Blood Borne Pathogens and Spill Clean-up

1. Blood Borne Pathogens and Spill Clean-up How to Protect Yourself from Exposure to Blood at Work

2. Contact Information • Pam Boatright, Coordinator • Regents’ Training Center • 655 Research Parkway • 405/225-9458 • pboatright@osrhe.edu

3. Bloodborne Pathogens Training • Occupational Safety and Health Administration (OSHA) Regulations • Bloodborne Pathogens (BBP), Signs, Symptoms, and Epidemiology • Engineering Controls • Work Practice Controls • Personal Protective Equipment • Proper Cleaning Procedures • Exposure Reporting Procedures

4. OSHA Regulations

5. OSHA BBP Regulation • 29 CFR 1910.1030 (1991; 2001) • Applies to all occupational exposure to blood or “other potentially infectious materials” (OPIM) • 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 an employee's duties. • Training • Immunizations • Exposure Reporting Procedures • Exposure Control Plan

6. Required Annually or if a Job Changes Copy of the OSHA standard Epidemiology and Symptoms Modes of Transmission Exposure Control Plan Exposure Controls Signs and Labels Emergency Procedures Post-Exposure Procedures Opportunity for Questions and Answers OSHA BBP Required Training

7. Blood and OPIM

8. Blood and OPIM • Hepatitis A is not included in this list because it is not carried in the blood. • Human blood can contain many pathogens (organisms that cause disease) including: • Hepatitis B • Hepatitis C • HIV virus • Exposure can take place either by a getting stuck with a needle (or other sharp); from a splash of blood to the face, eyes, other mucous membranes; or exposure to the hands (when cut, scratched, chapped).

9. Blood and OPIM • Neither HIV nor any bloodborne Hepatitis can be caught by casual contact, such as from co-workers. • The job of cleaning up a spill should be limited only to those persons who are properly trained. • If an untrained person encounters blood, they should limit access and find someone to help who is trained.

10. Blood and OPIM • There are now 5+ recognized varieties of infectious hepatitis. Viral hepatitis can cause the liver to be irritated and inflamed. • Symptoms of HIV and all viral hepatitis are often vague (flu-like) and may not be recognized (fatigue, fever, nausea, etc.). • The incubation period is from 2 weeks to 6 months, depending on the variety. • Hepatitis B and C can lead to liver cancer or scarring of the liver (cirrhosis).

11. Immunizations • No immunization for HCV or HIV • The HBV immunization series takes six months to complete • 90-95% effective • Few side effects • Expensive on a large scale • Employees have the right to decline getting the vaccination series or take it later if they choose.

12. Preventing Exposures

13. Preventing Exposures • Employee protection can also be accomplished through preventing exposures by using: • Engineering controls • Safe Work Procedures • Personal Protective Equipment (PPE)

14. Engineering Controls • Any Physical Device Or Equipment Used Or Installed To Prevent Occupational Hazard Exposure, Illness, Or Injury

15. Engineering Controls • Sharps Containers • Safe Needle Devices • Broom and Dust Pan

16. Work Practice Controls • The Process And Procedures Used To Assure Work Is Conducted In A Safe And Healthy Manner

17. Work Practice Controls (#1) • To protect yourself against BBP, the use of Universal Precautions is needed. • Universal Precautionsmeans treating ALL human blood or OPIM as if it were infected regardless of the person, their age, or any other factor, including those persons you know as well as those you don’t.

18. Work Practice Controls • Wear gloves correctly sized (not too small or large). • Wash hands properly after glove removal. • Never touch broken glass with bare hands. • Do not eat, drink, or apply cosmetics in areas where there may be contamination of blood or OPIM. • Minimize splashing during clean-up. • Use proper spill decontamination techniques.

19. Handwashing • Always was hands thoroughly with warm soapy water after removing gloves. • Wash for at least 15-20 seconds. • Pay attention to cleaning around and under the nails. • Neither abrasive nor antibacterial soap is needed. • This is also just “good infection control” for colds and the flu virus.

20. Gloves Gowns Aprons Face Shield Masks CPR shields Respirators Goggles or other eye protection Personal Protective Equipment

21. Personal Protective Equipment • Persons who clean up blood spills should wear disposable gloves of sufficient strength to avoid tearing (at a MINIMUM). • If you clean a rough surface, consider wearing a thicker glove or two pair of thinner gloves. • If you have on a ring that can tear a glove, it is best to remove it.

22. Glove Removal Technique

23. Glove Removal Technique

24. Cleaning Up a Spill of Blood

25. Proper Cleaning Procedures • ALWAYS wear gloves and other PPE (as needed): • Mask and/or Face shield • Disposable apron or other body covering • Shoe covers • Commercial blood spill kits often have these types of PPE.

26. Surface Disinfectants • There are three kinds of disinfectants that should be used to clean up spills of blood according to OSHA: • EPA registered “hospital disinfectant”chemical germicides (tuberculocidal claim) • EPA registered as effective against HIV • A fresh solution of 1:10 household bleach.

27. Proper Cleaning Procedures • Use only disposable towels, gloves, and materials to clean up blood because of the difficulties laundering and disinfecting reusable items. • If a spill involved broken glassware, NEVER pick up the glass directly with your hands. Always use mechanical means such as tongs or brush and a dustpan.

28. Proper Cleaning Procedures • Isolate the area. Do not allow unauthorized persons to enter until the spill has been cleaned up. • All surfaces to be cleaned must first be cleaned of all visible soil and blood before a disinfectant is applied. • Carefully remove visible blood with disposable towels by putting them over the spill to absorb it (soak with disinfectant to for a while if needed).

29. Proper Cleaning Procedures • If the blood spill has dried, soak the area, or scrub the area with disposable towels and disinfectant as needed. • Place the towels in a plastic waste disposal bag that is either: • Red, or • Marked with the biohazard symbol.

30. Proper Cleaning Procedures • After cleaning up visible blood and soil, the area should be decontaminated a second time with an appropriate disinfectant used according to the manufacturer’s directions. • The area can have a final rinse after disinfection, if needed.

31. Proper Cleaning Procedures • All clean up materials, including PPE, should be placed in the disposal bag and double-bagged. • Remove gloves inside out and also place them in the disposal bag. • For disposal, contact your supervisor.

32. Proper Cleaning Procedures • Blood on carpet or upholstery needs special attention. • It is possible to clean carpet or upholstery when small spills of blood occur, but a professional cleaning service may be needed. • Contact your supervisor for details and assistance.

33. Exposure Reporting

34. Exposure Reporting Procedures • Don’t let an injured person drive alone to get treatment. • Supervisors should be notified immediately and should contact their human resources department for appropriate forms. • Persons exposed to blood (or OPIM) MUST seek medical evaluation within 1 to 2 hours according to current medical guidelines! • Complete any paperwork as soon as feasible.

35. Exposure Reporting Procedures • Exposure to blood at work will be handled under the Workers’ Compensation System. • If you find a needle at work, isolate the area and report it immediately to your supervisor for assistance with disposal.

36. Cautions and Reminders • Do not attempt to render first aid or perform tasks that involve blood that are beyond the scope of your training. • If the victim is conscious, let them control their own blood flow. • Questions?? • Short Quiz!!