OSHA’s Bloodborne Pathogens Standard-29 CFR 1910.1030

1. Kentucky Education and Workforce Development CabinetOccupational Health and Safety ProgramBloodborne Pathogen Exposure

2. OSHA’s Bloodborne Pathogens Standard-29 CFR 1910.1030 PURPOSE-Limits occupational exposure to blood and other potentially infectious materials since any exposure could result in transmission of bloodborne pathogens which could lead to disease or death.

3. OSHA’s Bloodborne Pathogens Standard SCOPE-Covers all employees with occupational exposure to blood or other potentially infectious materials as a function of their jobs.

4. What are Bloodborne Pathogens? Bloodborne pathogens are micro-organisms in the bloodstream that cause diseases.

5. What are Other Potentially Infectious Materials (OPIM)? • Human body fluids listed in the standard. • Unfixed tissue or organ (other than intact skin) from a living or dead human. • HIV containing cell or tissue cultures, organ cultures. • HIV or HBV containing culture medium or other solutions. • Blood, organs or other tissues from experimental animals infected with HIV or HBV.

6. Occupational Exposure Reasonably anticipated skin, mucous membrane or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee’s duties. 29 CFR 1910.1030(b) 803 KAR 2:320

7. Occupational Exposure Employers are to evaluate each job task and procedure to determine which employees may be expected to be occupationally exposed to blood or other potentially infectious materials.

8. Occupational Exposure Exposure determination is made without regard to the use of personal protective equipment.

9. Occupational Exposure OSHA expects an employer to take into account all potential circumstances of exposure (biting, contact with skin lesions, and/or potentially infectious secretions) when determining which, if any, employees have occupational exposure.

10. Occupational Exposure Based on potential contact with blood and other potentially infectious materials, the employer is to select the appropriate personal protective equipment in accordance with the standard.

11. Occupational Exposure-First Aid Trained Employees First aid trained employees assigned to provide emergency first aid as part of their specific job duties are covered by the Bloodborne Pathogens Standard. GOOD SAMARITAN ACTS-Not covered by the standard.

12. Occupational Exposure Collateral Jobs Those positions that do not have occupational exposure to blood or other potential infectious body fluids. Employees in Collateral Jobs • Maintenance Workers • Good Samaritan Acts • Office Staff • Janitorial Employees

13. Planning and Assessment • Bloodborne Pathogen Plan for cabinet. • Bloodborne Pathogen Plan for each central office-Contained in the Safety Plan. • Written assessment of personnel to determine if there is occupational exposure.

14. Bloodborne Pathogens The three most significant bloodborne pathogens found in the workplace: • HIV-Human Immunodeficiency Virus, • Hepatitis-B Virus, • Hepatitis-C Virus.

15. Hepatitis B Control Each employee with occupational exposure will within 10 days of employment shall: • Provide evidence of receiving three doses of Hepatitis B vaccine; or • Provide evidence of a positive Antibody to Hepatitis; or • Sign a form consenting to be vaccinated or to finish an incomplete vaccination series; or • Specifically decline vaccination by signing a Declination Form.

16. Hepatitis B Control Provided at no cost to the employee. Provided at a reasonable time and place and performed by or under the supervision of a licensed physician or other health care professional.

17. Staff Training Provided at no cost to the employee annually. Training Records • Dates of each training session. • Content specific syllabus and any information distributed to employees. • The name(s) and qualifications of the person(s) conducting the training. • Names and job titles of all persons attending the training. • Records shall be retained for 3 years from the date of training.

18. Employee Medical Records Retained by Employer • Documentation of up-to-date hepatitis B vaccination. • Incident Reports. • Results of post exposure testing and follow-up. • Copy of physician’s written opinion. • Copy of any written information provided to the employee. • Records are confidential and cannot be disclosed without the employee’s express written consent. • Records must be retained for 30 years following end of employment. • Records must be kept separate from personnel records.

19. Blood Defined as human blood, human blood components, and products made from human blood.

20. Other Potentially Infectious Materials (OPIM) • Saliva in dental procedures. • Semem. • Vaginal secretions. • Internal body fluids. • Body fluids visibly contaminated with blood. • Body fluids in situations where it is difficult or impossible to identify type of fluid.

21. Other Potentially Infectious Materials (OPIM) • AmnioticFluid-Bacteria and Fungal Germs. • Cerebrospinal Fluid-Bacteria, Fungi, Viruses. • Feces-Bacteria, Rotavirus, Hepatitis A Virus. • NasalDischarge-Common cold virus, Influenza Virus, HIV and Hepatitis B Virus. • PericardialFluid-Organisms that can cause infections. • PeritonealFluid-Organisms that can cause infections. • Pleural Fluid-Organisms that can cause disease. • Saliva-Common cold virus, Influenza Virus.

22. Other Potentially Infectious Materials (OPIM) • Semen-Gonorrhea, Hepatitis B Virus, Hepatitis C Virus, HIV. • Synovial-Bacteria, Fungi, Viruses, Blood in Fluid. • Urine-Cytomegalovirus, Mononucleosis Virus.

23. How Bloodborne Pathogens are Transmitted An employee must make contact with contaminated fluids and permit a way to enter the body.

24. How Bloodborne Pathogens Enter the Body • Direct blood inoculation-placenta, transfusion, blood products. • Accidental injury which breaks, punctures or cuts the skin or mucous membranes (Parenteral Contact). • Non-sterile technique when tattooing, body piercing, sharing injections. • Open cuts, nicks, and skin abrasions, even dermatitis and acne.

25. How Bloodborne Pathogens Enter the Body • Mucous membranes (i.e. mouth, eyes (contact lenses), nose. • Sexual intercourse (any type). • Indirect transmission (touching something that is contaminated and then touching an opening in the skin).

26. Virus Survival • HIV-can survive only a short time outside the body. • HBV-can survive up to a week outside the body at room temperature. • HCV-unknown.

27. Hepatitis-B (HBV) • Hepatitis means “inflammation of the liver.” • HBV is the major infectious bloodborne hazard on the job. • Affects approximately 8,700 employees a year, resulting in more than 400 hospitalizations and 200 deaths. • Flu-like symptoms, becoming so severe as to require hospitalization.

28. Hepatitis-B (HBV) • Illness may last 6 months to 2 years. In some cases, HBV damages the liver so severely it leads to cirrhosis and possible death. • Some people exhibit no symptoms at all and most people recover in time. • A small percentage of people become carriers. • Blood testing is available.

29. Hepatitis C (HCV) • HVC is different from Hepatitis B. • HCV is transmitted directly by blood, but unknown if other body fluids like sexual fluids or saliva will carry the virus. • Flu like symptoms can show up within days or years after exposure. • HCV can be ACUTE requiring liver transplant or death within weeks or months.

30. Hepatitis C (HCV) • CHRONIC requiring intensive medical therapy. • 70% of those infected will eventually develop chronic liver disease, cirrhosis of the liver, and almost certain death. • Blood test is available. • There is no vaccine for HCV at this time.

31. Human Immunodeficiency Virus (HIV) • HIV attacks the immune system and eventually causes AIDS. • HIV infection is treatable, but not curable. • HIV continues to be infectious in blood and sexual fluids even during treatment. • Blood testing is available. • There is no vaccine for HIV at this time.

32. Employees-Providing First Aid If employees are trained and designated as responsible for rendering first aid or medical assistance as part of their job duties, they are covered by the OSHA Bloodborne Pathogen Standard.

33. Employees-Providing First Aid Employees, who administer first aid as a collateral duty to their routine work assignments, need not be offered the pre-exposure hepatitis B vaccination, provided that a number of conditions are met.

34. Employees-Providing First Aid All first aid providers who provide assistance in any situation involving the presence of blood or other potentially infectious materials, regardless of whether or not a specific exposure incident occurs, must have the vaccine made available to them as soon as possible, but in no event later than 24 hours after exposure.

35. Employees-Providing First Aid In an exposure incident as defined in the standard has taken place, other post exposure follow-up procedures must be initiated immediately, per the OSHA Standard.

36. Other General Industry Employees While OSHA does not generally consider maintenance and janitorial staff employed in non-health care facilities to have occupational exposure, it is the employer’s responsibility to determine which job classification or specific tasks and procedures involve occupational exposure.

37. Universal Precautions UNIVERSAL PRECAUTIONSis the term used when handling all blood or other potentially infectious material as if it were, in fact, infectious. Since there is no way of know if an injured person or body fluid is infected, employees in ALL CASES must use universal precautions when exposed to another’s body fluids.

38. Universal Precautions for Home Visits • Universal Precautions for home visits must be observed. • Employer and employee are to assume that all human blood and human body fluids are infectious for HIV, HBV, and other bloodborne pathogens. • Where differentiation between types of body fluids is difficult or impossible, all body fluids are to be considered potentially infectious.

39. Universal Precautions for Home Visits • Treat all blood and body fluids as being potentially infectious. • Use appropriate Personal Protective Equipment. • Do not bend, break, shear or recap needles. • Wash hands thoroughly before and after each home visit. • Do not clean blood spills in a client’s home. • Keep mouthpieces and resuscitation equipment readily available if use if likely. • No visits if customer has draining sores. • No visits if customer has an infection transmissible by the airborne route. • Restrict eating, drinking, smoking, apply cosmetics or lip balm, and handling contact lenses during a customer’s home visit.

40. Universal Precautions • Wash hands. • Wear gloves (wash hands after glove removal). • Wear impervious apron when splashing is possible. • Wear mask and eye protection. • Handle sharp objects carefully and dispose properly. • Dispose of all spills properly.

41. Hand Washing • Wash hands with soap and running water. • Rinse hands under running water. • Dry hands well with paper towel. • Use a paper towel to turn off faucet. • Dispose of single use towel. • Wash/disinfect cloth towels.

42. Hand Washing • Apply hand cream after frequent washing to prevent skin irritation, breakdown, and subsequent infection. • Use waterless soap/wipes when soap and water are not available.

43. Hand Washing When antiseptic hand cleansers or towelettes are used, hands will be washed with soap and running water when the employee returns to a location where hand washing facilities are available.

44. Hand Washing Wash hands immediately or as soon as feasible after removal of gloves or other protective equipment.

45. Hand Washing Employer must ensure that employees wash hands and any other skin with soap and water, or flush mucous membranes with water immediately, or as soon as feasible, following contact with blood or body fluid.

46. Personal Protective Equipment • Employers will provide to employees with occupational exposure PPE appropriate for the risk. • No cost to the employee. • PPE will be available for use at each site.

47. Personal Protective Equipment PPE will be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through to reach the employee’s work clothes, street clothes, undergarments, skin, eyes, mouth, and/or other mucous membranes.

48. Personal Protective Equipment-Eye Protection Eye protection is to be worn whenever splashes, spray, spatter or droplets of blood or other potentially infectious materials may be generated and eye, nose, and/or mouth contamination can be reasonably anticipated.

49. Personal Protective Equipment-Gloves Gloves will be worn when it can be reasonably anticipated that the employee may have hand contact with blood, other potentially infectious materials, mucous membranes, and/or non-intact skin.

50. Personal Protective Equipment-Gloves Wear gloves when: • Actual or potential touching blood and/or body fluids; • Actual or potential touching mucous membranes; • Actual or potential touching non-intact skin; • Actual or potential handling items or surfaces soiled by blood and/or other body fluids.