Bloodborne Pathogens
Jill Cranmore
Director, Human Resources
Danville Area Community College
2000 E. Main St.
Danville, IL 61834
217-443-8756
jcranmore@dacc.edu
Bloodborne Pathogens
Occupational exposures to bloodborne and other
pathogens and consequent infection can occur not
only as the result of accidents, but also during the
performance of routine work activities. Therefore, it
makes good sense to plan your work with regard to
the basic principles of biosafety.
Bloodborne Pathogens
Part I:
The Infectious Disease
Process
Bloodborne Pathogens
Microorganisms include the following
classifications:

Bacteria

Viruses

Fungi

Algae

Yeasts

Protozoa
These microorganisms are too small to be seen by the unaided human
eye.
They are found in the soil, in the water,
and on plants and animals. In fact, billions
are found in humans on the skin and in
both the nasal and intestinal tracts.
Bloodborne Pathogens
Although most microorganisms live in
harmony with the human body, some—called
pathogens—can infect the body and cause
disease. Infectious diseases range from mild
illnesses, such as a cold, to fatal illnesses,
such as AIDS.
Bloodborne Pathogens
We occasionally come into contact with people or
animals that are infected and thus expose ourselves
to the pathogens of their diseases. In fact, our
environment is such that everyday we live with
some risk of exposure to diseases.
Bloodborne Pathogens
Some individuals, because of the work they
do, are “at risk” for occupationally acquired
infection. For this reason, DACC has
developed training and procedures to help
minimize your health risks.
This training program will cover:

the infectious disease process

potential exposure risks to employees

work practices that will minimize your risk of exposure to
pathogenic microorganisms
Let's start by exploring the infectious disease process.
Bloodborne Pathogens
The infectious disease process is defined as the
interaction between the pathogenic microorganism,
the environment, and the host. The process may be
thought of as a circular chain with six links.
The following story illustrates the chain…
Bloodborne Pathogens
The chain begins with the
existence of a specific
pathogenic microorganism.
The second link is the
reservoir, an environment
where the pathogen can
survive.
Bloodborne Pathogens
The third link is the
means of escape
from the reservoir.
The fourth link is the
mode of transmission
from the reservoir to
the host.
Bloodborne Pathogens
The fifth link is the means
of entry into the host.
And the last link is the
host's susceptibility to
the pathogenic
microorganism.
Bloodborne Pathogens
For an infectious disease to occur, each link in the
chain must be connected.
Bloodborne Pathogens
If even one link of the chain is missing, it interrupts
the process, and no infection will occur. Here the
chain is broken at the point of host susceptibility.
Bloodborne Pathogens
Here the mode of
transmission breaks
the chain of infection.
Before looking at the infectious disease process for
several different illnesses, see if you can correctly
answer the following question…
Bloodborne Pathogens
The chain of infection illustrates?
A.
Contact with a pathogen means
you will become fatally ill.
B.
Every link in the chain must
be broken to prevent infection.
C.
You can prevent infection by
interrupting the process anywhere
in the chain.
D.
All microorganisms are hazardous
to your health.
And the answer is…
Bloodborne Pathogens
C. You can prevent infection by
interrupting the process anywhere
in the chain.
Bloodborne Pathogens
Hepatitis B Virus (HBV)
The microorganism known as Hepatitis B Virus (HBV)
causes an inflammation of the liver. This can result in
illnesses such as chronic hepatitis, cirrhosis of the liver, and
liver cancer. Because the virus is present in the blood or
body fluids of a person with the Hepatitis B Virus, it is termed
a bloodborne pathogen. Hepatitis B Virus is a serious health
concern for any employee whose work responsibilities bring
them in contact with blood or body fluids.
Bloodborne Pathogens
Human Immunodeficiency Virus (HIV)
The Human Immunodeficiency Virus (HIV) is another
bloodborne pathogen. This life-threatening virus
compromises the body's immune system. Early symptoms
may be similar to those of the flu. During later stages of the
disease, the body is incapable of warding off other infections
which frequently prove fatal.
Bloodborne Pathogens
Penetration into the Bloodstream
Bloodborne pathogens are transmitted when an individual comes in
contact with an infected person's blood or body fluids. However, contact
alone does not mean infection will result. Pathogens must enter the
bloodstream to cause infection. In the workplace, an employee may be
exposed to HBV or HIV when infected blood or body fluid is
allowed to enter the body by means of penetration.
This can occur through:

a needle stick

a cut or break in the skin

contact with mucous membranes
such as those of the eye, nose,
and mouth
Bloodborne Pathogens
Preventive Measures
To interrupt the chain of infection for HBV or HIV, use the following
preventive measures:
Wash your hands to remove infectious
organisms before they can enter the body.
Wear gloves as a barrier when handling
blood and other body fluids.
Wear face protection when work tasks
include the potential for spraying
or splattering of body substances.
Bloodborne Pathogens
Use caution when handling needles or
other sharp objects. They can penetrate
the skin and create entries for pathogens.
The safest way to handle contaminated
needles or other sharp objects is to place
them directly into a labeled sharps
container without recapping. This practice
minimizes your risk of a needle stick. If
your work requires you to recap needles,
you will want to learn a special one-handed technique.
Finally, receive an HBV vaccination to decrease your susceptibility to the
disease. Presently, no vaccine for HIV is available.
Bloodborne Pathogens
Preventing infection from bloodborne pathogens involves?
A.
Vaccination against HIV.
B.
Preventing blood or body
fluids from contacting your
skin or mucous membranes.
C.
Washing your hands before beginning work.
D.
Wearing gloves as a barrier against
needle sticks.
The answer is…
Bloodborne Pathogens
B. Preventing blood or body fluids from
contacting your skin or mucous
membranes.
Bloodborne Pathogens
Mycobacterium (tuberculosis)
Another group of pathogens known as
Mycobacterium cause the chronic lung
disease tuberculosis (TB). Although
human beings are the main reservoirs,
other primates, cattle, and swine can also
be reservoirs. TB is transmitted
primarily through the air. A person with
an active case of TB discharges the microorganisms by coughing or
sneezing.
Inhalation: Exposure occurs when others breathe the contaminated air.
Once inhaled, the pathogen may lodge in lung tissue and produce
lesions.
Bloodborne Pathogens
Preventive Measures
How then can employees protect themselves from airborne diseases such
as TB?
If necessary, and risk factors for TB are
present, wear respiratory protection.
Screen yourself for exposure to TB by
receiving a TB skin test.
Bloodborne Pathogens
TB is an airborne disease?
A.
Transmitted by plants.
B.
That used to be a health concern,
but is not relevant in the workplace any longer.
C.
Prevented by wearing a respiratory mask to prevent
inhaling contaminated air.
D.
Prevented by holding your breath.
The answer is…
Bloodborne Pathogens
C. Prevented by wearing a respiratory
mask to prevent inhaling
contaminated air.
Bloodborne Pathogens
Salmonella
The next disease, salmonellas, is caused by a group of bacteria called
salmonella. The most common manifestation of this disease is acute
gastroenteritis or intestinal inflammation. Both animals and humans are
reservoirs for the salmonella organism. Diseased animals and humans
discharge large numbers of salmonella in their feces.
Bloodborne Pathogens
Ingestion
Infection results from ingesting (i.e., through the mouth) salmonella
organisms. Employees may be exposed to these organisms when
handling soiled diapers and linens, working with animals, or cleaning and
maintaining restrooms.
Bloodborne Pathogens
Preventive Measures
You can guard against salmonella exposure by incorporating the
following practices into your daily routine:
As a first line defense against ingesting
microorganisms, don't put anything in
your mouth while at work.
Wear gloves when your hands will
likely come in contact with
contaminated materials.
Bloodborne Pathogens
Wipe counters with a disinfectant after
performing tasks with materials that
may be contaminated.
And, thoroughly wash your hands after
handling potentially contaminated items.
Even microscopic amounts of fecal matter
may contain millions of salmonella
organisms.
Bloodborne Pathogens
Preventing ingestion of salmonella
organisms involves?
A.
Not washing your hands if they look clean.
B.
Wearing gloves, washing hands, and disinfecting work
surfaces.
C.
Not eating right after work.
D.
Putting only your own pencils and pens in your mouth.
The answer is…
Bloodborne Pathogens
B. Wearing gloves, washing hands, and
disinfecting work surfaces.
Bloodborne Pathogens
In summary, the infectious disease process typically consists of three
routes of entry:

PENETRATION into the bloodstream, exemplified by HBV and HIV;

INHALATION of airborne organisms, illustrated by TB; and

INGESTION of organisms, demonstrated by salmonella.
As seen in the examples, occupational exposures and consequent
infection can occur not only as the result of accidents but also during the
performance of routine work activities. Therefore, it makes good sense to
plan your work with regard to the basic principles of biosafety.
Bloodborne Pathogens
The best strategy to decrease your risk of infection is to?
A.
Enhance your susceptibility
through proper nutrition.
B.
Not worry about things you
cannot see.
C.
Rely on vaccination.
D.
Break the chain of infection by using several preventive
measures.
The answer is…
Bloodborne Pathogens
D. Break the chain of infection by using
several preventive measures.
Bloodborne Pathogens
“AT RISK” employees continue!
At risk employee groups include, but are not limited to:

Athletic Trainers and Coaches

Building Services Attendants

Child Development Center staff

First Aid / CPR Instructor

Groundskeeper

Instructors of Invasive Labs

Maintenance Mechanics

Nursing and C. N. A. staff

Science Lab staff
Bloodborne Pathogens
Part II:
Exposure Control
Strategies
Bloodborne Pathogens
The next part of this program will cover exposure control strategies that
include the use of:







universal precautions
immunization
good personal work habits
containment
personal protective equipment
decontamination
emergency procedures for
accidental exposures
Bloodborne Pathogens
Universal Precautions
Universal precautions are work practices
that reduce your risk of exposure to
pathogens found in blood and body fluids,
particularly HBV and HIV. A government
regulation referred to as the "Bloodborne
Pathogen Rule" requires that employees
with a risk of occupational exposure receive training in universal
precautions and other safety measures. At-risk employees are those
individuals whose work responsibilities could potentially bring them in
contact with blood and body fluids.
Bloodborne Pathogens
Preventing Accidental Exposures
Most occupational exposures to bloodborne pathogens occur accidentally from:




needle sticks
injuries from sharp objects
splashes to the eyes, nose, and mouth
contact with broken skin
The following universal precautions are aimed at preventing these exposures:



Eliminate the use of needles and sharp instruments whenever possible.
Choose safer alternatives for your work tasks.
When use of needles and sharps is required, place used items directly into a
sharps container located within easy reach. Remember that recapping
should be avoided, because it increases your risk of needle stick injuries.
Use only labeled, leak-proof, puncture-resistant sharps containers to help
avoid accidental exposure of co-workers and waste handlers down the line.
Bloodborne Pathogens

Wear personal protective equipment such as gloves, face shields,
eyewear with side shields, and gowns to prevent contact with blood
and body fluids. Properly decontaminate or dispose of this
equipment after use.

Wash your hands routinely, even after removing gloves. Gloves may
have minute holes through which fluids can pass.
Bloodborne Pathogens
Immunization
Finally, decrease your susceptibility to infection by being immunized.
Recommended Vaccines:




HBV for potential exposure to
blood or body fluids
Measles, Rubella, Diphtheria,
Poliomyelitis, and Tetanus for
anyone who has not been
vaccinated in childhood
Tetanus and Rabies for work with animals
Other vaccines for foreign travel and research with pathogens
Bloodborne Pathogens
The HBV vaccine is offered free of charge
to all employees who may be occupationally
exposed to blood or other body fluids. The
vaccine is effective in more than 90% of
healthy people who receive the series of
injections. It is administered intramuscularly
in three doses within a six-month period. The most common side effect
of vaccination is soreness at the injection site.
If you decide against vaccination, you will
be required to sign a declination form.
However, you will remain eligible for
vaccination if you desire it at a later time.
Bloodborne Pathogens
Following universal precautions means you should?
A. Handle every sample as if it
is infectious.
B. Use protective equipment
only when you think the
sample is from a patient with HBV.
C. Think about washing your hands and do so when
you have time.
D. Use needles and blades whenever possible.
The answer is…
Bloodborne Pathogens
A. Handle every sample as if it is
infectious.
Bloodborne Pathogens
Good Personal Work Habits
Hand Washing:
Conscientious hand washing is an essential part of your daily
regimen. Hands routinely come into contact with items and
materials that may be contaminated with pathogens.
Hands also unconsciously touch the eyes, nose, and mouth
numerous times throughout the day. These body areas are potential
portals of entry for infectious organisms. Because of these factors,
it is extremely important to wash your hands frequently.
Wash hands immediately if you contact potentially contaminated
material.
Wash them after:








handling infectious waste, even if it is properly contained
removal of gloves
using the restroom
And finally, wash your hands before going on breaks and before
leaving work at the end of the day.
Bloodborne Pathogens
Proper hand washing involves the following steps:

Wet both hands and wrists. Lather well using
two squirts of soap or hand washing solution.

Spread the lather to the back of the hands and
wrists. Clean between the fingers. Washing time
should be at least 10 seconds.

Rinse hands and wrists well to remove all soap.

Dry hands completely. Turn off the water using
disposable towels when the faucet has handles.
This prevents recontamination of the hands.
Bloodborne Pathogens
Many personal activities increase the risk of
exposure to pathogens transmitted by hand and
mouth. Therefore, the following activities are
discouraged in your work area:




smoking (prohibited)
eating or drinking
food storage
application of cosmetics or
contact lens
Bloodborne Pathogens
Hand washing is an important work habit because?
A.
It is easy for everyone to remember.
B.
After you wash your hands, you can
eat lunch in the lab.
C.
It removes pathogens that you may not know are on your
hands.
D.
One thorough cleansing lasts all day.
The answer is…
Bloodborne Pathogens
C. It removes pathogens that you may
not know are on your hands.
Bloodborne Pathogens
Containment
Another approach to preventing exposure
to pathogens is to ensure containment of
potentially infectious materials, that is, to
prevent the contamination of other items
whenever possible.
An action as simple as opening a container can create a hazard by
splashing or spraying material onto your hands and work area.
Procedures that can result in the
generation of droplets include pipetting,
vortex mixing of unsealed containers, and
decanting liquids.
Bloodborne Pathogens
Careful, thoughtful manipulation of potentially
infectious materials is the key to avoiding
splashes, spills, and the production of droplets.
Using safety devices and equipment appropriate
to the task also helps to minimize the release of
pathogens into your work environment.
Centrifuge containers prevent splattering of
materials if the sample container is
damaged during centrifugation. You will
avoid the need for extensive environmental
cleanup by containing the spill within a
secondary container.
Bloodborne Pathogens
When your work involves manipulations of
potentially infectious materials, be certain
equipment is functioning properly and is
designed to keep the materials contained.
If you must carry potentially infectious
materials to another area, place the primary
containers in a leak-proof container to
prevent a spill during transport.
Bloodborne Pathogens
Personal Protective Equipment

Now let's turn our attention to the use of personal protective
equipment – barriers you wear to prevent contact with infectious
materials.

DACC provides lab coats, gowns, gloves, caps, shoe covers, and
respiratory and eye protection, as needed. Choosing the appropriate
form of protection depends on work tasks and situations you might
encounter.
Bloodborne Pathogens
As mentioned earlier, gloves prevent direct
contamination of the hands and are especially
necessary to block entry of pathogens if the
skin is broken. Remember, you must wash your
hands after removing gloves.
Properly fitted face masks offer protection
against inhalation of airborne pathogens.
Put on a mask before entering an area
where there is a risk of respiratory
exposure.
Bloodborne Pathogens
During work activities where splashes to
the face might occur, wear both a mask and
eye protection or a face shield to prevent
contact with infectious organisms.
If you work with blood or other potentially
infectious materials, you must wear
protective garments designed to prevent
these materials from soaking through to
your clothing or skin. Garments such as
gowns, lab coats, aprons, and coveralls
offer such protection.
Bloodborne Pathogens
All personal protective clothing and
equipment must be removed before
leaving the work area so as not to
accidentally expose others. When
removing garments, grasp the clean
side, peel off the article, and fold the
contaminated side inward.
Place contaminated items in a
designated container.
Bloodborne Pathogens
Personal protective equipment must be?
A.
Designed to allow pathogens to contact your skin.
B.
Removed when leaving the work area and going to the
cafeteria for lunch.
C.
The same for all tasks.
D.
Stylish and flattering.
The answer is…
Bloodborne Pathogens
B. Removed when leaving the work area
and going to the cafeteria for lunch.
Bloodborne Pathogens
Decontamination
The next portion of this program will examine various decontamination
procedures used to destroy pathogens on items and materials that
become contaminated during regular work activities.
Bloodborne Pathogens
Waste items that have been properly decontaminated may be discarded
in the regular trash.
Bloodborne Pathogens
One particular means of decontamination is with the use of chemical
disinfectants. Choosing the type and concentration of a disinfectant
depends on its effectiveness against specific pathogens. Soak
contaminated items in a suitable chemical disinfectant to render them
safe for further handling. Items may then be washed, and if needed,
sterilized.
Bloodborne Pathogens
An important practice aimed at preventing
transmission of pathogens is routine use of
chemical disinfectants for wiping work surfaces.
Wipe your work area with an appropriate
disinfectant before starting work, between projects,
immediately after a spill, and at the end of the work
shift.
Use a disinfectant to wipe equipment that cannot
be autoclaved or soaked. This is especially
important if the equipment is sent elsewhere to be
recalibrated or repaired.
If parts of the equipment cannot be disinfected, the
equipment must be packaged and labeled to
ensure that others will handle it with caution.
Bloodborne Pathogens
The fluorescent orange or red biohazard
emblem is used to communicate a risk of
exposure to pathogens.
Biohazard labels must be affixed on
refrigerators, freezers, and any other
containers used for storage or transport of
potentially infectious materials.
Bloodborne Pathogens
The biohazard label on a waste bag or use
of a red bag signify that items inside pose
an exposure risk. These containers require
careful handling until they can be
decontaminated by methods such as
autoclaving or incineration.
To handle an infectious waste bag, grasp
and lift the bag by its top. If an infectious
waste bag develops a leak or a tear, contact
your supervisor immediately.
Bloodborne Pathogens
Never discard needles, syringes, blades, or other
sharp objects directly into waste bags because of
the high puncture risk. Instead, place them in an
approved, puncture-resistant, leak-proof sharps
container that is labeled or color coded red by the
supplier.
Use the approved sharps container for all sharp
items, even those free of pathogens. Never reach
inside, and be sure to replace containers when
about three-fourths full. Overfilling containers is
hazardous.
Contaminated laundry and linens should be placed
in designated bags provided by DACC for safe
collection and decontamination.
Bloodborne Pathogens
A sharps container is?
A.
Safe to use when more than three-fourths full.
B.
Any rigid container you can find.
C.
Leak-proof, puncture-resistant, and
properly labeled by the supplier.
D.
Optional for labs using
uncontaminated sharps.
The answer is…
Bloodborne Pathogens
C. Leak-proof, puncture-resistant, and
properly labeled by the supplier.
Bloodborne Pathogens
Accidental Exposures
Earlier in the program, it was mentioned that most
occupational exposures to pathogens occur
accidentally from needle sticks, injuries from sharp
instruments, splashes onto mucous membranes of
the face, or contact with broken skin.
If your skin is cut or punctured while
handling potentially infectious materials:



encourage the wound to bleed
flush with water
apply antiseptic
Then notify your supervisor, and immediately seek medical attention.
Bloodborne Pathogens
If you receive a splash to the face or any other unprotected skin:



flush well at the nearest sink or
eyewash fountain
notify your supervisor
seek medical attention
Bloodborne Pathogens
DACC has developed a Bloodborne Pathogens Exposure Control Plan
(available in the DACC Safety and Procedures Plan)
that outlines how to report an exposure incident, where to
go to receive an immediate medical evaluation, and what services are
available for follow-up care. Review the Exposure Control Plan so
that you know what to do in an emergency.
Bloodborne Pathogens
If handled properly, accidental spills of potentially infectious materials
onto environmental surfaces need not result in personal exposure.
Employ the following cleanup procedure…
Immediately decontaminate the surface area;



Place paper towels over the spill;
Gently pour a disinfectant on the towels;
And allow the area to soak for about 10
minutes before cleanup.
If broken glass or other sharp equipment is
involved, scoop up the material with a dust
pan or cardboard to avoid the risk of injury.
Place materials in a puncture-resistant
container and then in a biohazard bag.
Bloodborne Pathogens
Some spills require special cleanup techniques. If a spill of pathogenic
material transmitted through inhalation occurs…




leave the room
close the doors
restrict access
immediately call Campus Security
(dial 8888)
Other accidental spills might involve the release of hazardous chemicals
or materials along with pathogens. If such a situation occurs, be sure to
report this additional information when you call Campus Security.
Bloodborne Pathogens
Emergency situations such as needle sticks, spills, or
splashes of infectious material?
A.
Don't happen in my building.
B.
Are of little concern if I have had
a tetanus shot.
C.
Need not be reported until
someone gets sick.
D.
Should be planned for in advance so the appropriate
response can be initiated promptly.
The answer is…
Bloodborne Pathogens
D. Should be planned for in advance so
the appropriate response can be
initiated promptly.
Bloodborne Pathogens
This program has covered exposure control strategies that include the
use of:







universal precautions
vaccination
good personal work habits
containment
personal protective equipment
decontamination
emergency procedures for accidental exposures
Bloodborne Pathogens
If you have any questions or concerns, please contact your
immediate supervisor or Jill Cranmore.
Jill Cranmore can be reached at 217.443.8756 or
jcranmore@dacc.edu