You cant tell by looking.
• Treat every person, every needle, and every body
  fluid as if its infected.
• USE UNIVERSAL PRECAUTIONS EVERY TIME.

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Summary

• Universal precautions
• Use PPE and safe work practices
• Decontaminate contaminated surfaces
• Report Exposure incidents

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Use Universal Precautions!

• Lets break the chain of infection.