1. OSHA Regulations and Bloodborne Pathogens Marisa Bush with info from: Sandy Bennett and

2. What is OSHA?  Occupational  Safety and  Health  Administration Ensuring safety for all American workers

3. What are bloodborne pathogens?  Bloodborne pathogens are microorganisms present in blood that can lead to disease.

4. Healthcare workers get exposed to BBPs by:  Surgery  First Aid procedures  Open wounds  Changing wound dressings  Changing contaminated linens  Suturing wounds  Processing lab cultures  Drawing blood  Broken glass contaminated with blood  NEEDLESTICKS!

5. Common bloodborne pathogens The three most common BBPs are:  HIV (Human immunodeficiency virus)  HBV (Hepatitis B virus)  HCV (Hepatitis C virus)

6. Hepatitis  Viruses which attack the liver  Liver performs many functions vital to life Blood reservoir Blood reservoir Blood filter Blood filter Carbohydrate Carbohydrate Fat & protein metabolism Fat & protein metabolism Storage of vitamins, iron, etc. Storage of vitamins, iron, etc.

7. Hepatitis Compare the types of hepatitis: Type of Hepatitis ABCDE Source of virusFecesBlood & body fluids Feces Route of transmission Fecal- oral Break in skin or mucous membranes Same as BSame as C Fecal-oral Chronic infection? NoYes No PreventionVaccine Blood donor screening Risk factor modification Vaccine (for B) Risk factor mod. Safe drinking water

8. Hepatitis A--Symptoms  Jaundice  Fatigue  Abdominal pain  Loss of appetite  Nausea  Diarrhea  Fever

9. Hepatitis A  Caused by infection with Hepatitis A virus  Virus is found in the stool of infected persons  HAV is usually spread from person to person by putting something in the mouth (even though it may look clean) that has been contaminated with the stool of a person with hepatitis A  Occurs in epidemics both nationwide and in communities

10. Hepatitis A Prevention  Good personal hygiene and proper sanitation can help prevent hepatitis A  Always wash your hands with soap and water after using the bathroom, changing a diaper, and before preparing and eating food  Vaccine is available

11. Hepatitis B  Caused by infection with Hepatitis B virus  Occurs when blood or body fluids from an infected person enters the body of a person who is not immune  Occurs when blood or body fluids from an infected person enters the body of a person who is not immune  HBV is spread through: having sex with an infected person without using a condom (the efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission) having sex with an infected person without using a condom (the efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission) by sharing drugs, needles, or "works" when "shooting" drugs by sharing drugs, needles, or "works" when "shooting" drugs through needlesticks or sharps exposures on the job, or through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth from an infected mother to her baby during birth  Can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death

12. Hepatitis B Symptoms  Jaundice  Fatigue  Abdominal pain  Loss of appetite  Nausea, vomiting  Nausea, vomiting  Joint pain

13. Hepatitis B--Prevention  A safe and effective vaccine is available  Use latex condoms correctly and every time you have sex. The efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission.  If you are pregnant, get a blood test for hepatitis B; Infants born to HBV-infected mothers should be given HBIG (hepatitis B immune globulin) and vaccine within 12 hours after birth.  Never share drugs, needles, syringes, or "works“  Do not share personal care items that might have blood on them (razors, toothbrushes)

14. Hepatitis C  Hepatitis C is a disease of the liver caused by the Hepatitis C virus (HCV)  Occurs when blood or body fluids from an infected person enters the body of a person who is not infected  Occurs when blood or body fluids from an infected person enters the body of a person who is not infected  HCV is spread through: sharing needles or "works" when "shooting" drugs, sharing needles or "works" when "shooting" drugs, through needlesticks or sharps exposures on the job, or through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth from an infected mother to her baby during birth  Chronic infection: 55%-85% of infected persons  Chronic liver disease: 70% of chronically infected persons  Deaths from chronic liver disease: 1%-5% of infected persons may die  Leading indication for liver transplant  Most infections are due to illegal injection drug use

15. Hepatitis C--Symptoms  Jaundice  Fatigue  Dark urine  Abdominal pain  Abdominal pain  Loss of appetite  Nausea  80% of infected persons have no signs or symptoms

16. Hepatitis C--Prevention  There is no vaccine to prevent hepatitis C  Do not shoot drugs and never share needles, syringes, or "works"  Do not share personal care items that might have blood on them (razors, toothbrushes)

17. Hepatitis D  Hepatitis D is a liver disease caused by the hepatitis D virus (HDV)  It is a defective virus that needs the hepatitis B virus to exist

18. Hepatitis E  Hepatitis E is a liver disease caused by the hepatitis E virus (HEV)  It is transmitted in much the same way as hepatitis A virus Hepatitis E, however, does not occur often in the United States

19. HIV  Human immunodeficiency virus  HIV can be passed from person to person if someone with HIV infection has sex with or shares drug injection needles with another person  It also can be passed from a mother to her baby when she is pregnant, when she delivers the baby, or if she breast-feeds her baby  Leads to disease AIDS  Destroys the immune system

20. HIV Symptoms  You might have HIV and still feel perfectly healthy  The only way to know for sure if you are infected or not is to be tested

21. HIV and AIDS  HIV is the virus.  AIDS stands for Acquired Immune Deficiency Syndrome. A syndrome is a combination of symptoms or diseases and in this case these are common only when the immune system is deficient.  The only way to know for sure if you are infected or not is to be tested!

22. Diseases & symptoms of AIDS  Flu-like symptoms at time of infection  Kaposi’s sarcoma  Pneumocystis pneumonia  Wasting syndrome  Esophageal candidiasis  Respiratory infections  Peripheral neuropathy  Burkitt’s lymphoma  Cervical cancer

23. HIV Prevention  Don’t share needles and syringes used to inject drugs, steroids, vitamins, or for tattooing or body piercing  Don’t share equipment ("works") used to prepare drugs to be injected  Practice safe sex: The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse, or to be in a long term mutually monogamous relationship with a partner who has been tested and you know is uninfected; use a latex condom to reduce the risk of STD transmission.  Don’t share razors or toothbrushes because of the possibility of contact with blood  If you are pregnant or think you might be soon, talk to a doctor or your local health department about being tested for HIV. Drug treatments are available to help you and reduce the chance of passing HIV to your baby if you have it  Limit contact with blood and body fluids

24. 10 potentially infectious materials  Blood  Semen  Vaginal secretions  Cerebrospinal fluid  Pleural fluid  Pericardial fluid  Amniotic fluid  Saliva (in dental procedures)  Peritoneal fluid  Unfixed tissues or organs

25. You Do Not Get Hepatitis B, C, or HIV  By working with or being around someone who has the disease  From sweat, spit, tears, clothes, drinking fountains, phones, toilet seats, or through everyday things like sharing a meal  From insect bites or stings  From donating blood  From a closed-mouth kiss (though it is possible to get it from open-mouthed kissing because of possible blood contact)

26. What is an exposure control plan?  An employer’s plan describing how compliance with the standard is achieved.

27. How can we be safe from these dreaded BBPs??? Universal Precautions!!!!!!! Treat all blood and body fluids as potentially hazardous

28. HANDWASHING It’s the single most important aspect of infection control of ALL KINDS.

29. When you should wash your hands…  Before any patient contact  After any patient contact  After going to the bathroom  Before eating

30. Rules for dealing with sharps  Use sharps with injury prevention devices or needleless systems  Use a puncture-resistant waste container  Don’t bend, break, recap or remove needles.  Don’t pick up broken glass with your hands (use a broom or tongs instead)  Don’t reach into sharps containers.

31. REMEMBER…  Accidents involving contaminated sharps are the most common route of exposure to bloodborne pathogens.

32. PPE – Personal Protective Equipment Methods that create a barrier between YOU and blood and/or body fluids

33. How do you get rid of PPE? Take gloves off without touching the exposed side Take gloves off without touching the exposed side Remove carefully keeping the exposed side away from you Remove carefully keeping the exposed side away from you Biohazardous waste (Red bags) Biohazardous waste (Red bags)

34. PPE – Personal Protective Equipment  Gloves  Goggles  Masks  Gowns  Shoe covers  Other…?

35. The biohazardous label must be on…  Biohazardous waste  Contaminated linens  Refrigerators or freezers that store blood or body fluids  Anything that is used to dispose, transport, or ship blood or body fluids

36. Disinfectants remove organisms from surfaces and equipment.  Tuberculocidal  Any disinfectant labeled effective against BBPs such as HBV, HCV, HIV, etc.  Bleach in a 1% to 10% solution prepared daily is an inexpensive disinfectant

37. Antiseptic chemicals remove organisms from the skin.  Can be antibacterial  Hand sanitizers with alcohol are a common example

38. MSDS Material Safety Data Sheets Provide information about what to do in case of emergency exposure to potentially dangerous chemicals

39. Hepatitis B Vaccinations  The most effective way to protect against Hepatitis B (HBV).

40. Hepatitis B Vaccinations  Must be offered within 10 days of job assignment  Must be free to the employee  Can be declined by an employee  Administered IM (intramuscular route)

41. Hepatitis B Vaccinations  There are 3 shots in the vaccination series.  Preferred schedule: immediately 1 month 4 months or 6 months  You CAN start the series after an exposure occurs.

42. Hepatitis B Vaccinations  Do not take if you are allergic to yeast.  Common negative reactions are: Fever Fever Redness Redness Headache Headache

43. What the injecting nurse documents  Date of immunization  Time of immunization  Injection site (L or R)  Dosing method (IM, etc.)  Lot number of dose

44. The End