BLOODBORNE PATHOGENS Training

1. BLOODBORNE PATHOGENS Training “If it’s wet and it’s not yours, don’t touch it!” South Burlington School District

2. Bloodborne Pathogens Training Introduction Welcome to the South Burlington School District’s bloodborne pathogen training module. The Occupational Safety and Health Administration (OSHA) requires that all employees who are at risk for exposure to blood or body fluids receive annual training which will give specific information to help protect against bloodborne disease. This module is intended to provide this important information. All employees are expected to review this information each year.

3. But it is just as important…… • to also prevent the spread of bloodborne disease and • to model to students the appropriate way to handle blood and body fluids.

4. Topics of Discussion • What is a Bloodborne Pathogen? • Transmission of Disease in the School Environment. • The District’s Exposure Control Plan. • How to Reduce your Risk of Exposure. • Actions to Take After an Exposure Incident.

5. What is a Bloodborne Pathogen?? Bloodborne= transmitted by blood (or other body fluids) Pathogen = microorganism capable of causing disease Bloodborne Pathogens are present in: --Blood --Semen --Vaginal Secretions --Torn or Loose Skin --Other Body Fluids, particularly if tainted with blood

6. HIV, Hepatitis B and Hepatitis C viruses are examples of bloodborne pathogens. These areserious diseases. What are some Examples of Bloodborne Pathogens?? HIV Hepatitis B Hepatitis C

7. HIV Information HIV (Human Immunodeficiency Virus) is the virus which causes AIDS. This virus attacks the body’s immune system and interferes with the ability to fight infection. HIV is spread mainly through sexual contact, but may also be spread by contact with blood and body fluids. There is no vaccine to prevent AIDS. If you contract HIV, you may: --suffer flu-like illness (fever, fatigue, diarrhea) --carry the virus and show NO symptoms for years --eventually develop AIDS --develop AIDS-related illness (cancer, neurological problems and other opportunistic infections)

8. Hepatitis Information Hepatitis means ‘inflammation of the liver.’ Most people who contract hepatitis will heal in about six months. In others, the virus can cause liver damage and be life threatening. There is a vaccination for Hepatitis B.

9. Hepatitis Information If you become infected with Hepatitis B virus, you may: --suffer flu-like illness (fatigue, weight loss, fever, diarrhea) --require hospitalization --not show any signs / symptoms --be unaware that you are a carrier --have infected blood and body fluids --pass the virus on to sexual partners, family members, or newborns from infected mother

10. Hepatitis C Information If you become infected with Hepatitis C, you may: --Look and feel ill (jaundice, dark urine, nausea, abdominal pain, no appetite). --Pass the virus on to others by sharing needles, through contact with infected blood/body fluids, and to newborns from an infected mother. Between 55%-85% of infected people will have a chronic infection. Between 1%-5% will die.

11. Many contagious people show no signs or symptoms of infection. Only blood tests can positively identify these diseases.

12. Transmission of Disease in the School Environment Pathogens can enter your body through various avenues • Cuts, scratches • Skin abrasions • Dermatitis, eczema • Acne areas • Mucus membranes: eyes, nose, mouth • Any sort of damaged or broken skin such as sunburn or blisters Staff working with severely disabled children should take extra caution, as some disabled children may be more vulnerable to injury, likely to have special medical needs, dependent upon adults for personal care and need more assistance or care when injured.

13. You can also become infected with: • Broken glass (science labs, cooking class) • Sharp metal / scissors • Needles (consumer science classes) • Exacto Knives (art classes) • Exposed ends of orthodontic wires (braces)

14. Risks in the School Setting Custodial duties Coaching/refereeing Administering First Aid Working with a student with a disability Intervening in fights Assisting students with checking their blood sugar Working w/ students using heat sources, sharp instruments, power tools

15. You can become infected INDIRECTLY: When you touch a surface that has been contaminated with infected blood and then, transfer the germs to your eyes, nose, mouth or open skin. • The Hepatitis Bvirus is very durable; studies show that HBV can survive on surfaces dried and at room temperature for a week. • HIV, on the other hand, is very fragile and will not survive very long outside of the human body. However, because HIV is such a devastating disease, all precautions must be taken to avoid exposure.

16. BBP Exposure Control Plan OSHA requires that our District have a written Exposure Control Plan. • What is the Purpose? When an “exposure incident” occurs, we will know how to respond quickly and appropriately, ensuring a positive outcome. • What is Included? --Identification of personnel covered by the OSHA standard. --Analysis of potential hazards of each job description. --Determination of measures to be taken to reduce the risk of exposure to bloodborne pathogens on the job. --Written procedures related to exposure risks. • Where is it located? Business Office and School Health Offices.

17. Reducing Your Risk of Exposure In other words, whether or not you think the blood/body fluid is infected with bloodborne pathogens, you treat it as if it is. Using this, along with other protective practices can greatly reduce your risk. It is impossible to tell who is infected with a disease simply by appearances; many people who are infected show no visible signs or symptoms and may not even know their infectious state. Therefore, using universal precautions is essential. UNIVERSAL PRECAUTIONSis a prevention concept in which all blood and body fluids are treated as if they are infectious.

18. Work Practice Controls Work Practice Controls refers to specific procedures one must follow on the job to reduce exposure to blood or other potentially infectious materials. For example, our custodial staff has special training in proper procedures for cleaning up blood and body fluid spills.

19. Reducing your Risk:Handwashing • Every time you remove gloves or other personal protective equipment. • ASAP if your skin / mucous membrane has come in direct contact with blood or other body fluid. • Regularly throughout the day... before eating, after using bathroom, after handling animals, etc.   If handwashing facilities are not available, use an antiseptic gel or towelette until you can get to sink with soap and running water. This is your most important work practice control! You should wash your hands with soap and water –

20. Reducing your Risk:Gloves Gloves must be worn if you anticipate exposure to another person’s blood, potentially infectious materials, mucous membranes or non-intact skin. • Keep gloves within easy reach at all times; all staff should have access. Your building nurse will supply you with gloves as needed. • If you assist with first aid where blood or body fluids are involved, you must wear gloves.  Replace gloves as soon as you can if they are torn, punctured, contaminated or defective in any way (sometimes they wear out). • Do NOT reuse disposable • gloves. • Always wash your hands after taking your gloves off.

21. Reducing your Risk:Removing Gloves Unsure of the proper way to remove gloves? Follow these steps listed below. If you have any questions, consult with your building nurse for a demonstration. • With both hands gloved, peel one glove off by grabbing it in the middle of your palm and pulling it off your fingers last (the glove should come off your hand inside out). Hold it in the gloved hand. 2. With the exposed hand, peel the second glove FROM THE INSIDE, tucking the first glove inside the second. 3. Dispose of the gloves properly. 4. Never touch the outside of the gloves with your bare skin. 5. Wash your hands as soon as possible.

22. Reducing your risk:Housekeeping Reminders Minimize blood spatter when helping an injured and bleeding person. Encourage students to self- administer first aid if possible. Handlecontaminated laundry / clothing as little as possible. Dispose sharps (needles, broken glass, bloody metal) and infectious wastes in designated containers. Call a custodian for clean-up of blood or body fluids. Inspect and clean wastepaper baskets and other receptacles that are reused (and have a likelihood of becoming contaminated with blood orother infectious materials)on a regular basis. Avoid picking-up broken glass with your bare hands. Use a broom and dustpan, tongs or some other device.

23. Reducing your Risk:Personal Hygiene Reminders Avoid eating, drinking, applying makeup or lip balm where there is a possibility of exposure. Cover cuts, scratches, rashes or other open sores on exposed skin. Avoid sharing razors, toothbrushes or other personal items. Avoid handling contact lenses where there is a possibility of exposure.

24. Reducing Your Risk:Hepatitis B Vaccination Studies show it is around 85% effective at protecting you from Hep B. Yeast-based (not derived from human plasma). 3 shots given over 6 months. Safe. Good for at least 10 years. Booster doses may be needed later. Part of the District’s Control Plan includes offering the Hepatitis B vaccination. Side effects may include: soreness at injection site, fever, malaise, fatigue. You may discuss the pros and cons of this vaccination with your health care provider. If you decide to receive the Hep B series, contact the business office directly.

25. All employees are required to have a copy of the SBSD Hepatitis B Vaccination Consent-Declination Form on file with the district. This is done at the time of initial hire with the district. If you decide not to get this vaccination at this time, you may change your mind at any time in the future. You may review the SBSD Hepatitis B Vaccination Consent – Declination Form in the Appendix at the end of this training module. More Hepatitis B Information

26. What is an “Exposure Incident?” To reiterate… When your “non-intact skin” or mucus membranes come in contact with another person’s blood or body fluid. Examples of non-intact skin: Cuts, scrapes, burns, dermatitis, or any other skin lesions Examples of mucus membranes Lips, nostrils, mouth, eyes, vagina, rectum

27. Emergency Action Steps after an Exposure Incident: • Immediately wash hands or the exposed area with soap and water; flush with copious amounts of water. • Apply an antiseptic or band aid as needed. • Report the incident to supervisor / building nurse / principal as appropriate. • Employee will then be referred for consultation for medical evaluation and follow up. • Records will be kept confidential by the health care provider. • There may be other paperwork required by SBSD depending upon the situation (i.e. accident report, workman’s compensation, etc).

28. Questions?? If you have any questions now or throughout the year, or if you would like to review this information with a video, booklet or similar article, please contact your building nurse. Each nurse has access to materials for you to read at your convenience. More information is available at the following web sites: OSHA www.osha.org VT Dept of Health www.healthvermont.gov Center for Disease Control www.cdc.gov

29. Appendix A Hepatitis B Vaccination Consent-Declination Form I understand the benefits and risks of the Hepatitis B vaccination. I understand that I must receive at least 3 intramuscular doses of vaccine in the arm over a 6-month period to confer immunity. However, as with all medical treatment, there is no guarantee that I will become immune or that I will not experience an adverse side effect from the vaccine. I have had an opportunity to ask questions and all my questions have been answered to my satisfaction. I am aware that the SBSD assumes no responsibility for advice or counsel regarding this inoculation and I have been advised to consult with my personal physician regarding the possible impact of this vaccine upon my health and well being. I hold the South Burlington School District harmless for any consequences of this vaccination. The cost of the Hepatitis B vaccine series of the inoculations will be at no charge to the employees who have occupational blood exposure. I understand that participation is voluntary and my consent or refusal of the vaccination does not have any impact upon the conditions of my employment. I understand hat I may withdraw from the vaccination regimen at any time. I voluntarily and of free choice, indicate that I have adequate knowledge upon which to base my informed consent or declination of the vaccine as indicated above. (Please check one) __________I wish to receive the Hepatitis B vaccination series. __________I decline the Hepatitis B vaccination series. I understand that by declining this vaccination, I continue to be at risk of contracting Hepatitis B, a serious disease. If, in the future, I continue to have exposure to potentially infectious materials and want to be vaccinated with the Hepatitis B vaccine, I can receive the vaccination series at no charge to me. Name (print) _________________________________________________________________________________ Signature __________________________________________________________________ Date_____________

30. Appendix BMRSAMethicillin-Resistant Staphylococcus Aureus Staph (staphylococcus aureus) is a very common bacterium that can live on the skin or in the noses of healthy people. It is a common cause of skin lesions, such as pimples and boils. Staph can sometimes lead to more serious infections on the skin and other sites on the body. Some staph infections are harder to treat because the bacteria have become resistant over time to the antibiotics usually used to treat these infections. MRSA is spread through breaks in the skin, by skin to skin contact, or less often, by touching surfaces that have MRSA on them. MRSA is a type of staph infection that has become resistant to some anti-biotics. These infections can be mild or very serious. MRSA infection is preventable and treatable. MRSA is rarely serious when contracted in the community setting, where it typically appears as an easily treatable skin infection. MRSA acquired in the hospital or health care setting is a different strain and more serious that MRSA acquired in the community. MRSA can be life-threatening to older people and those with a weakened immune system.

31. Appendix BMeasures to Prevent MRSA Simple measures can be taken to prevent MRSA infections: --Wash hands often and well. --Shower after exercise. --Cover cuts, scrapes and wounds with bandages until healed. --Don’t share personal items such as used razors, towels or other objects that could pass bacteria from one person’s skin to another. --Place barriers between skin and shared equipment like weight lifting benches and sanitize frequently-touched surfaces. If you think you have an infected wound, see your medical health care provider. Any student with an open wound, or wound draining pus should be referred to the school nurse for further evaluation. The Vermont Department of Health has more information on their web site: www.healthvermont.gov