Crime Scene and Crime Lab Safety

1. Crime Scene and Crime Lab Safety Bloodborne Pathogens

2. Who is OSHA? • Occupational Safety and Health Administration • Created by Department of Labor by the Occupational Safety and Health Act of 1970

3. OSHA Purpose • To assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources

4. Bloodborne Pathogen Standard PURPOSE • To limit occupational exposure to blood and other potentially infectious materials since any exposure could result in transmission of BBP which could lead to disease or death

5. SCOPE • Covers all employees who could reasonably anticipate to face contact with blood or other potentially infectious materials

6. Motivation • OSHA estimates that 5.6 Million workers in the Health Care and other facilities are at risk of Exposures to Bloodborne Pathogens

7. Those at Risk • Law Enforcement Personnel • Firefighters • Paramedics • EMT’s • First Responders

8. OSHA Requires Training • Modes of Transmission • Symptoms • Epidemiology • Warning signals indicating exposure • Procedures to follow if exposure occurs

9. OSHA Requires Training • Recognizing tasks that may involve potential exposure • Practices that reduce exposure • Use of personal protective equipment (PPE) • Emergency procedures following exposure • Information on biohazard labeling

10. Modes of Transmission • Disease transmission is two-way street • Pathogen is disease-producing organism that enters the body, basically a germ • Most infectious diseases are caused by one of 6 pathogens - usually bacteria or virus • Immune system relies on skin to limit amount of pathogens that enter the body

11. Four ways pathogens enter body 1. Direct contact 2. Indirect contact 3. Airborne 4. Vector borne

12. Transmission occurs with: 1. Presence of pathogen 2. Sufficient quantity of pathogen 3. Personal vulnerable to disease 4. Correct entry site for the pathogen • Also called portal of entry

13. Hepatitis • Several types • Hepatitis B most serious health threat to healthcare workers - 200-300 die annually • Caused by Hepatitis B virus (HBV) • Damages liver, causing symptoms from mild or inapparent to severe or fatal • 10% become HBV carriers. They develop liver disease and are infectious to others

14. Hepatitis Signs and Symptoms • Flu-like symptoms • Fatigue • Abdominal pain with nausea/vomiting • Loss of appetite • Jaundice • Liver ailments - cancer, cirrhosis

15. Hepatitis mode of transmission • Direct and indirect contact with • blood • saliva • semen • feces • food • water • other products

16. HBV Occupational Exposure • Needlestick - 6-30% • Broken or nonintact skin • Mucous membranes of eyes, nose and/or mouth • Saliva through a human bite • HBV can live in dry environment for at least 7 days. Once virus is dead - it’s dead!

17. HIV/AIDS • AIDS - Acquired Immunodeficiency Syndrome is caused by HIV • HIV is Human Immunodeficiency Virus • Outcome of virus varies: • Some have no symptoms • Some have less severe symptoms than AIDS • AIDS destroys immune system allowing life-threatening infections that threaten life and health

18. HIV/AIDS Symptoms • Fever • Night sweats • Weight loss • Diarrhea • Severe fatigue • Shortness of breath • Lesions

19. HIV/AIDS Transmission • Direct and indirect contact with: • blood • semen • vaginal fluid • other fluids possible

20. HIV transmission in person life • Anal sex • Vaginal or oral sex with someone who uses IV drugs or engages in anal sex • Sex with someone you don’t know well • Sex with someone who has multiple sex partners • Sex without a condom with an infected person • Sharing IV drug needles

21. Risk of occupational exposure • Needlestick 0.5% with contaminated needle • Chapped/broken skin or mucous membranes • Contact with blood or other body fluids

22. How to protect yourself? • HBV vaccinations • Wear Personal Protective Equipment (PPE) ALWAYS! • Avoid contact with mouth (use BVM or pocket mask for mouth-to-mouth) • Protect yourself from fluids that are potentially infectious - especially blood • Practice good hygiene, get plenty of rest and eat properly

23. Other diseases of concern • Herpes • Meningitis • Tuberculosis • Varicella - chicken pox • Mumps • Measles • And other childhood disease

24. TUBERCULOSIS Increasing Epidemically

25. Tuberculosis • By 1950’s antibiotics had put stop to epidemic • Recent comeback • Caused by: • Mycobacterium Tuberculosis • primary a human bacteria • spread by droplets of fluid being expelled from infected person then inhaled by uninfected person - airborne transmission

26. Risk Factors for TB • Most significant is living conditions • cramped - prisons, long term care centers or homeless shelters • unsanitary conditions

27. DRUG RESISTANT STRAINS OF TB • OSHA issued mandatory guidelines • Prevention of Transmission • Multi resistant strains develop when non compliance with TB Rx

28. Since 1985 the incidence of TB in the general US population has increased 18 percent reversing a 30 year downward trend 25,500 cases were reported in the US in 1990

29. TUBERCULOSIS SYMPTOMS • Productive Cough • Coughing up blood • Weight loss • Loss of appetite • Lethargy/weakness/malaise • Night sweats • Fever - usually low grade • Swollen lymph nodes

30. Tuberculosis Precautions • Gloves and mask (hepa) • Vigorous hand-washing • Use disinfectant that is tuberculocidal • Mask for patient - if on medication cover mouth and nose when cough/sneezing • Have regular PPD tests - positive PPD indicates person is infected with TB only

31. EXPOSURE CONTROL PLAN • Requires employers to identify in writing, tasks & procedures as well as job classifications where occupational exposure to blood occurs • Must also set a schedule of implementation • Plan must be accessible to employees and to OSHA

32. METHODS OF COMPLIANCE • Mandates Universal Precautions • Emphasizes Engineering and Work Place Controls • Procedures for Hand-washing, Minimize needlesticks, splashing & spraying of blood • Ensure appropriate packaging of blood/specimens

33. METHODS OF COMPLIANCE • Regulates Waste • Decontamination Procedures for equipment • Labeling of Infectious or Contaminated Items • Employers must provide at no cost PPE (gloves, masks, face shields, goggles, safety glasses, lab coats, full body suits, repirators etc.) • Written Schedule for Cleaning and method of decontamination

34. METHODS OF COMPLIANCE • Specifies methods of Disposing Sharps • Sets forth standards for containers • Sets standard for containers for regulated waste • Handling of contaminated laundry

35. HBV Vaccination • Requires vaccinations to be made available to all employees who are at risk • Procedures for Declination of vaccine.

36. POST EXPOSURE EVALUATION & FOLLOW UP • Procedures for all employees who have had an exposure • Laboratory Test at No Cost • Confidential • Post Exposure Prophylactics • Counseling

37. HAZARD COMMUNICATION • Warning Labels • Red Bags • Containers • Restricted Areas

38. Biomedical/Biohazard Symbol

39. METHODS • INTERMEDIATE-LEVEL DISINFECTANT • Use of chemical germicides that are tuberculocidal (bleach 1:10 dilution) • LOW-LEVEL DISINFECTING: Laundry detergents and hot water

40. CLEANING AND DECONTAMINATING SPILLS OF BLOOD

41. METHODS • Put on gloves and clean with disposable towels. Placed soiled towels in plastic bag • Wear eye and face protection if there is splashing • Wear shoe covers if amount of blood is great • Remove contaminated items, gloves last

42. WASH HANDS AFTER REMOVING GLOVES Use soap and water if available, waterless soap if not until water can be accessed.