Introduction Exposure to blood and other potentially infectious materials is a major concern to educational institutions and their employees, particularly for those who respond to medical incidents.
Introduction • Bloodborne pathogens are microorganisms such as viruses or bacteria that are carried in blood and can cause disease in people • Malaria • Syphilis • Brucellosis • Hepatitis B (HBV) • Hepatitis C (HCV) • Human Immunodeficiency Virus (HIV)
Bloodborne Diseases - Hepatitis B and Hepatitis C • Hepatitis B (HBV) is a virus that causes: • Inflammation of the liver. • Can cause liver cell damage leading to cirrhosis and cancer • HBV infection can cause illness ranging from: • mild (tiredness and flu-like symptoms), • severe (severe abdominal symptoms, fever, yellow skin, dark urine, muscle aches and rash), • to no symptoms at all. Symptoms can occur 1 to 6 months after infection. HBV infection can cause chronic liver disease.
Bloodborne Diseases - Hepatitis B and Hepatitis C • Carriers and people with HBV illness can spread the disease to other people. HBV is transmitted: • By blood, semen, or vaginal secretions during sexual contact • Through sharing contaminated needles • Through transfusion of infected blood and accidental needle sticks
Bloodborne Diseases - Hepatitis B and Hepatitis C Through sharing contaminated instruments used for tattooing, ear piercing, or personal items like razors or toothbrushes Through spills of blood or wound drainage in the eyes or mouth or broken skin From an infected mother to her child during birth and/or during breast-feeding
Hepatitis C HCV is also a virus that causes inflammation of the liver. The virus can cause liver cell damage, leading to cirrhosis and cancer. The symptoms of HCV infection are the same as those for HBV Contact with infected blood is the most common method of transmission.
Bloodborne Diseases - HIV The Human Immunodeficiency Virus (HIV) can cause the illness known as AIDS (Acquired Immune Deficiency Syndrome) AIDS can develop as long as 7 to 10 years after a person has become infected with HIV.
Bloodborne Diseases - HIV May carry the virus without developing symptoms for several years Will eventually develop AIDS May suffer from flu-like symptoms, fever, diarrhea, and fatigue May develop AIDS-related illnesses including neurological problems, cancer, and other opportunistic infections
Bloodborne Diseases - HIV • HIV virus is transmitted by sexual or blood contact with HIV infected persons in these ways: • By blood, semen, or vaginal secretions during sexual contact • Through sharing contaminated needles • Through transfusion of infected blood (rarely occurs today) • From an infected mother to her child during birth and/or during breast-feeding
Bloodborne Diseases - HIV • Research has shown that HIV is not transmitted through nonsexual or non-blood contact • HIV is easily washed away with soap and water and killed by ordinary household bleach • Research has also shown that you cannot catch HIV • From touching HIV-infected people or eating food prepared by HIV-infected people • From mosquito bites, toilet seats, drinking fountains or swimming pools • By giving (donating) blood
Bloodborne Pathogens Modes of Transmission
Modes of Transmission • Bloodborne pathogens such as HBV, HCV, and HIV can be transmitted • An accidental injury by a sharp object contaminated with blood or other infectious material. A sharp is basically anything that can pierce or puncture the skin and includes things like needles, knives, razor blades, broken glass, scalpels, scissors.
Modes of Transmission Getting blood or other infectious material in open cuts, nicks, and skin abrasions Getting blood or other infectious material in the eyes, nose, or mouth Indirect transmission can occur by touching a contaminated object or surface and then transferring the infectious material to your mouth, eyes, nose, or open skin.
Modes of Transmission • Anytime there is a blood-to-blood contact with infected blood or body fluids, there is a potential for transmission • providing first aid to a student in the classroom • picking up broken glass • handling needles • or cleaning up blood from a spill.
Modes of Transmission • Unbroken skin forms an impervious barrier against bloodborne pathogens • infected blood can enter your system through: • Open sores • Cuts • Abrasions • Acne • Any sort of damaged or broken skin such as sunburn or blisters
Work Practices & Engineering Controls ''Universal Precautions'' Prevention Strategy Treat all potentially infectious material treated as if it is infectious
Personal Protective Equipment • To protect yourself, it is essential to have a barrier between you and the potentially infectious material. • Always wear personal protective equipment in an exposure situation • Remove PPE that is torn or punctured, or has lost its ability to function as a barrier to bloodborne pathogens
Personal Protective Equipment Replace PPE that is torn or punctured Remove PPE before leaving the work area
Gloves Gloves should be made of latex, nitrile, rubber, or other impervious material. Double gloving can provide an additional layer of protection If you know you have cuts or sores on your hands, you should cover these with a bandage
Gloves You should always inspect your gloves for tears or punctures before putting them on. If a glove is damaged, don’t use it!
Hygiene Practices Hand washing is one of the most important (and easiest) practices used to prevent transmission of bloodborne pathogens. Use soft, antibacterial soap Avoid harsh, abrasive soaps, as these may open fragile scabs or other sores. Hands should be washed immediately (or as soon as feasible) after removal of gloves or other personal protective equipment
Hygiene Practices • If you are working in an area where there is reasonable likelihood of exposure, you should never: • Eat • Drink • Smoke • Apply cosmetics or lip balm • Handle contact lenses
Decontamination and Sterilization • Decontamination should be accomplished by using: • A solution of 5.25% sodium hypochlorite (household bleach / Clorox) diluted between 1:10 and 1:100 with water. The standard recommendation is to use at least a quarter cup of bleach per one gallon of water.
Decontamination and Sterilization Lysol or some other EPA-registered disinfectant. Check the label of all disinfectants to make sure they meet this requirement. If a product is registered as a disinfectant/sanitizer it will have an EPA number on the product label.
Decontamination and Sterilization If you are cleaning up a spill of blood, you can carefully cover the spill with paper towels or rags, then gently pour the 10% solution of bleach over the towels or rags, and leave it for at least 10 minutes This will help ensure that any pathogens are killed before you actually begin cleaning or wiping up the material.
Decontamination and Sterilization Any materials you use to clean up a spill of blood or potentially infectious materials must be decontaminated immediately This would include mops, sponges, re-usable gloves, buckets, pails, etc.
Sharps Needles Broken Glassware
Needles Needles must be disposed of in approved sharps containers. Needles should never be replaced. Needles should be moved only by using a mechanical device or tool such as forceps, pliers, or broom and dustpan. Never break or shear needles
Needles Needles shall be disposed of in labeled sharps containers only. Sharps containers shall be closable, puncture-resistant, leak-proof on sides and bottom, and must be labeled or color-coded.
Needles When sharps containers are being moved from the area of use, the containers should be closed immediately before removal or replacement to prevent spillage or protrusion of contents during handling or transport.
Broken Glassware Broken Glassware should not be picked up directly with the hands. Sweep or brush the material into a dustpan. Uncontaminated broken glassware may be disposed of in a closable, puncture resistant container such as a cardboard box or a coffee can.
Signs, Labels & Color Coding • Labels should display the universal biohazard symbol should be displayed for: • Regulated waste • Any liquid or semi-liquid blood or other potentially infectious materials • Contaminated items that would release blood or other potentially infectious materials in a liquid or semi liquid state if compressed
Regulated waste • Regulated waste • Items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling • Contaminated sharps • Pathological and microbiological wastes containing blood or other potentially infectious materials
Non-regulated waste anything that does not fit the above definition for regulated waste It is considered non-regulated and is therefore treated as routine trash (with a few extra precautions). Most waste that is generated in school districts is considered non-regulated waste
Non-regulated waste Non-regulated waste includes items such as towels or rags used to clean up a blood spill, items used to provide first aid such as gauze or bandages, mop heads, and trash from restrooms Red biohazards bags should not be used for non-regulated waste
Exposure Incidents • If an exposure incident does occur, you should report it to your supervisor immediately • Document the route(s) of exposure and the circumstances under which the exposure incident occurred. • Identify and document the source individual unless such documentation is impossible or prohibited by law.
Exposure Incidents Test the source individual’s blood for HBV, HCV and HIV as soon as possible after consent is obtained. If the source individual is known to be positive for HBV, HCV or HIV, testing for that virus need not be done.
Exposure Incidents Collect your blood as soon feasible Test it after your consent is obtained. If you consent to baseline blood collection, but do not give consent at that time for HIV serological testing, your blood sample will be kept for at least 90 days. If, within 90 days of the incident, you decide to consent to have the baseline sample tested, such testing shall be done as soon as possible, and at no cost to you.
Exposure Incidents Administer post exposure medical care including medications, when medically indicated, as recommended by the US Public Health Service. Provide counseling. Evaluate reported illnesses
Hepatitis B Vaccinations Anyone who is determined to have “occupation exposure” to blood or other potential infectious materials shall be offered the Hepatitis B vaccine series at no cost unless: They have previously received the vaccine series Antibody testing has revealed they are immune The vaccine is not recommended for medical reasons
Hepatitis B Vaccinations • Occupational exposure • reasonably anticipated skin, eye, mucous membrane, or parenteral (skin piercing) contact with blood • or other potentially infectious material that may result from the performance of an employee’s duties
Hepatitis B Vaccinations your employer must offer the vaccine to you, you do not have to accept that offer if you decline the initial offer, you may choose to receive the series at anytime during your employment thereafter
Hepatitis B Vaccinations The Hepatitis B vaccination is given in a series of three shots. The second shot is given one month after the first The third shot follows five months after the second.
Conclusion Conducting your job and helping others should not be something that puts your health at risk. Taking the right precautions to prevent exposure to blood will help keep you, and others, safe and healthy.