OCCUPATIONAL EXPOSURE TO
BLOODBORNE PATHOGENS
ANNUAL TRAINING
North Seattle Community College
PURPOSE OF THIS SESSION:
 Protection
against bloodborne
pathogens
 Infectious diseases
 NSCC Exposure Control Plan
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REGULATIONS (where it all begins!)
 FEDERAL:
“Occupational Exposure to
Bloodborne Pathogens Standard”, Part
1910.1030, Title 29 Code of Federal Regulations
(effective date: 3/6/92)
 WASHINGTON STATE: “Bloodborne
Pathogens Standard”, WAC 296-62-08001
(effective date: 5/26/92)
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PURPOSE OF THE STANDARD
PROTECTION:
Workers shall be protected
from exposure to biological
agents, including bloodborne
pathogens, which you may
come into contact with during
your job duties (handling
wastes and materials).
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BLOODBORNE PATHOGENS
Infectious germs (bacteria and
viruses) that are present in human
blood/body fluids and can cause
disease in humans. These pathogens
include, but are not limited to,
Hepatitus B (HBV), Hepatitus C
(HCV), and human immonodeficiency virus (HIV).
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OCCUPATIONAL EXPOSURE
 Contact
with blood/body fluids or
other potentially infectious materials
on your skin or in your eye, nose, or
mouth during your job duty. This
includes a needle poke.
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INFECTIOUS MATERIALS
 Blood
 All
body fluids (such as diarrhea and vomit)
since all can be potentially contaminated with
blood or germs
 Viruses and bacteria that spread communicable
diseases through contact with bodily fluids.
 Semen/vaginal secretions
 any body fluid visibly contaminated with blood
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NSCC EXPOSURE CONTROL
PLAN
 Exposure
 Control
Determination
Methods
 Hepatitis
B Immunizations
 Post-exposure
 Training
evaluation/follow-up
and Education
 Record-keeping
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Exposure Determination
 Risk
assessment associated with different
jobs - identification of tasks and potential
exposures
 Classification I - tasks routinely involve a
potential for contact with BBP
 Classification II - tasks normally do not
involve exposure to BBP, but may require
performing unplanned Classification I tasks
 Tasks involve no exposure to BBP
Control Measures
 Using
Universal Precautions
 Establishing appropriate Engineering
Controls
 Implementing appropriate Work Practice
Controls
 Personal Protective Equipment
 Housekeeping
UNIVERSAL PRECAUTIONS
A method of infection control in which
all human body fluids (blood, urine,
feces, vomit, etc.) and other potentially
infectious materials are treated as if
known to be infectious.
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Universal Precautions
 Wash
hands
 Wear gloves
 Wear impervious gown or apron
 Wear mask
 Wear appropriate PPE - including eye and
mask protection - mouth pieces for
resuscitation
 Handle sharp objects carefully
 Dispose of all spills
Engineering Controls
 Labeled
sharp containers
 Biohazard bags and containers
 Specific collection site for disposal of
contaminated waste and PPE
 Self sheathing needles shall be used
 Hand washing facilities, eyewashes and/or
showers shall be provided as close as
possible to work area
Work Practice Controls
 Minimize
splashing, spraying and
generation of droplets of blood or OPIM
 Wash hands as soon as possible after
exposure incident
 Do not recap or break contaminated sharps
 Do not keep food or beverages or eat or
drink in contaminated work areas
 Use mechanical device to pick up
contaminated broken glass
OCCUPATIONAL EXPOSURE
INCIDENT
 Contact
with blood/bodily fluids or
other potentially infectious materials
on your skin or in your eye, nose, or
mouth during your job duty. This
includes a needle poke.
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EXPOSURE INCIDENT PROCEDURES
 Cleanse
exposed area THOROUGHLY
-if open wound, “milk” entry wound
 Eyes: flush w/large amounts of running water
for a minimum of 15 minutes
Mouth: rinse out thoroughly
Nose: blow nose; wipe inside nostrils
 Report incident to your supervisor.
 Complete necessary NSCC forms:
– Exposure Incident Report App I
 Seek
Professional Medical Care immediately
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Post-Exposure follow-up
Evaluation
 Confidential
medical evaluation and follow-
up
 Written report on exposure incident
 Tests to determine if source blood is
HIV/HBV positive – results to be made
available to exposed individual
 Written opinion within 15 days
Personal Protective Equipment
 Eye
protection
 Gloves
 Protective clothing
 Removal and cleaning of PPE
 Availability and Accessibility
WHEN TO WEAR GLOVES
 If
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you, as the care provider, have an open
lesion on your hand(s).
 If handling contaminated disposable items
(e.g., diapers;contaminated clothing/waste).
 If direct hand contact with body fluids is
anticipated (e.g., when providing first aid)
 If cleaning up body fluid spills.
 When diapering or helping to toilet a child.
 When disinfecting surfaces or articles.
Housekeeping
 Cleaning
equipment and surfaces
 Cleanup of blood or other potentially
infectious materials
 Handling sharps and other wastes
 Hand washing
HANDWASHING
 before
drinking, eating, or smoking
 before handling clean utensils, equipment or food
 before and after going to the bathroom
 after contact with any body fluid
 after handling soiled diapers or equipment
 after caring for children, especially those with body
fluid discharges
 after removing disposable gloves or other
protective equipment
 After touching animals
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DISINFECT PROPERLY
 Wear
disposable latex gloves and appropriate PPE
 Promptly sanitize contaminated toys, equipment,
or surfaces (diaper table).
 Use a proper disinfectant
-One part bleach to ten parts water is recipe for disinfectant.
-New solution must be made daily to be effective.
 Let
disinfectant sit 1-2 minutes.
 Use paper towels to clean up spills and place in lined
waste container. If they contain blood, place in bag
identified as “biohazard”.
 Dispose of gloves and wash hands thoroughly.
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Disposal of gloves and
contaminated articles
 Dispose
of gloves after each client contact.
 Dispose of gloves and all contaminated articles
containing blood or body fluids (band-aids,
dressings, diapers) in red plastic bags and
identify as a “biohazard”.
 If
child’s clothing becomes contaminated: place
in plastic bag, seal, and mark (e.g., if sending
home with child for parents to launder).
 Wash
your hands thoroughly after
removing gloves!
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THE HEPATITIS VIRUSES
 Six
known kinds of viral hepatitis: A-E, G
 They differ in how they are transmitted and
how they affect you.
 Hepatitis A and E: mild, spread through
contaminated foods or water. Not life
threatening.
 Hepatitis B, C, and D: spread through contact
with human blood or by sexual activity (B).
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HEPATITIS A
 Transmission
through contaminated food or
water (fecal contamination).
 Symptoms: fatigue, abdominal pain, loss of
appetite, nausea, diarrhea.
 Does not attack the liver.
 Not as common and is treatable by medicine.
 Prevention: proper hygiene, wash hands, use
gloves
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HEPATITIS B
 Transmitted
through direct physical contact with
infected bodily fluids. Saliva is rare.
 Symptoms: Flu-like, loss of appetite, weak,
nausea, etc.
 Attacks the liver, can have virus for many years
without knowing.
 Blood tests to determine if infected.
 A person’s antibodies will fight the virus and can
eliminate it from your system.
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HEPATITIS B (cont.)
 Acute:
short term infection (less than 6 months)
 Chronic: long term infection (more than 6
months), your body fails to fight the virus.
 300,000 new cases each year in U.S.
 6-10% of new cases become chronic carriers.
 1-1.25 million chronically infected Americans.
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HEPATITIS B (cont.)
 HIGH
number of viruses present in blood
 Vaccine: 80-90% success rate. Series of
three injections - then titer is checked
 Risk Groups: Drug users, homosexual males,
multiple sexual partners, infants born to
infected mothers, health care or child
care workers exposed to blood.
 Prevention: Avoid direct contact with bodily
fluids. Wear gloves when administering
first aid and during diaper changes.
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Hepatitis B Vaccination Program
 Offered
to all covered employees at no cost
 Made available within 10 days of initial
assignment and is not mandatory
 Employees may decline vaccination and
accept at a later date - waiver form
 All employees exposed to blood or OPIM
on the job will be offered vaccination and
post exposure evaluation and treatment
HEPATITIS C
 Transmitted
through direct physical contact
with infected bodily fluids (also through sex
but not as common)
 Symptoms: Flu-like, loss of appetite, weak,
nausea, etc.
 Attacks the liver, can have virus for many
years without knowing.
 36,000 new cases per year in the U.S.
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HEPATITIS C (cont.)
 >85%
of new cases become chronic carriers.
 2.7 million chronically infected Americans.
 No vaccine available yet.
 Hepatitis C is the “new” epidemic. Doctors are
just beginning to realize its impact.
 Virus is reaching epidemic proportions because
of the lack of testing available several years
ago when people were likely infected.
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HEPATITIS C (cont.)
 Risk
Groups: Drug users, homosexual males,
infants born to infected mothers, health care or
child care workers exposed to blood.
 Prevention: Avoid direct contact with bodily
fluids. Wear gloves when administering first aid
and during diaper changes.
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WHAT IS AIDS?
(Acquired Immune Deficiency Syndrome)
Caused
by the Human Immunodeficiency
Virus (HIV)
The result of a long process that begins
with HIV infection (last stage of HIV)
An acquired illness of the immune system
which reduces the body’s ability to fight
specific types of infections and cancers
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At Higher Risk of Contacting HIV:
homosexual
males or people with
multiple sexual partners
IV drug users
children born to infected mothers
HIV TRANSMISSION
 Transmitted
through direct physical contact with
infected bodily fluids (most common transmission
is through sexual contact).
 Targets the immune system.
 Risk from one-time exposure: 0.5% (LOW
number of viruses present in blood, the virus can
not live outside of the human body).
High
risk groups: homosexual males or
people with multiple sex partners, drug users,
infants born to infected mothers.
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HIV IS NOT TRANSMITTED BY:
 casual
contact
 hugging or kissing
 mosquitoes or insects
 donating or giving blood
 sharing food
 sharing telephones
 hot tubs or swimming
 being a friend
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Some Statistics on AIDS
Cumulative # of cases/year
 United
States, 1981 - 372 cases
 United States, 1998 - 688,400 cases
 United States, 2000 - 753,907 cases total
 Washington State, 1982 - 20 cases
 Washington State, 1998 - 8,733 cases
 Washington State, 2000 - 9,387 cases total
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You can’t tell by looking....!
(or initially, even by feeling!)
 It
is possible to be infected with HIV for
years even though you are
-looking fine
-feeling fine
-have no knowledge of the infection
AIDS
 Diagnosis
of AIDS is reserved for those
persons with life-threatening infections.
 AIDS definition includes:
-T-cell count of 200 or less
-Presence of specific illnesses or
conditions which meet criteria specified
in the AIDS case definition
 AIDS is the last stage of HIV infection
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Prevention for all types of viruses:
 PRACTICE
UNIVERSAL PRECAUTIONS:
Protect from direct contact (e.g., wear
disposable gloves; use condoms; don’t share
needles) with ANY blood or other potentially
infectious materials. ALWAYS assume that
such material is infectious.
 PRACTICE GOOD PERSONAL HYGIENE
Wash, wash, wash, wash your hands.
 FOLLOW GOOD HOUSEKEEPING
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ADMINISTERING FIRST AID
 Follow
Universal Precautions.
 Treat all body fluids as if infectious.
 Wear GLOVES (and other personal
protective equipment, mask with one way
valve if administering CPR).
 Wash hands after removing gloves!
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In Summary: Avoid BBP Exposures!
 Practice
Universal Precautions
 Monitor Personal Hygiene
 Practice Good Housekeeping
 Dispose of Wastes Properly
ANY QUESTIONS??
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