NEW YORK MEDICAL COLLEGE Environmental Health and Safety Department

1. NEW YORK MEDICAL COLLEGEEnvironmental Health and Safety Department BLOODBORNE PATHOGENS (BBP’s) Training Program

2. Objectives • To recognize the agency that regulates the BBP standard • List BBP covered the standard • To recognize what the hazardous are and how you can be exposed • To apply safe work practices when working with blood and other bodily fluids • To manage disposal of contaminated biohazard materials

3. Regulators • OSHA= 29 CFR 1910.1030 • (Occupational Safety and Health Administration) • Covers ALL employees who may be exposed to blood and other potential infectious material (OPIM)

4. What is a Bloodborne Pathogen? • A pathogenic organism present in blood (in addition to other body fluids), which may cause disease in humans

5. Bloodborne Pathogens • Of Particular Concern: (covered under the OSHA standard) • Human Immunodeficiency (HIV) • Hepatitis B (HBV) • Hepatitis C (HCV) • Other examples include malaria, syphilis, African sleeping sickness, leptospirosis, relapsing fever (Borrelia), and viral hemorrhagic fevers (including Ebola)

6. Who is at risk for BBP Exposure? • Anyone—but particularly: • Laboratory personnel • Physicians • Nurses • Phlebotomists • Laundry and Janitorial workers • EMT/Paramedics

7. Human Immunodeficiency Virus (HIV) • First recognized in 1981 • Infects key cells in the human body that are part of the immune system, specifically CD4 and T cells • Modes of transmission: sexual intercourse, direct contact with infected blood, and from an infected mother to her unborn child • 1 in 300 possibility of getting infected after exposure from needlestick or 1:1000 from mucosal splash • Can only survive a short time outside a host • No vaccine or cure available

8. Hepatitis • Hepatitis is a viral disease of the liver that can results in chronic liver disease. • There are 5 well known viral strains of hepatitis • Hepatitis B and C are bloodborne pathogens • There is a 1 in 3 chance of contracting HBV/HCV after exposure. • Hep B/C can survive on environmental surfaces. Decontamination is important with 10% bleach solution • The number of new HBV infections per year has declined from an average of 260,000 in the 1980s to about 60,000 in 2004. The number of new HCV infections per year has declined from an average of 240,000 in the 1980s to about 26,000 in 2004. CDC website (March 2005), • http://www.cdc.gov/ncidod/diseases/hepatitis/b/index.htm

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10. Transmission of BBPs • Sexual Contact • Shared needles • Direct contact between broken or chaffed skin and infected body fluids • Needlesticks: most common method of transmission of BBP in the medical environment • Protect yourself by safely handling the needles and disposing them immediately in a sharps container after use • Report all needle stick and other sharps-related injuries promptly to ensure that you receive appropriate follow-up care • Never recap or resheath a needle • Never leave a needle unattended on a work surface

11. Exposure Control Plan • Located in Health Services Department (Basic Science Building; ext. 4324) • Breaks down each job by class and identifies the employee’s risk of exposure to blood or other potentially infectious material • Establishes procedures for evaluating the circumstances of an exposure incident • Explains the Hepatitis B Program • Explains post exposure follow up and record keeping procedure

12. Health Services (BSB room C12)

13. Sharps Containers • Used to collect materials such as contaminated needles, syringes, slides/cover plates, dissection tools for disposal • Make certain that the lid is closed when discarding materials. • Never place sharps in an overfilled container

14. All sizes of sharps containers have a “recommended fill line”, please follow instructions/guidelines FILL LINE Do not overfill…!!!

15. Red Sharps Containers (17 gal) Sharps Containers Fill Line Red Sharps Containers (17 gal) Do not overfill…!!! FILL LINE

16. Regulated Medical Waste Bin Place waste materials in RED BAG in container

17. “Chain of Infection” • Pathogen • Reservoir • Escape from Reservoir • Transmission through Environment • Portal of Entry • Susceptible Host • Infection Control = Break any link in chain

18. Risk Factors for Infection • Pathogenicity of organism • Dose • Route of entry (injection, contact with mucous membrane or open wound) • Host susceptibility • Work practices HepB HIV

19. Protect Yourself:Use Universal Precautions • These are recommended physical requirements, procedural actions and precautions for safe work with human/primate pathogenic materials or microbes in healthcare, laboratory and other work environments. • Because the potential for infectivity of any blood and body fluids isunknown, universal precautions should be adhered to for all specimens regardless of evidence of infectious material.

20. What to treat with UNIVERSAL PRECAUTIONS • Blood • Cerebrospinal fluid, synovial fluid, peritoneal fluid, pericardial fluid, pleural fluid, semen, vaginal secretions, breast milk, amniotic fluid, • Any other visibly bloody body fluids/secretions • Any unfixed tissue or organ, other than intact skin, from a living or dead person • Organ cultures and culture medium or other solutions that may contain pathogenic agents 20

21. Exposure Incident • A specific incident of contact with potentially infectious bodily fluid • If there are no infiltrations of mucous membranes or open skin surfaces, it is not considered an occupational exposure • Report all accidents involving blood or bodily fluids • If you have an exposure incident –inmmediately wash the exposed area with warm water and soap for 15 minutes. • CONTACT HEALTH SERVICE @ 594-4235

22. Disinfecting To disinfect your liquid waste, make a 10% solution of household bleach in the liquid waste and treat overnight Next morning discard in the lab sink.

23. Personal Protective Equipment (PPE) • Gloves • Goggles • Lab Coats • Face Shields • Masks • Gowns • Caps • Shoe Covers

24. PPE: Gloves • Protect yourself: wear gloves! • Remember: Washing latex gloves with plain soap, chlorhexidine, or alcohol can cause micropunctures. Exposure to glutaraldehyde, hydrogen peroxide, and alcohol preparations may weaken both latex and nitrile gloves

25. Common Sense Precautions • Wash hands when gloves are removed • If needed, irrigate the eyes and skin IMMEDIATELY for at least 15 minutes…!!! • Do not bend, recap, or remove contaminated needles • As soon as you are finished using sharps, immediately discard them in a puncture resistant, leak-proof container: SHARPS CONTAINER

26. Summary • OSHA is responsible for the BBP Standard • Be aware of potential risks in the lab when working with BBP’s • Familiarize yourself and apply all safety practices • Apply all safety practices when disposing biohazardous materials • Protect yourself: always wear PPE (safety glasses, gloves, lab coat) • Take advantage of the Hepatitis Program • Note: BBP training must be taken annually

27. Perfect! Congratulations, you finished the presentation and now take a test, click on the link and follow the instructions: http://www.proprofs.com/quiz-school/story.php?title=bloodborne-pathogens_26