Biohazard Safety Training

Objectives  In this course you will learn: Characteristics of blood-borne pathogens (BBPs) and other potentially infectious materials (OPIM) Characteristics of blood-borne pathogens (BBPs) and other potentially infectious materials (OPIM) Routes of transmission of infectious agents Routes of transmission of infectious agents Exposure control methods to prevent exposure Exposure control methods to prevent exposure Infectious or biomedical waste disposal procedures Infectious or biomedical waste disposal procedures How to address accidents and injuries when working with BBPs and OPIMs How to address accidents and injuries when working with BBPs and OPIMs

Training  Employers shall ensure that all employees with occupational exposure participate in a training program which must be provided at no cost to the employee and during working hours.

Training  Training shall be provided as follows: At the time of initial assignment to tasks where occupational exposure may take place; At the time of initial assignment to tasks where occupational exposure may take place; Annual training for all employees shall be provided within one year of their previous training. Annual training for all employees shall be provided within one year of their previous training. Employers shall provide additional training when changes such as modification of tasks or procedures or institution of new tasks or procedures affect the employee's occupational exposure. The additional training may be limited to addressing the new exposures created. Employers shall provide additional training when changes such as modification of tasks or procedures or institution of new tasks or procedures affect the employee's occupational exposure. The additional training may be limited to addressing the new exposures created.

Universal (Standard) Precautions “Precautions to protect against exposure must be taken when there is any potential for exposure to bodily fluids. It is assumed that all bodily fluids have the potential to transmit disease” “Precautions to protect against exposure must be taken when there is any potential for exposure to bodily fluids. It is assumed that all bodily fluids have the potential to transmit disease” The Universal Precaution Rule: Treat all human blood, bodily fluids and other potentially infectious materials as if they are infectious.

Blood-borne Pathogens (BBP)  Blood-borne pathogens (BBP) are specific microorganisms transmitted in human blood or bodily fluids, which can cause disease in people.  There are three major BBPs: Hepatitis B (HBV) Hepatitis B (HBV) causes inflammation of the liver that might lead to liver failurecauses inflammation of the liver that might lead to liver failure completely preventable by a vaccinecompletely preventable by a vaccine Hepatitis C (HCV) Hepatitis C (HCV) also causes inflammation of the liver,also causes inflammation of the liver, no vaccine to prevent infectionno vaccine to prevent infection Human Immunodeficiency Virus (HIV) Human Immunodeficiency Virus (HIV) HIV is a human retrovirus that causes AIDS (Acquired Immune Deficiency Syndrome).HIV is a human retrovirus that causes AIDS (Acquired Immune Deficiency Syndrome). There is no vaccine to prevent HIV infection.There is no vaccine to prevent HIV infection.

Other Potentially Infectious Materials  Besides blood-borne pathogens, there are other potentially infectious materials (OPIM) found in the academic and research laboratory settings: Bacteria, Fungi, Rickettsia, Parasites Bacteria, Fungi, Rickettsia, Parasites Other Viruses, including oncogenic (cancer causing) viruses Other Viruses, including oncogenic (cancer causing) viruses Recombinant DNA from infectious agents Recombinant DNA from infectious agents Cell or tissue cultures of human origin Cell or tissue cultures of human origin

Routes of exposure  Blood-borne Pathogens such as HBV, HCV and HIV are transmitted through contact with human blood and bodily fluids. Contacts include: “sharps” exposures in occupational settings “sharps” exposures in occupational settings sexual activity sexual activity sharing of needles sharing of needles mother-to-child exposures at birth mother-to-child exposures at birth HIV is passed from one person to another through blood-to-blood and sexual contact. Infected pregnant women can pass HIV to their babies during pregnancy, delivery, and breast feeding. HIV is passed from one person to another through blood-to-blood and sexual contact. Infected pregnant women can pass HIV to their babies during pregnancy, delivery, and breast feeding.

Routes of exposure  Unbroken skin is a good barrier against BBPs. However, infectious materials can enter your system through skin openings such as: Open sores Open sores Cuts Cuts Abrasions Abrasions Acne Acne Sunburn Sunburn Blisters Blisters  BBPs may also be transmitted through mucous membranes of the Eyes Eyes Nose Nose Mouth Mouth

Other routes of exposure  Other types of potentially infectious material (OPIM) can be transmitted by the following routes: Inhalation/aerosol exposures Inhalation/aerosol exposures Ingestion, especially of contaminated food or drink Ingestion, especially of contaminated food or drink Vector-borne transmission, by mosquito or other biting insects Vector-borne transmission, by mosquito or other biting insects

Exposure control  Exposure Controls consist of those policies and practices that prevent occupational exposures to infectious materials, including: Administrative Controls Administrative Controls Exposure control plan (ECP)Exposure control plan (ECP) Individual Laboratory Risk assessmentsIndividual Laboratory Risk assessments Universal (Standard) Precautions Universal (Standard) Precautions Personal Protective Equipment (PPE) Personal Protective Equipment (PPE) Engineering Controls (HVAC, bio-safety cabinets, self-sheathing needles, safer medical devices, and needleless systems) Engineering Controls (HVAC, bio-safety cabinets, self-sheathing needles, safer medical devices, and needleless systems)

Exposure control plan (ECP)  The OSHA BBP Standard requires employers to develop written documents to explain how they will implement the standard, provide training to employees, and to eliminate or minimize occupational exposure to blood-borne pathogens to protect the health and safety of their workers.  The ECP must be tailored to the specific requirements of the institution; plans must be accessible to all employees, either on-line or in an area where they are available for review on all shifts.

Exposure control plan (ECP)  The ECP includes: Determination of employee exposure and Determination of employee exposure and Implementation of various methods of exposure control, including: Implementation of various methods of exposure control, including: Universal (Standard) precautionsUniversal (Standard) precautions Engineering and work practice controlsEngineering and work practice controls Personal protective equipmentPersonal protective equipment Waste segregation, treatment and disposal, including sharpsWaste segregation, treatment and disposal, including sharps Hepatitis B vaccinationHepatitis B vaccination Post-exposure evaluation and follow-upPost-exposure evaluation and follow-up Communication of hazards to employees and trainingCommunication of hazards to employees and training Recordkeeping: Training records, employee health records, exposure/incident recordsRecordkeeping: Training records, employee health records, exposure/incident records Procedures for evaluating circumstances surrounding exposure incidentsProcedures for evaluating circumstances surrounding exposure incidents

Exposure control plan (ECP) cont…  Administrative Controls: Administrative controls, including risk assessments, are steps taken by supervisors and individual employees, including: Administrative controls, including risk assessments, are steps taken by supervisors and individual employees, including: Conducting a risk assessment of the materials in useConducting a risk assessment of the materials in use Adhering to vaccination schedules and training schedulesAdhering to vaccination schedules and training schedules Training personnel to handle specific infectious materials and their hazardsTraining personnel to handle specific infectious materials and their hazards Promoting individual awareness of personal protective equipment use and engineering controls (sample containers) to minimize or eliminate potential exposurePromoting individual awareness of personal protective equipment use and engineering controls (sample containers) to minimize or eliminate potential exposure

Exposure control plan (ECP) cont…  Sharps Precautions You must exercise care when using needles, scalpels, glass pipettes and other sharp instruments or devices. Follow these rules of thumb when handling sharps: You must exercise care when using needles, scalpels, glass pipettes and other sharp instruments or devices. Follow these rules of thumb when handling sharps: Do not recap, bend, break, or otherwise manipulate used needles by hand.Do not recap, bend, break, or otherwise manipulate used needles by hand. Do not remove used needles from disposable syringes.Do not remove used needles from disposable syringes. Place used sharps in labeled or color-coded puncture- resistant, leak-proof, closable, sharps containers for disposal.Place used sharps in labeled or color-coded puncture- resistant, leak-proof, closable, sharps containers for disposal. Do not overfill sharps containers.Do not overfill sharps containers. Consider the use of alternative, non-sharps equipment whenever possible.Consider the use of alternative, non-sharps equipment whenever possible.

Exposure control plan (ECP) cont…  Personal Protective Equipment (PPE) Whenever you may be exposed to infectious materials you must wear the appropriate personal protective equipment. PPE places a barrier between you and potentially infectious material. Whenever you may be exposed to infectious materials you must wear the appropriate personal protective equipment. PPE places a barrier between you and potentially infectious material. Here are some basic rules to follow: Here are some basic rules to follow: PPE should be readily accessiblePPE should be readily accessible Always wear PPE in exposure situations-Wear a lab coat, gloves and eye protection whenever splashing is imminentAlways wear PPE in exposure situations-Wear a lab coat, gloves and eye protection whenever splashing is imminent Remove and replace PPE that is torn or punctured, or that loses its ability to function as a barrier to potentially infectious materialsRemove and replace PPE that is torn or punctured, or that loses its ability to function as a barrier to potentially infectious materials Remove PPE before leaving the work areaRemove PPE before leaving the work area Dispose of contaminated PPE properly-in biohazard containersDispose of contaminated PPE properly-in biohazard containers

Exposure control plan (ECP) cont…  Types of Personal Protective Equipment (PPE): Gloves Gloves Protective clothing such as, but not limited to, gowns, aprons, lab coats, clinic jackets, or similar outer garments Protective clothing such as, but not limited to, gowns, aprons, lab coats, clinic jackets, or similar outer garments Eye protection devices, such as masks, goggles or glasses with solid side shields, or chin-length face shields Eye protection devices, such as masks, goggles or glasses with solid side shields, or chin-length face shields

Exposure control plan (ECP) cont…  Hand Hygiene Most common mode of transmission of pathogens is via hands! Most common mode of transmission of pathogens is via hands! Often infections acquired in healthcare and research settings are due to not washing your hands. Often infections acquired in healthcare and research settings are due to not washing your hands. Employees must wash their hands with soap and water: Employees must wash their hands with soap and water: immediately, or as soon as feasible, after removal of gloves or other PPE.immediately, or as soon as feasible, after removal of gloves or other PPE. whenever they leave the work area, go on break, or before eating.whenever they leave the work area, go on break, or before eating. following contact with blood or other potentially infectious materials.following contact with blood or other potentially infectious materials.

Exposure control plan (ECP) cont…  Engineering controls Containment is the concept of managing materials to reduce or eliminate potential exposures to personnel, the general public and the outside environment. Containment is the concept of managing materials to reduce or eliminate potential exposures to personnel, the general public and the outside environment. Primary containment consists of good microbiological techniques, appropriate vaccinations or immunizations, appropriate PPE and safety equipment.Primary containment consists of good microbiological techniques, appropriate vaccinations or immunizations, appropriate PPE and safety equipment.

Exposure control plan (ECP) cont…  Engineering Controls Needlestick Prevention: Needlestick Prevention: Sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needleless systems are used to isolate or remove certain blood-borne pathogens hazards from the workplace.Sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needleless systems are used to isolate or remove certain blood-borne pathogens hazards from the workplace.

Accidents and Injuries  If you are exposed to blood or other potentially infectious or hazardous materials, follow these steps: If you experience a needlestick or sharps injury, immediately wash needlesticks or cuts with soap and water. If you experience a needlestick or sharps injury, immediately wash needlesticks or cuts with soap and water. Splashes to the nose, mouth, or skin should be flushed with water. Splashes to the nose, mouth, or skin should be flushed with water. Irrigate eyes using eyewash, for 10 to 15 minutes. Irrigate eyes using eyewash, for 10 to 15 minutes. Report the incident to your supervisor. Colorado State law requires you to notify your supervisor in writing within 4 days of an accident, injury or exposure. Report the incident to your supervisor. Colorado State law requires you to notify your supervisor in writing within 4 days of an accident, injury or exposure. Immediately seek medical treatment. Immediately seek medical treatment. Immediately seek medical treatment Immediately seek medical treatment

Summary  Treat all human blood, bodily fluids and other potentially infectious materials as if they are infectious  There are 3 major Blood-borne pathogens: Hepatitis B, Hepatitis C and HIV.  The most common mode of transmission of pathogens is the hands  Wear proper PPE in exposure situations

References University of Colorado at Denver and Health Sciences Center University of Colorado at Denver and Health Sciences Center UCDHSC Biosafety Program, Policies and Procedures UCDHSC Biosafety Program, Policies and Procedures UCDHSC Biosafety Program, Policies and Procedures UCDHSC Biosafety Program, Policies and Procedures UCDHSC Exposure Control Plan UCDHSC Exposure Control Plan UCDHSC Exposure Control Plan UCDHSC Exposure Control Plan ClinImmune Labs SOP-Exposure Control Plan and General Safety SOP-Exposure Control Plan and General Safety