BBP Training

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BBP Training

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Title: BBP Training

1
UWSP Bloodborne Pathogens Training
2
EHS Officer

Environmental Health and Safety Officer
University of Wisconsin - Stevens Point
101 George Stien Building
Stevens Point, WI 54481
(715) 346-2320
(715) 346-3780 (fax)
dbartosh_at_uwsp.edu
www.uwsp.edu/ehs

3
Introduction

BLOODBORNE PATHOGENS AWARENESS
Bacteria that cause disease are called
pathogens.
Bloodborne pathogens are pathogenic
microorganisms such as viruses or bacteria that
are carried in blood and can cause disease in
people. Types of Bloodborne Pathogens include
Malaria
Hepatitis B (HBV)
Hepatitis C (HCV)
HIV
OSHAs Bloodborne Pathogens standard prescribes
safeguards to protect workers against the health
hazards from exposure to blood and other
potentially infectious materials, and to reduce
their risk from this exposure

4
Who is covered by the OSHA Bloodborne Pathogen
Standard?

All employees who could be reasonably
anticipated as the result of performing their
job duties to face contact with blood and other
potentially infectious materials -
Medical, housekeeping/laundry, lab, bloodbank,
emergency, medical waste, etc.
Good Samaritan acts such as assisting a
co-worker with a nosebleed would not be
considered occupational exposure

5
UWSP BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN

Outlines specific procedures for UWSP.
See http//www.uwsp.edu/ehs/policydownloads/expco
n.doc

6
What is Regulated Material?

Human Blood , human blood components, and
products made from human blood.
OPIM (Other Potentially Infectious Materials)
saliva in dental procedures, semen, vaginal
secretion, internal body fluids (I.e.spinal,
synovial,etc) other external body fluids visibly
contaminated with blood along with all body
fluids in situations where it is difficult or
impossible to differentiate between body fluids

Other
unfixed human tissues or organs (other than
intact skin) HIV-containing cell or tissue
cultures, organ cultures, and HIV- or HBV-
containing culture media or other solutions and
blood, organs, or other tissues from experimental
animals infected with HIV or HBV.

7
/Saliva
8
BBP TRANSMISSION

BBP most commonly transmitted through
Sexual Contact
Sharing of needles
From mothers to their babies at/before birth
Accidental puncture from contaminated needles,
broken glass, or other sharps
Contact between broken or damaged skin and
infected body fluids
Contact between mucous membranes and infected
body fluids

9
How does exposure occur?

Occupational Transmission of Bloodborne
Pathogens
Anytime there is blood-to-blood contact with
infected blood or body fluids, there is a
potential for transmission. Unbroken skin forms
a generally good barrier against bloodborne
pathogens. However, infected blood can enter your
system through open sores, cuts, abrasions, acne,
burns, and open blisters.
Most common occupational exposure needlesticks
Cuts from other contaminated sharps (scalpels,
broken glass, etc.)
Contact of mucous membranes (for example, the
eye, nose, mouth) or broken (cut or abraded) skin
with contaminated blood.

10
HEPATITIS B (HBV)

Hepatitis B (HBV) Disease caused by a virus that
attacks the liver. Can cause lifelong infection,
cirrhosis (scarring) of the liver, liver cancer,
liver failure, and death. Acute Chronic Cases.
Most serious.
Signs Symptoms Jaundice, fatigue, abdominal
pain, loss of appetite, nausea, vomiting, joint
pain, flu.
Transmission Occurs when blood or body fluids
from an infected person enters the body of a
person who is not immune. Can be treated to
overcome infection. More infectious than HIV.
Prevention Hepatitis B vaccine Universal
precautions.
NOTE Number of new infections per year has
declined from an average of 260,000 in the 1980s
to about 79,000 in 1999.

11
HEPATITIS C (HCV)

Hepatitis C Causes chronic liver disease. Deaths
lt3.
Signs Symptoms Jaundice, fatigue, abdominal
pain, loss of appetite, nausea, dark urine.
Transmission Occurs when blood or body fluids
from an infected person enters the body of a
person who is not infected. Transfusions /
Injection (prior to pre blood testing). NOTE
Most infections are due to illegal injection drug
use.
Prevention No vaccine available. Use universal
precautions. Post exposure medical care.

12
HEPATITIS A (HAV)

Hepatitis A is a liver disease caused by the
hepatitis A virus. Hepatitis A can affect anyone.
Signs Symptoms Jaundice, fatigue, abdominal
pain, loss of appetite, nausea, diarrhea, fever.
Transmission HAV is usually spread from person
to person by putting something in the mouth (even
though it may look clean) that has been
contaminated with the stool of a person with
hepatitis A.
Prevention Always wash your hands with soap and
water after using the bathroom, changing a
diaper, before preparing and eating food. Good
personal hygiene and proper sanitation.
Hepatitis A vaccine.

13
HIV/AIDS

What is HIV and how can I get it? HIV - the human
immuno deficiency virus - virus that kills bodys
"CD4 cells." CD4 cells (T-helper cells) help body
fight infection disease.
What is AIDS - the acquired immunodeficiency
syndrome - is a disease where HIV destroys bodys
immune system. Deadly No Cure.
HIV is found in varying concentrations or amounts
in blood, semen, vaginal fluid, breast milk,
spinal, synovial, saliva, sweat and tears, other
bodily fluids.

14
HIV/AIDS

Signs Symptoms The only way to determine
infection is to test. Many people infected with
HIV do not have symptoms at all for many years.
The following may be warning signs of infection
with HIV rapid weight loss dry coughrecurring
fever or profuse night sweats profound and
unexplained fatigue swollen lymph glands in the
armpits, groin, or neck diarrhea gt week white
spots or unusual blemishes on the tongue, in the
mouth, or in the throat pneumonia red, brown,
pink, or purplish blotches on or under the skin
or inside the mouth, nose, or eyelids memory
loss, depression, and other neurological
disorders.
Do not assume infection. Each symptoms can be
related to other illnesses. Testing must be
accomplished.

15
HIV/AIDS

Transmission General Sexual contact with
infected individual sharing needles blood
transfusions mother to baby breast feeding.
Occupational Transmission Needle Sticks/Sharps,
Infected blood/fluid into open cut or a mucous
membrane (for example, the eyes or inside of the
nose).
Only one case of doctor to patient.
No additional routes of transmission have been
recorded.

16
HIV/AIDS

You cannot get HIV
By working with or being around someone who has
HIV.
From sweat, spit, tears, clothes, drinking
fountains, phones, toilet seats, or through
everyday things like sharing a meal.
From insect bites or stings.
From donating blood properly.
From a closed-mouth kiss (but there is a very
small chance of getting it from open-mouthed
kissing with an infected person because of
possible blood contact).

17
HIV/AIDS

PREVENTION
Personal abstinence, safe sex, dont shoot
drugs, needle/razor safety, dont share other
personal hygiene items, tattoo/body piercing,
pregnancy issues.
Occupational Follow Universal Precautions
Proper Work Practices. See slide 23.

18
TUBERCULOSIS (TB) NOT A BBP

TB is a disease caused by bacteria that can
attack any part of your body, but usually attack
lungs. TB disease once leading cause of death in
the U.S.
TB, can be fatal if not treated. However, several
antibiotics are available that are very
effective.
NOTE TB is not a bloodborne pathogen, but we
would like to discuss it in todays session.

19
TB Types

Latent TB Breathe in TB bacteria and become
infected, but able to fight bacteria and stop
growth. The bacteria become inactive, but remain
alive and can become active later. Many latent TB
infections never develop into disease. But in
other people, especially with weak immune
systems, bacteria become active and cause TB
disease.
TB Disease Active bacteria - the body is not
able to fight and the individual becomes sick.

20
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21
TB - Transmission

Transmission spread through air from person to
person when the bacteria is aerosolized by
someone with TB disease. When a person breathes
in TB bacteria, the bacteria can settle in the
lungs and grow. From there, can move through the
blood to other body parts, such as kidney, spine,
and brain. TB in the lungs or throat can be
infectious. TB in other parts of the body, such
as the kidney or spine, usually not infectious.
Cannot get TB from touching someones clothes,
drinking glass, handshake, or toilet.
Most likely to spread it to people they spend
time with every day and are in close contact.

22
TB Prevention

Prevention Testing, Medical Treatment,
Isolation, Notification, Medical Clearance.
TB patients are no longer considered infectious
if they 1) are on adequate therapy 2) had
favorable clinical response to therapy and 3)
have three consecutive negative test results.

23
BBP Universal Precautions / Work Practices

Treat all human blood and Other Potentially
Infectious Materials as if they are infectious
Observed in all situations where there is a
potential for contact with blood or other
potentially infectious materials
To protect yourself, it is essential to have a
barrier between you and the potentially
infectious material.
PPE and BBP Containers (i.e. Sharps containers).
Report any suspected exposure to your Supervisor
and/or Employee Health Services.

24
Personal Protective Equipment

Specialized clothing or equipment worn by an
employee for protection against infectious
materials in all possible exposure situation.
Gloves, masks, eye protection, coveralls, face
shield, mouthpiece, etc. Ensure Readily
Available!
Must be properly cleaned, laundered, repaired,
and disposed of.
Must be removed when leaving area or upon
contamination asap.

25
Specific Universal Precautions

Gloves must be worn during contact with blood or
other body fluids that could possibly contain
visible blood, such as urine, feces, or vomit.
Inspect, Replace, Do not Reuse, Remove
Properly.Wash Hands.
Safety glasses, goggles, face shields, masks, and
other barriers if risk of splash, spray, or
vaporization.
Cuts, sores, or breaks on both the care givers
and patients exposed skin should be completely
covered with bandages or other barriers.

26
Specific Universal Precautions

Hands and other parts of the body should be
washed immediately after contact with blood or
other body fluids, and surfaces soiled with blood
should be disinfected appropriately.
Practices that increase the likelihood of blood
contact, such as sharing of razors and
toothbrushes, should be prevented.
Needles and other sharp instruments should be
used only when medically necessary. More.

27
NEEDLES/SHARPS

Handle with extreme care!
Needles, broken glass, razors, or other sharp
objects must be disposed of in labeled sharp
containers.
Needles should never be recapped.
Needles/Sharps should be moved by using a
mechanical device or tool such as forceps,
pliers, or broom and dust pan NOT BY HAND.
Never break or shear needles.
Broken glassware that has been visibly
contaminated with blood must be sterilized with
an approved disinfectant solution before it is
disturbed or cleaned up.
Glassware that has been decontaminated may be
disposed of in an appropriate sharps container.
Uncontaminated broken glassware may be disposed
of in a closable, puncture resistant container
such as a coffee can.

28
Work Practice Controls
Examples

PPE!!!
Proper Housekeeping Decontaminated.
Wash hands after removing gloves and as soon as
possible after task or exposure.
Do not bend or break sharps.
Place sharps in containers ASAP.
Do not eat, drink, smoke, apply cosmetics, or
handle contacts in any potential exposure area.
Prevent splashing, spraying, or aerosolizing
bodily fluids.
Safer medical devices
Needle less systems
Sharps with engineered protections

29
Hand Washing

Use warm running water and nonabrasive soap.
Premoisten towels / lotions should not take the
place of hand washing.
Wet the hands apply liquid soap to hands.
Rub hands together vigorously for at least 15
seconds. Be sure to scrub between fingers, under
fingernails, and around the tops and palms of the
hands, and up to wrist or other affected areas.
Rinse hands under warm running water. Leave the
water running while drying hands.
Dry hands with clean, disposable (or single use)
towel, avoid touching the faucet handles or towel
holder with clean hands.
Turn the faucet off using the towel as a barrier
between your hands and the faucet handle.
Discard the used towel.
Consider using hand lotion to prevent chapping of
hands.
Assist children as needed.
Wash hands frequently before and after tasks,
eating, drinking, applying makeup, washroom,
contact, handling items, etc.

30
Clean Up Small Spills

Bloodborne pathogens biohazard kits are available
to clean small amounts of bodily fluids. The
kits are available from Central Stores (item
8102104, 8.40). Contain items to protect
responders such as gloves, protective clothing,
and disinfectants.
A solution of household bleach (Clorox) diluted
between 110 and 120 with water.
Other Check the label of all disinfectants to
make sure they meet EPA disinfection requirement.
Entire area must be cleaned (including any
affected equipment).
Use proper PPE.
Proper tools to clean up sharps (tongs, dustpan,
puncture resistant gloves, etc).

31
Clean Up

All regulated waste must be disposed in the
proper biohazard waste "stream".
All regulated waste must be disposed in properly
labeled containers or red biohazard bags, sealed,
and stored correctly.
Large spills beyond supplies or ability require
contacting Protective Services at 3456 (custodial
services).
EHS for waste pickup at extension 2320.

32
What is Regulated Waste?

The Bloodborne Pathogens Standard defines
(1) liquid or semi-liquid blood or OPIM
(2) items contaminated with blood or OPIM and
which would release these substances in a liquid
or semi-liquid state if compressed
(3) items that are caked with dried blood or OPIM
and are capable of releasing these materials
during handling
(4) contaminated sharps and
(5) pathological and microbiological wastes
containing blood or OPIM.

33
Regulated Waste

Must be placed in closeable, leak-proof
containers built to contain all contents during
handling, storing, transporting or shipping and
be appropriately labeled or color-coded.
Contact UWSP EHS at Extension 2320 or 4464 with
questions regarding Bloodborne Pathogens and for
waste pickup and disposal.

34
Laundry

Handle contaminated laundry as little as possible
and use PPE
Must be bagged or containerized at location where
used
No sorting or rinsing at location where used
Must be placed and transported in labeled or
color-coded containers
Contact EHS 2320 for details.

35
Biohazard Warning Labels

Warning labels required on
Containers of regulated waste
Refrigerators and freezers containing blood and
other potentially infectious materials
Other containers used to store, transport, or
ship blood or other potentially infectious
materials
Red bags or containers may be substituted for
labels if marked properly.

36
Hepatitis B Vaccination Requirements

Hepatitis B vaccine is an additional protective
measure offered to all employees who receive
occupational exposure.
Must make available to all employees at risk of
exposure
The vaccination must be performed by a licensed
healthcare professional
Declination form signed for those who do not wish
to have vaccination.

37
UWSP Hepatitis B Vaccination

The cost of the vaccination is the responsibility
of the employee's department. Cost for three
doses 108.00.
Vaccinations provided by the Portage County
Health Department, 817 Whiting Avenue, 345-5350.
Series of three.
Contact EHS at 2320 to coordinate vaccination
arrangements.

38
What to do if an exposure occurs?

Wash exposed area with soap and water. Use
non-abrasive, antibacterial soap
Flush splashes to nose, mouth, or skin with water
for minimum of 15 minutes.
Irrigate eyes with water or saline for 15
minutes.
Report the exposure to your Supervisor
Direct the worker to a healthcare professional
for immediate follow-up care. (i.e. post Hep. B
vaccine, HIV inhibitors).

39
Post-Exposure Follow-Up

Document routes of exposure and how exposure
occurred with accident investigation. For
work-related incidents, the exposed employee and
Supervisor must complete, (in 24 hrs)
Employees Work Injury and Illness Report
(UWS/OSLP-1Emp) "Employer's First Report of
Injury" form (WKC-12) and "Supervisor's Accident
Analysis and Prevention" form (UWS/OSLP-2). For
non-employees, complete the UWSP Accident Report
for Non Employees.
Also completed Determination of Exposure to
Blood/Body Fluids (WKC-8165). It should be
presented to the attending physician when seeking
medical assistance. Health care providers
equivalent form may be used in place of WKC-8165.
The evaluating physician should provide the
employee with a written opinion within 15 days
after completion of the evaluation. Contact your
supervisor or the Safety and Loss Control
Department, X2618, to obtain and assistance in
completing the forms.
If the attending physician determines that source
testing is warranted, he/she will contact the
source individual for consent. If consent is
obtained, the source individuals blood will be
tested and those results will, upon consent, be
made available to the exposed employee.
Provide risk counseling and offer post-exposure
protective treatment for disease when medically
indicated.
Provide written opinion of findings to employer
and copy to employee within 15 days of the
evaluation.
If the injury was from a contaminated sharp, it
must be entered into the sharps injury log.
Contact EHS at 2320 to complete.