BLOODBORNE PATHOGENS AND EXPOSURE CONTROL Blookborne pathogens and Exposure Control 4/21/2017 BLOODBORNE PATHOGENS AND EXPOSURE CONTROL Welcome to the Bloodborne Pathogens Exposure Control training. Today we’re here to talk to you about bloodborne pathogens and how we can prevent injury on the job by using preventative measures and personal protective equipment. For further questions or additional information, resources and contact information will be provided at the end of this training. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Frequently Asked Questions Blookborne pathogens and Exposure Control 4/21/2017 Frequently Asked Questions What are Bloodborne pathogens? How are they transmitted? How to come in contact with them? What are the risks and diseases associated with them? Before we go any further, let’s discuss some basic information. What are bloodborne pathogens? How are they transmitted? How do we come in contact with them and what are the risks and diseases associated with bloodborne pathogens? \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

What is a Bloodborne Pathogen? Blookborne pathogens and Exposure Control 4/21/2017 What is a Bloodborne Pathogen? Bloodborne pathogens (BBP) are disease causing microorganisms found in human blood, and human blood components and products. Bloodborne pathogens are disease causing microorganisms found in human blood and human blood components and products. Though the risk of coming into contact with Bloodborne pathogens is small, the effects can be severe. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Blood Blood is the most obvious transmitter for bloodborne pathogens but there are other transmitters that are not so obvious. (blood cells moving through artery) \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Coming in Contact with Blood Blookborne pathogens and Exposure Control 4/21/2017 Coming in Contact with Blood Paper cuts Falls Nose Bleeds You may be asking yourself, well how often do I come into contact with blood? It does happen more often than you would imagine. Paper cuts, falls, nose bleeds are everyday activities that can affect all people. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Other Potentially Infectious Materials (OPIM) Blookborne pathogens and Exposure Control 4/21/2017 Other Potentially Infectious Materials (OPIM) Cerebral Spinal Fluid Synovial Fluid Bloodborne pathogens can also be transmitted through contact with other potentially infectious materials (OPIM) which include bodily fluids that might be clear. Some clear bodily fluids that you may come into contact with include: Cerebrospinal fluid (CSF) which is a clear, colorless bodily fluid found in the brain and spine. Synovial fluid is a viscous fluid found in the joints. The principal role is to act as a lubricant to joints during movement but someone might come into contact when a bone breaks the skin. You may come into contact with Pleural fluid which is a cloudy fluid that surrounds the lungs if there is a puncture near the rib area. The term “water breaking” during labor is in fact the rupture of the amniotic sac which also has a cloudy color. Because bloodborne pathogens can be transmitted by fluids other than blood, it is important to treat any fluid as a potentially infectious material. Pleural Fluid Amniotic Fluid \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Bloodborne Pathogen Diseases Blookborne pathogens and Exposure Control 4/21/2017 Bloodborne Pathogen Diseases Human Immunodeficiency Virus (HIV) Hepatitis C (HCV) Hepatitis B (HBV) Malaria Brucellosis Syphilis Gonorrhea Ebola Bloodborne pathogens can cause a variety of diseases. Some major diseases caused by blood borne pathogens include: the Human Immunodeficiency Virus or HIV, Hepatitis B, Hepatitis C, Malaria, Brucellosis, Syphilis, Gonorrhea and Ebola. In this training we will only briefly discuss the three most commonly transmitted blood borne pathogens. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Progressive Failure of the Immune System Blookborne pathogens and Exposure Control 4/21/2017 HIV Progressive Failure of the Immune System Human immunodeficiency virus (HIV) HIV attacks the immune system People can carry the virus for years and show no symptoms The Human Immunodeficiency virus or HIV infects the body’s immune system. The virus leads to acquired immunodeficiency syndrome, or AIDS, a condition in humans in which progressive failure of the immune system allows for life-threatening opportunistic infections and cancers, to thrive. Currently, there is no vaccine for the virus. There is treatment available for people infected but there is no cure, once the virus is in the body, it will be there for life. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Human Immunodeficiency Virus (HIV) Blookborne pathogens and Exposure Control 4/21/2017 Human Immunodeficiency Virus (HIV) More than 1.2 million people in the United States are living with HIV infection, and almost 1 in 7 (14%) are unaware of their infection. HIV can develop into Acquired Immune Deficiency Syndrome (AIDS) The virus itself does not live long outside the body but the occupational risks are still there. The main risk of HIV transmission as an occupational hazard is through accidental injuries from needles and other sharp instruments that may be contaminated with the virus. According to the United States Center for Disease Control and Prevention (or the CDC), About 1.2 million people in the United States were living with HIV in 2011, which is the most recent year this information was available. Of those people, about 14% did not know they were infected. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg 9

Blookborne pathogens and Exposure Control 4/21/2017 HBV Attacks the Liver Hepatitis B (HBV) Attacks the liver causing inflammation Can lead to cirrhosis, liver cancer, or death There is a vaccine Most people recover The Hepatitis B Virus, also known as HBV is a virus caused by bloodborne pathogens that attack the liver causing serious liver infection. The infection can lead to liver failure, cirrhosis (which is scarring of the liver), or liver cancer. Results can be fatal without medication. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg 10

Blookborne pathogens and Exposure Control 4/21/2017 Hepatitis B (HBV) HBV can be transmitted indirectly if you touch a contaminated surface and then touch your nose, mouth, eyes, or broken skin HBV can survive dried and at room temperature on surfaces up to a week 12 million Americans have been infected by Hepatitis B The disease can be transmitted directly through contact with infected blood or other potentially infected materials but, HBV can also be transmitted indirectly if you touch a contaminated surface and then touch your nose, mouth, eyes, or broken skin. The virus can survive at room temperature on surfaces for up to a week. Nearly 12 million Americans have been infected by Hepatitis B. Thankfully, there is a vaccine available for HBV. Most of those who are infected with HBV are able to make a full recovery with medication. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 HCV Attacks the Liver Hepatitis C (HCV) Leading cause for liver transplants There is no cure or vaccine Similar symptoms to HBV The third major blood borne pathogen disease is Hepatitis C (HCV). Hepatitis C, like Hepatitis B, also affects the liver. Though people infected often show no symptoms, the virus can scar the liver and eventually lead to liver failure or liver cancer. It currently is the leading cause for liver transplants. There is no cure or vaccine for HCV. About 80% of those infected show no symptoms. Those who do have symptoms show symptoms similar to HBV. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg 12

Hepatitis C Virus (HCV) Blookborne pathogens and Exposure Control 4/21/2017 Hepatitis C Virus (HCV) Hepatitis C (HCV) Inflammation of the liver Can lead to chronic liver disease and death People can carry the virus for years and show no symptoms Those who have experienced a needle stick injury from someone who was HCV positive has about a 1.8% chance of subsequently contracting the disease themselves. More than 3 million Americans have HCV but because the disease has mild to no symptoms, many carriers of the virus are unaware they have it. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg 13

Blookborne pathogens and Exposure Control 4/21/2017 The only way to be certain that you have not contracted a blood borne disease is to contact a healthcare specialist and get checked out yourself. The only way to be certain that you have not contracted a bloodborne disease is to contact a healthcare specialist and get tested. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #1: Which organ does Hepatitis B and Hepatitis C attack? A. Heart B. Liver C. Thyroid D. Kidneys Answer is B, liver \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #2: Which bloodborne pathogen has a vaccine available? A. Human Immunodeficiency Virus (HIV) B. Hepatitis B (HBV) C. Hepatitis HEB (HEB) D. Hepatitis C (HCV) Answer is B, Hepatitis B \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #3: The only way to be certain that you have not contracted a bloodborne disease A. Contact a healthcare specialist and get tested B. Take your blood and check it yourself C. Ask your supervisor D. Ask the City Manager Answer is A, Contact a healthcare specialist and get tested. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Am I at risk? Do I work out in the field? Would I be expected to perform CPR? Do I encounter sharps? Clean ups Ponds First Aid maintenance field Am I at risk? A few questions you may need to ask yourself are: Do I work out in the field? Do I provide first-aid? Do I encounter sharps? Creeks \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Occupation Safety and Health Acts (OSHA) Requirements Blookborne pathogens and Exposure Control 4/21/2017 Occupation Safety and Health Acts (OSHA) Requirements 29 CFR Part 1910.1030 Extends protection provided to employees of private entities by OSHA rules to employees of State and local governments Requires employers to develop a Bloodborne Pathogen Exposure control plan The Occupation Safety and Health Acts work to eliminate or minimize occupational exposure. Occupational exposure means that as an employee while you are performing your duties you could possibly come into contact with blood or other potentially infectious materials. These risks can be decreased with increased training and the use of vaccination to employees. A central component to the training program is the blood borne pathogen exposure control plan, required by the bloodborne pathogens standard. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Reducing Occupational Exposure Blookborne pathogens and Exposure Control 4/21/2017 Reducing Occupational Exposure Develop a Bloodborne Pathogen Exposure Control Plan Log and records of: Injuries from Contaminated Sharps Training Records for 3 years Medical Records Report Exposures to Texas Department of Health 30 years The City of Austin has a Bloodborne Pathogen Exposure Control Plan that we review and update every year. We also require the Log and records of: Injuries from Contaminated Sharps Training Records for 3 years from the date of training Medical Records regarding vaccinations, needle sticks exposures and treatments for the term of employment plus 30 years. The City must also record and report blood borne exposures to the Texas Department of Health. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Identifying Risks All employers must provide a healthy and safe environment. Part of the City of Austin Bloodborne Pathogen Exposure Control Plan is to perform risk assessment for jobs. A risk assessment identifies risks associated with job duties and employee positions. Examples of jobs that have higher risks of coming into contact with bloodborne pathogens include any one who works in the field especially jobs performed in storm drain tunnels, creeks and water ways. Those who preform CPR and/or anyone who works directly with sharp objects especially needles, also have higher risks of coming into contact with bloodborne pathogens. The City is then responsible for providing annual training. If your position has been identified as an at risk position it is your right to be vaccinated. Staff at risk can be vaccinated \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #4: If your position has been identified as an at risk position what Right do you have? A. To leave work early B. To take a nap on site C. To get vaccinated D. To drink an alcoholic beverage Answer is C, the right to be vaccinated \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #5: What does “Occupational Exposure” mean? A. That your work is infectious B. You work in the sun at least 5 hours a day C. You are a doctor or a custodian D. During work you could possibly come into contact with blood or other potentially infectious materials Answer is D, that during work you could possibly come into contact with blood or other potentially infectious materials \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #6: How long does the City need to keep exposure records? A. 1 year B. Until unemployment C. They don’t D. 30 years after employment Answer is D, 30 years after employment \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Taking Responsibility Blookborne pathogens and Exposure Control 4/21/2017 Taking Responsibility “What should I be doing?” Let’s go over some safety practices that you should use to reduce the risk of coming into contact with infectious materials. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Universal Precautions Bloodborne pathogens and Exposure Control 4/21/2017 Universal Precautions Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious for HIV, HBV and other bloodborne pathogens The center for disease control and prevention defines universal precautions as: "a set of precautions designed to prevent the transmission of HIV, hepatitis B, hepatitis C and other bloodborne pathogens when providing first aid or health care.” Remember using Universal Precautions is an attitude. Assume all bodily fluids are infectious. Take your time in dangerous circumstances. It’s an attitude \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Universal Precaution Tools Blookborne pathogens and Exposure Control 4/21/2017 Universal Precaution Tools Personal Protective Equipment: Gloves Shoe Protection Gowns/ Overalls Protective eyewear Aprons CPR Barrier (Mouth to Mouth Breathing) Universal precautions are achieved by using protective barriers that include: Gloves in first aid kits and spills kits, close-toed shoes, gowns, protective eyewear-like goggles, aprons and a CPR Barrier that allows for Mouth-to-Mouth Breathing. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Safe Work Practices Tools to use: Proper protective equipment Devices designed to reduce risk of exposure Disposal materials Aid and Safety Kits By using safe practices, there are several ways that we can prevent the risk of exposure. Safe practices include: Safely handling contaminated or at risk devices using tongs or dust pans to pick up sharps and other hot items, Properly disposing biohazard waste using disposable materials for cleanups, Making sure kits are available for cleanups before an incident occurs, And never reaching into a trash can or an area where waste is disposed with bare hands. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Do’s and Don’ts of Glove Use Blookborne pathogens and Exposure Control 4/21/2017 Do’s and Don’ts of Glove Use Work from “clean to dirty” Don’t touch without gloves Do Discard in appropriate receptacle When wearing gloves it’s important to go from “clean to dirty” surfaces or materials. This limits opportunities to touch contaminants. This protects you, others, and the environment. When wearing gloves don’t touch your face or adjust Personal Protective Equipment with contaminated gloves! If gloves are torn or heavily soiled, be sure to change your gloves! Never wash or reuse disposable gloves. Simply discard gloves in appropriate receptacle. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 How to Remove Gloves Slide ungloved finger under the wrist of the remaining glove Peel off from inside, creating a bag for both gloves Discard Grasp outside edge near wrist Peel away from hand, turning glove inside-out Hold in opposite gloved hand Video It may seem like a simple task but there are incorrect ways to take off gloves. The correct way is to: Grasp outside edge near wrist Peel away from hand, turning glove inside-out Hold in opposite gloved hand Slide ungloved finger under the wrist of the remaining glove Peel off from inside, creating a bag for both gloves Discard properly This video will show you how to do the following. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Hand Hygiene Happy Birthday Wash hands with soap and water or use an alcohol-based hand rub Perform hand hygiene immediately after removing protective equipment When dealing with bodily fluids it’s important to wash your hands to remove traces of toxins or fluids. Wash hands with non-abrasive soap and water or use an alcohol-based hand rub. Perform hand hygiene immediately after removing protective equipment Vigorously rub hands together for 20 seconds—sing happy birthday to monitor appropriate time to wash hands Don’t want to sing Happy Birthday? Try singing the Neil Diamond’s Chorus of Sweet Caroline Or the rap in the middle of bohemian rhapsody If hands become visibly contaminated during personal protective equipment removal, wash hands before continuing. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Insert the demo on hand washing \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Disposal Containers Warning labels must be affixed to containers of regulated waste Color is important Red bags/red containers Signage Bio fluid & Clean-up Materials Sharp Materials Bloodborne kits with biohazard cleanup bags are available at identified locations. Labels must be fluorescent orange, orange-red, or red with lettering or symbols in a contrasting color. Bio-fluids and cleanup materials should go in biohazard bags while sharps like needles, glass and other metals should go in hard containers. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Sharps Disposal Program – Qualified Employees Blookborne pathogens and Exposure Control 4/21/2017 Sharps Disposal Program – Qualified Employees A qualified employee is an employee who is has met the following requirements: 1. Received a Hepatitis B vaccination 2. Completed all required trainings within the past twelve months to include: Training on proper methods of sharps disposal Required tools/ PPE Bloodborne Pathogen training 3. Identified as qualified to participate in the sharps disposal program by their supervisor. Participation is on a volunteer basis You will not be forced against your will Only qualified employees may pick up sharps but who is a qualified employee? A qualified employee is an employee who is has met the following requirements: They have received and completed their series of shots for the hepatitis b vaccination or a signed declination form on file with the safety office. They have completed all required trainings and refresher trainings within the last twelve months that include: Training on proper methods of sharps disposal Proper use of required tools like personal protective equipment And Bloodborne Pathogen training A qualified employee has also been previously identified to participate in the sharps disposal program by their supervisor. Participation in the Sharps disposal program is on a volunteer basis. Under no circumstances will WPD employees be asked to handle or dispose of sharps against their will. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

What Would a Qualified Employee Do? Blookborne pathogens and Exposure Control 4/21/2017 What Would a Qualified Employee Do? 1. All required personal protective equipment is available prior to initiating disposal procedures. 2. Employee disposing sharp materials should be wearing latex or nitrile gloves. 3. Sharps will be picked up using tongs or pliers. Sharps shall never be handled by hand. Oh no! Now let’s say you’ve encountered a possibly contaminated area. What would you do? Let’s talk through the procedure. First, fortunately you are at work and you know all the required personal protective equipment is available. It is important to have personal protective equipment available prior to initiating disposal procedures. Do not bend, break or attempt to recap any needles.   Second, required Personal Protective Equipment for disposing of sharps must consist of latex or nitrile gloves worn by the employee disposing of the sharps. Third, when Personal Protective Equipment is in place the sharps material will be picked up using tongs or pliers or a dustpan. Sharps shall never be handled by hand even if the employee is wearing puncture resistant gloves. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Sharps Containment 4. Sharps will be placed into a properly labeled sharps container and follow storage procedures. The fourth step is to place sharps into a properly labeled sharps container and follow disposal procedures. Contaminated sharps should be kept in an appropriate container until disposed of properly. Contaminated sharps containers should be stored in a locked and secured area. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Reporting Sharps 5. Notify your supervisor by the end of the work day. They will assist you in proper disposal. Notification of the sharps collection shall be made to your supervisor as soon as possible, but no later than the conclusion of the working day. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #7: How long should you wash your hands? A. Until they turn blue B. 10 seconds C. Never D. The time it takes to sing Happy Birthday (20 seconds) Answer is D; Happy Birthday \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #8: Proper disposal: A needle should be disposed of by… A. Placing in a red biohazard bag B. Placing in a biohazard bin or container C. In the trash D. In your pocket Answer is B, Placing in a biohazard bin or container \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Question #9: What is a safe way to pick up broken glass? A. With a dust pan B. With tongs C. A & B D. With your bare hands Answer is C, A&B \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 In Case Of Exposure! Report an exposure incident IMMEDIATELY Medical evaluations are confidential Post exposure treatment options are available and confidential. Reporting is crucial to starting the treatment option. Because treatment is time sensitive, exposure incidents should be reported immediately. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Post Exposure Evaluation & Follow-Up Blookborne pathogens and Exposure Control 4/21/2017 Post Exposure Evaluation & Follow-Up Evaluation by a licensed healthcare professional Results of source testing is made available to exposed employee Establish confidential medical record Post Exposure Prophylaxis medication Follow up with Healthcare professional Covered under Workers’ Compensation Follow-ups are also available for post-risk exposure incidents. During this time you will be evaluated by a licensed healthcare professional where you will be tested. The results of the testing will only be made available to you. From there a confidential medical record will be established and you will be given Post Exposure Prophylaxis medication. After that you will follow up with the Healthcare professional. All of these expenses will be covered under Workers’ Compensation. These medical records will be kept for the time of your employment, plus 30 years. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg

Blookborne pathogens and Exposure Control 4/21/2017 Certificate of Completion Click the paperclip below for an attachment with contact and resource information. Please complete the entry for the completion certificate by entering your first and last name in the Name field. Print the certificate for your records. This concludes the Introduction to the City of Austin Bloodborne Pathogen program. We are working to keep you informed and safe on the job. \\wpdrd\PolicyPlanning\MP\SafetyHR_Trg