Blood borne Pathogens

What Are Bloodborne Pathogens? Bloodborne pathogens are microorganisms such as viruses or bacteria that are carried in blood and can cause disease in people. 2

Training The employer shall train each employee with occupational exposure in accordance with the requirements: At the time of initial assignment to tasks where occupational exposure may take place At least annually thereafter Provide additional training when changes such as modifications of tasks or procedures or institution of new tasks or procedures affect the employee’s occupational exposure (additional training may be limited to addressing the new exposures created) Company Overview

Types of Bloodborne Pathogens Bloodborne pathogens include: Malaria Syphilis Brucellosis - contact with animals (i.e. dairy) Hepatitis B (HBV) and Hepatitis C (HCV) Human Immunodeficiency Virus (HIV) 3

Human Immunodeficiency Virus (HIV) Workplace Concerns Hepatitis B (HBV) Hepatitis C (HCV) Human Immunodeficiency Virus (HIV)

is transmitted primarily through "blood to blood" contact Hepatitis B (HBV)… is a virus that causes infection and inflammation of the liver is transmitted primarily through "blood to blood" contact can lead to serious conditions such as cirrhosis & liver cancer can survive in dried blood for up to seven days 4

Hepatitis B (HBV)… There is no "cure" or specific treatment for HBV Many people develop antibodies to fight the disease which may prevent future infection 5

Hepatitis B (HBV)… Vaccines are available to those who’s job requires them to be exposed to bloodborne pathogens Typically the vaccines are a series of 3 shots and then blood work to determine if the vaccine took (you developed antibodies) However, the licensed health care provider (LHCP) will determine the course of action that needs to be taken for each employee. Company Overview

Hepatitis B (HBV)… Vaccines are provided by the company Employees who decline to take the vaccine must sign a declination form These employee can come back at any time and request the vaccine Company Overview

Hepatitis B (HBV)… Incubation period is 30 – 180 days. Initial symptoms can include: Mild flu-like symptoms Fatigue Possible stomach pain Loss of appetite Nausea Symptoms can last 3-10 days. This is followed by jaundice or dark urine. 6

What is Hepatitis C? (HCV) Hepatitis C is a disease of the liver caused by the hepatitis C virus. HCV is spread by contact with the blood of a hepatitis C 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 n infected person. You may be at risk for years ago received a blood transfusion or solid organ transplant before July, 1992

HCV cont’d… received a blood product for clotting problems produced before 1987 have ever been on long-term kidney dialysis have evidence of liver disease (e.g., persistently abnormal ALT levels) There is no vaccine for Hepatitis C Virus.

Human Immunodeficiency Virus (HIV) AIDS, or acquired immune deficiency syndrome, is a disease caused by a virus called the human immunodeficiency virus, or HIV. It may be many years before AIDS actually develops. HIV attacks the body's immune system, weakening it so that it cannot fight other deadly diseases. AIDS is a fatal disease, and while treatment for it is improving, there is no known cure. 9

HIV and Direct Contact The HIV virus is very fragile and will not survive very long outside of the human body. It is primarily of concern to employees providing first aid or medical care in situations involving fresh blood or other potentially infectious materials. 10

HIV Symptoms Symptoms of HIV infection can vary, but often include: Weakness Fever Sore throat Nausea Headaches Diarrhea White coating on the tongue Weight loss Swollen lymph glands 11

Some Workers Who are at Risk Physicians, nurses and emergency room personnel Orderlies, housekeeping personnel, and laundry workers Dentists and other dental workers Laboratory and blood bank technologists and technicians Medical examiners and morticians Law enforcement personnel and firefighters Paramedics and emergency medical technicians Anyone providing first-response medical care Medical waste treatment employees Home healthcare workers The scope of the Bloodborne Pathogens standard is not limited to employees in these jobs. The hazard of exposure to infectious materials affects employees in many types of industries and is not restricted to the health care industry. Discuss the jobs/tasks at your site where there could be a exposure to a bloodborne pathogen.

Bloodborne Pathogen Transmission Bloodborne pathogens are transmitted through contact with infected human blood and other body fluids such as: Semen Vaginal secretions Cerebrospinal fluid (brain & spine) Synovial fluid (joints) Pleural fluid (lungs) Peritoneal fluid (heart) Amniotic fluid (baby) Saliva with visible blood (in Dental setting) 12

Bloodborne Pathogen Transmission In the occupational setting, transmission is by percutaneous injuries (needlesticks/sharp puncture or cut), mucous membrane and non-intact skin exposure to contaminated blood or other potentially infectious materials (OPIM). HCV is transmitted by percutaneous exposure to contaminated blood and plasma derivatives. Company Overview

Skin Provides a Barrier Unbroken skin forms an impervious barrier against bloodborne pathogens. However, infected blood can enter your system through: Open sores Cuts Abrasions Acne Any sort of damaged or broken skin such as sunburn or blisters 13

Mucous Membranes Eyes Nose Mouth Bloodborne pathogens may also be transmitted through the mucous membranes of the: Eyes Nose Mouth 14

Risk of Infection After Occupational Exposure Not all the bloodborne pathogens carry the same risk of infection from an occupational exposure. Frequency in patient population, the ability of the virus to survive on environmental surfaces and the amount of virus present in the body fluid, all impact the risk of acquiring infection, if exposed. The following table demonstrates infection risk from a percutaneous exposure to HBV, HCV, and HIV. Risk of Infection From Percutaneous Exposure Virus Viral particles/mL of serum/plasma Infection Risk HBV 102 - 108 30% HCV 100 - 106 3% HIV 100 - 103 0.3% Company Overview

Signs & Labels Warning labels must be placed on containers of regulated waste, refrigerators and freezers containing blood or other potentially infectious material; and other containers used to store, transport, or ship blood or other potentially infectious materials. 15

What is Regulated Waste? Any liquid or semi-liquid blood or other potentially infectious materials Contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed Items that are caked with dried blood or other potentially infectious materials 16

Hierarchy Engineering Controls Administrative Controls These controls reduce employee exposure by either removing the hazard or isolating the hazard. Administrative Controls These controls reduce the likelihood of exposure by altering how a task is performed. Examples include: Wash hands after removing gloves and as soon as possible after exposure Do not bend or break sharps No food or smoking in work areas Company Overview

Hierarchy PPE Specialized clothing or equipment worn by employees for protection against infectious materials: Must be properly cleaned, laundered, repaired, and disposed of at no cost to employees Must be removed when leaving area or upon contamination Company Overview

How Should Any Type of Exposure Be Handled? Universal Precautions- an approach to infectious control in which all human blood and most bodily fluids are treated as infectious materials Types of PPE Face shield Barrier masks Gloves 16 26

Emergencies In an emergency situation, call for professional medical help and notify your immediate supervisor Only provide emergency treatment to the level of your training (after medics have been summoned) and ONLY IF proper PROTECTIVE EQUIPMENT (i.e. barrier mask, gloves, etc) is available. Remember to treat all injured victims using Universal Precautions. Allow medical staff to clean up and dispose of any contaminated waste materials. 17

Post Exposure Follow-Up Knowing the right steps to take after an exposure incident is critical in reducing the likelihood of acquiring a bloodborne pathogen. Immediately after any exposure incident: Wash the exposed are with soap and water; if the exposure involves the eyes, you should flush with tap water Report the incident to your supervisor and complete an incident report Report the incident to your site’s Safety Specialist Follow any instructions given for treatment Company Overview

Exposure Control Plan Your site’s Exposure Control Plan covers exposure control, the facilities where the vaccinations and the testing is performed; post exposure incident evaluations, exposure incident investigations and the declination form for Hepatitis B. Review your site’s Exposure Control Plan Company Overview