1. Bloodborne Pathogens

2. Overview Definitions Definitions HIV HIV Hepatitis B Hepatitis B Hepatitis C Hepatitis C Exposure Control Plan Exposure Control Plan Signs/Labels Signs/Labels Precautions Precautions Reporting/Follow-up procedures Reporting/Follow-up procedures

3. Definitions Bloodborne Pathogens: Pathogenic micro-organisms in human blood that can cause disease in humans Other Potential Infectious Materials (OPIM) : 1. Human blood components and/or products 2. Semen 3. Vaginal secretions 4. Cerebrospinal fluid 5. Synovial fluid (joints) 6. Pleural fluid (chest) 7. Pericardial fluid (heart) 8. Peritoneal fluid (abdomen) 9. Amniotic fluid (childbirth) 10. Saliva in dental procedures 11. Any body fluid that is visibly contaminated with blood 12. Any fluids in which differentiation of body fluid types is difficult

4. HIV (Human Immuno-deficiency Virus) Virus that causes AIDS Virus that causes AIDS Passed from one person to another through blood-to- blood and sexual contact Passed from one person to another through blood-to- blood and sexual contact Cannot live more than several hours outside of host Cannot live more than several hours outside of host Most people with HIV will develop AIDS as a result of their infection Most people with HIV will develop AIDS as a result of their infection Currently no cure, but those infected live longer than decades ago Currently no cure, but those infected live longer than decades ago

5. HIV These bodily fluids DO SPREAD the HIV virus… These bodily fluids MAY SPREAD the HIV virus… BloodSemen Vaginal fluid Breast milk Other body fluids containing blood Cerebrospinal fluid (brain) Synovial fluid (joints) Amniotic fluid (child birth)

6. Hepatitis B Virus (HBV) A virus that attacks the liver A virus that attacks the liver 100 times more likely to contract HBV than HIV 100 times more likely to contract HBV than HIV Can stay alive in dried blood for up to one year Can stay alive in dried blood for up to one year HBV vaccination available to ALL who have occupational exposure HBV vaccination available to ALL who have occupational exposure

7. Hepatitis B Virus (HBV) Body Fluids that transfer HBV Symptoms of HBV BloodSemen Vaginal fluid Other body fluids containing blood Feeling of stomach flu Feeling of stomach flu Loss of appetite Loss of appetite Fatigue Fatigue Abdominal cramps Abdominal cramps Nausea or vomiting Nausea or vomiting Dark yellow or brown urine Dark yellow or brown urine Pale or white-colored bowel movements Pale or white-colored bowel movements Jaundice (yellow eyes or skin) Jaundice (yellow eyes or skin)

8. Hepatitis C Virus (HCV) Most common chronic bloodborne infection in the United States Most common chronic bloodborne infection in the United States Only transmitted by blood to blood contact Only transmitted by blood to blood contact Most common exposure is through intravenous drug use Most common exposure is through intravenous drug use Only survives outside of the host for a few hours Only survives outside of the host for a few hours

9. Written Exposure Control Plan (ECP) What potential exposures exist What potential exposures exist Implementation details Implementation details Company’s policies to control BBP exposure Company’s policies to control BBP exposure Hepatitis B vaccination and follow-up Hepatitis B vaccination and follow-up Employee training Employee training Recordkeeping Recordkeeping The procedures for reported incidents The procedures for reported incidents Employer must make sure a copy of the ECP is available to all employees Employer must make sure a copy of the ECP is available to all employees Must be reviewed and updated annually and whenever jobs/tasks/procedures are changed Must be reviewed and updated annually and whenever jobs/tasks/procedures are changed

10. Labels/Signs Labels Labels Must be on any containers containing blood/OPIM or regulated waste disposal, refrigerators, etc. Must be on any containers containing blood/OPIM or regulated waste disposal, refrigerators, etc. Biohazard symbol Biohazard symbol Fluorescent orange/red Fluorescent orange/red Red bags/containers can substitute for labels Red bags/containers can substitute for labels Signs Posted at entrance to specified work areas Fluorescent orange/red Bearing the following legend: Name of the infectious agent Special requirements for entering area Name, phone number of responsible person

11. Universal Precautions Differentiation between body fluid types is difficult, all body fluids must be considered as infectious materials Differentiation between body fluid types is difficult, all body fluids must be considered as infectious materials Always use proper PPE Always use proper PPE Nitrile Gloves Nitrile Gloves Safety glasses Safety glasses Face Shield Face Shield Apron Apron Hand washing Hand washing

12. Precautions- Engineering Examples Sharps disposal containers Sharps disposal containers Self sheathing needles Self sheathing needles Mechanical needle recapping device Mechanical needle recapping device Where engineering controls will reduce employee exposure either by removing, eliminating or isolating the hazard, they must be used.

13. Precautions- Engineering Sharps containers must be: Puncture resistant Puncture resistant Properly labeled or color-coded for biohazards Properly labeled or color-coded for biohazards Leak proof on the sides and bottom Leak proof on the sides and bottom Impossible for employees to reach into the container by hand to retrieve sharps Impossible for employees to reach into the container by hand to retrieve sharps Conveniently located to work area Conveniently located to work area Maintained in upright position Maintained in upright position Replaced or emptied routinely, not allowed to overfill Replaced or emptied routinely, not allowed to overfill

14. Precautions- Administrative/PPE Examples: Employer provided PPE Employer provided PPE Prohibiting recapping of needles using a two-handed technique Prohibiting recapping of needles using a two-handed technique Flushing mucous membranes after contact with body areas with blood or OPIM Flushing mucous membranes after contact with body areas with blood or OPIM Appropriate procedures for laundry handling Appropriate procedures for laundry handling Hand washing Hand washing

15. Precautions- House Cleaning Always wear proper PPE Always wear proper PPE Gloves (Latex or nitrile) Gloves (Latex or nitrile) Safety glasses/Face Shield Safety glasses/Face Shield Apron Apron Never blindly reach into a trash can Never blindly reach into a trash can Needles put into sharps containers Needles put into sharps containers Sweep up any sharp objects Sweep up any sharp objects Use of biohazard containers Use of biohazard containers

16. Precautions- House Cleaning Cleaning up blood or OPIM Use a BBP spill kit Use a BBP spill kit Wear proper PPE Wear proper PPE If necessary, apply chlorinated absorbent to the liquid on ground If necessary, apply chlorinated absorbent to the liquid on ground Scoop up all absorbed blood or OPIM and dispose of into red bio-hazard bag Scoop up all absorbed blood or OPIM and dispose of into red bio-hazard bag Clean area with disposable towels soaked in approved disinfectant Clean area with disposable towels soaked in approved disinfectant Dispose of towels into red bio-hazard bag Dispose of towels into red bio-hazard bag Wipe surface with germicidal wipe Wipe surface with germicidal wipe Once area is cleaned up, dispose of gloves into red bio-hazard bag Once area is cleaned up, dispose of gloves into red bio-hazard bag Use antimicrobial hand wipes and wash hands immediately Use antimicrobial hand wipes and wash hands immediately

17. Precautions- House Cleaning Regulated Waste Blood in liquid or semi-liquid form Blood in liquid or semi-liquid form Items that would release blood or OPIM if compressed Items that would release blood or OPIM if compressed Contaminated sharps Contaminated sharps Items caked with dried blood or OPIM Items caked with dried blood or OPIM

18. Precautions- House Cleaning Laundry Handling Always wear appropriate PPE (gloves, apron, etc.) Always wear appropriate PPE (gloves, apron, etc.) Use bags or containers marked with biohazard symbol for laundry soaked in infectious waste Use bags or containers marked with biohazard symbol for laundry soaked in infectious waste Can use red bags or containers instead Can use red bags or containers instead Put into secondary container if leaks are possible Put into secondary container if leaks are possible Never wash with normal laundry or in same machines Never wash with normal laundry or in same machines

19. Reporting/Follow-up Procedures If exposure occurs: Wash the exposed area of skin or flush mucous membrane with large amounts of water Wash the exposed area of skin or flush mucous membrane with large amounts of water Report it immediately Report it immediately How, when, where How, when, where Whose blood or exactly what happened Whose blood or exactly what happened The Hepatitis B vaccination The Hepatitis B vaccination Recommended regardless of source’s HBV status Recommended regardless of source’s HBV status It is up to you It is up to you

20. Reporting/Follow-up Procedures The employer must: Document the route of the exposure and how the exposure occurred Document the route of the exposure and how the exposure occurred Identify and document the source individual if feasible and not prohibited by law Identify and document the source individual if feasible and not prohibited by law Obtain consent and test source individual’s blood as soon as possible Obtain consent and test source individual’s blood as soon as possible Provide the exposed employee with the test results of source’s blood test and inform about applicable disclosure laws (HIPAA) Provide the exposed employee with the test results of source’s blood test and inform about applicable disclosure laws (HIPAA) Obtain consent, collect, and test exposed employee’s blood as soon as possible after the incident Obtain consent, collect, and test exposed employee’s blood as soon as possible after the incident

21. Reporting/Follow-up Procedures The employer: Provides the employee with a copy of a written opinion from the health care professional within 15 days of the evaluation stating two things Provides the employee with a copy of a written opinion from the health care professional within 15 days of the evaluation stating two things HBV vaccination HBV vaccination Post-exposure evaluation Post-exposure evaluation

22. Questions Special Districts Association of Oregon Loss Control Department 503-371-8667800-285-5461