1. Bloodborne Pathogens
Are You Protected?

2. Bloodborne Pathogen
Bloodborne – carried by and lives in human blood or other bodily fluids
Blood
Semen
Feces
Urine
Vomit
Pathogen – a microorganism that can cause disease

3. Types of Pathogens Virus – parasitic microscopic protein
AIDS, Hepatitis, Herpes, Bird Flu
Bacteria – one celled organism
Tetanus, Tuberculosis, Staph Infection
Fungus – single or multi-celled organism
Ringworm, Athlete’s Foot
Protozoa – primitive single-celled organism
Malaria, Giardia

4. How Pathogens Enter the Body
Ingestion
Punctures, cuts, abrasions, and other non-intact skin.
Mucous Membranes
Mouth
Nose
Eyes
Sexual Contact

5. Your Potential Workplace Exposure
Janitorial Duties
First Aid Responder

6. First Aid First aid training Good Samaritan Collateral duty*
4/15/2017
First Aid
First aid training
Good Samaritan
Collateral duty*
Designated responder
BBP standard
applies
Not covered by
BBP Standard
BBP standard applies
* if First-Aid response is an expected part of the job
Do the BBP requirements apply to first aid trained individuals?
The answer depends on the employers expectation of that employee’s application of 1st aid in the course of their job.
As you may know, all employers must have 1st aid trained employees at their workplaces.
Handout: WRD 11.45, 1st aid certification & BBP requirements.
Good Samaritan: If employers have a distinct policy of 1st aid treatment that is only offered on a voluntary basis by the trained individuals, these actions may be classified as “Good Samaritan”. The BBP standards do not apply only under these circumstances. BBP issues and some training would be required under APP.
Collateral Duty: The employer made it part of the job duty for an employee to provide 1st aid, but the actual event would be rare. All elements of the BBP standard apply, but HBV vaccinations may be delayed until the first time there is a 1st aid incident involving blood or OPIM (regardless of whether there is an exposure incident). See WRD 92-6, corrective amendment.
Designated Responder: The employer makes 1st aid part of the job duty for an employee and exposure would be anticipated. All elements of BBP standard apply.
Rev. April, 1997

7. HEPATITIS A Acquired primarily through the fecal-oral route.
Causes an infection of the liver.
Cannot be distinguished from other forms of Hepatitis without testing.
The “restaurant” hepatitis.

8. HEPATITIS B Contracted from contact with blood or other bodily fluids.
100 times more contagious than Human Immunodeficiency Virus (HIV).
Can live in a dry environment for at least 7 days
Some people can be carriers and never get sick, but they can infect others.
There is no cure, but there is a preventative vaccine.

9. Hepatitis B Very infectious 1/3 no symptoms, 1/3 flu-like, 1/3 severe
6 to 10% of cases infectious for life (carrier state)
In the past, 140, ,000 new infections per year
5,000-6,000 deaths/yr from chronic liver disease

10. HEPATITIS C Spread by infected blood or other bodily fluids.
85% of Hepatitis C infections persist for life
Once contracted, over 70% of cases become chronic.
No preventative vaccine.
Current risk rate of contraction is 1 in 10,000.

11. HEPATITIS C 4 million Americans infected
Only 25% of those infected have been diagnosed
Carrier state can develop with or without symptoms
Carrier state can lead to chronic liver disease, cirrhosis (10 year latency), or cancer (alcohol is strong co-factor)
Leading cause of liver transplant in U.S.

12. HEPATITIS C
Signs and symptoms may not appear until 10 years after infection
Onset of symptoms may present with severe liver disease
No broadly effective treatment
No vaccine available

13. HEPATITIS- A,B,&C
Heating foods above 1800 F for one minute will kill the virus.
Good hygiene (washing hands and face) in the best prevention method.
A 10% bleach solution if also an excellent disinfectant.

14. Signs and Symptoms of Hepatitis
Flu-like fatigue and loss of appetite
Fever, nausea, and joint pain
Headaches
Jaundice
Dark colored urine
Light colored stool

15. Hepatitis B Infected Liver
Normal
Hepatitis B

16. Human Immunodeficiency Virus (HIV)
Spread by exchange of blood or other bodily fluids.
Attacks the body’s immune system.
Can live in a dry environment for only a few hours

17. Human Immunodeficiency Virus (HIV)
> 1 million infections in U.S.
138 cases of possible occupational transmission
Infected persons may be asymptomatic for years.
Usually develops into Acquired Immunodeficiency Syndrome (AIDS)

18. Signs and Symptoms of HIV and AIDS
After infection a person will experience flu-like symptoms, then they may become asymptomatic for years.
When symptoms do appear they are usually in the form of weight loss, fatigue, night sweats and fever.
As the disease progresses the infected person usually dies from an opportunistic infection or cancer due to their weakened immune system.

19. How Do You Protect Yourself?
Exposure Control Plan
Use the Universal Precaution
Work Practice Controls
Engineering Controls
Personal Protective Equipment

20. Exposure Control Plan Hepatitis B vaccination
Post exposure evaluation & follow-up
Communication and training
Recordkeeping

21. UNIVERSAL PRECAUTION
Treat all potentially infectious material as if it contained bloodborne pathogens!

22. Work Practice Controls
Controls that reduce the likelihood of exposure by altering how a task is performed.
Examples:
Washing hands after coming into contact with potentially infectious materials.
Not eating, drinking, or smoking in areas where potentially infectious materials are located.
Decontaminating work surfaces after use.

23. Housekeeping Maintain a clean and sanitary workplace
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Housekeeping
Maintain a clean and sanitary workplace
Written cleaning and decontamination schedule
Contaminated waste disposal methods
Laundry
The employer has to ensure that the worksite is maintained in a clean and sanitary condition.
An appropriate written schedule for cleaning and decontamination must be developed for the program.
The written procedures has to include individual locations, how often, what specific cleaners and disinfectants are used and the specific cleaning procedures.
The disinfectant must be an EPA approved tuberculocidal or HIV/HBV effective disinfectant. The label on the product will have this information. Check with distributors or EPA maintains a listing of the products.
A dilution of household bleach to water of between 1:10 to 1:100 may be used. It should be made daily, older solutions lose potency.
Rev. April, 1997

24. Engineering Controls
Controls that reduce employee exposure by either removing the hazard, or by isolating the employee.
Examples:
Using a dust pan or tongs to pick up broken glass.
Using biohazard disposal containers to dispose of potentially infectious materials.

25. Biohazard Bag

26. Personal Protective Equipment
Specialized clothing or equipment used for protection against infectious materials.
Examples:
Gloves
Protective Eyewear
Face shields
Mouthpieces and Resuscitation Devices
All PPE will be provided to you at no personal cost.

27. PPE Gloves Latex Nitrile Vinyl Utility 4/15/2017
Gloves must be carefully selected for their intended use. Important considerations are permeability to microorganisms, dexterity and durability.
Gloves must be frequently changed because the will develop pinhole leaks that are not visible but can allow passage of microscopic organisms.
Pictured above is a dispensing rack with gloves of different size. It is important that the glove are located where they are used.
Latex gloves are strong allergic sensitizers. It is estimated that up to 8-12% of the users of latex gloves will develop an allergic dermatitis reaction. Some may even have stronger respiratory allergic reactions. Substitute materials must be found to accommodate sensitized individuals. Common substitute materials are nitrile and vinyl. If using latex, chose powderless and those with low-protein or antigen content
Thicker utility gloves are needed for tougher jobs where more abrasion is encountered. These gloves must be changed before they start to show wear. They must be disinfected in between uses.
Rev. April, 1997

28. Vaccinations
The Hepatitis vaccination is given as a series of three injections, whose schedule will be determined by a doctor.
The Hepatitis B vaccine prevents Hepatitis B in 85 – 95% of the people who get all three shots.

29. Hepatitis B Vaccination
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Hepatitis B Vaccination
Make Hepatitis B vaccination available
Declination statement required
Available at later date if desired
No cost to employees
Reasonable time and place
If series is interrupted, continue at any time rather than restart series
All employees with occupational exposure must be offered the vaccination
Employees have the right to refuse the vaccination, but must sign the declination form in Appendix A. They may change their mind at any time in the future.
Rev. April, 1997

30. Recordkeeping Medical records HBV vaccination status
4/15/2017
Recordkeeping
Medical records
HBV vaccination status
Written medical opinion of exposure incidents
Exposure incident details
Maintain for length of employment + 30 years
Medical records that are maintained by the employer may not contain any confidential medical information. The only exception is the HBV vaccination status of the employee. The employer can make arrangements with a healthcare provider to maintain medical records
A disease that is attained through an exposure incident must be documented on the OSHA 200 log.
If 10 or less employees, a record of injuries must be kept even if the OSHA 200 log is not required.
A needlestick injury with a contaminated needle must be recorded on the OSHA 200 log if the injury results in loss of consciousness, restricted duties, seroconversion, or medical treatment such as vaccinations or post-exposure prophylaxis (PEP).
Rev. April, 1997

31. Recordkeeping Training records Dates Content summary
4/15/2017
Recordkeeping
Training records
Dates
Content summary
Trainer name & qualifications
Attendee’s names & job titles
Maintain for 3 years
Rev. April, 1997

32. If you are exposed: Wash cuts with soap and water.
Flush splashes to the nose, mouth, or skin with water.
Flush out eyes with clean water or saline.

33. If you are exposed Notify your supervisor immediately.
Seek medical attention.
Fill out a Supervisor’s Injury/Exposure Report.
Fill out an Affidavit of Possible Exposure to Reportable Disease/Follow Up Form.

34. Questions?