Bloodborne Pathogens In the Workplace 29 CFR 1910'1030

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Bloodborne Pathogens In the Workplace 29 CFR
1910.1030
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Bloodborne Pathogens Standard

• 29 CFR 1910.1030, Occupational Exposure to
  Bloodborne Pathogens
• Published December 1991
• Effective March 1992
• Scope
• ALL occupational exposure to blood and other
  potentially infectious material (OPIM)

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Definition of Blood and Bloodborne Pathogens

• Blood human blood, human blood components
  products made from human blood.
• Bloodborne Pathogen Pathogenic organisms that
  are present in human blood can cause disease in
  humans.

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Where Are They Found?

• Bloodborne pathogens are transmitted through
  contact with infected human blood and other body
  fluids such as

• Semen
• Vaginal Secretions
• Pleural Fluid
• Cerebrospinal Fluid
• Synovial Fluid
• Amniotic Fluid
• Saliva in dental procedures

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What are Other Potentially Infectious Materials
(OPIM)?

• Any body fluid that is visibly contaminated with
  blood
• All body fluids in situations where it is
  difficult to differentiate between body fluids
• Any unfixed tissue/organ (other than intact skin)
  from a human
• HIV-containing cell or tissue cultures
• Blood, organs or other tissue from experimental
  animals infected with HBV

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Modes of Transmission

• Sticks with sharps
• Cuts breaks in the skin
• Eyes and mucous membranes

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Groups Affected by Standard

• Medical community
• Dental practitioners
• Emergency services personnel
• Law enforcement prison guards
• Cosmetologists barbers
• Funeral directors
• Educational facility personnel
• Industrial facility personnel

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Types of Bloodborne Pathogens Include

• Malaria
• Syphilis
• Hepatitis A, B, C, D, E
• Human Immunodeficiency Virus (HIV)
• Brucellosis
• Relapsing Fever
• Crutzfeldt-Jakob disease

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Hepatitis A

• Transmitted by
• Contaminated food or water which contains fecal
  matter
• There is a vaccine to prevent HAV

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Hepatitis B (HBV)

• Transmitted by
• injections transporting a virus bearing serum,
  most often during blood transfusions
• By contaminated needles and syringes

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HBV

• Is a virus that infects and inflames the liver
• Is transmitted primarily through blood to blood
  contact
• Can lead to serious conditions such as cirrhosis
  liver cancer
• Can survive in dried blood for up to seven days

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HBV - No Cure

• There is no CURE or specific treatment for HBV
• Many people develop antibodies to fight the
  disease which may prevent future infection

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HBV - Symptoms

• Mild flu-like symptoms
• Fatigue
• Possible stomach pain
• Loss of appetite
• Nausea
• Jaundice
• Darkened urine

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HBV - Vaccine

• Available to all exposed employees
• At no cost to employees
• At a reasonable time place
• By licensed health care provider

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HBV - Vaccine

• Availability
• After training is provided
• Within 10 working days of initial assignment
• No prescreen or prerequisites allowed
• Exceptions
• Previously received HBV vaccination series
• Antibody test shows immunity
• Administration is contraindicated

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HBV - Vaccine

• Series of three shots
• Second shot is given one month after first
• Third shot follows five months after the second
• This series gradually builds up the bodys
  immunity to HBV

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Hepatitis C

• Transmitted in blood or body fluids
• Currently, no vaccination exist for HCV

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Hepatitis D

• The latest form of hepatitis which is transmitted
  primarily through sexual contact

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Hepatitis E

• Transmitted in contaminated drinking water
• Currently no treatment exists for HEV

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Human Immunodeficiency Virus (HIV)

• Acquired immune deficiency syndrome, or AIDS, is
  caused by a virus call the human immunodeficiency
  virus, or HIV
• It may be many years before AIDS actually
  develops
• HIV attacks the bodys immune system, weakening
  it from fighting other diseases
• AIDS is a fatal disease and there is no known cure

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HIV Symptoms

• Symptoms of HIV infection can include
• Weakness
• Fever
• Sore Throat
• Nausea and Diarrhea
• Headaches
• White coating of the tongue
• Weight loss
• Swollen lymph glands

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Post-Exposure Management

• Document the exposure circumstances route of
  exposure
• When possible, identify the source individual
• If source agrees, test blood
• Document refusal of testing consent
• Inform employee of test results legal
  provisions for disclosure

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Collecting Serological Testing of Blood for HIV
HBV

• Exposed employees blood collected after
  receiving consent
• If consent not given for HIV
• Hold for 90 days
• Test if employee reconsiders

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Exposure Determination

• List of jobs where personnel are potentially
  exposed to BBPs
• List of tasks/procedures for potential exposure
• Make an exposure determination for each task
  without regard to the use of PPE

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Means of Minimizing Risk

• Exposure Control Plan
• Implement Controls
• Engineering
• Work Practices
• Personal Protective Equipment

• Housekeeping
• Hepatitis B Vaccine
• Container Labeling
• Employee Training

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Exposure Control Plan

• A written plan of action that describes effective
  barriers that can minimize the risks of blood
  borne diseases in the workplace

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Exposure Control Plan

• Accessible to all effected employees and
  available for OSHA if necessary
• Reviewed/updated annually and when
  procedures/processes are modified

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Implement Controls

• Sharps Containers
• Washing Facilities
• Waste Disposal Containers
• Autoclaves
• Biological Safety Cabinets
• Emergency Flushing equipment

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Schedule for Inspecting Controls

• Daily
• Weekly
• Monthly Annually

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Work Practices

• Use of protective equipment
• Use of sharps containers
• Sharps containers as close as practical
• Maintained upright
• Closed before moving
• Never allowed to become overfilled

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Work Practices

• No pipetting by mouth
• Refrigerators food vs biological
• Waste disposal receptacles
• Needles - Note No recapping by hand shearing
  is prohibited

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Work Practices (Cont)

• Clean spills promptly
• No handling of broken glass by hand
• Stay alert for cross-contamination
• Consider workplace layout human factors
• Minimize splashing, spraying, spattering of
  blood OPIM
• Prohibit eating drinking in work area

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Protective Equipment

• The best protection is to wear PPE
• emergency medical personnel, doctors, nurses,
  dentists, dental assistants, and other healthcare
  professionals always wear protective gloves
• It is essential to have a barrier between you and
  the infectious material

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Protective Equipment

• General requirements
• Provided at no cost to employee
• Worn when reasonably anticipated that contact
  with blood/OPIM will occur
• Selection
• Gloves masks eye, face, head foot
  protection gowns

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Protective Equipment

• Use
• Whenever there is a potential for exposure
• Type depends on the nature of the hazard
• Access
• Various sizes
• Readily available

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Rules To Follow

• Always wear PPE
• Treat all blood or OPIM as if contaminated
• Replace PPE that is torn or punctured
• Remove PPE before leaving the work area
• Properly disinfect or dispose of PPE
• Wash hands immediately after removing PPE

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Skin Provides a Barrier

• Unbroken skin forms a barrier, however, infected
  blood can enter your system through

• Open sores
• Cuts
• Abrasions
• Acne
• Any damage to broken skin, even sunburn or
  blisters

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Gloves

• Gloves should be made of impervious materials
• Inspect gloves before use
• Double glove if possible
• Cover cuts or sores with bandages
• Do not touch the outside of used gloves

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Goggles, Face Shields Aprons

• Use goggles if there is risk of splashing
• Face shields provide addition protection for nose
  and mouth
• Aprons afford extra protection for the body

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Hand Washing

• Simple and important practice for protection
  against bloodborne pathogens
• Wash hands or other exposed skin as soon as
  practical after contact with blood or OPIM
• Never use harsh, abrasive soap
• When washing facilities are unavailable, use
  alternative methods.

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Contaminated Clothing

• Remove clothing that is contaminated as soon as
  possible
• Use Universal/Standard Precautions when handling
  contaminated laundry
• Place clothing in approved labeled
  bags/containers

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Decontamination and Sterilization

• Decontaminate/sterilize
• All surfaces, tools, equipment and other objects
  that may come in contact with blood or OPIM
  before they are put back to use

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Housekeeping

• Written cleaning schedule
• Different methods
• Level of contamination
• Hard surfaces
• Soft surfaces
• Covering surfaces to protect from contamination
• Clean waste cans as soon as contaminated

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Signs Labels

• Warning labels must be placed on
• containers of regulated waste
• refrigerators/freezers containing blood or OPIM
• other containers used to store, transport, or
  ship blood or OPIM

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Labeling Exceptions

• Universal precautions when handling specimen or
  laundry container
• Products released for transfusion
• Individual containers inside a properly labeled
  bulk container
• Decontaminated medical waste
• Red bags or containers

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Hygiene Rules

• If you work in a area where there is reasonable
  likelihood of exposure, Never
• Eat
• Drink
• Smoke
• Apply cosmetics or lip balm
• Handle contact lenses

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Food Rules

• Do not keep food or drink near blood or any OPIMs

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Broken Glassware

• Sterilize broken glassware with an approved
  disinfectant solution before it is disturbed or
  cleaned up
• Decontaminated glassware may be disposed of in an
  appropriate sharps container
• Do not pick up broken glassware with your hands

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Spill Cleanup

• Carefully cover the spill with paper towels or
  rags
• Gently pour 10 solution of bleach over the
  towels or rags
• Let sit for 10 minutes
• Wear gloves to collect dispose of waste

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Spill Cleanup
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Precautions With Needles
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Precautions With Needles

• Recap needles only with a mechanical device
• Use forceps, pliers, or broom and dust pan to
  move needles
• Never bend, break or shear
• Dispose of needles in labeled sharps containers

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The Needlestick Safety and Prevention Act
Mandated

• OSHA Clarify and revise 29 CFR 1910.1030, the
  Bloodborne Pathogens Standard

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Needlestick Safety and Prevention Act Timeline

• Revised standard published in Federal Register
  Jan 2001
• Effective April 2001
• Enforcement of new provision July 2001
• Adopted to OSHA state plans Oct 2001

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Needlestick Safety and Prevention Act

• Requires the Exposure Control Plan to reflect how
  employers implement new developments in control
  technology.
• Requires employers to solicit input from
  employees responsible for the identification,
  evaluation, and selection of engineering and work
  practice controls.
• Requires employers to establish and maintain a
  sharps injury log.

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Employee Training

• Training Schedule
• Initially when first hired
• Annually thereafter
• Material appropriate in content, vocabulary,
  education, literacy level, language of employee

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Training Records

• Session dates
• Content summary
• Names job titles
• Maintained for 3 years

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Summary

• Always know what you are working with.
• Use proper PPE in situations with bloodborne
  pathogens.
• Report all suspected exposures
• Properly dispose of pathogen waste and PPE.