1. THE OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) STANDARD
BLOODBORNE PATHOGENS
THE OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) STANDARD

2. OSHA’S EXPECTATIONS Employer’s Duties Compliance Employee’s Duties
identify job risks and classify
provide appropriate training
provide a plan
provide appropriate equipment
Compliance
Employee’s Duties
follow employer’s plan
know job classification
complete training
use equipment provided by employer
Compliance
Meeting OSHA’s expectations is accomplished by:
Training
Providing OSHA required information
Providing site specific required information
Documentation
Ongoing observed practice
Systematic review of practice
Training must be provided by qualified personnel.
Site specific training must be provided.
The timing of the training is important and documentation is required.
Training must be appropriate to the education and reading level of the participants.
A qualified person must be available to answer questions during training.
TIP: Training records assist the employer and OSHA in determining whether the training program adequately addresses the risk in each job.

3. OSHA REQUIRED INFORMATION
Documents
General explanation of bloodborne pathogens
Hepatitis B immunization
Explanation of tasks that may involve exposure

4. BLOODBORNE PATHOGENS DEFINED
Disease-causing microorganisms that may be present in human blood or OPIM (other potentially infectious material)
Viruses
Bacteria
Parasites

5. MODES OF TRANSMISSION Puncture wounds or cuts
Contact (touch, splash, or spray) with blood or OPIM on:
mucous membrane
non-intact skin
cuts, abrasions, burns
acne, rashes
papercuts, hangnails
contaminated sharps
TIP: Puncture wounds most often occur when:
Disposing of needles
Administering injections
Drawing blood
Recapping needles
Handling trash or dirty linens

6. RISK OF EXPOSURE
Objective of BBP standard is to minimize or eliminate the hazard posed by work that may expose one to blood or OPIM

7. RISK OF EXPOSURE If a risk of exposure exists one should know:
if there is a way to prevent infection
symptoms and course of infection
availability of counseling
availability of post-exposure treatment & follow-up

8. OCCUPATIONAL EXPOSURE INCIDENTS
Occupational contact with blood or OPIM is considered an exposure incident
If an exposure occurs:
wash with soap & water
report incident
document incident
seek “immediate” medical evaluation
follow employer’s exposure control plan

9. IMMEDIATE MEDICAL EVALUATION
“Immediate” means prompt medical evaluation and prophylaxis
An exact timeline cannot be stated
Time limits on effectiveness of prophylactic measures vary depending on the infection of concern

10. REPORTING AN INCIDENT Minimal Information to Report
Work practice being followed
Procedure being performed
PPE in use
Date and time of incident
Job classification
Location in the worksite where incident occurred

11. MEDICAL EVALUATION POST EXPOSURE
Entitled to confidential medical evaluation
Personal decision about blood testing
Blood may be tested only with consent
Blood may be stored for 90 days, while considering testing
Interpretation of any test results occurs with health care provider

12. BLOOD TESTING Blood may be tested for antibodies to:
Human Immunodeficiency Virus (HIV)
Hepatitis C Virus (HCV)
Hepatitis B Virus (HBV)
Other disease-causing organisms

13. SPECIFIC BLOODBORNE PATHOGENS
Definition
Signs and symptoms
Course of infection
Prevention and control
Post-exposure prophy-laxis and follow-up care

14. HIV DEFINED HIV is Human Immunodeficiency Virus
HIV can cause acquired immune deficiency syndrome (AIDS)
Risk of HIV infection from a puncture injury exposure to HIV infected blood is very low %

15. SIGNS & SYMPTOMS OF HIV Signs and symptoms include:
Weight loss
Night sweats or fever
Gland swelling or pain
Muscle and/or joint pain
Cannot rely on signs and symptoms to confirm if one is infected

16. COURSE OF INFECTION WITH HIV
Incubation period from HIV infection to AIDS can be 8 to 10 years
Varies greatly among individuals

17. HIV PREVENTION There is no vaccine to prevent HIV infection
Follow Universal Precautions

18. HIV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP
No cure for HIV infection
Testing schedule for HIV antibodies
at time of exposure
at 3 months
at 6 months
HIV antibodies usually become detectable within 3 months of infection
Treatment requires health care provider
OSHA requires treatment that meets most recent CDC guidelines

19. HCV DEFINED HCV is Hepatitis C Virus It affects the liver
It is the most common chronic bloodborne infection in US
Risk of HCV infection after exposure to HCV infected blood is 1.8%
70 to 75% of those with acute HCV infection have no symptoms

20. SIGNS & SYMPTOMS OF HCV
Jaundice - yellow color to skin and whites of eyes
Fatigue
Headache
Abdominal Pain
Loss of appetite
Nausea and vomiting

21. COURSE OF HCV INFECTION
Incubation period averages 7 weeks
Chronic liver disease may occur in 70% of those infected with HCV

22. HCV PREVENTION No vaccine exists to prevent HCV infection
Follow Universal Precautions

23. HCV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP
Treatment of HCV requires a health care provider
OSHA requires treat-ment that meets most recent CDC guidelines
No cure for HCV
No post-exposure pro-phylaxis recommended
Tests for HCV anti-bodies & liver function recommended at time of exposure
Tests should be repeated 4-6 months post exposure

24. HBV DEFINED HBV is Hepatitis B Virus It affects the liver
Prevalence of HBV infection among healthcare workers is 10 times greater than HCV infection

25. SIGNS & SYMPTOMS OF HBV
Jaundice - yellow color to the skin and whites of eyes
Fatigue
Headache
Abdominal Pain
Loss of appetite
Nausea and vomiting

26. COURSE OF HBV INFECTION
Incubation period averages 12 weeks
Most cases of HBV resolve without complications
Chronic liver disease may occur in 6 to 7% of those infected with HBV

27. HBV PREVENTION A vaccine does exist to prevent HBV infection
Employers are required to offer HBV vaccination HBV vaccination to employees covered under BBP standard. Debra Currier at Shiprock Administration Office
Ext: 10103
Follow Universal Precautions

28. HBV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP
Treatment requires health care provider
OSHA requires treatment meet CDC’s most recent guidelines
No cure for HBV infection
Post-exposure prophylaxis should begin within 24 hours; no later than 7 days after exposure
Exposed person should receive HBV vaccine

29. HBV IMMUNIZATION
Employees with routine occupational exposure to blood/OPIM have right to HBV vaccination at no personal expense
Employee refusal established by signing HBV vaccination declination form
You may change your mind at a later time and receive the vaccine as long as you are in a job covered by the standard

30. HBV VACCINATION SCHEDULE
Vaccine given in 3 doses over 6 months
1st on initial assignment
2nd one month later
3rd five months after 2nd dose
Employer cannot require employee to use health insurance to cover test cost
Pre-screening is not required
HBV is declining because of vaccine use!

31. PREVENTION Work Practice Controls Personal Protective Equipment
Universal Precautions

32. SHARPS CONTAINERS MUST BE:
closable and puncture resistant
leak proof
labeled or color-coded
functional
sufficient in number
easily accessible and main-
tained in upright position
replaced per agency policy
DO NOT overfilled

33. HANDWASHING Readily available facilities Washing after removing PPE
Using antiseptic hand cleanser when a sink isn’t readily available

34. HANDWASHING
First roll out paper towel or have towel readily available so as not to touch other surfaces to reach it

35. HANDWASHING Turn on tap water and adjust temperature
Use plenty of soap

36. HANDWASHING
Wash hands using friction on all surfaces for at least 30 seconds

37. HANDWASHING
Dry hands thoroughly
DO NOT turn off the water yet

38. HANDWASHING Turn off tap with a dry part of the towel
DO NOT touch surfaces with clean hands

39. CLEANING
Clean work surfaces according to employer’s exposure control plan
Use PPE and EPA-approved solution
DO NOT take contaminated materials home to launder!

40. PERSONAL PROTECTIVE EQUIPMENT (PPE)
Specialized clothing/equipment used for protection when risk of exposure exists
Must prevent blood or OPIM from contaminating clothing or skin
Must be available at no cost to employee
Must be in appropriate sizes
Must be in good working condition
Must be properly maintained
Employee must be trained in proper use

41. TYPES OF PERSONAL PROTECTIVE EQUIPMENT
Gloves
Masks
Eye shields
Gowns/aprons

42. LATEX GLOVES Medical products containing latex must be labeled
Allergies to latex are increasing
Substitutes for latex-containing materials must be made available

43. UNIVERSAL PRECAUTIONS
Infection control approach that treats all human blood and certain body fluids as if they are known to contain bloodborne pathogens

44. CCSD Policy: GBGC-E Exposure Control Plan Contact Payroll for Workman’s Comp Charlotte Simpson Ext Contact Debra Currier for Hep B vaccine information. Ext

45. EXPOSURE Determination
High Risk – Coaches, physical ed instructors, custodians, certain special ed program personnel, playground duty personnel, health services personnel, and security personnel.
Moderate Risk – Regular instructional program personnel, other special ed program personnel, school level office personnel, maintenance personnel, food services personnel, and special assignment personnel (e.g., counselors, librarians).
Includes record keeping provisions and is reviewed annually

46. QUESTIONS?