The OSHA BBP StandardThe OSHA BBP Standard

Employers must:Employers must:

Have a written exposure control planHave a written exposure control plan Have engineering, work practice, and Have engineering, work practice, and

housekeeping procedures to control hazardshousekeeping procedures to control hazards Provide personal protective equipment.Provide personal protective equipment. Train employees how to protect themselves Train employees how to protect themselves

from exposure.from exposure.

What Are Bloodborne What Are Bloodborne Pathogens?Pathogens?

Bloodborne pathogens are Bloodborne pathogens are microorganisms such as viruses or microorganisms such as viruses or bacteria that are carried in blood bacteria that are carried in blood and can cause disease in people. and can cause disease in people.

How Disease SpreadHow Disease Spread

Four Condition must be present:Four Condition must be present: A PathogenA Pathogen Enough Pathogen to cause a diseaseEnough Pathogen to cause a disease Susceptibility to the pathogenSusceptibility to the pathogen Pathogen passes through correct Pathogen passes through correct

entry site entry site

Pathogen enter the Pathogen enter the body by:body by:

Direct ControlDirect Control Indirect ControlIndirect Control AirborneAirborne Vector-borneVector-borne

Skin Provides a BarrierSkin Provides a Barrier

Unbroken skin forms an impervious barrier Unbroken skin forms an impervious barrier against bloodborne pathogens. However, against bloodborne pathogens. However, infected blood can enter your system through: infected blood can enter your system through:

• Open sores Open sores

• Cuts Cuts

• Abrasions Abrasions

• Acne Acne

• Any sort of damaged or broken skin such as Any sort of damaged or broken skin such as sunburn or blisters sunburn or blisters

Mucous MembranesMucous Membranes

Bloodborne pathogens may also be Bloodborne pathogens may also be transmitted through the mucous transmitted through the mucous membranes of the membranes of the

• Eyes Eyes

• Nose Nose

• Mouth Mouth

Types of Bloodborne Types of Bloodborne PathogensPathogensBloodborne Pathogens IncludeBloodborne Pathogens Include

– MalariaMalaria

– SyphilisSyphilis

– BrucellosisBrucellosis

– Hepatitis B (HBV) Hepatitis B (HBV)

– Human Immunodeficiency Virus Human Immunodeficiency Virus (HIV)(HIV)

Hepatitis B Hepatitis B (HBV)…(HBV)…

is a virus that causes infection and is a virus that causes infection and inflammation of the liver inflammation of the liver

is transmitted primarily through "blood is transmitted primarily through "blood to blood" contact to blood" contact

can lead to serious conditions such as can lead to serious conditions such as cirrhosis & liver cancer cirrhosis & liver cancer

can survive in dried blood for up to can survive in dried blood for up to seven days seven days

No Cure for HBVNo Cure for HBV

There is no "cure" or specific There is no "cure" or specific treatment for HBVtreatment for HBV

Many people develop antibodies to Many people develop antibodies to fight the disease which may prevent fight the disease which may prevent future infectionfuture infection

HBV Symptoms HBV Symptoms (45 - 160 day (45 - 160 day incubation)incubation) Mild flu-like symptoms Mild flu-like symptoms

Fatigue Fatigue Possible stomach pain Possible stomach pain Loss of appetite Loss of appetite Nausea Nausea Jaundice Jaundice Darkened urine Darkened urine

Hepatitis B Hepatitis B VaccinationsVaccinationsEmployees who have routine exposure to bloodborne Employees who have routine exposure to bloodborne

pathogens (such as doctors, nurses, first aid pathogens (such as doctors, nurses, first aid responders, etc) shall be offered the Hepatitis B responders, etc) shall be offered the Hepatitis B vaccine series at no cost to themselves unless: vaccine series at no cost to themselves unless: – They have previously received the vaccine series They have previously received the vaccine series – Antibody testing has revealed they are immune Antibody testing has revealed they are immune – The vaccine is contraindicated for medical The vaccine is contraindicated for medical

reasons reasons In these cases they need not be offered the series. In these cases they need not be offered the series.

Vaccination ProcessVaccination Process

Series of three shots. Series of three shots. Second shot is given one month after Second shot is given one month after

the firstthe firstThird shot follows five months after Third shot follows five months after

the second.the second.

This series gradually builds up the This series gradually builds up the body's immunity to the Hepatitis B body's immunity to the Hepatitis B virus.virus.

Post Exposure and Post Exposure and Follow-upFollow-up

No cost to employeeNo cost to employee ConfidentialConfidential Medical evaluation and treatmentMedical evaluation and treatment CounselingCounseling Psychological SupportPsychological Support

Human Human Immunodeficiency Virus Immunodeficiency Virus (HIV)(HIV) AIDS, or acquired immune AIDS, or acquired immune

deficiency syndrome, is caused by a deficiency syndrome, is caused by a virus called the human virus called the human immunodeficiency virus, or HIV. immunodeficiency virus, or HIV.

It may be many years before AIDS It may be many years before AIDS actually develops.actually develops.

HIVHIV

HIV attacks the body's immune HIV attacks the body's immune system, weakening it so that it system, weakening it so that it cannot fight other deadly diseases. cannot fight other deadly diseases. AIDS is a fatal disease, and while AIDS is a fatal disease, and while treatment for it is improving, there treatment for it is improving, there is no known cure.is no known cure.

HIV and Direct ContactHIV and Direct Contact

The HIV virus is very fragile and will not The HIV virus is very fragile and will not survive very long outside of the human survive very long outside of the human body. It is primarily of concern to body. It is primarily of concern to employees providing first aid or medical employees providing first aid or medical care in situations involving fresh blood or care in situations involving fresh blood or other potentially infectious materials. other potentially infectious materials.

HIV SymptomsHIV SymptomsSymptoms of HIV infection can vary, but often Symptoms of HIV infection can vary, but often

include:include:• Weakness Weakness • Fever Fever • Sore throat Sore throat • Nausea Nausea • Headaches Headaches • Diarrhea Diarrhea • White coating on the tongue White coating on the tongue • Weight loss Weight loss • Swollen lymph glandsSwollen lymph glands

How can you protect How can you protect yourself from yourself from

exposure?exposure?

H. A. PH. A. P

Hygiene RulesHygiene Rules

If you are working in an area where there If you are working in an area where there is reasonable likelihood of exposure, you is reasonable likelihood of exposure, you should never: should never:

• Eat Eat

• Drink Drink

• Smoke Smoke

• Apply cosmetics Apply cosmetics

• Handle contact lenses Handle contact lenses

Food RulesFood Rules

Do not keep food or drink Do not keep food or drink refrigerators, freezers, shelves, refrigerators, freezers, shelves, cabinets, or on counter tops cabinets, or on counter tops where blood or potentially where blood or potentially infectious materials are infectious materials are present.present.

Decontamination & Decontamination & SterilizationSterilizationAll surfaces, tools, equipment and other All surfaces, tools, equipment and other

objects that come in contact with blood objects that come in contact with blood or potentially infectious materials must or potentially infectious materials must be decontaminated and sterilized as soon be decontaminated and sterilized as soon as possible. Equipment and tools must as possible. Equipment and tools must be cleaned and decontaminated before be cleaned and decontaminated before servicing or being put back to use.servicing or being put back to use.

Decontamination Decontamination

Solution of 5.25% sodium hypochlorite Solution of 5.25% sodium hypochlorite (household bleach) diluted between 1:10 (household bleach) diluted between 1:10 and 1:100 with water. The standard and 1:100 with water. The standard recommendation is to use at least a recommendation is to use at least a quarter cup of bleach per one gallon of quarter cup of bleach per one gallon of water.water.

Decontamination Decontamination

Use Lysol or some other EPA-registered Use Lysol or some other EPA-registered tuberculocidal disinfectant. Check the tuberculocidal disinfectant. Check the label of all disinfectants to make sure label of all disinfectants to make sure they meet this requirement. they meet this requirement.

Spill Cleanup (Process)Spill Cleanup (Process)

Carefully cover the spill with paper Carefully cover the spill with paper towels or ragstowels or rags

Gently pour 10% solution of bleach over Gently pour 10% solution of bleach over the towels or ragsthe towels or rags

Let sit for 10 minutesLet sit for 10 minutes Wear gloves to collect & dispose of wasteWear gloves to collect & dispose of waste

Spill Cleanup (Safety Spill Cleanup (Safety Committee)Committee) Secure the areaSecure the area Let the janitorial crew respondLet the janitorial crew respond Ensure appropriate containers are availableEnsure appropriate containers are available

– Bio-Hazard bagBio-Hazard bag– CloseableCloseable– Puncture resistantPuncture resistant

Precautions with Precautions with Needles Needles Recap needles only with a Recap needles only with a

mechanical device. mechanical device. Use forceps, pliers, or broom Use forceps, pliers, or broom

and dust pan to move needlesand dust pan to move needles Never break or shear Never break or shear

needles. needles. Needles must be disposed in Needles must be disposed in

labeled sharps containerslabeled sharps containers

Broken GlasswareBroken Glassware

Broken glassware should be sterilized Broken glassware should be sterilized with an approved disinfectant solution with an approved disinfectant solution before it is disturbed or cleaned up. before it is disturbed or cleaned up.

Glassware that has been decontaminated Glassware that has been decontaminated may be disposed of in an appropriate may be disposed of in an appropriate sharps containersharps container

Don’t pick up broken glassware with Don’t pick up broken glassware with your handsyour hands

ATTITUDEATTITUDEIn an emergency situation, always use In an emergency situation, always use

Universal PrecautionsUniversal Precautions• Treat all blood or potentially infectious Treat all blood or potentially infectious

body fluids as if they are contaminated. body fluids as if they are contaminated. • Protect yourself first, then treat victim Protect yourself first, then treat victim • Treat all items as though they are Treat all items as though they are

contaminated contaminated • Wash hands immediately after the Wash hands immediately after the

incident.incident.

If you are exposedIf you are exposed Wash the exposed area Wash the exposed area

thoroughly with soap thoroughly with soap and running water.and running water.

Use non-abrasive, Use non-abrasive, antibacterial soap antibacterial soap

Flush mouth, nose, eyes Flush mouth, nose, eyes for 15 minutes if blood for 15 minutes if blood is splashed in mucous is splashed in mucous membranesmembranes

Other Actions if Other Actions if ExposedExposed Report the exposure to Risk Report the exposure to Risk

Management Management Complete an Incident ReportComplete an Incident Report Request blood testing & Hepatits B Request blood testing & Hepatits B

vaccinationvaccination

Exposure vs Exposure vs ContactContact

Exposure: mucous membrane, non-intact Exposure: mucous membrane, non-intact skin or parenteral contact with blood or skin or parenteral contact with blood or other potentially infectious material (OPIM) other potentially infectious material (OPIM) that results from the performance of an that results from the performance of an employee’s duties.employee’s duties.

Contact: When blood contacts intact skin Contact: When blood contacts intact skin other than mucous membranes.other than mucous membranes.

Personal Protective Personal Protective EquipmentEquipmentThe best protection against exposure The best protection against exposure

is to ensure you are wearing the is to ensure you are wearing the appropriate personal protective appropriate personal protective equipment (PPE). To protect equipment (PPE). To protect yourself, it is essential to have a yourself, it is essential to have a barrier between you and the barrier between you and the potentially infectious material.potentially infectious material.

Rules to follow:Rules to follow: Always wear personal protective Always wear personal protective

equipment in exposure situations. equipment in exposure situations. Replace PPE that is torn or Replace PPE that is torn or

punctured. punctured. Remove PPE before leaving the Remove PPE before leaving the

work area. work area. Properly disinfect or dispose of Properly disinfect or dispose of

used PPEused PPE

GlovesGloves

Gloves should be made of latex, Gloves should be made of latex, nitril, rubber, or other water nitril, rubber, or other water impervious materials.impervious materials.

Inspect gloves before useInspect gloves before use Double gloving can provide an Double gloving can provide an

additional layer of protection.additional layer of protection.

GlovesGloves

If you have cuts or sores on your If you have cuts or sores on your hands, you should cover these with hands, you should cover these with a bandage or similar protection as a bandage or similar protection as an additional precaution before an additional precaution before donning your gloves.donning your gloves.

Don’t touch the outside of used Don’t touch the outside of used glovesgloves

Goggles, Face Shields Goggles, Face Shields & Aprons& Aprons Use goggles if there is a risk of Use goggles if there is a risk of

splashing or vaporization of splashing or vaporization of contaminated fluidscontaminated fluids

Face shields provide additional face Face shields provide additional face protection for the nose and mouth.protection for the nose and mouth.

Aprons protect Aprons protect

Contaminated ClothingContaminated Clothing

Remove clothing that is contaminated Remove clothing that is contaminated with blood as soon as possiblewith blood as soon as possible

Use Universal Precautions when handling Use Universal Precautions when handling contaminated laundrycontaminated laundry

Place clothing in approved & labeled Place clothing in approved & labeled bags or containersbags or containers

Hand WashingHand Washing Hand washing is one of the most Hand washing is one of the most

important (and easiest) practices used to important (and easiest) practices used to prevent transmission of bloodborne prevent transmission of bloodborne pathogens. pathogens.

Wash hands or other exposed skin Wash hands or other exposed skin thoroughly as soon as possible following thoroughly as soon as possible following an exposure incident. an exposure incident.

Use antibacterial soapUse antibacterial soap Don’t use harsh, abrasive soapsDon’t use harsh, abrasive soaps

Signs & LabelsSigns & Labels

Warning labels must be placed on Warning labels must be placed on containers of regulated waste, containers of regulated waste, refrigerators and freezers containing refrigerators and freezers containing blood or other potentially infectious blood or other potentially infectious material; and other containers used to material; and other containers used to store, transport, or ship blood or other store, transport, or ship blood or other potentially infectious materials. potentially infectious materials.

BIOHAZARDBIOHAZARD

What is Regulated What is Regulated Waste?Waste? Any liquid or semi-liquid blood or other Any liquid or semi-liquid blood or other

potentially infectious materials.potentially infectious materials.

Contaminated items that would release blood Contaminated items that would release blood or other potentially infectious materials in a or other potentially infectious materials in a liquid or semi-liquid state if compressed.liquid or semi-liquid state if compressed.

Items that are caked with dried blood or other Items that are caked with dried blood or other potentially infectious materials potentially infectious materials

SummarySummary

Always use Universal Precautions Always use Universal Precautions Use proper PPE in situations with Use proper PPE in situations with

Bloodborne Pathogens Bloodborne Pathogens Report all suspected exposures Report all suspected exposures Don't handle sharps or broken glass with Don't handle sharps or broken glass with

your hands your hands Properly dispose of pathogen waste, PPE Properly dispose of pathogen waste, PPE

and Sharps and Sharps

Questions?Questions?

Please ask any questions you may Please ask any questions you may have. have.

We want to ensure you understand all We want to ensure you understand all the information on Bloodborne the information on Bloodborne

PathogensPathogens