Occupational Exposure to Blood and Airborne Pathogens

1. Occupational Exposure to Blood and Airborne Pathogens

2. Introduction • In 1992, the Occupational Safety and Health Administration (OSHA) enacted the Bloodborne Pathogens Standard codified as 29 CFR 1910. 1030. The purpose of the standard is to protect workers from anticipated exposures to bloodborne pathogens including Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV). 

3. Introduction • The Exposure Control Plan is designed to minimize occupational exposure by identifying potentially exposed employees, routinely employing Standard Precautions and instituting engineering and work practice controls. 

4. Exposure Control Plan Located in each classroom with the emergency plan.

5. Exposure Determination • OSHA requires employers to perform an exposure determination concerning which employees may incur occupational exposure to blood or other potentially infectious materials.

6. Identify at Risk Employees Blood Borne Pathogen Categories (BBP) Cat 1 Daily work will have contact Cat 2 Daily work may have contact Cat 3 Daily work has no contact

7. Identify at Risk Employees Airborne Pathogen (ABP) Daily job will and/ or may have contact.

8. Identify at Risk Employees Infection Control Committee identify Positions to determine risk of exposure.

9. Vocabulary • Blood means human blood, human blood components, and products made from human blood.

10. Vocabulary • Bloodborne Pathogens (BBP) means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

11. Vocabulary • Airborne pathogens are pathogenic microorganisms that are spread by droplet nuclei through the air by coughing. sneezing. singing, or talking. • These pathogens include. but are not limited to: hemophilus influenza, measles, meningitis, mumps, pertussis, tuberculosis, diphtheria, plague, and varicella.

12. Vocabulary • Droplet Infection. A person may acquire a droplet infection by inhaling pathogenic microorganisms in particles of liquid that an infected person exhales, sneezes, or coughs, usually within a 3 foot range.

13. Vocabulary • Contaminated means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.

14. Vocabulary • Contaminated Sharps means any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, scissors, broken glass, broken capillary tubes, and exposed ends of dental wires.

15. Vocabulary • Engineering Controls means controls (e.g. sharps disposal containers, self-sheathing needles) that isolate or remove the bloodborne pathogens hazard from the workplace.

16. Vocabulary • Exposure Incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee’s duties.

17. Vocabulary • Handwashing Facilities means a facility providing an adequate supply of running potable water, soap and single use towels or hot air drying machines.

18. Vocabulary • Occupational Exposure means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of any employee’s duties.

19. Other Potentially Infectious Materials (OPIM) • The following human body fluids: • semen • vaginal secretions • cerebrospinal fluid

20. The following human body fluids: • synovial fluid (joints) • pleural fluid (lungs) • pericardial fluid (heart) • peritoneal fluid (abdomen) • amniotic fluid (fluid around baby)

21. The following human body fluids: • saliva in dental procedures • any body fluid that is visibly contaminated with blood

22. The following human body fluids: • all body fluids in situations where it is difficult or impossible to differentiate between body fluids

23. Other Potentially Infectious Materials (OPIM) • Any unfixed tissue or organ (other than intact skin) from a human (living or dead)

24. Other Potentially Infectious Materials (OPIM) • HIV-containing cell or tissue cultures, organ cultures, and HIV or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

25. Other Potentially Infectious Materials(OPIM) • Included are human cells, tissue cultures, and blood products and blood components containing known or suspected bloodborne pathogens, unless documented to be free of human bloodborne pathogens

26. Vocabulary • Personal Protective Equipment is specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g. uniforms, pants, shirts, or blouses) are not intended to function as protection against a hazard are not considered to be personal protective equipment.

27. Standard Precautions • Is an approach to infection control. According to the concept of Standard Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV and other bloodborne pathogens.

28. Work Practice Controls • means controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g. prohibiting recapping of needles by a two-handed technique)

29. HIV/AIDS Diagnoses • At the end of 2003, an estimated 1,039,000 to 1,185,000 persons in the United States were living with HIV/AIDS • CDC estimates that approximately 40,000 people become infected with HIV each year

30. What is HIV and how can I get it? • HIV - the human immunodeficiency virus - is a virus that kills your body’s "CD4 cells." CD4 cells (also called T-helper cells) help your body fight off infection and disease. 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.

31. What is HIV? • HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus may be passed from one person to another when infected blood, semen, or vaginal secretions come in contact with an uninfected person’s broken skin or mucous membranes*. In addition, infected pregnant women can pass HIV to their baby during pregnancy or delivery, as well as through breast-feeding. People with HIV have what is called HIV infection. Some of these people will develop AIDS as a result of their HIV infection.

32. Signs of a Person Infected with HIV • They may carry the virus for years without developing any signs or symptoms. • The may suffer from flu-like signs of fever, diarrhea, and fatigue. • They may develop AIDS-related illnesses such as nervous system problems, cancer, pneumonia, tuberculosis, and • opportunistic infections. • They eventually will probably develop AIDS.

33. What is AIDS? AIDS stands for Acquired Immunodeficiency Syndrome. Acquired – means that the disease is not hereditary but develops after birth from contact with a disease causing agent (in this case, HIV). Immunodeficiency – means that the disease is characterized by a weakening of the immune system. Syndrome – refers to a group of symptoms that collectively indicate or characterize a disease. In the case of AIDS this can include the development of certain infections and/or cancers, as well as a decrease in the number of certain cells in a person’s immune system. A diagnosis of AIDS is made by a physician using specific clinical or laboratory standards.

34. AIDS • It can take as short as a year to as long as 10 to 15 years to go from being infected with HIV to "full-blown" AIDS. • According to the Center for Disease Control and Prevention, a person is considered to have AIDS when they have a T cell count (also called CD4 cell count) of 200 or less (healthy T cell levels range from 500 to 1500) or they have an AIDS-defining condition.

35. HIV and Its Transmission • In the health care setting, workers have been infected with HIV after being stuck with needles containing HIV-infected blood or, less frequently, after infected blood gets into a worker’s open cut or a mucous membrane (for example, the eyes or inside of the nose).

36. HIV and Its Transmission • By having unprotected sex- sex without a condom- with someone who has HIV. The virus can be in an infected person’s blood, semen, or vaginal secretions and can enter your body through tiny cuts or sores in your skin, or in the lining of your vagina, penis, rectum, or mouth.

37. HIV and Its Transmission • Some people fear that HIV might be transmitted in other ways; however, no scientific evidence to support any of these fears has been found. If HIV were being transmitted through other routes (such as through air, water, or insects), the pattern of reported AIDS cases would be much different from what has been observed. For example, if mosquitoes could transmit HIV infection, many more young children and preadolescents would have been diagnosed with AIDS.

38. HIV and Its Transmission • All reported cases suggesting new or potentially unknown routes of transmission are thoroughly investigated by state and local health departments with the assistance, guidance, and laboratory support from CDC. No additional routes of transmission have been recorded, despite a national sentinel system designed to detect just such an occurrence.

39. HIV in the Environment • Scientists and medical authorities agree that HIV does not survive well in the environment, making the possibility of environmental transmission remote. HIV is found in varying concentrations or amounts in blood, semen, vaginal fluid, breast milk, saliva, and tears.

40. Households • Although HIV has been transmitted between family members in a household setting, this type of transmission is very rare. These transmissions are believed to have resulted from contact between skin or mucous membranes and infected blood. To prevent even such rare occurrences, precautions, as described in previously published guidelines, should be taken in all settings "including the home" to prevent exposures to the blood of persons who are HIV infected, at risk for HIV infection

41. Businesses and Other Settings • There is no known risk of HIV transmission to co-workers, clients, or consumers from contact in industries such as food-service establishments

42. Businesses and Other Settings • routine precautions that all personal-service workers (such as hairdressers, barbers, cosmetologists, and massage therapists) should follow, even though there is no evidence of transmission from a personal-service worker to a client or vice versa.

43. Businesses and Other Settings • CDC knows of no instances of HIV transmission through tattooing or body piercing, although hepatitis B virus has been transmitted during some of these practices. One case of HIV transmission from acupuncture has been documented.

44. Kissing • Casual contact through closed-mouth or "social" kissing is not a risk for transmission of HIV.

45. Biting • Biting is not a common way of transmitting HIV. In fact, there are numerous reports of bites that did not result in HIV infection.

46. Saliva, Tears, and Sweat • Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.

47. Insects • CDC and elsewhere have shown no evidence of HIV transmission through insects--HIV is not transmitted by insects.

48. Effectiveness of Condoms • Condoms are classified as medical devices and are regulated by the Food and Drug Administration (FDA).

49. Effectiveness of Condoms • numerous studies among sexually active people have demonstrated that a properly used latex condom provides a high degree of protection against a variety of sexually transmitted diseases, including HIV infection.

50. AIDS Vaccine • NONE at this time