TABLE OF CONTENTS
Introduction......................................................................................................... 1
Bloodborne Pathogens ..................................................................................... 1
Hepatitis B ................................................................................................... 1
Hepatitis C ................................................................................................... 2
HIV ............................................................................................................... 3
Transmission And Safety Guidelines ............................................................. 4
Transmission .............................................................................................. 4
Safety Guidelines ....................................................................................... 5
Prevention .......................................................................................................... 6
Reducing The Risk..................................................................................... 7
Safe Work Practices .................................................................................. 7
Housekeeping .................................................................................................... 8
What To Do If Exposed .................................................................................... 9
Acronyms ............................................................................................................ 9
Web Sites For More Information ..................................................................... 9
Comprehensive Test ............................................................................... 11
All new employees are required to watch the Bloodborne
Pathogens for School Employees: The Straight Facts
training video. Employees are then expected to read this
pamphlet annually and, if needed, review the training video.
All South Lyon Community School employees are required
to sign off, annually, on this training. Additional copies of this
booklet may be checked out at the main office in your
building or may be viewed on the District Intranet.
INTRODUCTION
Most school personnel can reasonably anticipate coming into contact
with blood during their day-to-day work duties -- whether in the
classroom, on the playground, on the playing field, or on the school bus.
That's why it's imperative that all school employees understand the
danger of exposure to bloodborne pathogens and ways to minimize their
risk. The three more deadly bloodborne diseases are Hepatitis B,
Hepatitis C and HIV, the Human Immunodeficiency Virus.
Research shows that safety precautions
such as – handling all blood and body
fluids as though they are infectious; disposing
of sharps safely; and using sharps safety devices –
have decreased the numbers of exposures to bloodborne pathogens,
or BBPs. It is important to consistently use safety precautions in the
event you are exposed to human blood or other potentially infectious
materials on the job.
This booklet discusses the most deadly bloodborne diseases, and
explains how they are spread. It also outlines prevention and protection
against bloodborne pathogens.
BLOODBORNE PATHOGENS
Bloodborne pathogens are microorganisms carried by human blood and
other body fluids. They are organisms so small you cannot see them with
the naked eye. They can be spread through contact with infected blood
and if they get into your bloodstream, you may become infected and sick.
Let’s take a closer look at the bloodborne pathogens putting you at
greatest risk on the job – Hepatitis B, Hepatitis C and HIV, and what you
need to do to protect yourself against them.
Hepatitis B
Hepatitis B (HBV) is a serious disease caused by a virus that attacks the
liver. The virus, which is called Hepatitis B virus, can cause lifelong
infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and
death. About 30% of infected persons have no signs or symptoms
People infected with Hepatitis B may experience symptoms such as
jaundice, fatigue, abdominal pain, loss of appetite, occasional nausea, or
vomiting.
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Most people infected with HBV recover and clear the infection. But about
10% become chronically infected for life. In studies that examine
transmission following exposure, HBV is 100 times more contagious than
HIV.
HBV can also be transmitted indirectly because it can survive on
surfaces dried and at room temperature for at least a week! That is why
contaminated surfaces are a major factor in the spread of HBV.
Each year more than 5,000 people die from
related chronic liver disease and liver cancer
linked to Hepatitis B.
Because it is more easily transmitted, the Hepatitis B virus poses a
greater risk than either Hepatitis C or HIV. As of yet, there is no sure
cure for Hepatitis B, fortunately, Hepatitis B can be prevented by taking
the Hepatitis B vaccine, using latex condoms during sex, not sharing
needles, and using Universal Precautions in the workplace. South Lyon
Community Schools provides the vaccine, at no cost, to qualifying
employees.
Hepatitis C
Hepatitis C, or HCV, is a serious and often fatal disease that attacks the
liver. The infection can cause liver inflammation that is often
asymptomatic, but ensuing chronic hepatitis can result later in fibrotic
scarring of the liver and liver cancer.
HVC is more common than HBV and ranks slightly below alcoholism as
a cause of liver disease. It is also the leading indicator for liver
transplants.
The Hepatitis C virus is spread by blood-to-blood contact, most
commonly through shared needles. However, unlike Hepatitis B,
currently there is no vaccine for Hepatitis C and unlike HBV, there is no
drug to prevent HVC infection after an exposure. Newly improved
antiviral drugs have been effective in some people who have contracted
this infection.
While eighty-five percent of people infected with HVC have chronic
infections, only about ten percent of those infected with HBV are
chronically infected. In fact, The Centers for Disease Control and
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Prevention, or the CDC, reports about 3 million people in the United
States are chronically infected with the Hepatitis C virus while about 1
and 1/4 million are chronically infected with the Hepatitis B virus.
Remember, many people infected with these two viruses have no
symptoms at all. In fact, people who are chronically infected with
Hepatitis C may have no symptoms for up to 30 years, yet during that
time, the infection may be slowly damaging the liver.
Every year, up to 10,000 people die from Hepatitis C
related chronic liver disease.
Unfortunately, there is no vaccine to prevent Hepatitis C. However, newly
approved antiviral drugs have been effective in some people who have
contracted this infection.
HIV
HIV, the human immunodeficiency virus, attacks the body's immune
system causing it to weaken and become vulnerable to infections that
can lead to a diagnosis of acquired immune deficiency syndrome or
AIDS. A person may carry the virus and live a normal, healthy life for
years. Blood tests can diagnose this bloodborne disease, but no vaccine
or cure has been developed although many advances have been made
in recent years regarding HIV treatment, including the development of
several anti-retro viral drugs.
Three to six weeks after contacting the infection an
individual may develop flu-like symptoms. Due to a
weakened immune system these individuals are
more susceptible to other infections and diseases
such as pneumonia, tuberculosis, cancer or
meningitis.
HIV is transmitted mainly through sexual contact
and sharing contaminated needles, but also may be spread by contact
with infected blood and body fluids. HIV is NOT transmitted indirectly by
touching or working around people who are HIV-positive.
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TRANSMISSION AND SAFETY GUIDELINES
Transmission
Hepatitis B, Hepatitis C, and HIV spread most easily through
contact with blood. They also spread through contact with
other potentially infectious materials (OPIM), including
semen and vaginal secretions, as well as any other
body fluid or tissue containing visible blood.
Bloodborne viruses are most commonly transmitted
through sharing needles to inject drugs, having
unprotected sexual intercourse with an infected person
or from mother to unborn child before or during birth.
Bloodborne pathogens can cause infection by entering your body. Your
skin provides a protective barrier against bloodborne pathogens and to
get through the skin, the virus needs a “doorway” into the body such as
open cuts and nicks, skin abrasions, dermatitis, acne, mucous
membranes of your mouth, eyes or nose.
Pathogens can enter your body indirectly is you touch an infectious
material and then touch your mouth, eyes, nose or open wound. Dried
HBV can survive on surfaced at room temperature for at least a week.
Unlike the flu or common cold, HIV, HBV and HVC are not spread
through the air, therefore, you cannot get HIV, HBV or HVC by working
near someone who is infected. You also cannot become infected with
these viruses through coughing, sneezing, a hug and a kiss on the cheek
or from food and drinking fountains.
Unless visibly contaminated with blood, the body fluids listed below are
NOT expected to be infectious for bloodborne pathogens. Although not
expected to be infectious, they my be infectious for other organisms,
common everyday “germs” that can may you sick if introduced into your
body.
 urine or feces
 tears
 sputum
 vomit
 sweat
 nasal secretions
Remember to use proper personal hygiene, such as frequent hand
washing, if your job requires you to come in contact with these fluids.
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Special education employees should take extra caution while working
with severely disabled children as these children are dependent on
adults for personal care. Also some disabled children might be more
vulnerable to injury or may be more likely to have special medical needs
Anytime you have an occupational exposure to blood or other possible
infectious materials, you MUST consider it a potential transmission of
bloodborne pathogen.
Safety Guidelines
To help protect you, and as a
requirement of the Occupational
Safety
Health
Administration
(OSHA), South Lyon Community
Schools has, in each building, an
Exposure Control Plan that is always
available to you. This plan lists the
potential hazards of each job and
explains how to reduce your risk.
Here are a just a few of the safety precautions you should take.
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Use PPE such as gloves, masks or aprons.
Handle all sharps (i.e. needles, scalpels) safely. Do not recap a
needle. Dispose of properly by using a sharps container.
Dispose of all biohazardous waste properly.
Wash your hands thoroughly.
According to OSHA, immunization against the Hepatitis B virus has
proven very effective. The South Lyon School District provides the
Hepatitis B vaccine, at no expense, to qualifying employees.
The Hepatitis B vaccine is a safe three shots vaccination series, given
in the upper arm, over a period of six months. Today’s vaccines are safe
and very effective at protecting you from getting Hepatitis B infection if
the series is completed.
Protecting yourself with the Hepatitis B vaccine is very important. But it’s
not enough. We lack vaccines to prevent Hepatitis C and HIV infection
so you must follow these safety measures at all times.
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PREVENTION
Standard Precautions as published by the Centers for Disease Control is
based on the principle that all blood, body fluids, secretions, excretions
except sweat, nonintact skin, and mucous membranes may contain
transmissible infectious agents.
"Universal precautions," as defined by CDC, are a set of precautions
designed to prevent transmission of human immunodeficiency virus
(HIV), Hepatitis B virus (HBV), and other bloodborne pathogens when
providing first aid or health care. Under universal precautions, blood and
certain body fluids of all patients are considered potentially infectious for
HIV, HBV and other bloodborne pathogens.
Dried HBV can survive on surfaces at room
temperature for at least a week.
Forms of Personal Protective Equipment (PPE) available in the South
Lyon Community School District includes gloves, gowns, aprons,
protective eyewear, masks, mouthpieces, and resuscitation bags. What’s
appropriate for your job depends on the level of risk you are exposed to.
PPE is always accessible to you whether it be in a custodian’s closet, in
the main office or in a classroom. All PPE is maintained, replaced, and
disposed of by the District. However, PPE can’t protect you if it is not
used correctly every time it’s needed, if it’s the wrong item for the job, if it
doesn’t fit properly or it it’s damaged.
In the event that your PPE is contaminated with blood or other potentially
infectious material, the contaminated laundry should be disposed of or
handled according to the District Exposure Control Plan.
Two common types of PPE are Masks and Gloves. Masks are designed
to protect you from a victim’s body fluids expelled during resuscitation.
Use these devices instead of unprotected mouth-to-mouth resuscitation.
Gloves shall be worn when it can be reasonably anticipated that the
employee may have hand contact with blood, other potentially infectious
materials, mucous membranes, and non-intact skin; and when handling
or touching contaminated items or surfaces.
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Disposable gloves shall be replaced as soon as practical when
contaminated or as soon as feasible if they are torn, punctured, or when
the ability to function as a barrier is compromised. Disposable gloves
shall NOT be washed or decontaminated for re-use.
Hypoallergenic gloves, glove liners, powderless gloves, or other similar
alternatives shall be readily accessible to those employees who are
allergic to the gloves normally provided. See your building or department
administrator to obtain this alternative.
Utility gloves may be decontaminated for re-use if integrity of the glove is
not compromised. However, they must be discarded if they are cracked,
peeling, torn, punctured, or exhibit other signs of deterioration or when
their ability to function as a barrier is compromised.
To properly remove your gloves, carefully peel one glove off from the
wrist to the fingertips, then hold it in the gloved hand. With the exposed
hand, peel the second glove off the same way, tucking the first glove
inside the second. Dispose of promptly and never touch the outside of a
glove with your bare skin. Lastly, always wash your hands with soap and
running water as soon as possible.
REDUCING THE RISK
Safe Work Practices
Hand washing is your number one protection against infection, and it
keeps you from infecting other people or objects. Wash your hands after
contacting blood, body fluids, excretions or secretions, even if you are
wearing gloves. Here’s how. Wash hands with
soap and running water for ten to fifteen
seconds. Rub vigorously over all surfaces
including above your wrists. Rinse
thoroughly. Then dry with a clean paper
towel and discard. Now using a clean paper
towel, turn off the faucet. Antimicrobial
soaps or cleaners should only be used when
indicated, since they remove your skin’s natural
protective defenses.
Many safe work practices are just common sense. Employees should not
eat, drink, apply cosmetics or lip balm, or handle contact lenses where
there is a reasonable likelihood of exposure to bloodborne infectious
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diseases. Never keep food or drink in places where blood or other
potentially infected materials are present.
Clean all blood and fluid spills promptly, according to the District
Exposure Control Plan. Keep work surfaces and protective coverings
clean. Wear gloves to handle contaminated laundry and be careful to
prevent exposure of your clothing and skin. Deposit wet laundry in a leak
resistant container.
Trash may contain sharps or other infectious materials, so do not push it
down with your hands or feet. Instead, gently shake down waste
containers and carry waste bags, by the top, away from your body.
Dispose of blood and other regulated medical waste in appropriately
labeled, closeable, leak proof containers.
Follow your state’s regulations, as specified in the District Exposure
Control Plan. Remember, florescent orange-red labels, red bags and
containers, and warning signs must be used to warn that the contents
contain blood or other potentially infected material.
Housekeeping
Good housekeeping is everyone’s responsibility.
The Exposure Control Plan lists specific methods
and schedules for cleaning environmental
surfaces possibly contaminated with infectious
materials, But, here are a few general rules.
Clean and decontaminate equipment and working surfaces with an
appropriate disinfectant as soon as possible after contact with potentially
infectious material. Use a broom and dustpan to pick up broken glass not
your hands or call a custodian. Put contaminated sharps and other
potentially infectious wastes in closable containers labeled “biohazard” or
color coded, leak proof containers. Sharps should be placed in sharps
containers, not in the trash.
Handle contaminated laundry as little as possible with minimal agitation.
Place items in labeled or color coded bags or containers without sorting
or rinsing them, and use leak proof bags to transport wet laundry.
Regularly inspect and decontaminate bins, pails, cans and other
reusable receptacles likely to be contaminated.
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What to do if Exposed
Do not panic if you are exposed to blood or other potentially infected
material. Immediately, wash the exposed skin area, with soap and water.
If infectious material enters your eyes, flush eyes and exposed mucous
membranes with large amounts of clean water. Do not use caustic
agents such as bleach since they can damage the skin.
Your next step is to report the exposure to the designated person
immediately, so that post exposure evaluation, counseling, and any
necessary treatment can begin. Act quickly, because with some
infections, treatment works best when you start it right away. Remember,
exposure dose not always lead to infection.
To become infected, a large enough dose of the live virus must enter
your bloodstream and overcome your body’s defense system. Studies
report the risk of acquiring Hepatitis B for those who have not been
vaccinated is from 6-30% or about 1 in 6; for Hepatitis C it’s from 2-20%
or about 1 in 20; and for HIV the risk is approximately 0.3% or 1 in 300.
The risks of infection are real and should be taken seriously. But we’re
making progress in our mission to learn more about BBPs. Right now,
our best tool is to follow work practices designed to keep us safe.
Acronyms
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AIDS – Acquired Immune Deficiency Syndrome
BBP – Bloodborne Pathogens
CDC – Center for Disease Control
HBV – Hepatitis B Virus
HCV – Hepatitis C Virus
HIV – Human Immunodeficiency Virus
OPIM – Other Potentially Infectious Material
OSHA – Occupational Safety and Health Administration
PPE – Personal Protective Equipment
WHO – World Health Organization
Visit the web sites below for more information
CDC – http://www.cdc.gov/
OSHA - http://www.osha.gov/
WHO - http://www.who.int/en/
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COMPREHENSIVE TEST
Select the choice that best completes the following statement.
1. A person with an HBV infection would exhibit symptom\ms like:
A. Dermatitis
B. Chest pain
C. Jaundice
D. Stiff, sore muscles
Select the choice that best answers the following question.
2. Which of the following bloodborne pathogens is easily transmittable?
A. Hepatitis B virus
B. Hepatitis C virus
C. Human Immunodeficiency virus
D. Hepatitis E virus
Select the choice that best answers the following question.
3. How is Hepatitis B infection different from a Hepatitis C infection?
A. According to the CDC, three million people will die from Hepatitis
B while a million people with Hepatitis C will have liver cancer
B. 85% of the HCV cases have chronic infections and only 10% of
those infected with HBV have chronic infections
C. Symptoms of an HBV infection appear immediately whereas the
symptoms of an HCV infection remain dormant for years
D. 85% of the HBV cases have chronic infections whereas only
10% of those infected with HCV are chronically infected
Select the choice that best completes the following statement.
4. In recent times, the number of HIV infected people who develop
serious illness and die from AIDS has:
A. Increased
B. Decreased
C. Stopped completely
D. Not changed
Select the choice that best answers the following question.
5. Many people infected with HIV remain in good health for many years.
A. True
B. False
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Select the choice that best answers the following question.
6. How do Hepatitis B, Hepatitis C and HIV infect the body?
A. Through contact with body perspiration
B. Through contact with blood
C. By breathing the air around infected bloodborne material
D. Through cleaning a contaminated countertop with a disinfectant
Select the choice that best completes the following statement.
7. At work, you can be exposed to HBV, HCV or HIV:
A. By sharing gym equipment with an infected person
B. If a contaminated sharp punctures your skin
C. By breathing the air around infected bloodborne material
D. When you clean a contaminated countertop with a disinfectant
Select the choice that best answers the following question.
8. What information does your school’s exposure control plan provide?
A. How to minimize your risk of exposure
B. New treatments for bloodborne diseases
C. Information on how to identify infected people
D. Symptoms of bloodborne viral infections
Select the choice that best answers the following question.
9. The Hepatitis B vaccine is effective only if the series is completed.
A. True
B. False
Select the choice that best answers the following question.
10. The CDC defines Standards Precautions as:
A. Treating all blood and body fluids as not infectious until it can be
tested
B. Treating all blood and body fluids as though infected with
bloodborne pathogens
C. Testing all blood and body fluids for bloodborne pathogens
D. A method of isolating those who are wounded and are bleeding
Select the choice that best completes the following statement.
11. What should you do, if blood of other infectious material penetrates
your PPE while you are wearing it?
A. Remove it after the task is completed
B. Remove it immediately
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C. Wipe it off and finish the task
D. Immediately don a new set of PPE over the penetrated PPE
Select the choice that best completes the following statement.
12. Heavy duty utility gloves:
A. Should be used for housekeeping
B. Should be worn over disposable examination gloves for added
protection
C. Should be used once and then discarded
D. Are never used to cleanup blood
Select the choice that best completes the following statement.
13. If you are allergic to the disposable glove’s material:
A. Don’t use gloves
B. Use glove liners
C. Apply an ointment for the allergy and then don the gloves
D. Use cotton gloves
Select the choice that best completes the following statement.
14. When removing single use gloves, be sure to:
A. Wash gloved hands, discard cloves, then wash hands again
B. Avoid touching the outside of the gloves, discard gloves, then
wash hands
C. Grasp the fingertips of each glove to remove gloves, discard
gloves, then wash hands
D. Inspect gloves for damage, wash gloves, then store gloves to
reuse
Select the choice that best completes the following statement.
15. What should you do, if a glove tears, punctures, leaks, or becomes
contaminated?
A. Don a new glove over the one that is defective
B. Replace it as soon as possible
C. Remove after the task is completed
D. Repair them as soon as possible
Select the choice that best completes the following statement.
16. The single, most important technique for reducing the risk or
exposure to a bloodborne pathogen is:
A. Isolating infectious materials
B. Wearing PPE
C. Handwashing
D. Disinfecting environmental surfaces
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Select the choice that best answers the following question.
17. How should you pick up broken glass?
A. With a broom and dustpan
B. With a damp cloth, lightly dab and gather the pieces within the
cloth
C. Use a shop vacuum
D. Wear utility gloves to pick up the pieces
Select the choice that best answers the following question.
18. All of the following are good housekeeping practices except:
A. Handle contaminated laundry with minimal agitation’
B. Use single use disposable gloves for decontaminating bins and
reusable receptacles
C. Regularly decontaminate bins and pails
D. Use leak proof bags to transport laundry
Select the choice that best answers the following question.
19. What should you do if infectious material splashes into your eyes?
A. Wipe your eyes with a moist towelette
B. Flush the eyes with large amounts of clean water
C. Use eye drops to rinse out your eyes
D. Let tears flow freely to cleanse the eyes
Select the choice that best completes the following statement.
20. For an exposure to become an infection, there must be:
A. Close contact with those who are infected
B. A large enough dose of the live virus must enter your
bloodstream and overcome the body’s defense system
C. A weaken immune system
D. Exposure to live virus for several years
Answers:
1–C
2–A
3–B
4–B
5–A
6–B
7–B
8–A
9–A
10 – B
11 – B
12 – A
13 – B
14 – B
15 – B
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16 – C
17 – A
18 – B
19 – B
20 – B