3. All employees with occupational exposure to blood or other potentially infectious body fluid are required to be trained to have annual blood borne pathogens training. While performing your routine job duties, you may come in contact with potentially infectious body fluid that can make your ill. Learn how to protect yourself and others from becoming infected.

4. What is a BB Pathogen? Viruses, bacteria and microorganisms that are carried in the blood that can cause disease in humans

5. Common BB Pathogen Diseases Hepatitis B Virus (HBV) Hepatitis C Virus (HCV) Human Immunodeficiency Virus (HIV) There are many other BBP but these 3 are the most common ones.

6. Hepatitis “inflammation of the liver”

7. Liver The liver is essential digest foods absorb nutrients produces immune factors to resist infection removes wastes and poisons makes proteins vital for blood clotting.

8. Hepatitis B (HBV) 1 – 1.25 million Americans are chronically infected. (www.cdc.gov)www.cdc.gov Symptoms include: flu like symptoms, right sided stomach pain, jaundice, dark urine, pale stools. Symptoms appear 2 – 6mos after exposure. May lead to liver failure, liver cancer, cirrhosis, acute hepatitis, chronic hepatitis and death. Does NOT appear to be caused by exposure to tears, sweat, urine, stool or droplets.

9. Hepatitis B (HBV) 30% of those infected with HBV have no symptoms. Highest rate of Hepatitis B occurs in 20-49 year olds because of life style choices. 40,000 new cases of Hep B occur each year. ( www.hepb.org/hepb/statistics)

10. Hepatitis C Hepatitis C is the most common bloodborne disease in the United States. (Blood products were not screened until 1992). 80% of those infected have no symptoms. Incubation period is 2-6 months after exposure. Highest incidence of the virus is in the 20-29year old age group. (www.cic.gov/ncidod/diseases/hepatitis/b)

11. Hepatitis C (HCV) Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, dark colored urine, pale stools. May lead to chronic infection (75%-85%),chronic liver disease (70%), cirrhosis, liver cancer. 1%-5% of those infected may die of liver disease. Leading cause of liver transplants. (www.cdc/gov/incidod/diseases/hepatitis/c/fact)

12. Treatment of HCV The most common chronic blood borne infection in the US. There is no cure for HCV. Vaccines and immunoglobulins (attach to bacteria/viruses and assist in destroying them) for HCV do not exist. Treat with drugs to contain the virus and slow disease progression.

13. Treatment of HBV Vaccination available since 1982 for prevention Immune Globulin (human made protein) that provides short- term protection. Anti-viral Medications may help chronic Hep B carriers.

14. Hepatitis B Vaccination Offered to all employees Provided at no cost to employees Memorial Hospital administers the vaccination 3 step series over 6 months

15. A small amount of blood harbor’s a large dose of virus. (More virulent than HIV). HBV & HCV can survive on inanimate objects for up to a week.

16. Human Immunodeficiency Virus (HIV) HIV attacks the immune system and can cause the disease known as AIDS. HIV does not survive well outside the body longer than 24 hours

17. Human Immunodeficiency Virus (HIV) HIV cannot be contracted through casual contact, insects, air, or water. Contact with saliva, sweat, urine, feces or tears has NEVER been found to cause HIV. AIDS is the 2 nd leading cause of death for age group 25 – 44 years. 25% of those in U.S. with HIV are unaware of their infection status.

18. Symptoms of HIV Flu like symptoms (within 1-2mos of exposure) Night sweats or fever Fatigue Swollen glands Other symptoms noted later: Decreased EnergyWeight loss Frequent feversSkin rashes Short term memory lossPersistent yeast infection

19. HIV Individuals can carry the virus without developing symptoms for 10 years or longer. (www.nicid.nih.gov/factsheets/hivinf)

20. Treatment of HIV / AIDS No vaccine approved yet (experimental vaccines are available). Antiretroviral medications (main type of tx for HIV, can prevent illness for many years). There is NO cure for HIV/AIDs at this time.

21. Diagnosis of BBP’s HCV, HBV and HIV/AIDS can all be tested by a simple blood test ordered by your physician. HIV can be tested on Tuesdays and by appt. at the Union County Health Dept.

22. Universal Precautions Treat all bodily fluids as if they are infectious!

23. Potentially Infectious Bodily Fluids Blood Saliva Vomit Urine Semen or vaginal secretions Skin, tissue, cell cultures Other body fluids

24. There must be CONTACT with broken skin or mucous membranes (eyes, mouth, nose) and a potentially infected body fluid.

25. Your Exposure Potential Accident / Injury Administering first aid Handling of any waste products (Diapers & Kleenex) Post-accident cleanup Janitorial or maintenance work

26. Universal Precautions Use of proper PPE Proper cleanup and decontamination Disposal of all contaminated material in the proper manner Treat all blood and bodily fluids as if they are contaminated!!!

27. Personal Protective Equipment (PPE) Anything that is used to protect a person from exposure

28. Protective Equipment Bleeding control: gloves Spurting blood: gloves, protective clothing (gown), mask, eye/face protection (goggles, glasses, or face shield) Post accident cleanup – gloves Janitorial work - gloves

29. CPR Masks - PPE

30. More PPE…

31. Decontamination Wear protective gloves. Disinfectant/cleaner provided in each building or…. Solution of ¼ cup bleach per gallon of water (only good for 24hours). Properly dispose of contaminated PPE, towels, rags, etc. (double bag items’ or place in biohazard container.

32. 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.

33. Hand washing The single most important way to prevent the spread of disease is HAND WASHING Wet hands with running water Apply soap Lather well Rub hands vigorously for at least 20 seconds(back of hands, wrists, betw. Fingers. Rinse well. Dry hands. If you have towel, use it to turn off faucet.

34. Hand Washing Wash hands immediately after removing PPE Use a soft antibacterial soap A hand sanitizer can be used but wash with soap and water as soon as possible thereafter

35. Alcohol Based Hand Sanitizers Procedure for use: 1) Apply to palm of hand. 2) Rub hands together. 3) Rub the product over all surfaces of hands and fingers until the hands are dry. Must be 60-95% alcohol based to be effective. Work by stripping the outer layer of oil on skin which destroys microorganisms on skin surface. Re- growth of bacteria occurs slowly. (www.osha-slc.gov/oshstd_data/1910_1030)

36. Staff Exposure Incidents What is an exposure incident??? A specific incident of contact with potentially infectious bodily fluid. If there are no infiltrations of mucus membranes or open skin surfaces, it is not considered an occupational exposure.

37. Staff Exposure Incidents What should you do if you suspect an exposure incident??? Provide first aid (wash the exposure area with soap and water. Complete Staff Incident Report within 24 hours. Report all accidents & injuries to your supervisor. You will be sent to Occupational Health for treatment.

38. Time to Wake Up!