BLOODBORNE
PATHOGENS
Presented by
Office of Environmental Health and Safety
Goals of training:
• Knowledge of regulatory requirements
• Increase awareness of diseases
• Provide information regarding:
– Routes of exposure
– Risk of transmission
– Prevention
Regulated requirements
• OSHA Bloodborne Pathogens standard
– Designed to protect workers
– In effect since 1992
– Goal: Prevent occupational transmission
of diseases potentially present in blood
and bodily fluids
– Regulated in Calif. by Title 8
Some of the requirements:
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Written plan
Use of controls
Cleaning and decontamination program
Sharps injury prevention plan
Training & protective equipment
HBV vaccinations
Body fluids that can transmit infection:
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Blood
Semen
Vaginal secretions
Cerebrospinal fluid
Synovial fluid
Pleural fluid
Pericardial fluid
Peritoneal fluid
Amniotic fluid
Saliva (e.g. dental procedures)
Any unfixed human tissue or organ
PREVENTION: Universal precautions
• Treat all blood and other potentially
infectious body fluids as if infected
• Avoid direct contact with blood and body
fluids & contaminated materials
• Wear PPE appropriate for job
• Practice good housekeeping and personal
hygiene
Universal precautions – cont.
• Follow proper decontamination
procedures
• Dispose of all contaminated materials
properly
• Seek prompt medical attention in the
event of exposure
Personal Protective Equipment
Provides a barrier
Examples:
• Latex/PVC gloves
• Goggles, safety glasses w/side shields
• Plastic or rubberized gowns/aprons
• Surgical masks/face shields
• Pocket mouth-mouth resuscitation masks
Special PPE precautions
• Cover open cuts, rashes, and other broken
skin.
• Check condition before using
• Remove carefully to avoid contaminating
yourself or anything around you
• Dispose properly
• Don’t mix contaminated clothing or laundry
with other laundry
• Wash hands thoroughly after removing
gloves.
Hygiene
• Wash hands w/ soap and water
• Don’t keep food or drink in work areas w/
exposure potential
• Don’t eat, drink, smoke, apply make-up or lip
balm, or handle contact lenses
• Avoid splashing/spattering of potentially
infectious materials
• Don’t suction potentially infectious materials
by mouth.
Housekeeping
• Clean up all spills immediately.
• Clean and decontaminate all equipment and
surfaces after contact w/ blood and other
potentially infectious materials.
• Clean and sanitize pails and other reusable
waste containers regularly.
• Replace protective coverings, immediately
upon obvious contamination, or at end of
work day.
Cleaning vs. Sanitizing
• Cleaning:
Removal of infectious agent via
mechanical means using a cleaning
agent.
• Sanitizing:
Applying sanitizing agent, carefully
following label instructions.
Contaminated surfaces and
equipment must be sanitized!
Sharps Injury Prevention
• Evaluate and provide devices designed to prevent injury
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Syringes w/ sliding sheath that engages after use
Needles that retract after use
Shielded or retracting catheters
IV delivery systems w/ catheter port/needle in protective covering
• Provide training on new equipment
• Keep a sharps injury log – which includes:
– date and time of incident
– type of sharp involved
– description of incident
• PI/Supervisor must immediately report all sharps
incidents to EH&S
Proper Disposal Procedures
Contaminated materials
• Dispose in red, plastic biohazard bag.
• Tie off bag tightly.
• Place bag in labeled, rigid container with
close-fitting lid.
• All bags must be transported in labeled rigid
containers with close-fitting lids.
– Note that this requirement is in effect whenever
the waste leaves the point of generation.
Disposal - cont.
Potentially contaminated sharps
• Dispose in rigid, labeled sharps
containers.
• Never:
– Break off needles or blades
– Attempt to retrieve sharps from a sharps
container
Disposal - cont.
• Bloodborne pathogen waste cannot remain on
campus beyond one week.
– Waste is currently picked up by a licensed contractor
every Tuesday.
• Contact EH&S at 8-7422 if you have bloodborne
pathogen waste requiring disposal
HBV Vaccination
• HBV vaccination series will be made
available to employees at risk of
exposure at no cost.
• Employee may decline series by
completing declination form.
• If employee declines series, may elect
to have series at a later time.
Post exposure
• Wash needlesticks/cuts with soap &
water.
• Flush splashes to nose, mouth, or skin
with water.
• Irrigate eyes with clean water, saline, or
sterile irrigants.
• Report the exposure promptly!
Post exposure – cont.
• After exposure incident; employee shall
be offered post-exposure evaluation,
including at no cost:
– Medical exam
– Blood testing
RISK OF INFECTION
from Occupational Exposure
Overall risk depends on:
• # infected individuals in patient population
• Type and # of blood/fluid contacts
Risk factors following exposure:
• Pathogen involved
• Type of exposure
• Amount of blood/fluid involved
• Amount of virus present in blood/fluid at exposure
Bloodborne Diseases
• HIV/Aids
• HBV, HCV
Risk of infection cont.
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HIV needlestick/cut: 0.3%
HIV mouth/nose/eye: 0.1%
HIV skin: 0.1%
HBV w/ pre-vaccination: no risk
HBV w/o pre-vaccination: 6 ~ 30 %
depending on HBV antigen status of source
individual
• HCV: 1.8 %
HIV/AIDS Stats cont.
• As of Dec. 2001:
57 documented cases of occupational
HIV transmission to healthcare
personnel
Primarily from accidental “sticks”
AIDS: Advanced HIV
• Definition:
– Fewer than 200 CD4-T cells/mm
blood (vs. healthy: 1000+)
– Clinical conditions, opportunistic
infections and cancers generally not
affecting health people
Diagnosis of HIV
• May take 1 ~ 6 months post infection for
presence of sufficient # of antibodies using
standard blood tests
• Acute/recent exposures: screen for presence
of HIV genetic mat’l
• Depending on exposure circumstances,
more tests may be necessary
Prompt disclosure of details re: suspected exposure
4 Proper diagnosis procedure
HIV: Post exposure treatment
• Determined on a case-by-case basis
Treatment should be started within
hours
• Slows spread of HIV and delays start of
opportunistic infections/conditions
• Post Exposure Prophylaxis treatment
4 80% reduction infection risk
HEPATITIS – HBV, HCV
• Virus that can cause acute liver infections or
chronic liver disease (cirrhosis, liver cancer)
• Approx. 300,000 cases of acute HBV
infection annually.
• 5 ~ 10% become chronically infected
• Approx. one million chronic carriers
• HBV: Highly effective vaccine available
• No cure for HBV or HCV
HEPATITUS
Routes of Exposure
• HBV, HCV: Entrance of infected blood
into the body.
– Includes bodily fluids that could contain
blood in amounts not visible to naked eye.
HBV Post Exposure Treatment
May include:
Depends on several factors:
• Whether source individual is positive for HBV
• Whether you have been vaccinated
• Whether the vaccine provided you w/
immunity.
No post exposure treatment for HCV
Comparison of HBV/HIV
HBV:
• More “sturdy”, can survive outside the body
up to a week vs. less than a day for HIV
• Likely to be more concentrated in blood
and bodily fluids
• Much higher risk of transmission.
– One case of HBV transmission in athletics
setting.
Summary…
• Use Universal Precautions when in
contact with bodily fluids.
• Use PPE and use it properly
• Sanitize – don’t just “clean”!
• Protect yourself from HBV infection
– Complete your vaccination series
– Get your titer checked