Vincent J. Giblin, General President

1. Bloodborne Pathogens Vincent J. Giblin, General President Phone: (304) 253-8674 Fax: (304) 253-7758 E-mail: hazmat@iuoeiettc.org 1293 Airport Road Beaver, WV 25813

2. This material was produced under grant number 46C5-HT16 from the Occupational Safety and Health Administration, U.S. Department of Labor. It does not necessarily reflect the views or policies of the U.S. Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Operating Engineers National Hazmat Program

3. UNDERSTANDING THE RISKS Operating Engineers National Hazmat Program

4. TERMS USED IN EPIDEMIOLOGY • Epidemiology - The evaluation of the causes, occurrence, distribution, and control of disease. • Infection - The presence and multiplication of infectious microorganisms in a host’s tissue. Operating Engineers National Hazmat Program

5. TERMS USED IN EPIDEMIOLOGY • Sub-Clinical Infection - When the reaction between an infecting agent and host is so limited that the diagnosis of infection can only be established by laboratory or other testing. • Carrier - A person infected with a disease-causing microorganism who is free of clinical signs of the disease. Operating Engineers National Hazmat Program

6. WHAT ARE BLOODBORNE PATHOGENS? Microorganisms that can be present in human blood and other body fluids and can spread disease. Chiefly: • HIV, the virus that causes AIDS (acquired immuno-deficiency syndrome) • Hepatitis B Operating Engineers National Hazmat Program

7. HOW ARE WORKERS EXPOSED? • While giving first aid • By handling infectious waste or other contaminated material Operating Engineers National Hazmat Program

8. HIV • Human Immuno-deficiency Virus • Attacks body’s immune system and causes AIDS • The HIV virus is fragile, and does not live long outside the human body • Since symptoms may not develop for as many as 10 years, you do not know who may be infected with HIV Operating Engineers National Hazmat Program

9. AIDS • About 220,000 Americans have AIDS • Up to 897,000 Americans are HIV-positive • AIDS is spread most often by male-to-male sexual contact and IV drug use Operating Engineers National Hazmat Program

10. INITIAL SYMPTOMS OF AIDS • Only 50% have symptoms at initial infection • Mononucleosis-like • Constant fatigue • White spots or unusual blemishes in the mouth • Unexplained weight loss Operating Engineers National Hazmat Program

11. HBV • Hepatitis B Virus • Starts as “inflammation of the liver,” can cause • severe liver damage • liver cancer • death Operating Engineers National Hazmat Program

12. SYMPTOMS OF HEPATITIS B • Flu-like • Fatigue and weakness • Diarrhea and vomiting • Fever • Jaundice • Loss of appetite Operating Engineers National Hazmat Program

13. HEPATITIS B IN THE U.S. • 1 to 1.25 million are carriers • 80% of these are unaware of their infectious status • 140,000 to 320,000 infections/year • 5,000-6,000 deaths/year Operating Engineers National Hazmat Program

14. TREATMENT OF HEPATITIS B • There is no specific treatment • Bed rest may be required • Hospitalization may be needed for severe vomiting • Alcohol must be avoided; a low-fat diet is recommended Operating Engineers National Hazmat Program

15. HEPATITIS B CARRIERS • Most people who are infected with HBV get well, but some develop chronic (long-term) hepatitis • They have vague symptoms • You can not tell who might be a hepatitis B carrier Operating Engineers National Hazmat Program

16. THE HBV VIRUS IS TOUGH • It can live outside the body on contaminated needles and other infectious waste • You can get hepatitis B from dried blood Operating Engineers National Hazmat Program

17. THE HBV VIRUS IS TOUGH • You can get hepatitis B by touching a contaminated object and then your eyes, nose, or mouth Operating Engineers National Hazmat Program

18. HIV AND HBV • Both can be found in any body fluid that is contaminated with blood • Can enter the body through mucous membranes (eyes, mouth, nose) or lacerated/punctured skin. Operating Engineers National Hazmat Program

19. PARENTERAL TRANSMISSION • Occurs when skin or mucous membranes are pierced by: • puncture wounds • human bites • abrasions • This is a risk to maintenance workers when machinery has been used in landfills Operating Engineers National Hazmat Program

20. TAKING HOME HBV AND HIV • Both can be transmitted sexually • Both can be passed to their babies by pregnant women • When you protect yourself, you also protect the people you care about Operating Engineers National Hazmat Program

21. VACCINATION AGAINST HBV • The vaccine is safe • Almost everyone can be vaccinated • Vaccination is recommended for anyone who is at increased risk Operating Engineers National Hazmat Program

22. RESPONSIBILITIES OF EMPLOYERS 29 CFR 1910.1030 explains the employer’s responsibilities to protect employees: Operating Engineers National Hazmat Program

23. EXPOSURE CONTROL PLAN • Describes employees at risk • Methods of eliminating or reducing exposure • How employer will handle exposure incidents Operating Engineers National Hazmat Program

24. REQUIRE UNIVERSAL PRECAUTIONS • Approach to infection control • All human blood and some body fluids are treated as if known to be infectious Operating Engineers National Hazmat Program

25. BODY FLUIDS REQUIRING UNIVERSAL PRECAUTIONS • Blood • Semen and vaginal fluids (including menstrual blood) • Amniotic (pregnancy) fluid, cerebrospinal (brain and backbone) fluid, synovial (joint) fluid, pleural (chest) fluid, peritoneal (abdominal) fluid, pericardial (heart) fluid Operating Engineers National Hazmat Program

26. Feces Nasal secretions Saliva Sputum Sweat Tears Urine Vomit BODY FLUIDS NOT REQUIRING UNIVERSAL PRECAUTIONS Unless visibly containing blood: Operating Engineers National Hazmat Program

27. UTILIZE ENGINEERING & WORK PRACTICE CONTROLS • Hand washing • Use of resuscitation devices for mouth-to-mouth breathing • Cover broken skin • Good housekeeping Operating Engineers National Hazmat Program

28. PROVIDE SUITABLE PERSONAL PROTECTIVE EQUIPMENT • When appropriate, employers must provide: • Gloves • Masks and eye protection • Gowns, aprons, and other PPE Operating Engineers National Hazmat Program

29. MAKE HEPATITIS B VACCINATIONS AVAILABLE • Vaccination must be offered to at-risk employees at no charge • Employees may decline to be vaccinated; however, they must be offered free vaccination if they change their minds Operating Engineers National Hazmat Program

30. OFFER POST-EXPOSURE EVALUATION • Employees may be tested and vaccinated after an exposure • A health care professional must provide a written evaluation and treatment plan Operating Engineers National Hazmat Program

31. COMMUNICATE HAZARDS TO EMPLOYEES • Warning labels must be displayed on hazardous materials. • Red bags or containers may substitute for labels Operating Engineers National Hazmat Program

32. COMMUNICATE HAZARDS TO EMPLOYEES • Initial training must be offered to employees when they are assigned to jobs that involve a risk of bloodborne pathogens • Follow-up training must be given annually Operating Engineers National Hazmat Program

33. This material was produced under grant number 46C5-HT16 from the Occupational Safety and Health Administration, U.S. Department of Labor. It does not necessarily reflect the views or policies of the U.S. Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Operating Engineers National Hazmat Program

34. End • This publication was made possible by grant numbers 5 U45 ES06182-13 AND 5 U45 ES09763-13 from the National Institute of Environmental Health Sciences (NIEHS), NIH. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIEHS, NIH. Operating Engineers National Hazmat Program