1. Presented By Michael R. Broll MA MacNeil Environmental, Inc.

2. Training Outline Introduction Epidemiology BBP HBV HIV
Transmission Risks
Prevention
Exposure Control Plan
Universal Precautions
HBV Vaccine
Personal Protective Equipment
Signs/Labels/Dis-posal of Infectious Waste
Spill Cleanup/First Aid Response
Exposure Incident
Post-Exposure Followup

3. Bloodborne Pathogens
BBP: are pathogenic micro-organisms that are present in human blood, and can cause diseases in humans:
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)
Human Immunodeficiency Virus (HIV)
Other Potentially Infectious Materials (OPIMS), examples include:
vaginal secretions/semen, brain, joint, organ fluids, body fluids with blood including vomit and urine/feces

4. Hepatitis B Virus
Different Types of Hepatitis [A-E] - HBV is bloodborne
virus damages the liver
symptoms: none to flu-like that may require hospitalization
6-10% become HBV Carriers
result is fatal for carriers - cirrhosis
infectious: stays alive outside the body for 7 to 14 days
chance of contracting disease form needle stick is 6% to 30%
HBV Vaccine is available

5. Hepatitis B Vaccine Offered to designated First Aid Responders No Cost
3 - Shot Series: first shot next shot 1 month later final shot 6 months later
Injected intra-muscularly into the deltoid muscle (arm)
Complete Series highly effective - up to 96% efficacy rate

6. Hepatitis C Different types of Hepatitis (A-E)
-Hepatitis C is bloodborne
Virus damages the liver
Symptoms: None to flu-like that may require hospitalization
80% become HBC Carriers (20% develop Cirrhosis)
HBC Vaccine is not available
Transmission: using razors, needles, toothbrushes, nail files, tattooing, or body piercing used by an infected person.

7. Human Immunodeficiency Virus
Destroys the immune system immune system is comprised of white blood cells
HIV seeks nucleus of white blood cells
HIV replicates
Destroys white blood cells
years symptoms to manifest
White Blood Cell count falls below 200: diagnosis is Acquired Immuno- deficiency Syndrome [AIDS]
No vaccine, no cure - only prevention

8. Worldwide the first cases of HIV infection were recognized in 1981.
The first six cases of HIV infection in Wisconsin were reported in 1983.
Wisconsin AIDS/HIV Program

9. Possible Routes of Transmission
Accidental injury with a sharp object contaminated with blood/OPIM
Open cuts, nicks, skin abrasions, even dermatitis and acne
Mucous Membranes of mouth, eyes, nose
Indirect transmission, touching a previously contaminated surface & transfer to mouth, eyes, nose or open skin

10. Exposure Control Plan
Designed to minimize occupational exposure to BBP
Identifies employees covered in plan:
First aid responders
Cleanup personnel
Specific measures to minimize risk
Procedures to follow if there is an Exposure Incident

11. Universal Precautions
We are not able to tell for sure which people carry BBP; both HIV & HBV infect people of all ages, socio-economic classes, state, rural areas & cities
BBP carried with no visible symptoms
Many people carry infections without even knowing it

12. Reducing Your Risk Engineering Controls Work Practice Controls
specially marked bags & labels
designated infectious waste bins
sharps containers
Work Practice Controls
good hand-washing
personal hygiene
no eating/drinking/applying cosmetics in blood contaminated areas

13. Needle Capping How to Cap a Needle: NO two hands NO hand-mouth
YES: ONE HANDED METHOD
YES: Self Sheathing
YES: No cap at all, straight to Sharps Container

14. Sharps Containers “Sharps” are objects that can pierce the skin, like:
needles
razor blades
scalpels
exacta knives
pins
saw blades
glass

16. Reducing Your Risk [continued]
Personal Protective Equipment
equipment that protects …
Splash Generation (mask, eye/face, hand)
Clothing Exposure (add overalls/coverall)
Main exposure is to hands: Gloves
disposable
free of flaws (inspect)
correct fit & size
hypoallergenic, if necessary
Accessible

17. Spill Response Use Personal Protective Equipment
Utilize Body Fluid Cleanup Kits
Properly Dispose of Infectious Waste in Approved Containers and Bags
Carry Emergency Response Equipment to remote locations - accessible
Tuberculocidal Disinfectants-Hepi-Quat

18. Infectious Material PUT IT IN A RED BIOHAZRD BAG IF:
Drippable
Squeezable
Pourable
Saturated
WHERE DOES IT GO FROM HERE?

19. Conclusion Bloodborne Diseases Transmission of BBP
Protect yourself from transmission
Follow Universal Precautions
Have PPE Accessible & use it
Properly dispose & cleanup blood/OPIMs
Evaluate all Exposure
Good Handwashing
Report all Exposure Incidents