Bloodborne Pathogens (OSHA 10-Hour General Industry Outreach)

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1. Slide 1

   Bloodborne Pathogens

   • OSHA 10-hour Outreach Training
   • General Industry
2. Slide 2

   Introduction

   • Lesson objectives:
   • 1. Define bloodborne pathogens.
   • 2. Identify workers who are at risk of exposure to bloodborne pathogens.
   • 3. Identify key aspects of a Bloodborne Pathogen Exposure Control Plan;
   • 4. Describe methods for controlling exposure to bloodborne pathogens.
   • 5. Describe steps to take when exposed to a bloodborne pathogen.
3. Slide 3
   • 2016
   • Introduction
   • 1981
   • 2014
4. Slide 4

   Bloodborne Pathogens

   • What are bloodborne pathogens?
   • Pathogenic microorganisms present in human blood that can lead to diseases
   • Examples of primary concern
   • Hepatitis B (HBV)
   • Hepatitis C (HCV)
   • Human Immunodeficiency Virus (HIV)
5. Slide 5

   Bloodborne Pathogens

   • Hepatitis B (HBV)
   • Over 12 million Americans are infected (1 in 20)*
   • Silent infection; symptoms include jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting; may lead to chronic liver disease, liver cancer, and death
   • HBV can survive for at least one week in dried blood
   • Up to 40,000 people in US will become newly infected each year*
   • *Source: Hepatitis B Foundation
   • Reported cases of hepatitis B in the U.S. have generally declined from 1980 to 2014. Source: CDC
6. Slide 6

   Bloodborne Pathogens

   • Hepatitis C (HCV)
   • Hepatitis C is the most common chronic bloodborne infection in the U.S.
   • Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting
   • May lead to chronic liver disease and death
7. Slide 7

   Bloodborne Pathogens

   • Human Immunodeficiency Virus (HIV)
   • HIV is the virus that leads to AIDS
   • HIV affects the body’s immune system
   • HIV does not survive well outside the body
   • Estimated >1.1 million people living with HIV
   • Infected for life
   • Single, red-colored H9-T cell infected by numerous mustard-colored HIV particles which are attached to the cell’s surface membrane. Source: NIAID.
8. Slide 8

   Bloodborne Pathogens

   • Other bloodborne diseases
   • Caused by viruses or bacteria
   • Circulate in blood at some phase; capable of being transmitted
   • Most are rare in the U.S.
   • Zika Virus (left) and Ebola
   • Virus (right) can be spread to workers through contaminated blood or infectious body fluids.
   • Source: CDC / C.Goldsmith
   • Source: CDC / F. Murphy
9. Slide 9

   Bloodborne Pathogens

   • Examples
   • Hepatitis D (HDV)
   • Syphilis
   • Malaria
   • Babesiosis
   • Brucellosis
   • Leptospirosis
   • Arboviral Infections
   • Relapsing fever
   • Creutzfeldt-Jakob
   • Disease
   • Human T-Lymphotropic Virus Type I
   • Viral Hemorrahagic
   • Fever
10. Slide 10

    Risk of Exposure

    • Contamination sources:
    • Blood
    • Other potentially infectious materials (OPIM)
    • Source: OSHA
    • Human body fluids
    • Any unfixed tissue or organ from human
    • Cultures, culture mediums, or other solutions
    • Experimental animal blood, tissues, or organs infected with HIV or HBV
11. Slide 11

    Risk of Exposure

    • Spread of bloodborne pathogens occurs through:
    • Direct contact
    • Indirect contact
    • Respiratory transmission
    • Vector-borne transmission
    • Source: NIOSH
12. Slide 12

    Risk of Exposure

    • How exposure occurs:
    • Needlesticks
    • Cuts from other contaminated sharps
    • Contact of mucous membrane or broken skin with contaminated blood or OPIM
    • Source: OSHA DTE
13. Slide 13

    Risk of Exposure

    • Occupational exposures:
    • Occupations at risk
    • First responders
    • Housekeeping personnel in some industries
    • Nurses and other healthcare personnel
    • Source: OSHA
    • CDC estimates 5.6 million workers in healthcare and related occupations are at risk
    • All occupational exposure to blood or OPIM places workers at risk
14. Slide 14

    Risk of Exposure

    • The figure on left shows percent of occupational groups of healthcare workers exposed to blood or body fluids, with nurses (44%), physicians (28%), and technicians (15%) accounting for most of the incidents. The figure on the right shows healthcare work locations where exposures occurred, with inpatient facilities, such as the medical or surgical ward (20%) and intensive care unit (13%), and operating rooms (25%) accounting for the majority of exposure sites. Source: CDC (2008)
15. Slide 15

    Exposure Control Plan (ECP)

    • Establish an Exposure Control Plan
    • Written plan
    • Review and update plan
16. Slide 16

    Exposure Control Plan (ECP)

    • Required elements of Exposure Control plan include:
    • Exposure determination
    • Schedule and method of implementation
    • Procedure for evaluation of exposure incidents
17. Slide 17

    Exposure Control Plan (ECP)

    • Accessible to employees
    • Review and update
    • Annually
    • When new or modified tasks/procedures are implemented
18. Slide 18

    Controlling Exposures

    • Observe standard precautions, such as:
    • Treating all blood and bodily fluids as if they are contaminated
    • Proper cleanup and decontamination
    • Source: OSHA DTE
19. Slide 19

    Controlling Exposures

    • Engineering and work practice controls:
    • Safer medical devices
    • Sharps disposal containers
    • Hand hygiene
    • Source: OSHA DTE
    • Source: NIOSH
20. Slide 20

    Controlling Exposures

    • PPE examples:
    • Gloves
    • Masks
    • Aprons/Smocks/
    • Gowns
    • Face shields
    • Mouthpieces
    • Safety glasses
    • CPR pocket masks
21. Slide 21

    Controlling Exposures

    • Employer’s responsibilities:
    • Perform hazard assessment
    • Identify and provide appropriate PPE to employee at no cost
    • Train employees on use and care
    • Maintain/replace PPE
    • Review, update, evaluate PPE program
22. Slide 22

    Controlling Exposures

    • PPE selection
    • Safe design and construction
    • Fit comfortably
    • Required PPE training
    • When it is necessary
    • What kind is necessary
    • Proper donning, adjusting, wearing, doffing
    • Limitations
    • Proper care, maintenance, useful life, disposal
    • Source: CDC
23. Slide 23

    Controlling Exposures

    • Employee’s responsibilities:
    • Properly wear PPE
    • Attend training
    • Care for, clean, and maintain
    • Notify when repairs/replacement needed
24. Slide 24

    Controlling Exposures

    • Housekeeping:
    • Written schedule for cleaning and decontamination
    • Picking up broken glass
    • Not picked up by hands
    • Mechanical means only
    • Source: OSHA DTE
25. Slide 25

    Controlling Exposures

    • Clean-up and decontamination:
    • Wear protective gloves
    • Use appropriate disinfectant
    • Clean and disinfect contaminated equipment and work surfaces
    • Thoroughly wash up immediately after exposure
    • Properly dispose of contaminated PPE, towels, rags, etc.
    • Source: OSHA DTE
26. Slide 26

    Controlling Exposures

    • Regulated waste disposal:
    • Dispose of regulated waste in closable, leak-proof red or biohazard labeled bags or containers
    • Dispose of contaminated sharps in closable, puncture-resistant, leak-proof, red or
    • Source: OSHA DTE
27. Slide 27

    Controlling Exposures

    • Laundry
    • Contaminated laundry must be bagged or containerized at the location where it was used.
    • Source: OSHA DTE
28. Slide 28

    Controlling Exposures

    • Training:
    • Who
    • All employees with occupational exposure to blood or other potentially infectious material (OPIM)
    • Employees who are trained in first aid and CPR
    • Source: OSHA DTE
    • No cost; during working hours
    • When
    • Initial assignment
    • Annually; or with new/modified tasks
29. Slide 29

    Controlling Exposures

    • Hepatitis B vaccination:
    • Offered to all potentially exposed employees
    • Provided at no cost to employees (within 10 days to employees with occupational exposure)
    • Declination form
    • Source: OSHA DTE
30. Slide 30

    Controlling Exposures

    • No vaccinations for:
    • Hepatitis C
    • HIV
31. Slide 31

    When Exposure Occurs

    • Exposure incident:
    • Specific eye, mouth, or other mucous membrane, non-intact skin, parenteral contact with blood or OPIM that results from the performance of an employee’s duties.
    • Source: CDC
32. Slide 32

    When Exposure Occurs

    • Immediate actions
    • Wash exposed area with soap and water
    • Flush splashes to nose, mouth, or skin with water
    • Irrigate eyes with water and saline
    • Source: OSHA
33. Slide 33

    When Exposure Occurs

    • Report exposure immediately
    • Direct employee to healthcare professional for treatment
34. Slide 34

    When Exposure Occurs

    • Confidential medical evaluation and follow-up
    • Route(s) of exposure and circumstances
    • Source individual
    • Collect/test blood for HBV and HIV serological status
    • Post exposure prophylaxis (when medically indicated)
    • Counseling
    • Evaluation
35. Slide 35

    What Questions Do You Have?

36. Slide 36

    Knowledge Check

    • 1. Bloodborne pathogens can be transmitted by ___.
    • a. sexual intercourse or intravenous drug use
    • b. rubbing an eye after coming in contact with potentially infectious material
    • c. potentially infectious material coming in contact with inflamed acne or sunburn blisters
    • d. all of the above
    • Answer: d. All of the above
37. Slide 37

    Knowledge Check

    • 2. Employees should use PPE when ___.
    • a. there is a reasonable anticipation of contact with blood or OPIM
    • b. cleaning up spills
    • c. responding to an emergency
    • d. all of the above
    • Answer: d. all of the above
38. Slide 38

    Knowledge Check

    • 3. Which of the following is an example of a work practice control?
    • a. Spill kits
    • b. Accessible handwashing stations
    • c. Proper decontamination of spill areas
    • d. Red hazardous waste bags
    • Answer: c. Proper decontamination of spill areas
39. Slide 39

    Knowledge Check

    • 4. Which of the following is a standard precaution for workers exposed to bloodborne pathogens?
    • a. Treat all liquids as hazardous for HIV
    • b. Treat all blood and bodily fluids of patients as potentially infectious materials
    • c. Test all blood and unknown bodily fluids for HIV after spills
    • d. Label unknown liquids with hazard signs
    • Answer: b. Treat all blood and bodily fluids of patients as potentially infectious materials
40. Slide 40

    Knowledge Check

    • 5. Hepatitis B is an inflammation of which body organ?
    • a. Kidney
    • b. Lungs
    • c. Larynx
    • d. Liver
    • Answer: d. Liver
41. Slide 41

    Knowledge Check

    • 6. In the event of an exposure incident, which following action should be taken first?
    • a. Notify appropriate personnel
    • b. Wash the area thoroughly
    • c. Seek medical treatment
    • d. Complete an incident or accident report
    • Answer: b. Wash the area thoroughly
42. Slide 42

    Knowledge Check

    • 7. Which of the following actions can help prevent exposure to bloodborne pathogens?
    • a. Wearing latex gloves
    • b. Wearing goggles
    • c. Washing hands
    • d. All of the above
    • Answer: d. All of the above
43. Slide 43

    Knowledge Check

    • 8. A vaccine is only available for which of the following major bloodborne pathogen viruses?
    • a. HIV
    • b. Hepatitis B
    • c. Hepatitis C
    • d. No vaccines are available for any of the three major BBP viruses
    • Answer: b. Hepatitis B
44. Slide 44

    Knowledge Check

    • 9. Which of the following are potential routes of entry for bloodborne pathogens?
    • a. Mucous membranes of the eyes, nose, and mouth
    • b. Non-intact skin
    • c. Penetration by a contaminated sharp object
    • d. All of the above
    • Answer: d. All of the above