bloodborne pathogens the occupational safety and health administration (osha) standard
TRANSCRIPT
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BLOODBORNE PATHOGENS
THE OCCUPATIONAL SAFETY AND HEALTH
ADMINISTRATION (OSHA) STANDARD
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OSHA’S EXPECTATIONS
• Employer’s Duties– identify job risks
and classify – provide appropriate
training– provide a plan– provide appropriate
equipment
• Compliance
• Employee’s Duties– follow employer’s
plan– know job
classification– complete training– use equipment
provided by employer
• Compliance
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OSHA REQUIRED INFORMATION
• Documents• General explanation of
bloodborne pathogens• Hepatitis B
immunization• Explanation of tasks
that may involve exposure
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BLOODBORNE PATHOGENS DEFINED
• Disease-causing microorganisms that may be present in human blood or OPIM (other potentially infectious material)– Viruses– Bacteria– Parasites
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MODES OF TRANSMISSION
• Puncture wounds or cuts
• Contact (touch, splash, or spray) with blood or OPIM on:– mucous membrane– non-intact skin
•cuts, abrasions, burns•acne, rashes•papercuts, hangnails
– contaminated sharps
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RISK OF EXPOSURE
•Objective of BBP standard is to minimize or eliminate the hazard posed by work that may expose one to blood or OPIM
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RISK OF EXPOSURE
• If a risk of exposure exists one should know:– if there is a way to
prevent infection– symptoms and course of
infection– availability of counseling – availability of post-
exposure treatment & follow-up
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OCCUPATIONAL EXPOSURE INCIDENTS
• Occupational contact with blood or OPIM is considered an exposure incident
• If an exposure occurs:– wash with soap & water– report incident– document incident– seek “immediate” medical
evaluation– follow employer’s exposure
control plan
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IMMEDIATE MEDICAL EVALUATION
• “Immediate” means prompt medical evaluation and prophylaxis
• An exact timeline cannot be stated• Time limits on effectiveness of
prophylactic measures vary depending on the infection of concern
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REPORTING AN INCIDENT• Date and time of
incident• Job classification• Location in the
worksite where incident occurred
• Work practice being followed
• Procedure being performed
• PPE in use
Minimal Information to Report
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MEDICAL EVALUATION POST EXPOSURE
• Entitled to confidential medical evaluation
• Personal decision about blood testing• Blood may be tested only with
consent• Blood may be stored for 90 days,
while considering testing• Interpretation of any test results
occurs with health care provider
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BLOOD TESTING
• Blood may be tested for antibodies to:– Human Immunodeficiency Virus (HIV)– Hepatitis C Virus (HCV)– Hepatitis B Virus (HBV)– Other disease-causing organisms
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SPECIFIC BLOODBORNE PATHOGENS
• Definition• Signs and symptoms• Course of infection• Prevention and
control• Post-exposure prophy-
laxis and follow-up care
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HIV DEFINED
• HIV is Human Immunodeficiency Virus
• HIV can cause acquired immune deficiency syndrome (AIDS)
• Risk of HIV infection from a puncture injury exposure to HIV infected blood is very low -- 0.3%
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SIGNS & SYMPTOMS OF HIV
• Signs and symptoms include:– Weight loss– Night sweats or fever– Gland swelling or pain– Muscle and/or joint pain
• Cannot rely on signs and symptoms to confirm if one is infected
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COURSE OF INFECTION WITH HIV
• Incubation period from HIV infection to AIDS can be 8 to 10 years
• Varies greatly among individuals
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HIV PREVENTION
• There is no vaccine to prevent HIV infection
• Follow Universal Precautions
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HIV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP
• No cure for HIV infection
• Testing schedule for HIV antibodies– at time of exposure– at 3 months – at 6 months
• HIV antibodies usually become detectable within 3 months of infection
• Treatment requires health care provider
• OSHA requires treatment that meets most recent CDC guidelines
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HCV DEFINED
• HCV is Hepatitis C Virus• It affects the liver• It is the most common chronic
bloodborne infection in US• Risk of HCV infection after
exposure to HCV infected blood is 1.8%
• 70 to 75% of those with acute HCV infection have no symptoms
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SIGNS & SYMPTOMS OF HCV
• Jaundice - yellow color to skin and whites of eyes
• Fatigue• Headache• Abdominal Pain• Loss of appetite• Nausea and vomiting
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COURSE OF HCV INFECTION
• Incubation period averages 7 weeks
• Chronic liver disease may occur in 70% of those infected with HCV
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HCV PREVENTION
• No vaccine exists to prevent HCV infection
• Follow Universal Precautions
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HCV POST-EXPOSURE PROPHYLAXIS & FOLLOW-UP
• No cure for HCV • No post-exposure pro-
phylaxis recommended• Tests for HCV anti-
bodies & liver function recommended at time of exposure
• Tests should be repeated 4-6 months post exposure
• Treatment of HCV requires a health care provider
• OSHA requires treat-ment that meets most recent CDC guidelines
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HBV DEFINED
• HBV is Hepatitis B Virus
• It affects the liver
• Prevalence of HBV infection among healthcare workers is 10 times greater than HCV infection
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SIGNS & SYMPTOMS OF HBV
• Jaundice - yellow color to the skin and whites of eyes
•Fatigue•Headache•Abdominal Pain•Loss of appetite•Nausea and vomiting
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COURSE OF HBV INFECTION
• Incubation period averages 12 weeks
•Most cases of HBV resolve without complications
•Chronic liver disease may occur in 6 to 7% of those infected with HBV
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HBV PREVENTION
• A vaccine does exist to prevent HBV infection
• Employers are required to offer HBV vaccination HBV vaccination to employees covered under BBP standard. Debra Currier at Shiprock Administration Office 368-4984
Ext: 10103• Follow Universal Precautions
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HBV POST-EXPOSURE PROPHYLAXIS & FOLLOW-
UP• No cure for HBV
infection• Post-exposure
prophylaxis should begin within 24 hours; no later than 7 days after exposure
• Exposed person should receive HBV vaccine
• Treatment requires health care provider
• OSHA requires treatment meet CDC’s most recent guidelines
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HBV IMMUNIZATION
• Employees with routine occupational exposure to blood/OPIM have right to HBV vaccination at no personal expense
• Employee refusal established by signing HBV vaccination declination form
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HBV VACCINATION SCHEDULE
• Vaccine given in 3 doses over 6 months– 1st on initial assignment– 2nd one month later– 3rd five months after 2nd dose
• Employer cannot require employee to use health insurance to cover test cost
• Pre-screening is not required• HBV is declining because of vaccine
use!
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PREVENTION
• Work Practice Controls
• Personal Protective Equipment
• Universal Precautions
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SHARPS CONTAINERS MUST BE:
• closable and puncture resistant
• leak proof• labeled or color-coded• functional• sufficient in number• easily accessible and main- tained in upright position• replaced per agency policy• DO NOT overfilled
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HANDWASHING
• Readily available facilities
• Washing after removing PPE
• Using antiseptic hand cleanser when a sink isn’t readily available
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HANDWASHING
•First roll out paper towel or have towel readily available so as not to touch other surfaces to reach it
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HANDWASHING
•Turn on tap water and adjust temperature
•Use plenty of soap
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HANDWASHING
•Wash hands using friction on all surfaces for at least 30 seconds
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HANDWASHING
•Dry hands thoroughly
•DO NOT turn off the water yet
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HANDWASHING
•Turn off tap with a dry part of the towel
•DO NOT touch surfaces with clean hands
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CLEANING
• Clean work surfaces according to employer’s exposure control plan
• Use PPE and EPA-approved solution
• DO NOT take contaminated materials home to launder!
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PERSONAL PROTECTIVE EQUIPMENT (PPE)
• Specialized clothing/equipment used for protection when risk of exposure exists
• Must prevent blood or OPIM from contaminating clothing or skin
• Must be available at no cost to employee
• Must be in appropriate sizes• Must be in good working condition• Must be properly maintained• Employee must be trained in proper use
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TYPES OF PERSONAL PROTECTIVE EQUIPMENT
• Gloves• Masks• Eye shields• Gowns/aprons
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LATEX GLOVES
• Medical products containing latex must be labeled
• Allergies to latex are increasing
• Substitutes for latex-containing materials must be made available
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UNIVERSAL PRECAUTIONS
• Infection control approach that treats all human blood and certain body fluids as if they are known to contain bloodborne pathogens
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CCSD Policy: GBGC-EExposure Control
PlanContact Payroll for Workman’s Comp
Charlotte Simpson Ext. 10131Contact Debra Currier for Hep B vaccine information. Ext. 10103
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EXPOSURE Determination• High Risk – Coaches, physical ed instructors,
custodians, certain special ed program personnel, playground duty personnel, health services personnel, and security personnel.
• Moderate Risk – Regular instructional program personnel, other special ed program personnel, school level office personnel, maintenance personnel, food services personnel, and special assignment personnel (e.g., counselors, librarians).
• Includes record keeping provisions and is reviewed annually
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QUESTIONS?