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Bloodborne pathogens. James R. Ginder, MS, NREMT,PI,CHES,NCEE Health Education Specialist Hamilton County Health Department www.hamiltoncounty.in.gov. The Reader Will Be Able To. List three bloodborne pathogens. Explain how bloodborne pathogens are transmitted.
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Bloodborne pathogens James R. Ginder, MS, NREMT,PI,CHES,NCEE Health Education Specialist Hamilton County Health Department www.hamiltoncounty.in.gov
The Reader Will Be Able To... • List three bloodborne pathogens. • Explain how bloodborne pathogens are transmitted. • Identify three ways to prevent development of a bloodborne pathogen.
Introduction… • Bloodborne Pathogen Standard applies to all employees with occupational exposure to blood and other potentially infectious materials (OPIOM)
Bloodborne pathogen standard 1910.1030 • Covers all employees who could “reasonably anticipate" as the result of performing their job duties, to face contact with blood and other potentially infectious materials.
Risk of Infection… Risk of infection depends on several factors: • The pathogen involved • The type/route of exposure • The amount of virus in the infected blood at the time of exposure • The amount of infected blood involved in the exposure • Whether post-exposure treatment was taken • Specific immune response of the individual
Bloodborne Pathogens… • Bloodborne pathogens are microorganisms present in human blood which can infect and cause disease in people who are exposed to blood containing the pathogen. • These microorganisms can be transmitted through contact with contaminated blood and body fluids.
Who is at Risk… • Sheriff, Police, Jail Staff • Health Care Staff • Physicians, Nurses • First Responders • EMS • Therapists • Life Guards • Coroner & Morticians • Teachers/Child Care Providers • Housekeepers
How are diseases transmitted… • Direct Contact • Body Fluids • Indirect Contact • Objects With Body Fluids • Airborne • From The Air • Vector Borne • Animals And Insects
How You become sick.. • Is the disease present • Must have entry into the body • How much of the disease is present • How strong is your immune system
Where are Bloodborne Pathogens Found? • Blood products • Semen • Vaginal secretions • Cerebrospinal fluid • Pleural fluid (or lung fluid) • Synovial fluid (or fluid from your joints) • Amniotic fluid (or uterine fluid) • Peritoneal fluid (or fluid that fills your body cavity) • Saliva in dental settings • Any body fluid that is visibly contaminated with blood
Main bloodborne pathogens and diseases of concern • Hepatitis B Virus (HBV) • Hepatitis C Virus (HCV) • Human Immunodeficiency
Modes of Transmission Of All Bloodborne Pathogens… • Sexual contact • Sharing of needles • From mothers to their babies at/before birth • 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 • Anytime there is blood-to-blood contact with infected blood or body fluids
HIV • Fragile – survives only a few hours in dry environment • Attacks the immune system • CDC estimates that more than one million people are living with HIV in the United States • Approximately one in five (20 %) of those people living with HIV is unaware of their infection. (CDC) • Most people will develop AIDS • No cure; no vaccine available yet
Transmission Of HIV • Sexual contact • Sharing needles or drug equipment • Pregnancy, childbirth and breast feeding • Contact with other body fluids • Body Piercing and Tattooing
HIV Is NOT Spread Through… • Casual Contact • Saliva • Sweat • Spit • Tears • Air • Insects
Acquired Immunodeficiency Syndrome (AIDS) Having Two Of The 23 Opportunistic Infections & White Blood Cell Below 200 AIDS
Liver Healthy Liver Liver Infected With Hep. B
Hepatitis b • A virus that infects the liver • HBV can live outside the body for 7 days • 90% of adults contracting the disease will recover and develop immunity • Up to 10% of adults who contract the disease will not recover but have chronic Hepatitis • May lead to chronic liver disease, liver cancer, and death
Symptoms of Hepatitis B • Fever • Fatigue • Loss of appetite • Nausea • Vomiting • Abdominal pain • Dark urine • Clay-colored bowel movements • Joint pain • Jaundice
Hepatitis B Transmission • Sex with an infected partner • Injection drug use that involves sharing needles, syringes, or drug equipment • Children born to mothers who have Hepatitis B • 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
Hepatitis B Vaccine • No risk of developing Hepatitis B from the vaccine • The vaccine is 90%+ effective • The vaccine is given in three doses • Dose # 1- Initial dose • Dose # 2 -30 Days after dose 1 • Dose #3- 4 months after dose 2
Hepatitis C • The most common chronic bloodborne infection in the United States • Approximately 3.2 million persons are chronically infected • 80% of people have no signs or symptoms • May remain undetected in the body for years
Hepatitis C • Most commonly occurs in people who have: • Received blood transfusion before 1992 • Shared needles/drug equipment • Tattoos/body piercing • HIV + • Children born to mothers who have Hepatitis C • Shared nail clippers and toothbrushes • Risk of sexual transmission appears to be low
Signs and Symptoms of Hepatitis C • Fever • Fatigue • Dark urine • Clay-colored stool • Abdominal pain • Loss of appetite • Nausea • Vomiting • Joint pain • Jaundice • In those persons who do develop symptoms, the average time period from exposure to symptom onset is 4–12 weeks (range: 2–24 weeks).
Co-Infection… • Person is infected with both HIV and Hepatitis C • CDC estimates that 3,000,000 people are co-infected in the U.S. • 50%-90% of injection drug users are infected with Hepatitis C and HIV (CDC) • A person who is co-infected may develop liver damage faster
Transmission Potential • Contact with another person’s blood or bodily fluid that may contain blood • Mucous membranes: eyes, mouth, nose • Non-intact skin • Contaminated sharps/needles
Your Exposure Potential • Accidental Release • Post-Accident Cleanup • Administering First-Aid • Handling of Returned Product • Janitorial or Maintenance Work • Handling of any Waste Products
Universal Precautions • Use of proper Personal Protective Equipment (PPE) • Treat all blood and bodily fluids as if they are contaminated • Proper cleanup and decontamination • Disposal of all contaminated material in the proper manner
Personal Protective Equipment (PPE) • Anything that is used to protect a person from exposure • Latex or Nitrile gloves • Goggles • CPR mouth barriers, • Aprons • N95 mask & respirators
PPE Rules to Remember • Always check PPE for defects or tears before using • If PPE becomes torn or defective remove and get new • Remove PPE before leaving a contaminated area • Do not reuse disposable equipment
Decontamination • When cleaning up surfaces use diluted bleach solutions or other suitable commercial disinfectant (1:10) • Do an initial wipe up • Spray and allow it to stand for ten minutes, then wipe up • Dispose of all wipes in biohazard containers • PPE should be removed and disposed of in biohazard containers
Decontamination Procedures • Use appropriate personal protective equipment • Absorb grossly bloody materials with absorbent materials and place in a tied, red bag • Decontaminate mop, broom or dust pan in a bleach solution
Hand Washing • Wash hands immediately after removing PPE • Use a soft antibacterial soap • A hand sanitizer can be used, but wash with soap and water as soon as possible afterward
1. Wet hands 2. Use soap 3. Lather, rub Sing Happy Birthday twice (15- 20 seconds) 6. Turn off water with towel or sleeve 5. Towel or air dry hands 4. Rinse
Regulated Medical Waste… • Liquid or semi-liquid blood or other potentially infectious materials and sharps.
Regulated Waste… • Must be placed in closable leak-proof container built to contain all content during handling, storing, transporting or shipping and be appropriately labeled or color-coded
Signs and Labels • Labels must include the universal biohazard symbol, and the term “Biohazard” must be attached to: • Containers of regulated biohazard waste • Refrigerators or freezers containing blood or OPIM • Containers used to store, transport, or ship blood or OPIM
Exposure Incident… • A specific exposure to the • Eyes • Mouth • Mucus membrane • Or broken skin • As well as contact with blood or other potentially infectious material that results from the performance of an employee’s duties.
Exposure Incident… • Keep Calm • Tell a supervisor ASAP • If body fluid enters eyes or mouth, wash with water for 20 minutes • If body fluid comes in contact with broken or chapped skin or needle stick, wash with water and soap for 20 minutes • What do you do?
Injury report EXAMPLE
Known Source If you know the source EXAMPLE
UNKNOWN Source If you do not know who the source is EXAMPLE
Sharps Log Any needle sticks
Ryan White Law • The Ryan White Law, mandates that the source patient test results be provided to the designated infection control officer of the employee involved in an exposure incident.
Question • If you have any questions, contact: • Carol Cox coxc@lanesville.k12.in.us
Course confirmation • Print, sign and return slide # 51 to Carol Cox