BLOODBORNE PATHOGEN TRAINING

1. BLOODBORNE PATHOGEN TRAINING 2010

2. Bloodborne Pathogens Training • 29 CFR 1910.1300 is the OSHA regulation for occupational exposure to blood or other possibly infectious materials. • All employees who can be reasonably expected to be occupationally exposed must be provided with training.

3. Bloodborne Pathogens • Bloodborne pathogens are viruses, bacteria and other microorganisms that are borne (carried) in a person’s bloodstream and that cause disease. • If a person comes in contact with blood infected with a bloodborne pathogen, he/she may become infected as well. • Found in blood products, semen, vaginal secretions, amniotic fluid, fluid surrounding the brain, spine, heart and joints, and fluids in the chest and abdomen.

4. Hepatitis and HIV Of the many different Bloodborne Pathogens we will discuss three of the more talked about types. • Hepatitis B • Hepatitis C • HIV

5. Hepatitis B (HBV) Facts The major infectious bloodborne hazard you face on the job. • Hepatitis can survive on surfaces at room temperature for several days and in dried blood for up to a 7 days. • There is a vaccine for HBV but there is no cure. • Risk from needlestick or cut exposure is 6-30% if not vaccinated. • CDC estimates up to 1.4 million have chronic Hepatitis B infection. • GA’s rates of reported cases has dropped by 27%.

6. Symptoms of Hepatitis B HBV Attacks the liver. Can be in a chronic carrier state and have no symptoms, or if active state, can develop flu-like illness and: • Your eyes or skin may turn yellow. • You may lose your appetite. • You may have nausea. vomiting, fever, stomach or joint pain. • You may feel extremely tired and not be able to work for weeks or months. • May lead to cirrhosis, liver cancer or death.

7. Hepatitis B Modes of Transmission HBV is transmitted through activities that involve percutaneous (i.e., puncture through the skin) or mucosal contact with infectious blood or body fluids (e.g., semen, saliva), including • Sex with an infected partner • Injection drug use that involves sharing needles, syringes, or drug-preparation equipment • Birth to an infected mother • Contact with blood or open sores of an infected person • Needle sticks or sharp instrument exposures • Sharing items such as razors or toothbrushes with an infected person

8. Hepatitis C (HCV) Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), which is found in the blood of persons who have this disease. • Symptoms are milder than HBV or may not even be present (carrier state). • But can lead to cirrhosis, liver cancer or death. • No vaccine available. • Risk from needle-stick or cut exposure is 1.8%. • CDC estimates that 3.2 million people in US have chronic Hepatitis C infection. • GA just started reporting cases in 2004, so statistics are minimal and not sufficient to show true picture.

9. Hepatitis C Modes of Transmission HCV is transmitted primarily through large or repeated percutaneous (i.e., passage through the skin) exposures to infectious blood, such as • Injection drug use (currently the most common means of HCV transmission in the United States) • Receipt of donated blood, blood products, and organs (once a common means of transmission but now rare in the United States since blood screening became available in 1992) • Needle-stick injuries in healthcare settings • Birth to an HCV-infected mother

10. Hepatitis C Modes of Transmission HCV can also be spread infrequently through • Sex with an HCV-infected person (an inefficient means of transmission) • Sharing personal items contaminated with infectious blood, such as razors or toothbrushes (also inefficient vectors of transmission) • Other healthcare procedures that involve invasive procedures, such as injections (usually recognized in the context of outbreaks)

11. Human Immunodeficiency Virus HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). • Attacks the body’s immune system, making body less able to fight off infection. • May carry virus for years without symptoms. • Will eventually develops AIDS. • May suffer from flu-like symptoms, fever, diarrhea, and fatigue. • May develop AIDS-related illness, including neurological problems, cancer, and other opportunistic disease.

12. Human Immunodeficiency Virus • Unlike HBV, HIV typically lasts less than 2 hours outside the human body. • Not transmitted through casual contact (touching, feeding, or working around patients who carry the disease. • While treatment techniques are improving, there is no cure or preventative vaccine for HIV. • Risk from needlestick or cut exposure is 0.3%.

13. Human Immunodeficiency Virus • There are approximately 1.2 million Americans living with HIV/AIDS. • CDC estimates that 21% of HIV-positive people don’t know they are infected. • Estimated 56,300 Americans newly infected with HIV each year. More than half of new cases (57%) are aged 25-44. • GA had cumulative total of 33,847 people reportedly with AIDS (from beginning of epidemic to Dec. 2007. (8th highest among the 50 states).

14. HIV Modes of Transmission • Sexual Contact • Sharing of hypodermic needles • Accidental puncture from contaminated needles, broken glass, or other sharps • Contact between broken or damaged skin and infected body fluids • Contact between mucous membranes and infected body fluids

15. Occupational Exposures In health-care settings, bloodborne pathogens can be spread when infected fluids enter the body through: • Needle-stick injuries or other sharps injuries • Cuts, scrapes and other breaks in the skin • Splashes into the mouth, nose, eyes (mucus membranes)

16. Standard Precautions Treat ALL blood and potentially infectious body fluids, secretions and excretions (except sweat) as if they are infectious. • Use PPE • Decontaminate and clean-up appropriately • Dispose of contaminated items correctly

17. Reducing Your Risk Five major tactics reduce your risk of exposure to bloodborne pathogens on the job: • Engineering controls • Employee Work Practices • Personal Protective Equipment • Housekeeping • Hepatitis B Vaccine

18. Engineering Controls Physical or mechanical systems that eliminate hazards at their source: • Safety needle devices • Sharps containers • Biohazard labels • Leak-proof bags and containers for transporting specimens; disposing of waste • Alcohol hand gel • Germicides for disinfecting equipment

19. Employee Work Practices Procedures you follow on the job to reduce you risk of exposure: • Handle sharps carefully; don’t recap. • Place sharps immediately into sharps container. • Good hand hygiene practices. • Minimize splashing of fluids. • Do not eat, drink, smoke, apply cosmetics or lip balm where you may be exposed. • Don’t keep food/drink in refrigerators, cabinets or shelves where blood or infectious materials may be present.

20. Personal Protective Equipment • Latex gloves • Masks • Aprons, Gowns • Face shields • Resuscitation devices Personal protective Equipment should prevent blood or other possible infectious material from contaminating work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes.

21. Personal Protective Equipment • Always wear personal protective equipment in exposure situations. • PPE must be appropriate for the task. • Remove PPE that is torn or punctured, or has lost its ability to function as a barrier to bloodborne pathogens. • Gloves must fit properly. • Remove PPE before leaving the work area.

22. Housekeeping General housekeeping specifics: • Clean all equipment and surfaces contaminated immediately. • Do not pick up broken glass which may be contaminated with gloved or bare hands. • Place contaminated sharps and infectious wastes in designated containers. • Handle contaminated laundry as little as possible and with minimal agitation.

23. Hepatitis B Vaccine The Hepatitis B Vaccine is available to all clinical staff at no cost. • 3 injections over 6 month period. • 85 – 97% effective at protecting you from getting the disease or becoming a carrier.

24. Hand Hygiene Any exposed skin should be washed thoroughly as soon as possible. • Avoid harsh or abrasive soaps. • If washing facilities are not available, use waterless hand sanitizer. • Follow CDC hand hygiene guidelines. Hand washing is considered to be the most effective method of preventing transmission of BBPs

25. Emergency Procedures • If you are exposed: • Don’t panic. • Wash needlesticks and cuts with soap/water. • Flush splashes to nose, mouth, or skin with water. • Irrigate eyes with clean water or saline. • Report the exposure immediately • Your risk of contracting disease is very low. • Exposure Control Plan in each office

26. Sharps Prevention One out of five healthcare workers sustain a needlestick injury every year. (800,000/year in US from needles/sharps). 5% During device recapping 15% During or related to device disposal 40% During device use 40% After device use, before disposal

27. Tuberculosis (TB) Disease of the lungs caused by a bacterium Mycobacterium Tuberculosis. • Spreads when a person with active TB coughs, sneezes, speaks or sings. • Germs can stay in the air for several hours. • Latent TB-have TB germs in your body but they are not active. Cannot spread these germs to others. • Georgia ranked 9th highest rate of TB among 50 states based on case rates/ population in 2007.

28. Tuberculosis General Symptoms include: • Weakness • Weight loss • Fever • Night Sweats • Coughing • Chest pain • Hemoptysis (coughing up blood)