WELCOME

1. BLOODBORNE PATHOGENS OSHA TRAINING OSHA 29 CFR 1910.1030 WELCOME

2. COURSE OBJECTIVES • INTRODUCE 29 CFR 1910.1030, THE BLOODBORNE STANDARD • DISCUSS METHODS USED TO CONTROL INFECTIOUS MATERIALS • DISCUSS THE PHYSICAL AND HEALTH HAZARDS • DISCUSS THE LOCAL BLOODBORNE PATHOGENS CONTROL POLICY • DISCUSS EMPLOYEE PROTECTIVE MEASURES • DISCUSS WARNING LABELS • INTRODUCE THE BASIC SAFETY RULES

3. STUDENT LEARNING OUTCOMES • RECOGNIZE SITUATIONS WHERE PATHOGENS MAY BE PRESENT • UNDERSTAND THE LOCAL WRITTEN POLICY • SELECT APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT • SUCCESSFULLY PRODUCE APPROPRIATE WARNING LABELS • UNDERSTAND PROPER DECONTAMINATION PROCEDURES • UNDERSTAND THE BASIC SAFETY RULES

4. BASIS FOR THIS COURSE • 1,000,000 + PEOPLE INFECTED WITH HIV IN THE UNITED STATES • HEPATITIS B VIRUS (HBV) BIGGER THREAT THAN AIDS • 5.6 MILLION WORKERS AT RISK • OSHA BLOODBORNE PATHOGENS STANDARD • STANDARD: 29 CFR 1910.1030 • ESTABLISHES WORKPLACE EXPOSURE CONTROL PROGRAM • REQUIRES A WRITTEN PROGRAM • REQUIRES USE OF LABELS AND OTHER WARNINGS • REQUIRES HAZARDS AND PRECAUTIONS BE EXPLAINED • REQUIRES HOUSEKEEPING POLICY BE ESTABLISHED • REQUIRES RECORDKEEPING

5. BASIS FOR THIS COURSE THE BOTTOM LINE TRAINING YOU TO BE KNOWLEDGEABLE OF HOW TO LOWER YOUR CHANCES OF WORKPLACE EXPOSURE TO THE BLOODBORNE PATHOGENS YOU ARE POTENTIALLY EXPOSED TO IN YOUR DAILY WORKING LIFE!

6. REGULATORY STANDARD BLOODBORNE PATHOGENS 29CFR - 1910 - 1030 29CFR - SAFETY AND HEALTH STANDARDS 1910 - GENERAL INDUSTRY 1030 - BLOODBORNE STANDARD

7. COMPLIANCE TIMETABLE 29CFR 1910.1030 29CFR - 1910 - 1030 • MARCH 6, 1992 - FINAL RULE TOOK EFFECT • MAY 5, 1992 - EXPOSURE CONTROL PLAN • JUNE 4, 1992 - INFORMATION AND TRAINING • JULY 6, 1992 - ALL OTHER PROVISIONS

8. SMITH SMITH APPLICABILITY APPLIES TO EMPLOYEE’S WHO: • HAVE EMERGENCY RESPONSE DUTIES • PERFORM JANITORIAL DUTIES • PERFORM WORK WITH POTENTIAL BBP’S • HAVE ANY POTENTIAL WORKPLACE EXPOSURE

9. TRAINING REQUIREMENTS • THE EMPLOYER MUST: • MAINTAIN A BLOODBORNE TRAINING PROGRAM • REVIEW THE PROGRAM ON AN ANNUAL BASIS • TRAIN ALL EMPLOYEES HAVING OCCUPATIONAL EXPOSURE • DISCUSS EMPLOYEE PROTECTIVE MEASURES • TRAIN AT INITIAL ASSIGNMENT TO A JOB HAVING RISK • TRAIN AT LEAST ONCE A YEAR THEREAFTER • DISCUSS WARNING AND LABELING REQUIREMENTS

10. TRAINING REQUIREMENTS • THE EMPLOYER MUST: • DISCUSS DISPOSAL PROCEDURES • DISCUSS EPIDEMIOLOGY AND SYMPTOMS • DISCUSS DECONTAMINATION PROCEDURES • DISCUSS PERSONAL PROTECTIVE EQUIPMENT • DISCUSS WORK PRACTICES TO CONTROL EXPOSURE • DISCUSS HOW TO OBTAIN A COPY OF THE REGULATION

11. DANGER BLOODBORNE PATHOGENS RETRAINING REQUIREMENTS REQUIRED: • ANNUALLY • IF THERE IS REASON TO DOUBT PROFICIENCY • IF THERE IS A FAILURE IN CONTROL PROCEDURES

12. GENERAL PROGRAM REQUIREMENTS ALL EMPLOYERS MUST: • PROVIDE TRAINING TO ALL HAVING OCCUPATIONAL EXPOSURE • MAINTAIN A WRITTEN PROGRAM • DETERMINE WHO CAN BE POTENTIALLY EXPOSED • PERFORM RISK ASSESSMENT • DEVELOP PROCEDURES FOR INCIDENT INVESTIGATIONS • DETERMINE AND IMPLEMENT METHODS OF COMPLIANCE

13. SOP’S WRITTEN PROGRAM REQUIREMENTS ALL EMPLOYERS MUST: • DEVELOP AND MAINTAIN A WRITTEN PROGRAM • REVIEW THE PROGRAM ON AN ANNUAL BASIS • MAKE THE WRITTEN PROGRAM AVAILABLE TO ALL EMPLOYEES DURING EACH WORK SHIFT

14. FORMS PROGRAM MANAGEMENT FORMS COMMONLY USED PROGRAM MANAGEMENT FORMS • NON-ROUTINE TASK - (Protective Measures Determination): • USED BY SUPERVISORS TO ASSESS JOBS THAT ARE NOT PERFORMED ON A ROUTINE BASIS, BUT WHERE THE POSSIBILITY OF INJURY TO AN EMPLOYEE EXISTS.

15. FORMS PROGRAM MANAGEMENT FORMS COMMONLY USED PROGRAM MANAGEMENT FORMS • EXPOSURE INCIDENT REPORT: • USED TO INVESTIGATE INCIDENTS WHERE EXPOSURE MAY HAVE OCCURRED.

16. DEFINITIONS • BLOODBORNE PATHOGENS - MICROORGANISMS PRESENT IN HUMAN BLOOD • CONTAMINATED - THE PRESENCE OF BLOOD OR OTHER POTENTIALLY INFECTIOUS MATERIALS • DECONTAMINATION - THE USE OF PHYSICAL OR CHEMICAL MEANS TO REMOVE, DESTROY, OR RENDER SAFE POTENTIALLY INFECTIOUS MATERIALS

17. MEDICAL RECORDKEEPING EMPLOYERS MUST: • MAINTAIN COPIES OF VACCINATION RECORDS • MAINTAIN RECORDS IN STRICTEST CONFIDENCE • MAINTAIN HEALTHCARE PROVIDER WRITTEN OPINIONS • MAINTAIN DATA PROVIDED TO HEALTHCARE PROVIDERS • RETAIN RECORDS FOR 30YRS OR - EMPLOYMENT + 20YRS • ESTABLISH AND MAINTAIN ACCURATE EXPOSURE RECORDS

18. MEDICAL RECORDKEEPING HEPATITIS B VACCINATION DECLINATION STATEMENT: I Understand That Due to My Occupational Exposure to Blood or Other Potentially Infectious Materials I May Be at Risk of Acquiring Hepatitis B Virus (HBV) Infection. I Have Been Given the Opportunity to Be Vaccinated With Hepatitis B Vaccine, at No Charge to Myself. However, I Decline Hepatitis B Vaccination at This Time. I Understand That by Declining This Vaccine I Continue to Be at Risk of Acquiring Hepatitis B, a Serious Disease. If in the Future I Continue to Have Occupational Exposure to Blood or Other Potentially Infectious Materials and I Want to Be Vaccinated With Hepatitis B Vaccine, I Can Receive the Vaccination Series at No Charge to Me.

19. TRAINING RECORDKEEPING RECORDS MUST: • CONTAIN A SUMMARY OF TRAINING SESSIONS • BE RETAINED FOR 3YRS FROM DATE OF TRAINING • CONTAIN THE JOB TITLES OF PERSONS ATTENDING • BE PROVIDED UPON REQUEST TO OSHA INSPECTORS • CONTAIN ATTENDEE NAMES AND DATES OF TRAINING • CONTAIN NAMES AND QUALIFICATIONS OF INSTRUCTORS

20. EXPOSURE CONTROL PLAN THE PLAN MUST: • BE IN WRITTEN FORM • DETAIL METHODS OF COMPLIANCE • INCLUDE AN EXPOSURE DETERMINATION • DETAIL RECORDKEEPING REQUIREMENTS • DETAIL POST EXPOSURE FOLLOW-UP PROCEDURES • DETAIL COMMUNICATION OF HAZARDS TO EMPLOYEES • DETAIL EXPOSURE INCIDENT REPORTING PROCEDURES • DESCRIBE THE METHODS OF PROGRAM IMPLEMENTATION

21. DANGER BLOODBORNE PATHOGENS BLOODBORNE HAZARDS COMMON BLOODBORNE DISEASES: • SYPHILIS • MALARIA • HEPATITIS C • HEPATITIS B VIRUS (HBV) • HUMAN IMMUNODEFICIENCY VIRUS (HIV)

22. BLOODBORNE HAZARDS HEPATITIS B VIRUS (HBV): • ONE OF THE MOST COMMON VIRUSES • VACCINES AVAILABLE TO PREVENT INFECTION • CAN CAUSE DAMAGE TO LIVER LEADING TO DEATH • VIRUS CAN BE SPREAD TO FAMILY MEMBERS EASILY • SEVERE FLU-LIKE SYMPTOMS ARE A COMMON SYMPTOM • BLOOD, SALIVA AND OTHER BODY FLUIDS MAY BE INFECTIOUS • SYMPTOMS MAY BE DELAYED 28 TO 160 DAYS AFTER EXPOSURE

23. BLOODBORNE HAZARDS HUMAN IMMUNODEFICIENCY VIRUS (HIV): • NO KNOWN VACCINE FOR HIV • DIFFICULT TO CONTRACT IN THE WORKPLACE • VIRUS IS NOT SPREAD THROUGH CASUAL CONTACT • SYMPTOMS MAY BE DELAYED FOR MONTHS TO YEARS • DECREASES THE BODY’S ABILITY TO FIGHT INFECTION • BLOOD AND OTHER BODY FLUIDS MAY BE INFECTIOUS • SEVERE FLU-LIKE SYMPTOMS ARE A COMMON SYMPTOM • LEADS TO ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)

24. TRANSMISSION MODES BBP’S CAN BY TRANSMITTED BY: • BLOOD • VOMIT • BODY FLUIDS • NOSE AND MOUTH • MUCOUS MEMBRANES • ABSORPTION THROUGH THE EYES • CUTS, SCRAPES, BURNS, RASHES, DERMATITIS ETC.

25. TRANSMISSION MODES OCCUPATIONAL EXPOSURE CAN OCCUR: • CPR • REMOVAL OF SUTURES • BLOOD SUGAR SCREENING • BIOHAZARD SPILL CLEANUP • TREATING TEARS OF SKIN TISSUE • DISPOSAL OF CONTAMINATED SHARPS • CHANGING CONTAMINATED DRESSINGS • JANITORIAL DUTIES IN FEMALE REST ROOMS • REMOVAL OF FOREIGN BODIES FROM EYES OR SKIN

26. BIOHAZARD COMMUNICATION OF HAZARDS INTERNATIONAL SYMBOL FOR BIOHAZARD

27. COMMUNICATION OF HAZARDS WARNINGS AND LABELS: • LABELS MUST BE FLUORESCENT ORANGE OR ORANGE-RED • WARNING LABELS MUST BE AFFIXED TO WASTE CONTAINERS • LABELS MUST BE PROPERLY AFFIXED TO CONTAINERS • RED BAGS OR CONTAINERS MAY BE USED IN LIEU OF LABELS • DECONTAMINATED WASTE NEED NOT BE LABELED OR CODED • LABELS ARE ONLY REQUIRED ON THE OUTSIDE PACKAGE

28. COMMUNICATION OF HAZARDS SIGNAGE: • SIGNS MUST BE POSTED AT THE ENTRANCE TO WORK AREAS • HAVING POTENTIALLY INFECTIOUS MATERIALS BIOHAZARD NAME OF THE INFECTIOUS AGENT SPECIAL REQUIREMENTS FOR ENTRY NAME, TELEPHONE NUMBER OF THE RESPONSIBLE PERSON 1. 2. 3.

29. PPE REQUIREMENTS • PERSONAL PROTECTIVE EQUIPMENT REQUIREMENTS: • FOLLOW LOCAL JOB PROCEDURES • IF YOU THINK ADDITIONAL PPE IS NEEDED, REQUEST IT • DON’T AUTOMATICALLY ASSUME YOU’RE COVERED • IF YOU HAVE QUESTIONS CONSULT YOUR SUPERVISOR • UNDERSTAND WHAT YOUR DEALING WITH!

30. PPE REQUIREMENTS • PERSONAL PROTECTIVE EQUIPMENT REQUIREMENTS: • REMOVE PPE BEFORE LEAVING THE WORK AREA • KNOW BIOHAZARD WARNINGS AND LABELS • PLACE USED PPE IN DESIGNATED CONTAINERS • NEVER TRY AND DECONTAMINATE DISPOSABLE PPE • KNOW THE TYPE OF PPE REQUIRED FOR THE JOB!

31. GENERAL CONCEPTS OF TOXICOLOGY ROUTES OF ENTRY • INHALATION • -- A DOSE THAT IS ABSORBED THROUGH THE LUNGS INTO THE BLOODSTREAM • ABSORPTION • -- A DOSE THAT IS ABSORBED THROUGH THE SKIN OR EYES

32. GENERAL CONCEPTS OF TOXICOLOGY ROUTES OF ENTRY • INGESTION • -- A DOSE THAT IS ABSORBED THROUGH THE GASTRO- • INTESTINAL TRACT FROM EATING, DRINKING OR SMOKING • INJECTION • -- A DOSE THAT IS ABSORBED VIA BROKEN GLASS, SPRAY • GUNS, NEEDLES, COMPRESSED AIR, KNIVES ETC.

33. GENERAL CONCEPTS OF TOXICOLOGY EXPOSURE TERMINOLOGY • LOCAL EFFECT. DAMAGE TO BODY PARTS THAT ACTUALLY CONTACT • THE HARMFUL SUBSTANCE (ACID ON A HAND). • SYSTEMIC EFFECT. DAMAGE TO AN AREA OF THE BODY AFTER THE • SUBSTANCE IS ABSORBED (LIVER DAMAGE). • INDIVIDUAL SUSCEPTIBILITY. SOME PEOPLE ARE NATURALLY • SENSITIVE OR CAN DEVELOP SENSITIVITY TO A SUBSTANCE. • DOSE. COMBINATION OF CONCENTRATION AND LENGTH OF BODILY • EXPOSURE TO A SPECIFIC MATERIAL.

34. ABSORPTION • INGESTION • INJECTION METHODS OF CONTROL ROUTES OF ENTRY

35. CONTROL THE SPREAD OF CONTAMINATION METHODS OF CONTROL

36. METHODS OF CONTROL COMMON SENSE RULES: • WASH HANDS AND REMOVE PPE BEFORE: • EATING • SMOKING • DRINKING • HANDLING CONTACT LENSES • APPLYING COSMETICS OR LIP BALM

37. METHODS OF CONTROL UNIVERSAL PRECAUTIONS: • PROTECT ALL POTENTIAL ROUTES OF ENTRY • PROPERLY DECONTAMINATE ALL POTENTIALLY EXPOSED PPE • NEVER REUSE DISPOSABLE GLOVES (CROSS CONTAMINATION) • ASSUME ALL HUMAN BLOOD AND BODY FLUIDS ARE INFECTIOUS • INSPECT PERSONAL PROTECTIVE EQUIPMENT (PPE) BEFORE USE

38. METHODS OF CONTROL ACCIDENT/SPILL CLEANUP RECOMMENDATIONS: • PUT ON A LEAK-PROOF APRON • USE EYE AND FACE PROTECTION • RESTRICT ACCESS TO THE CONTAMINATED AREA • WEAR TWO PAIRS OF GLOVES TO PREVENT EXPOSURE • USE DISPOSABLE TOWELS TO SOAK UP FLUIDS OR BLOOD • DISINFECT MOPS AND OTHER CLEANUP EQUIPMENT AFTER USE • USE EYE PROTECTION (SPLASH GOGGLES) TO PREVENT EXPOSURE

39. METHODS OF CONTROL ACCIDENT/SPILL CLEANUP KIT RECOMMENDATIONS: • WIPER TOWELS • WATERPROOF APRON • IDENTIFICATION TAGS • INSTRUCTION FOR USE • PAPER, PENCILS AND TAPE • RED BIOHAZARD WASTE BAG • PICK-UP SCOOP WITH SCRAPER • EYE, FACE AND SKIN PROTECTION • ANTIMICROBIAL HANDWIPES (SKIN) • SEVERAL PAIRS OF LATEX GLOVES (USE DOUBLE SETS) • CONTAINER OF SOLIDIFIER/DECONTAMINANT/DEODORIZER • GERMICIDAL DISINFECTANT WIPES PACK (EQUIPMENT/SURFACES)

40. EMERGENCY ASSISTANCE SOME SUGGESTIONS: • KNOW WHAT TO DO BEFORE IT HAPPENS! • SOUND THE ALARM FOR HELP • SHUT OFF MACHINERY • DON’T ADD YOUR NAME TO THE LIST OF INJURED!! • DON’T TAKE UNNECESSARY RISKS • DON’T TOUCH BLOOD OR BODY FLUIDS • DON’T GIVE UNPROTECTED MOUTH-TO-MOUTH • STAY WITH THE INJURED PERSON • WAIT FOR EMERGENCY RESPONDERS TO ARRIVE

41. METHODS OF DECON DECONTAMINATION METHODS: • SOAP & WATER • 10% BLEACH SOLUTION • APPROVED TOWELETTES • SEGREGATED LAUNDERING • APPROVED DISINFECTANTS

42. EXPOSURE INCIDENT REPORTING SUGGESTED REPORTING METHOD: • DON’T PANIC! • DECONTAMINATE THE EXPOSED BODY PART • REPORT TO YOUR SUPERVISOR • DETERMINE THE SOURCE OF THE EXPOSURE • TRY TO OBTAIN A SAMPLE FOR ANALYSIS • ASK ABOUT VACCINATION, FOLLOW-UP ETC.

43. EXPOSURE INCIDENT REPORTING DOCUMENTING THE EXPOSURE: • DID PPE FAIL? IF YES HOW? • DESCRIBE THE CIRCUMSTANCES. • IDENTIFY THE SOURCE INDIVIDUAL. • GET COPIES OF ALL DOCUMENTATION. • WHAT DUTIES WERE YOU PERFORMING? • DESCRIBE POSSIBLE ROUTES OF EXPOSURE. • WHAT BODY FLUIDS WERE YOU EXPOSED TO?

44. NON-ROUTINE TASKS • DEFINITION: • A Task That Is Required Only on Occasion and Where Employees Are Not Completely Familiar With All Aspects of the Job. • PROBLEM: • This Lack of Familiarity Contributes Greatly to a Higher Probability of Injury. • SUPERVISORS MUST: • Identify Nonroutine Tasks and Assess Their Degree of Risk to Employees.

45. MANAGING INFECTIOUS WASTE STORAGE: • ESTABLISH DESIGNATED STORAGE AREAS • CONTROL ACCESS TO STORAGE AREAS • USE APPROVED RECEPTACLES • RED IS THE PRIMARY COLOR FOR CONTAINERS • ENSURE LABELS ARE PRESENT • ENSURE PACKAGING IS SUFFICIENT • (I.E. DON’T USE BAGS FOR SHARPS ETC.)

46. MANAGING INFECTIOUS WASTE DISPOSAL: • USE APPROVED HAULERS • REVIEW MANIFESTS CAREFULLY • ESTABLISH REGULAR PICKUP TIMETABLES • REVIEW HANDLING PROCEDURES PERIODICALLY

47. CONTRACTOR SAFETY REQUIREMENTS • OUTSIDE CONTRACTORS MUST: • INFORM REPRESENTATIVES OF THE FACILITY OF THE TYPES OF WORK THAT THEY WILL BE DOING AND BE PREPARED TO PROVIDE TRAINING DOCUMENTATION UPON REQUEST • EMPLOYER REPRESENTATIVES MUST: • INFORM THE CONTRACTOR OF PATHOGENS PRESENT IN THE AREA WHERE CONTRACTOR PERSONNEL WILL BE WORKING

48. TIPS FOR USING CONTRACTORS • REMEMBER, YOU CONTROL YOUR FACILITY OR AREA! • REVIEW THEIR PROCEDURES WITH THEM ! • REVIEW THEIR PROCEDURES BEFORE STARTING THE JOB! • DETERMINE THEIR SAFETY PERFORMANCE RECORD! • DETERMINE WHO IS IN CHARGE OF THEIR PEOPLE! • DETERMINE HOW THEY WILL AFFECT YOUR EMPLOYEES!

49. OSHA'S PERCEPTION OF A SUCCESSFUL PROGRAM 1. DETAILED EXPOSURE CONTROL PROCEDURES 2. EXTENSIVE EMPLOYEE TRAINING PROGRAMS 3. PERIODIC REINFORCEMENT OF TRAINING 4. SUFFICIENT DISCIPLINE REGARDING IMPLEMENTATION

50. THE FINAL WORD THE FINAL WORD CONCERNING PATHOGENS NEVER DISCOUNT ANY ROUTE-OF-ENTRY!