1a. blood and body fluids can carry pathogenic mircoorganisms that can cause: ◦ hepatitis b virus...

Bloodborne Pathogens

1a

Blood and body fluids can carry pathogenic mircoorganisms that can cause:

◦ Hepatitis B virus◦ Hepatitis C virus◦ Human immunodeficiency viruses◦ Cutaneous anthrax◦ Rabies◦ Vaccinia

Understand the dangers and your role in a medical emergency

Safety and health risks

1b

Who is at risk?

Workers with occupational exposure

Good Samaritans

Why is important?

o To implement an exposure control plan

o To determine a required training

o To be aware of risks

o To be aware of precautionary measures

At-risk employees

1c

Exposure can be divided into two subgroups:

Direct: Microorganisms transferred without a

contaminated intermediate object or person

Indirect: Transfer of infectious agent through

contaminated intermediate object or person

Causes and modes of transmission

3a

Hepatitis Transmits through direct and indirect contact Affects the liver, with symptoms of abdominal pain Causes can be due to:o Toxinso Certain drugso Diseaseso Heavy alcohol useo Bacterial and viral infections

Two of the most common types: Hepatitis B virus Hepatitis C virus


3b

Hepatitis B virus Ranges in severity Transmits when infected blood or other body fluid

enters body of non-infected person Exposes employees when:

o Needles, syringes, or other drug-injection equipment are shared

o Items such as razors are shared with an infected persono Direct contact with the blood (even dried blood spills) or

open soreso Exposed to blood from needlesticks or other sharp

instruments


3d

Hepatitis B virus

CDC says HBV is not spread routinely through:

Food or water

Sharing eating utensils

Hugging

Holding hands

Coughing

Sneezing


3e

Hepatitis C virus

Spreads through direct contact with infected blood

Can cause serious health problems

Is a leading cause of liver cancer

Is not transmitted efficiently through occupational

exposure


3f

Hepatitis C virus

Transmission methods include:

◦ Blood transfusions and organ transplants

◦ Sharing needles or other equipment to inject drugs

◦ Body piercing or tattoos in unlicensed or informal

facilities

◦ Blood contamination

◦ Sexual transmission, in rare cases

◦ Childbirth


3g

Hepatitis C virus

CDC says HCV is not spread routinely through:

Casual or mouth-to-mouth contact

Hugging

Sneezing

Coughing

Sharing food

Sharing eating utensils

Sharing glasses


3h

Human immuno-deficiency virus

Spreads through direct and indirect contact with HIV

Leads to AIDS

Two types:

o HIV–1

o HIV-2

Destroys blood cells that help body fight diseases


3i


Transmission methods include:

◦ Unprotected sex with someone who has HIV

◦ Sharing needles, syringes, rinse water, or other

equipment used to prepare illicit drugs for injection

◦ Birth to an infected mother — HIV can be passed from

mother to child during pregnancy, birth, or breast-

feeding


3j

Human immuno-deficiency virusLess common transmission in workplace include: Being “stuck” with an HIV-contaminated needle or other

sharp object Receiving blood transfusions, blood products, or

organ/tissue transplants contaminated with HIV Unsafe or unsanitary injections or other medical or

dental practices Being bitten and skin is not broken Contact between broken skin, wounds, or mucous

membranes and HIV-infected blood or blood-contaminated body fluids


3k


CDC says HIV cannot spread by:

Air or water

Insects, including mosquitoes

Saliva, tears, or sweat

Casual contact like shaking hands or sharing dishes

Closed-mouth contact


3l

Cutaneous anthrax

Occupational exposure could occur when:

Non-intact skin or mucous membrane is exposed to

drainage from cutaneous anthrax lesion

There is entry through skin with sharp instrument

contaminated with lesion drainage


3m

Rabies


Non-intact skin or mucous membrane is exposed to

saliva, nerve tissue, or cerebral spinal fluid from

infected person

There is entry through skin with sharp instrument

contaminated with infected nerve tissue


3n

Rabies

CDC says rabies is not thought to spread by:

Blood

Urine

Feces


3o

Vaccinia


Mucous membranes or non-intact skin contact with

drainage from a vaccinia infection

Susceptible skin comes into direct contact with object

contaminated with lesion material


3p

Hepatitis B virusSymptoms of acute HBV, if they appear, include: Fever Fatigue Loss of appetite Nausea Vomiting Abdominal pain Dark urine Clay-colored bowel movements Joint pain Jaundice (yellow color in the skin or the eyes)

Symptoms of bloodborne diseases

4a

Hepatitis B virus

Symptoms may appear:

90 days (or 3 months) after exposure

Any time between 6 weeks - 6 months after exposure

20 or 30 years after exposure

Vaccination must be offered after the worker is trained

and within 10 days of initial assignment to a job where

there is occupational exposure

Many people with HBV have no symptoms,

but can still spread the virus


4b

Hepatitis C virusSymptoms of HCV: Fever Fatigue Loss of appetite Nausea Vomiting Abdominal pain Dark urine Grey-colored bowel movements Joint pain Jaundice (yellow color in the skin or the eyes)


4c

Human immunodeficiency virusSymptoms of HIV: Fever Chills Rash Night sweats Muscle aches Sore throat Fatigue Swollen lymph nodes Ulcers in the mouth


4d

Human immunodeficiency virus

Symptoms may appear:

Within a few weeks after infection

Up to 10 years or longer

Many people with HIV have no symptoms,

but it is still affecting their body


4e

Cutaneous anthrax

Symptoms include:

Raised itchy bump that proceeds to painless ulcer with

black area in the center

Swollen lymph glands


4f

RabiesSymptoms include: General weakness or discomfort Fever Headache Prickling or itching at site of bite proceeding to:

o Cerebral dysfunctiono Anxiety o Confusiono Agitationo Deliriumo Abnormal behavioro Insomnia


4g

Vaccinia virus

Symptoms include: Rash (mild to severe)

Fever

Head and body aches


4h

Based on exposure determination Updated annually to reflect changes Contains employee input

Exposure control plan

5a

Elements of the plan:

Implementation of universal precautions

Identification and use of engineering

controls

Provisions for personal protective

equipment

Availability of hepatitis B vaccinations for

all employees with occupational exposure


5b

Elements of the plan:

Availability of post-exposure evaluation and follow-up

for any occupationally exposed employee who

experiences an exposure incident

Use of labels and signs to communicate hazards

Provision for information and training


5c

Occupational exposure to bloodborne pathogens is not

limited to occupations or employment in one or a few

industries.

It is based on whether or not employees are

reasonably expected to have skin, eye, mucous

membrane, or parenteral contact with blood and/or

any body fluids that are contaminated with blood

resulting from the performance of their assigned job

duties.

Methods to recognize exposure

6a

One way to determine occupational exposure is to recognize tasks such as: Drawing blood Processing and packaging blood and other biological

specimens for shipping Cleansing and bandaging cuts, burns, and other open

wounds Providing emergency treatment of traumatic wounds Performing cardiopulmonary resuscitation Cleaning up spilled blood or OPIMs


6b

Decontaminating surfaces and reusable equipment

Picking up waste baskets and bags which often contain

needles

Cleaning blood spills and handling infectious waste

Sorting or processing potentially contaminated laundry

Collecting a blood specimen, cleaning and dressing

wounds, and managing intrathecal, epidural, etc.

Exposure to behaviors that involve scratching, biting,

and self-mutilation


6c

Systems used to prevent and control exposure:

Engineering controls

Work practices

Personal protective equipment

Controls to prevent exposure

7a

Work practices Alter the manner in which a task is performed Can consist of:

o Restricting eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses

o Prohibiting mouth pipetting o Preventing the storage of food or drink in

refrigerators or other locations where blood or OPIMs are kept

o Providing and requiring the use of handwashing facilities

o Always using gloves when cleaning up any blood spills


7c

Personal protective equipment Must be used if engineering and work practice control

do not eliminate exposure Can consist of:

o Gloveso Gownso Laboratory coatso Face shields or maskso Eye protection

Appropriate only if it prevents blood or OPIMs from passing through or reaching clothes or body


7e

HousekeepingWork practices related to housekeeping:• Cleaning and decontaminating the environment that

has been contaminated with blood or OPIM• Decontaminating work surfaces after completion of

procedures; immediately after spills of blood or OPIMs• Removing and replacing protective coverings when

contaminated


7f

Universal precautionsPrecautionary measures based on the principle that all blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes may contain transmissible infectious agents.

These include: Hand hygiene Use of gloves, gown, mask, eye protection, or face

shield, depending on the anticipated exposure; and Safe injection practices


7i

For PPE to be effective, observe the following precautions: Remove protective equipment when contaminated and

before leaving work area Place in appropriately designated areas or container Wear appropriate gloves when there is reasonable

hazard of contact with blood or OPIMs Replace gloves if torn, punctured, contaminated, or no

longer function as a barrier (i.e. gloves) Never wash or decontaminate disposable gloves for reuse

Proper PPE use and handling

8a

This vaccine is: Free of charge to workers with occupational exposure Best way to prevent hepatitis B Given in 3-4 shots over a 6-month period Must be provided to employees within 10 days of initial

assignment.

Hepatitis B vaccine

10a

Possible side effects of vaccination: May still get the illness if body does not respond Fever or soreness at injection site Allergic reactions

Hepatitis B vaccine

10b

Your response to an injured or ill person: Depends on assigned job role Consists of the actions identified

Emergency action

11a

If occupational exposure occurs: Understand that medical evaluation and follow-up will

be available at no cost Evaluation and follow-up will be performed by or under

supervision of licensed health care professional Laboratory tests will be conducted by an accredited

laboratory at no cost

Post-exposure

13a

Warning labels will be affixed to items such as: Containers of regulated waste Containers of contaminated reusable sharps Refrigerators and freezers containing blood or OPIMs Containers used to store, transport, ship blood or OPIMs Contaminated equipment being

shipped or serviced Bags or containers of contaminated

laundry

Signs, labels, color-coding

14a

Key elements to take away: Know the causes and modes of transmission Recognize the symptoms of bloodborne diseases Know how to obtain a copy of exposure control plan Recognize tasks and other activities that may involve

exposure to blood or OPIMs Be aware of and use the available engineering controls

work practices, and personal protective equipment Understand your rights to vaccination, medical

evaluation, and follow-up Take appropriate actions in an emergency or incident

Conclusion

15a

1a. blood and body fluids can carry pathogenic mircoorganisms that can cause: ◦ hepatitis b virus...

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