THE OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) STANDARD BLOODBORNE PATHOGENS THE OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) STANDARD

OSHA’S EXPECTATIONS Employer’s Duties Compliance Employee’s Duties identify job risks and classify provide appropriate training provide a plan provide appropriate equipment Compliance Employee’s Duties follow employer’s plan know job classification complete training use equipment provided by employer Compliance Meeting OSHA’s expectations is accomplished by: Training Providing OSHA required information Providing site specific required information Documentation Ongoing observed practice Systematic review of practice Training must be provided by qualified personnel. Site specific training must be provided. The timing of the training is important and documentation is required. Training must be appropriate to the education and reading level of the participants. A qualified person must be available to answer questions during training. TIP: Training records assist the employer and OSHA in determining whether the training program adequately addresses the risk in each job.

OSHA REQUIRED INFORMATION Documents General explanation of bloodborne pathogens Hepatitis B immunization Explanation of tasks that may involve exposure

BLOODBORNE PATHOGENS DEFINED Disease-causing microorganisms that may be present in human blood or OPIM (other potentially infectious material) Viruses Bacteria Parasites

MODES OF TRANSMISSION Puncture wounds or cuts Contact (touch, splash, or spray) with blood or OPIM on: mucous membrane non-intact skin cuts, abrasions, burns acne, rashes papercuts, hangnails contaminated sharps TIP: Puncture wounds most often occur when: Disposing of needles Administering injections Drawing blood Recapping needles Handling trash or dirty linens

RISK OF EXPOSURE Objective of BBP standard is to minimize or eliminate the hazard posed by work that may expose one to blood or OPIM

RISK OF EXPOSURE If a risk of exposure exists one should know: if there is a way to prevent infection symptoms and course of infection availability of counseling availability of post-exposure treatment & follow-up

OCCUPATIONAL EXPOSURE INCIDENTS Occupational contact with blood or OPIM is considered an exposure incident If an exposure occurs: wash with soap & water report incident document incident seek “immediate” medical evaluation follow employer’s exposure control plan

IMMEDIATE MEDICAL EVALUATION “Immediate” means prompt medical evaluation and prophylaxis An exact timeline cannot be stated Time limits on effectiveness of prophylactic measures vary depending on the infection of concern

REPORTING AN INCIDENT Minimal Information to Report Work practice being followed Procedure being performed PPE in use Date and time of incident Job classification Location in the worksite where incident occurred

MEDICAL EVALUATION POST EXPOSURE Entitled to confidential medical evaluation Personal decision about blood testing Blood may be tested only with consent Blood may be stored for 90 days, while considering testing Interpretation of any test results occurs with health care provider

BLOOD TESTING Blood may be tested for antibodies to: Human Immunodeficiency Virus (HIV) Hepatitis C Virus (HCV) Hepatitis B Virus (HBV) Other disease-causing organisms

SPECIFIC BLOODBORNE PATHOGENS Definition Signs and symptoms Course of infection Prevention and control Post-exposure prophy-laxis and follow-up care

HIV DEFINED HIV is Human Immunodeficiency Virus HIV can cause acquired immune deficiency syndrome (AIDS) Risk of HIV infection from a puncture injury exposure to HIV infected blood is very low -- 0.3%

SIGNS & SYMPTOMS OF HIV Signs and symptoms include: Weight loss Night sweats or fever Gland swelling or pain Muscle and/or joint pain Cannot rely on signs and symptoms to confirm if one is infected

COURSE OF INFECTION WITH HIV Incubation period from HIV infection to AIDS can be 8 to 10 years Varies greatly among individuals

HIV PREVENTION There is no vaccine to prevent HIV infection Follow Universal Precautions

HIV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP No cure for HIV infection Testing schedule for HIV antibodies at time of exposure at 3 months at 6 months HIV antibodies usually become detectable within 3 months of infection Treatment requires health care provider OSHA requires treatment that meets most recent CDC guidelines

HCV DEFINED HCV is Hepatitis C Virus It affects the liver It is the most common chronic bloodborne infection in US Risk of HCV infection after exposure to HCV infected blood is 1.8% 70 to 75% of those with acute HCV infection have no symptoms

SIGNS & SYMPTOMS OF HCV Jaundice - yellow color to skin and whites of eyes Fatigue Headache Abdominal Pain Loss of appetite Nausea and vomiting

COURSE OF HCV INFECTION Incubation period averages 7 weeks Chronic liver disease may occur in 70% of those infected with HCV

HCV PREVENTION No vaccine exists to prevent HCV infection Follow Universal Precautions

HCV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP Treatment of HCV requires a health care provider OSHA requires treat-ment that meets most recent CDC guidelines No cure for HCV No post-exposure pro-phylaxis recommended Tests for HCV anti-bodies & liver function recommended at time of exposure Tests should be repeated 4-6 months post exposure

HBV DEFINED HBV is Hepatitis B Virus It affects the liver Prevalence of HBV infection among healthcare workers is 10 times greater than HCV infection

SIGNS & SYMPTOMS OF HBV Jaundice - yellow color to the skin and whites of eyes Fatigue Headache Abdominal Pain Loss of appetite Nausea and vomiting

COURSE OF HBV INFECTION Incubation period averages 12 weeks Most cases of HBV resolve without complications Chronic liver disease may occur in 6 to 7% of those infected with HBV

HBV PREVENTION A vaccine does exist to prevent HBV infection Employers are required to offer HBV vaccination HBV vaccination to employees covered under BBP standard. Debra Currier at Shiprock Administration Office 368-4984 Ext: 10103 Follow Universal Precautions

HBV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP Treatment requires health care provider OSHA requires treatment meet CDC’s most recent guidelines No cure for HBV infection Post-exposure prophylaxis should begin within 24 hours; no later than 7 days after exposure Exposed person should receive HBV vaccine

HBV IMMUNIZATION Employees with routine occupational exposure to blood/OPIM have right to HBV vaccination at no personal expense Employee refusal established by signing HBV vaccination declination form You may change your mind at a later time and receive the vaccine as long as you are in a job covered by the standard

HBV VACCINATION SCHEDULE Vaccine given in 3 doses over 6 months 1st on initial assignment 2nd one month later 3rd five months after 2nd dose Employer cannot require employee to use health insurance to cover test cost Pre-screening is not required HBV is declining because of vaccine use!

PREVENTION Work Practice Controls Personal Protective Equipment Universal Precautions

SHARPS CONTAINERS MUST BE: closable and puncture resistant leak proof labeled or color-coded functional sufficient in number easily accessible and main- tained in upright position replaced per agency policy DO NOT overfilled

HANDWASHING Readily available facilities Washing after removing PPE Using antiseptic hand cleanser when a sink isn’t readily available

HANDWASHING First roll out paper towel or have towel readily available so as not to touch other surfaces to reach it

HANDWASHING Turn on tap water and adjust temperature Use plenty of soap

HANDWASHING Wash hands using friction on all surfaces for at least 30 seconds

HANDWASHING Dry hands thoroughly DO NOT turn off the water yet

HANDWASHING Turn off tap with a dry part of the towel DO NOT touch surfaces with clean hands

CLEANING Clean work surfaces according to employer’s exposure control plan Use PPE and EPA-approved solution DO NOT take contaminated materials home to launder!

PERSONAL PROTECTIVE EQUIPMENT (PPE) Specialized clothing/equipment used for protection when risk of exposure exists Must prevent blood or OPIM from contaminating clothing or skin Must be available at no cost to employee Must be in appropriate sizes Must be in good working condition Must be properly maintained Employee must be trained in proper use

TYPES OF PERSONAL PROTECTIVE EQUIPMENT Gloves Masks Eye shields Gowns/aprons

LATEX GLOVES Medical products containing latex must be labeled Allergies to latex are increasing Substitutes for latex-containing materials must be made available

UNIVERSAL PRECAUTIONS Infection control approach that treats all human blood and certain body fluids as if they are known to contain bloodborne pathogens

CCSD Policy: GBGC-E Exposure Control Plan Contact Payroll for Workman’s Comp Charlotte Simpson Ext. 10131 Contact Debra Currier for Hep B vaccine information. Ext. 10103

EXPOSURE Determination High Risk – Coaches, physical ed instructors, custodians, certain special ed program personnel, playground duty personnel, health services personnel, and security personnel. Moderate Risk – Regular instructional program personnel, other special ed program personnel, school level office personnel, maintenance personnel, food services personnel, and special assignment personnel (e.g., counselors, librarians). Includes record keeping provisions and is reviewed annually

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