Bloodborne Pathogens

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Bloodborne Pathogens
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Standards

• 29 CFR 1910.1030 (Federal)
• Part 554 Bloodborne Infectious Disease (Michigan)

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Scope

• To protect workers against possible contamination
  from a Bloodborne Infectious Disease.

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When to comply?

• If there is an actual or reasonable anticipated
  risk of an exposure to blood or OPIM during
  routine tasks.

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Definitions

• Bloodborne pathogen
• HIV - the virus that causes the autoimmune
  deficiency syndrome (AIDS) (1-10 years)
• Hepatitis B (HBV) - acute or chronic infection of
  the liver (incubation 2-3 months)
• Hepatitis C (HCV) (incubation 6-9 weeks)
• Syphilis (incubation 3 weeks)
• Others

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Definitions
Other Potentially Infectious Material (OPIM)
(State Rule 325.7002(s))

• Semen
• Vaginal secretions
• Amniotic fluid
• Cerebrospinal fluid
• Perioneal fluid
• Pleural fluid
• Pericardial fluid

• Synovial fluid
• Saliva in dental procedures
• Any bodily fluid that is visibly contaminated
  with blood.
• Any body fluid that you cannot recognize if there
  is blood in it.

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Definitions

• Sharps - Any item that has a potential to cut or
  puncture skin. (broken glass, needles, lancets,
  etc.)

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Exposure Determination/Categories

• Category A
• Reasonable exposure
• Non-routine tasks as a condition of employment.
• Category B
• No anticipated exposure

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Exposure Control Plan

• Exposure determination
• Implementation of the rules
• Training outline
• Incident reporting and evaluation
• SOPs
• Annual review
• Available to employees

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Methods of Compliance

• Universal Precautions
• Engineering and Work Practice Controls
• Personal protective equipment
• Housekeeping

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Universal Precautions

• Blood and OPIM treated as Infectious Material.

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Engineering Controls

• Reduce exposure by design
• Self sheathing needles
• Sharp containers
• Sinks

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Engineering Controls

• On January 18, 2001 OSHA Standard 29 CFR
  1910.1030, Bloodborne Pathogens was revised.
• The major emphasis was "engineering" controls.
• Methods to reduce exposure
• Built-in safety devices
• Annual review
• Sharps injury log

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Engineering and Work Practice Controls
1910.1030(d)

• Employers must select and implement appropriate
  engineering controls to reduce or eliminate
  employee exposure.

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Engineering and Work Practice Controls

• The employer must
• Train employees to use new devices and/or
  procedures

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Sharps Container
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SESIPNew Definition

• Non-needle sharp or a needle with a built-in
  safety feature or mechanism that effectively
  reduces the risk of an exposure incident.
• Sharps with Engineered Sharps Injury Protections

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Hypodermic syringes with Self-Sheathing safety
feature
Self-sheathed protected position
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Hypodermic syringes with Retractable Technology
safety feature
Retracted protected position
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Phlebotomy needle with Self-Blunting safety
feature
Blunted protected position
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Add-on safety feature
Attached to syringe needle
Attached to blood tube holder
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Retracting lancets with safety features
Before During After
Before During After
In use After use
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Disposable scalpels with safety features
Retracted position
Protracted position
Protracted position
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Work Practices

• Reduce exposure by work habits
• Wearing gloves
• Washing hands
• Using sharp containers
• NO food, etc.

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Work PracticeSOPs

• Standard Operating Procedure
• Each task should have a written procedure to
  reduce risk of exposure.

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Personal Protective Equipment (PPE)

• Choose the correct ones for the task
• Gloves, Protective Eyewear, Face Shield, etc.
• DON DOFF

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Housekeeping

• PPE
• Recordkeeping

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Regulated Waste

• Determination of Regulated Waste
• Michigan Law
• Medical Waste Regulatory Act - Part 138

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Laundry

• Employers responsibility
• Personal Procedures (CDC Guidelines)

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Vaccination

• When
• Cost - Employers Expense
• Time
• Waiver
• What does it really mean?

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Vaccination

• Efficacy, safety, benefits, administration
• Availability Cost
• Timing
• Responsibility
• Waiver

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Waiver

• What is it?
• What does it really mean?
• Employee has the right not to receive the HBV
  vaccine however, must sign a waiver. The
  employee does have the right to request a HBV
  vaccine at a later date, at the employers
  expense.

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Post Exposure

• Determination
• Procedure
• prophylaxis
• Confidentiality

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Labels and Warnings

• Labels
• Colors
• Symbols

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Recordkeeping

• Training
• Post exposure

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Recordkeeping 1910.1030(h)

• Sharps Injury Log
• Only mandatory for those keeping records
  under 29 CFR 1904
• Confidentiality
• Maintained independently
• from OSHA 300 log

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Sharps Injury Log

• At a minimum, the log must contain, for each
  incident
• Type and brand of device involved
• Department or area of incident
• Description of incident

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Engineering and Work Practice Controls (cont)

• The employer must
• Train employees to use new devices and/or
  procedures
• Document in ECP

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Training

• Outline
• Qualifications
• Law
• Access to Plan
• Annual retraining