Protection From Bloodborne Pathogens

1. Protection From Bloodborne Pathogens For questions concerning this training topic contact: Environmental, Health, and Safety; Monday – Friday; 8:00 am to 5:00 pm 361-825-5555

2. A question of validity: Why do I need to know this stuff?

3. Why Bloodborne Pathogen Prevention Training What is the chance of an employee getting a scrape, cut, or a heart attack at work What is the chance of an employee having to provide CPR or First Aid to a victim What to do when an employee sees some blood on a surface from a cut or a scrape of another person Bloodborne Pathogens do not have to be one of the many mysteries of life

4. Outline • Regulations • Definitions • Transmission & Symptoms • Bloodborne Diseases • Methods of Compliance

5. Federal and State Regulations • OSHA 29 CFR 1910.1030 • TDH: Health and Safety Code, Chapter 81, subchapter H

6. Regulations state • Employers must have an Exposure Control Plan (ECP) and train employees to use it. • Employees must follow applicable rules to protect themselves • Employees can access TAMUCC’s ECP at http://safety.tamucc.edu.

7. What is an Exposure Control Plan? It is a written document outlining what the employer does to protect workers from bloodborne pathogen exposure by using methods of compliance to include, but not limited to: • Training to communicate hazards • Control the exposure • Safe Operating Procedures • Hepatitis B vaccination program

8. OSHA/TDH Bloodborne Pathogen Standard The standard is designed to protect workers whose job might expose them to bloodborne diseases. • Physicians, nurses, paramedics • Public safety workers • Public service workers • Sport Facility workers

9. Definitions Bloodborne Pathogens: microorganisms that are present in blood or other potentially infectious materials (OPIM) and can cause disease. Blood: includes human blood, human blood components, products made from human blood, and also medications derived from blood (e.g., immune globulins, albumin, etc.)

10. Other Potential Infectious Materials Include blood and: • Human body fluids such as saliva in dental procedures, semen, vaginal secretion, fluid surrounding the brain and spinal cord, fluid surrounding the bone joint, fluid in lungs. • Fluid surrounding a fetus, and any fluid that is visibly contaminated with blood, and all body fluid that is difficult to differentiate between body fluids.

11. Other Potential Infectious Materials Include blood and : • Any unfixed tissue or organ (other than intact skin) from a human living or dead • HIV-containing cells or tissue cultures, organ cultures, HIV-, HBV-, or HCV-containing culture

12. Regulated Waste Vs. Non Regulated Waste Regulated Waste must be disposed of properly through Bio Haz. waste or sterilized thoroughly by autoclave Non-Regulated Waste can be disposed of as solid waste

13. Regulated Waste • Contaminated items that would release blood or OPIM in liquid or semi-liquid state if compressed • Items that are caked with dried blood or OPIM and are capable of releasing these materials during handling • Contaminated sharps • Pathological and microbiological waste containing blood or OPIM

14. Non-Regulated Waste • Mucus, sweat, tears, • Urine, feces • Nasal secretions • vomit Unless the above material is visibly contaminated with blood or is difficult to differentiate.

15. Blood Borne Pathogen Training Segregating Medical Waste

16. Occupational Bloodborne Pathogen Transmission Through direct contact between infected blood and • Open sores • Cuts • Chapped skin • Mucus membranes in eyes, nose, mouth

17. Courtesy of Owen Mumford, Inc. Occupational Bloodborne Pathogen Transmission Infection from a bloodborne pathogen can result in chronic infection, serious illness, and death.

18. If you experienced a needle stick or sharps injury or were exposed to the blood or other body fluid of a patient during the course of your work, immediately follow these steps: Wash needle sticks and cuts with soap and water Flush splashes to the nose, mouth, or skin with water Irrigate eyes with clean water, saline, or sterile solution Report the incident to your supervisor Immediately seek medical treatment Source: CDC

19. Employees who may have occupational exposures to bloodborne pathogens will: • Receive a Bloodborne Pathogen Prevention training • Receive additional training on specific procedures from their department if required (ex. Blood or Potential Body Fluid Clean Up Procedures) • Be offered a series of HBV vaccination. Occupational Exposure

20. Hepatitis • Definition: A liver disease caused by a hepatitis virus. - hepatitis means “inflammation of the liver” • Types: A,B,C,D,E • Symptoms: Jaundice, fatigue, abdominal pain, loss of appetite, nausea, dark urine, vomiting, joint pain.

21. Hepatitis B - HBV • Hep B: Liver disease caused by the hepatitis B virus. • Occupational Transmission: Through direct contact with infected blood or certain bodily fluids (OPIM) • Occupational Risk Groups: • Healthcare workers • Public safety workers • Public services workers

22. Hepatitis B - HBV Characteristics: • There are no medications available for hepatitis B. • Hepatitis B vaccine is available for prevention. • There are antiviral drugs available for the treatment of chronic HBV infection. • HBV virus is very durable and can survive in dried blood for up to 7 days. • Hepatitis carrier: infected person who never fully recovers from infection can carry the virus that may infect others - about 1M in the US Source: cdc

23. Hepatitis C (HCV) • Hep C: Liver disease caused by the hepatitis C virus • Occupational Transmission: Needlestick or sharp injuries (not common) • Risk Groups: Healthcare workers after needlesticks, recipients of blood or organs from a donor who later tested positive for HCV. • No Hep C vaccine Source: cdc

24. HIV - seen as small spheres on the surface of white blood cells Human Immunodeficiency Virus (HIV) • Fragile – few hours in dry environment • Attacks the human immune system • Cause of AIDS • More than 1 million infected persons in U.S. • No cure; no vaccine available yet • Source: cdc

25. HIV & AIDS Occupational Risk Group: • Healthcare workers being stuck with infected needle • First Aid Providers getting infected blood into an open cut or mucus membrane • Source: cdc

26. 1 2 3 Hepatitis B Vaccination Third shot: 5 months after the second shot First shot Second shot: 1 month after the first shot

27. BBP Methods of Compliance 1) Isolate the blood borne pathogen hazards. Example: sharps disposal containers, autoclave, Biological cabinet, etc. 2) Use “Universal Precautions”: Treat all blood & bodily fluids as if they are infected. 3) Use PPE: Barriers between workers and potentially infected materials

28. Hygiene Practice Controls • Hand washing: One of the most important (and easiest) practices used to prevent transmission of blood borne pathogens • Wash hands with soap & water immediately or ASAP after removal of gloves or other PPE • If you are away from the hand-washing facilities, use antiseptic cleanser in conjunction with clean cloth/paper towels. Then wash hands with soap and water as soon as feasible • Eating/Drinking/Smoking/Applying make up/Handling contact lenses are prohibited in exposure areas

29. Hazard Communication: Signs/Labels Logo & Warning required to communicate the hazard

30. Disinfecting Surfaces or Tools • Clean and disinfect contaminated surfaces or tools ASAP with a bleach solution or an OSHA approved disinfectant • If using bleach, mix 10% solution (1 part of household bleach, 9 parts of water or 3/4 cup of bleach in a gallon container and fill it up with water) . Leave solution on contaminated surface for at least 15 minutes • If using OSHA approved disinfectant, follow manufacturer’s directions

31. Example of a Safe Operating Procedure - Blood Droplets Clean Up Cleaning up/disinfecting blood in droplets: • Put gloves on • Spray disinfectant over blood droplets until they are saturated • Wipe the contaminated surface dry with paper towels • Dispose of paper towels in solid waste container • Spray the contaminated surface thoroughly with disinfectant • Wait 10 minutes for disinfectant to work • Wipe the surface dry with paper towels • Dispose of paper towels and gloves in solid waste container • Wash hands with soap and warm water thoroughly

32. Sharps • Needles, scalpels, razor blades, broken glass • Dispose of sharps in a sharps container • NEVER PICK UP BROKEN GLASSWARE DIRECTLY WITH THE HANDS. SWEEP OR BRUSH THE MATERIAL INTO A DUSTPAN

33. Sharps Injury Log • TAMUCC is required to establish and maintain a sharps injury log for the recording of percutaneous injuries from contaminated sharps. The information in the sharps injury log shall be recorded and maintained in such manner as to protect the confidentiality of the injured employee. • TAMUCC is required to report sharp injury to the Public Health Dept. • Copy of Sharps Injury Log should be kept at TAMUCC EH&S office

34. If You are Exposed to BBP • Eye & mucus membrane: Flush out with water for 15 minutes, then report to your supervisor • Skin: wash skin with soap and non-abrasive antibacterial soap, then report to your supervisor

35. Medical Evaluation • If you think that you have been in direct contact with potentially infectious materials, report it immediately to your supervisor • You will be offered a confidential medical evaluation and follow-up

36. BBP Emergency Procedures In case of an emergency involving blood or OPIM • If you are not trained to deal with it, call E,H&S immediately • If you are trained to deal with it, make sure to: • Use Universal Precautions • Wear proper PPE • If incident involves sharps, use broom and dustpan to pick up. Never pick up sharps directly with the hands • If there is an injury from contaminated sharps, fill out form “Sharps Injury Log” from EH&S dept. within 24 hours • Assist EH&S in accident investigation if needed