NEW YORK MEDICAL COLLEGE Environmental Health and Safety Department

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NEW YORK MEDICAL COLLEGEEnvironmental Health and
Safety Department

• BLOODBORNE PATHOGENS (BBPs)
• Training Program

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Objectives

• To recognize the agency that regulates the BBP
  standard
• List BBP covered the standard
• To recognize what the hazardous are and how you
  can be exposed
• To apply safe work practices when working with
  blood and other bodily fluids
• To manage disposal of contaminated biohazard
  materials

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Regulators

• OSHA 29 CFR 1910.1030
• (Occupational Safety and Health Administration)
• Covers ALL employees who may be exposed to blood
  and other potential infectious material (OPIM)

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What is a Bloodborne Pathogen?

• A pathogenic organism present in blood (in
  addition to other body fluids), which may cause
  disease in humans

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Bloodborne Pathogens

• Of Particular Concern
• (covered under the OSHA standard)
• Human Immunodeficiency (HIV)
• Hepatitis B (HBV)
• Hepatitis C (HCV)
• Other examples include malaria, syphilis, African
  sleeping sickness, leptospirosis, relapsing fever
  (Borrelia), and viral hemorrhagic fevers
  (including Ebola)

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Who is at risk for BBP Exposure?

• Anyonebut particularly
• Laboratory personnel
• Physicians
• Nurses
• Phlebotomists
• Laundry and Janitorial workers
• EMT/Paramedics

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Human Immunodeficiency Virus (HIV)

• First recognized in 1981
• Infects key cells in the human body that are part
  of the immune system, specifically CD4 and T
  cells
• Modes of transmission sexual intercourse, direct
  contact with infected blood, and from an infected
  mother to her unborn child
• 1 in 300 possibility of getting infected after
  exposure from needlestick or 11000 from mucosal
  splash
• Can only survive a short time outside a host
• No vaccine or cure available

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Hepatitis

• Hepatitis is a viral disease of the liver that
  can results in chronic liver disease.
• There are 5 well known viral strains of hepatitis
  
• Hepatitis B and C are bloodborne pathogens
• There is a 1 in 3 chance of contracting HBV/HCV
  after exposure.
• Hep B/C can survive on environmental surfaces.
  Decontamination is important with 10 bleach
  solution
• The number of new HBV infections per year has
  declined from an average of 260,000 in the 1980s
  to about 60,000 in 2004. The number of new HCV
  infections per year has declined from an average
  of 240,000 in the 1980s to about 26,000 in 2004.
• CDC website (March 2005),
• http//www.cdc.gov/ncidod/diseases/hepatitis/b/ind
  ex.htm

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Transmission of BBPs

• Sexual Contact
• Shared needles
• Direct contact between broken or chaffed skin and
  infected body fluids
• Needlesticks most common method of transmission
  of BBP in the medical environment
• Protect yourself by safely handling the needles
  and disposing them immediately in a sharps
  container after use
• Report all needle stick and other sharps-related
  injuries promptly to ensure that you receive
  appropriate follow-up care
• Never recap or resheath a needle
• Never leave a needle unattended on a work surface

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Exposure Control Plan

• Located in Health Services Department
• (Basic Science Building ext. 4324)
• Breaks down each job by class and identifies the
  employees risk of exposure to blood or other
  potentially infectious material
• Establishes procedures for evaluating the
  circumstances of an exposure incident
• Explains the Hepatitis B Program
• Explains post exposure follow up and record
  keeping procedure

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Health Services (BSB room C12)
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Sharps Containers

• Used to collect materials such as contaminated
  needles, syringes, slides/cover plates,
  dissection tools for disposal
• Make certain that the lid is closed when
  discarding materials.
• Never place sharps in an overfilled container

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All sizes of sharps containers have a
recommended fill line, please follow
instructions/guidelines
FILL LINE
Do not overfill!!!
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Red Sharps Containers (17 gal)

• Red Sharps Containers (17 gal)

• Sharps Containers
• Fill Line

Do not overfill!!!
FILL LINE
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Regulated Medical Waste Bin
Place waste materials in RED BAG in container
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Chain of Infection

• Pathogen
• Reservoir
• Escape from Reservoir
• Transmission through Environment
• Portal of Entry
• Susceptible Host
• Infection Control Break any link in chain

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Risk Factors for Infection

• Pathogenicity of organism
• Dose
• Route of entry (injection, contact with mucous
  membrane or open wound)
• Host susceptibility
• Work practices

HIV
HepB
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Protect Yourself Use Universal Precautions

• These are recommended physical requirements,
  procedural actions and precautions for safe work
  with human/primate pathogenic materials or
  microbes in healthcare, laboratory and other work
  environments.
• Because the potential for infectivity of any
  blood and body fluids is unknown, universal
  precautions should be adhered to for all
  specimens regardless of evidence of infectious
  material.

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What to treat with UNIVERSAL PRECAUTIONS

• Blood
• Cerebrospinal fluid, synovial fluid, peritoneal
  fluid, pericardial fluid, pleural fluid, semen,
  vaginal secretions, breast milk, amniotic fluid,
• Any other visibly bloody body fluids/secretions
• Any unfixed tissue or organ, other than intact
  skin, from a living or dead person
• Organ cultures and culture medium or other
  solutions that may contain pathogenic agents

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Exposure Incident

• A specific incident of contact with potentially
  infectious bodily fluid
• If there are no infiltrations of mucous membranes
  or open skin surfaces, it is not considered an
  occupational exposure
• Report all accidents involving blood or bodily
  fluids
• If you have an exposure incident inmmediately
  wash the exposed area with warm water and soap
  for 15 minutes.
• CONTACT HEALTH SERVICE _at_ 594-4235

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Disinfecting
To disinfect your liquid waste, make a 10
solution of household bleach in the liquid waste
and treat overnight Next morning discard in the
lab sink.
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Personal Protective Equipment (PPE)

• Gloves
• Goggles
• Lab Coats
• Face Shields
• Masks
• Gowns
• Caps
• Shoe Covers

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PPE Gloves

• Protect yourself wear gloves!
• Remember Washing latex gloves with plain soap,
  chlorhexidine, or alcohol can cause
  micropunctures. Exposure to glutaraldehyde,
  hydrogen peroxide, and alcohol preparations may
  weaken both latex and nitrile gloves

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Common Sense Precautions

• Wash hands when gloves are removed
• If needed, irrigate the eyes and skin IMMEDIATELY
  for at least
• 15 minutes!!!
• Do not bend, recap, or remove contaminated
  needles
• As soon as you are finished using sharps,
  immediately discard them in a puncture resistant,
  leak-proof container SHARPS CONTAINER

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Summary

• OSHA is responsible for the BBP Standard
• Be aware of potential risks in the lab when
  working with BBPs
• Familiarize yourself and apply all safety
  practices
• Apply all safety practices when disposing
  biohazardous materials
• Protect yourself always wear PPE (safety
  glasses, gloves, lab coat)
• Take advantage of the Hepatitis Program
• Note BBP training must be taken annually

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• Perfect! Congratulations, you finished the
  presentation and
• now take a test, click on the link and follow the
  instructions http//www.proprofs.com/quiz-school/
  story.php?titlebloodborne-pathogens_26