Blood Borne Pathogens:

1
Blood Borne Pathogens

• Are you prepared?

2
What is a Blood Borne Pathogen?

• Any organism (bacteria, virus, etc..) that can
  cause disease is a pathogen. Blood-borne
  pathogens are those found in blood itself as well
  as on blood-soiled bandages, needles and other
  items that contain blood.

3
What is a Blood Borne Pathogen?

• Any organism (bacteria, virus, etc..) that can
  cause disease is a pathogen. Blood-borne
  pathogens are those found in blood itself as well
  as on blood-soiled bandages, needles and other
  items that contain blood.
• Includes, but is not limited to, HBV and HIV.

4
Well, why do I care?

• OHSA Standard CFR 1910.1030
• Civil Liability
• Workers Compensation
• Responsible Behavior

5
Well, why do I care?

• OHSA Standard CFR 1910.1030
• Designed to help limit/prevent occupational
  exposure, and provide consistent methods for
  employers to mitigate risks of employees
• Also provides for recordkeeping and training
  requirements
• Standard also addresses other potentially
  infectious materials ie other bodily fluids

6
Well, why do I care?

• OHSA Standard CFR 1910.1030
• Currently only a general industry standard by
  letter of interpretation, but
• May possibly be cited under General Duties Clause
• Might also apply to employees that have
  designated job duties for example, someone who
  is a designated medical First Responder on a
  jobsite.

7
Well, why do I care?

• Civil Liability
• An employer may be held liable in a civil action
• If there is a reasonable potential of
  occupational exposure but no steps to prevent or
  reduce risk, full liability can be assigned
• Even if no liability is assigned, can be VERY
  expensive to fight

8
Well, why do I care?

• Workers Compensation
• May be an allowable claim, even if no disease
  transmission occurred
• Cannot force transmitter to reveal disease status

9
Well, why do I care?

• Responsible Behavior
• If a known risk, employees worry less if
  safeguards are in place
• Doing the right thing isnt a bad idea in itself

10
So what am I supposed to be worried about?

• Pathogen a disease causing organism that enter
  the body. Basically, it is a GERM.
• Ones we are usually most concerned with are
  Hepatitis B, Hepatitis C, HIV
• May also need to be concerned with other common
  diseases and other modes of transmission

11
So what am I supposed to be worried about?

• Hepatitis B
• Liver infection caused by Hep B virus (HBV)
• Symptoms include anorexia ,fever, jaundice ,
  nausea vomiting but may take up to 6 months to
  appear
• Can be treated in some cases, but vaccination
  becomes very important

12
So what am I supposed to be worried about?

• Hepatitis C
• Liver infection caused by Hep C virus (HCV)
• Most common chronic bloodborne infection in the
  USA
• Leading cause of Liver transplants
• No treatment/no vaccine

13
So what am I supposed to be worried about?

• Human Immunodeficiency Virus (HIV)
• The virus that causes AIDS
• Results in a weakened immune system
• May have multiple opportunistic infections eg
  pneumonia, tuberculosis, cancers
• No vaccine/ multiple treatments, no cure

14
How Pathogens are spread

• Four conditions must be met
• Pathogen must be present
• Enough of the pathogen to cause the disease
• Pathogen must pass though the correct entry site
• Person is susceptible to the pathogen

15
Type of contact

• Direct Contact
• When infected blood or body fluid from one person
  enters another persons body at correct site
• Examples blood in cut, splashed in eye
• Most OJT exposures

• Indirect contact
• When a person touches an object that contains
  blood or another body fluid of an infected
  person, and the blood/fluid enters through a
  correct site
• Example cleaning up bandages and blood on
  bandage goes into a cut.

16
Type of contact

• Direct Contact
• Hepatitis B (as much as 30)
• Hepatitis C (about 2)
• HIV (about 1)

• Indirect contact
• Hepatitis B
• Hepatitis C
• HIV possible, but very unlikely

17
Type of contact

• May also have to worry about airborne
  (breathable, like tuberculosis) or vector borne
  (injectable, like lyme disease), but not usually
  a concern under blood borne pathogens rules

18
Types of contact

• Moral of the story
• If its wet and not yours, dont touch it!

19
OK, so now what do I do?

• Develop an exposure control plan!

20
According to the OSHA standard, an exposure
control plan should have 3 elements

• Exposure Determination
• Implementation
• Evaluating post-exposure

21
Exposure Determination

• Identify in writing the jobs and/or job duties in
  which exposure to blood and other bodily fluids
  can occur, regardless of the availability and use
  of PPE

22
POP QUIZHow many bodily fluids can you name?

• Blood
• Semen
• Saliva
• Tears
• Vomit
• Cerebrospinal fluid
• Vaginal secretions
• Amniotic fluid

• Sweat
• Nasal mucus
• Feces
• Urine
• Sputum
• Bile
• Breast milk
• And the list goes on.

23
Implementation precautions

• Personal Hygiene
• Hand washing is the 1 to prevent disease
  transmission
• Use warm water and scrub for at LEAST 20 seconds
  (2 verses of old McDonald or Happy Birthday)
• Use a utility or bathroom sink, not food prep
• Prevent chapping, use moisturizer after
• Use alcohol based cleansers if water not
  available
• Keep fingernails short

24
Implementation precautions

• Personal Protective Equipment
• Universal Precautions
• Use barriers
• Gloves
• Gowns
• Masks/shields
• Eyewear
• Breathing barriers

25
Implementation precautions

• Personal Protective Equipment
• Glove Practice

26
Implementation precautions

• Engineering and work practice controls
• What kinds of things can you do (or buy) that
  will limit the exposure risks of employees?

27
Implementation precautions

• Engineering controls
• Sharps disposal
• Biohazard bags
• Self-sheathing needles

• Work practice controls
• Having puncture resistant containers available
  for razor blades at point-of-use
• Disinfecting contaminated work areas as quickly
  as possible

28
Implementation signage

• Biohazard labels are required on any container
  holding contaminated materials
• Posted at work area entrances
• red-orange/orange (contrasting lettering)

29
Implementation spill cleanup

• CONTAINMENT!!!
• Using appropriate PPE, use commercial products,
  paper towels, or the like to absorb spill
• Do NOT use hands to pick up glass, needles, or
  other sharp objects
• Dispose of contaminated material in labeled
  container or bag
• Flood area with disinfectant (can be ¼ cup bleach
  per gallon of water) for at least 10 minutes
• Use appropriate material to clean up disinfectant
  and dispose of like other contaminated material

30
Hey, how do I get rid of the stuff?

• Best practice make arrangements with your
  Occupational Medicine provider or local hospital
  for incineration/disposal.

31
Implementation training

• Need to provide regular training to employees who
  are identified as working in risk-based job
  duties
• Initial training
• Annually
• Specialized training for lab workers or
  production facility

32
Implementation Immunizations

• The OSHA standard requires offering the HBV
  vaccine 3 injection series to all employees who
  are exposed to blood or other potentially
  infectious materials as part of job duties.
• Offered within 10 days of job assignment
• Also offered immediately after exposure if
  previously declined, unanticipated exposure, or
  otherwise not yet done

33
Implementation Immunizations

• Employee may decline with specific language
• DECLINATION OF HEPATITIS B VACCINE
• I understand that due to my occupational
  exposure to blood or other potentially infectious
  materials I may be at risk of acquiring hepatitis
  B virus (HBV) infection. I have been given the
  opportunity to be vaccinated with hepatitis B
  vaccine, at no charge to myself. However, I
  decline hepatitis B vaccination at this time. I
  understand that by declining this vaccine, I
  continue to be at risk of acquiring hepatitis B,
  a serious disease. If in the future I continue to
  have occupational exposure to blood or other
  potentially infectious materials and I want to be
  vaccinated with hepatitis B vaccine, I can
  receive the vaccination series at no charge to me.

34
UH-OH! We had an exposure incident!

• Emergency care
• Wash injuries, needlesticks, exposed skin with
  soap and water
• Flush nose and mouth with water if splashed
• Irrigate eyes with clean water, saline or sterile
  irrigants
• Get medical care/evaluation IMMEDIATELY!

35
UH-OH! We had an exposure incident!

• Emergency care
• Confidential Medical Evaluation and followup
• HBV vaccination if not previously done

36
UH-OH! We had an exposure incident!

• Recordkeeping
• Recorded on the 300 log as a privacy case
• Also keep a sharps injury log (unspecified
  format), including
• device involved (if known),
• location of the incident,
• description of the events that resulted in the
  injury

37
Employer Responsibilities summary

• Indentifying positions or tasks covered by the
  standard
• Creating an exposure control plan to minimize the
  possibility of exposure
• Must be easily accessible to employees
• Developing a plan for cleaning/decontaminating
  the workplace

38
Employer Responsibilities summary (continued)

• Creating a system for identifying and disposing
  of soiled/contaminated materials
• Conduct annual training for covered employees
• Offering HBV vaccine at no cost (and maintaining
  declinations
• Establishing procedures for reporting exposures

39
Employer Responsibilities summary (continued)

• Creating a system of recordkeeping
• OSHA 300 log privacy case
• Sharps Injury Log
• Type/brand of device
• Location of incident
• Description of incident
• Protects privacy/ confidentiality of employees

40
Hey, this is really exciting stuff!

• Where can I find out more?

41
Resources Online

• http//hazmap.nlm.nih.gov/
• Occupational Exposure to Hazardous Agents
  searchable database
• Searchable by
• Hazardous Agents
• Occupational Diseases
• High Risk Jobs

42
Resources Online

• http//www.cdc.gov/niosh/topics/bbp
• CDC resource site
• For both preplanning and emergency management

43
Resources Online

• www.redcross.org
• Locate Preventing Disease Transmission training
• Offered by ARC of GC regularly
• 614-251-1444
• Books /kits available

44
Resources Online

• http//www.osha.gov/OshDoc/data_BloodborneFacts/
• Lists Facts sheets for complying with the
  standard
• Standard and interpretations on website

45
Resourcesme

• Can do my best to answer Questions
• Office 614-276-5273
• Cell 614-402-9017
• lmitchell_at_strawserpaving.com