BLOODBORNE PATHOGENS Presented By Anchorage Fire Department WHY are we doing this training? We can’t ignore it! OSHA BB Pathogen standard “The employer shall provide an annual training for all employees…” OSHA 1910.1030 The more you know, the better you will perform in real situations! Definition “Bloodborne Pathogen" means any pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to HBV, HIV and HCV. Common BB Pathogen Diseases Malaria Brucellosis Syphilis Hepatitis B(HBV) Hepatitis C(HCV) Human Immunodeficiency Virus (HIV) HEPATITIS Hepatitis A, B, C, D and E: Serious Than You Think More Hepatitis is a disease characterized by inflammation of the liver. Viral hepatitis refers to several common diseases caused by viruses that can lead to swelling and tenderness of the liver. HEPATITIS A Hepatitis A – is known as “Infectious Hepatitis”. This disease is often associated with fecal contamination in water and is spread person-to-person through poor sanitary habits and the intake of uncooked food or unclean water. It takes about 15-50 days to develop symptoms of hepatitis A after exposure. Symptoms usually disappear even without treatment about two weeks later. Symptoms resemble the flu. Hepatitis B What is Hepatitis B? Caused by hepatitis B virus (HBV) Is a disease that damages the liver, causing symptoms that range from mild or unapparent to severe or fatal. Hepatitis B (HBV) Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting HBV can survive for at least one week in dried blood Symptoms can occur 1-9 months after exposure What occupational exposures put a worker at risk for HBV? Contact with blood or potentially infectious body fluids through: 1. Needle-stick 2. Mucous membranes of eyes, nose and mouth 3. Broken or non-intact skin Hepatitis Can Not be spread: breast feeding sneezing hugging or kissing coughing sharing eating utensils or drinking glasses food or water casual contact HBV can live in a dry environment for at least 7 days. HEPATITIS C Hepatitis C is considered to be a more serious threat to fire fighters, paramedics and EMT’s than hepatitis B virus. According to the Center of Disease Control (CDC), hepatitis C is the most common chronic bloodborne infection in the United States. Hepatitis C (HCV) Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting May lead to chronic liver disease and death HUMAN IMMUNODEFICIENCY VIRUS (HIV) Human Immunodeficiency Virus (HIV) HIV is the virus that leads to AIDS HIV depletes the immune system HIV does not survive well outside the body There is no threat on contracting HIV through casual contact You cannot “catch” HIV: through the air (like a cold or flu) through casual, everyday contact (sharing bathrooms, kitchens, etc.) through nonsexual social situations through insects or mosquitoes through urine, feces, nasal secretions, sputum, vomitus, saliva, sweat or tears from an infected person. HIV cannot live in dry environment for more than a few hours. Once the virus is dead – it’s dead. You cannot “reactivate” it by adding water. Meningitis Bacterial Meningitis Neisseria meningitidis Streptococcus pneumoniae Haemophilus influenzae type b (Hib) infection Viral Meningitis Fungal Meningitis Shingles “Shingles is a painful localized skin rash often with blisters that is caused by the varicella zoster virus, the same virus that causes chickenpox. Anyone who has had chickenpox can develop shingles because it remains in the body after the chickenpox infection clears Shingles most commonly occurs in people 50 years old or older.” CDC Posted Jan 2011 TUBERCULOSIS AIRBORNE PATHOGEN SIGNS & SYMPTOMS: •COUGHING •SUDDEN WEIGHT LOSS •NIGHT SWEATS TUBERCULOSIS Spread through the air by coughing, sneezing, laughs, or singing. Alaska has a high rate of TB in its rural population. Signs and symptoms High fever Headache Stiff neck Other Symptoms Nausea Vomiting Discomfort looking into bright lights Confusion sleepiness TETANUS A bacterial disease that affects the nervous system. Caused by soil contaminated with manure. Health & Human Services recommends being vaccinated. Vaccinations Vaccinations Hepatitis A Vaccine available Vaccinations Hepatitis B (HBV) Strongly endorsed by medical communities. Offered to all potentially exposed employees. Provided at no cost to employees Declination forms are available for those not wanting the immunization. Vaccinations Hepatitis C There is no vaccine to prevent hepatitis C. Vaccinations Human Immunodeficiency Virus There is no vaccine at the present time. Vaccinations Meningitis For Bacterial Meningitis Meningococcal conjugate vaccine (MCV4) Ages 2 to 55 years of age Menactra® (2005) Menveo® (2010) Meningococcal polysaccharide vaccine (MPSV4) Older than 55 years of age Menomune® (1981) Vaccination Viral Meningitis MMR (Measles, mumps & Rubella) Varicella (Chickenpox) Influenza Vaccinations Shingles CDC recommends Zostavax for use in people 60 years old and older to prevent shingles. This is a one-time vaccination. Vaccinations Tetanus The vaccine is Tetanus toxoid. It is usually given with Diphtheria, & Pertussis vaccine. (DTP) Typically, a booster is given if a wound is dirty and the last Td booster was given more than 5 years previous to the injury. Otherwise, recommendation for Tetanus Booster is every 10 years. Your Exposure Potential Industrial exposure Administering first aid Post-accident cleanup Handling of returned product Janitorial or maintenance work Handling of any waste products P&I 200-2 “Infectious Disease Prevention & Control Program. Standard Precautions Use of proper 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 Required PPE Table Operation Gloves Glasses Mask Impervious Gown Any medical response Yes Yes Optional Optional Uncontrolled bleeding Yes Yes Yes Yes Controlled bleeding Yes Yes Optional Optional Childbirth Yes Yes Yes Yes Coughing, spitting patient Yes Yes Yes Optional Nebulized Medications Yes Yes Yes Optional Invasive airway procedures Yes Yes Yes Optional Handling/cleaning possibly contaminated equipment Yes Yes Optional Optional Handling/cleaning obviously contaminated equipment Yes Yes Yes Yes Cleaning the patient compartment after a call – without obvious contamination Yes Yes Optional Optional Station Cleaning Yes Optional No No 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 of PPE PPE should be removed and disposed of in biohazard containers. The cleaning of contaminated PPE and work uniforms shall not be done at home. Non-disposable PPE shall be cleaned whenever necessary. Regulated Medical Waste Liquid or semi-liquid blood or other potentially infectious material (OPIM) Contaminated items that would release blood or OPIM when compressed Contaminated sharps Pathological and microbiological waste containing blood or OPIM Signs & 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 Report all exposures involving blood or bodily fluids to dispatch. Dispatch will contact the on duty Safety Officer. Do not seek treatment without contacting the Safety Officer. Post-exposure Evaluation Confidential medical evaluation Document route of exposure Identify source individual Test source individuals blood (with individuals consent) Provide results to exposed employee Recordkeeping Medical records include: Vaccination status Post-exposure evaluation and follow-up results Training records include: Training dates Contents of the training Name of trainer and trainee Hand Washing Hand washing is your best defense against exposure. Wash hands immediately after removing PPE A hand sanitizer can be used but wash with soap and water as soon as possible thereafter Protection The best defense is a great offense. Recognize and protect yourself Keep up to date with recommended immunizations is the best defense. Maintaining healthy habits, like getting plenty of rest, washing hands. In Conclusion BB pathogen rules are in place for your health and safety Failure to follow them is a risk that does not need to be taken Contact your Safety Officer.