Bloodborne pathogens

James R. Ginder, MS, NREMT,PI,CHES,NCEE Health Education Specialist

Hamilton County Health Departmentwww.hamiltoncounty.in.gov

The Reader Will Be Able To...

• List three bloodborne pathogens.

• Explain how bloodborne pathogens are transmitted.

• Identify three ways to prevent development of a bloodborne pathogen.

Introduction…

• Bloodborne Pathogen Standard applies to all employees with occupational exposure to blood and other potentially infectious materials (OPIOM)

Bloodborne pathogen standard 1910.1030

• Covers all employees who could “reasonably anticipate" as the result of performing their job duties, to face contact with blood and other potentially infectious materials.

Risk of Infection…

Risk of infection depends on several factors:

– The pathogen involved

– The type/route of exposure

– The amount of virus in the infected blood at the time of exposure

– The amount of infected blood involved in the exposure

– Whether post-exposure treatment was taken

– Specific immune response of the individual

Bloodborne Pathogens…

• Bloodborne pathogens are microorganisms present in human blood which can infect and cause disease in people who are exposed to blood containing the pathogen.

• These microorganisms

can be transmitted through contact with contaminated blood and body fluids.

Who is at Risk…

• Sheriff, Police, Jail Staff • Health Care Staff

• Physicians, Nurses • First Responders

• EMS • Therapists

• Life Guards

• Coroner & Morticians

• Teachers/Child Care Providers

• Housekeepers

How are diseases transmitted…

• Direct Contact– Body Fluids

• Indirect Contact– Objects With Body Fluids

• Airborne– From The Air

• Vector Borne– Animals And Insects

How You become sick..

• Is the disease present

• Must have entry into the body

• How much of the disease is present

• How strong is your immune system

Where are Bloodborne Pathogens Found?

• Blood products • Semen • Vaginal secretions • Cerebrospinal fluid • Pleural fluid (or lung fluid) • Synovial fluid (or fluid from your joints) • Amniotic fluid (or uterine fluid)• Peritoneal fluid (or fluid that fills your body cavity) • Saliva in dental settings • Any body fluid that is visibly contaminated with

blood

Main bloodborne pathogens and diseases of concern

• Hepatitis B Virus (HBV)

• Hepatitis C Virus (HCV)

• Human Immunodeficiency

Modes of Transmission Of All Bloodborne Pathogens…

• 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

• Anytime there is blood-to-blood contact with infected blood or body fluids

HIV• Fragile – survives only a few

hours in dry environment

• Attacks the immune system

• CDC estimates that more than one million people are living with HIV in the United States

• Approximately one in five (20 %) of those people living with HIV is unaware of their infection. (CDC)

• Most people will develop AIDS

• No cure; no vaccine available yet

Transmission Of HIV

• Sexual contact

• Sharing needles or drug equipment

• Pregnancy, childbirth and breast feeding

• Contact with other body fluids

• Body Piercing and Tattooing

HIV Is NOT Spread Through…

• Casual Contact

• Saliva

• Sweat

• Spit

• Tears

• Air

• Insects

Acquired Immunodeficiency Syndrome (AIDS)

Having Two Of The 23 Opportunistic Infections

&White Blood Cell Below 200

AIDS

Acquired Develops after contact with HIV

Immunodeficiency A weakening of the immune system

Syndrome A group of signs and or symptoms caused by a disease

Liver

Healthy Liver

Liver Infected With Hep. B

Hepatitis b• A virus that infects the liver

• HBV can live outside the body for 7 days

• 90% of adults contracting the disease will recover and develop immunity

• Up to 10% of adults who contract the disease will not recover but have chronic Hepatitis

• May lead to chronic liver disease, liver cancer, and death

Symptoms of Hepatitis B

• Fever

• Fatigue

• Loss of appetite

• Nausea

• Vomiting

• Abdominal pain

• Dark urine

• Clay-colored bowel movements

• Joint pain

• Jaundice

Hepatitis B Transmission

• Sex with an infected partner

• Injection drug use that involves sharing needles, syringes, or drug equipment

• Children born to mothers who have Hepatitis B

• Contact with blood or open sores of an infected person

• Needle sticks or sharp instrument exposures

• Sharing items such as razors or toothbrushes with an infected person

Hepatitis B Vaccine

• No risk of developing Hepatitis B from the vaccine

• The vaccine is 90%+ effective

• The vaccine is given in three doses– Dose # 1- Initial dose– Dose # 2 -30 Days after dose 1– Dose #3- 4 months after dose

2

Hepatitis C

• The most common chronic bloodborne infection in the United States

• Approximately 3.2 million persons are chronically infected

• 80% of people have no signs or symptoms

• May remain undetected in the body for years

Hepatitis C

• Most commonly occurs in people who have:

– Received blood transfusion before 1992

– Shared needles/drug equipment– Tattoos/body piercing– HIV +– Children born to mothers who

have Hepatitis C– Shared nail clippers and

toothbrushes

• Risk of sexual transmission appears to be low

Signs and Symptoms of Hepatitis C

• Fever • Fatigue • Dark urine • Clay-colored stool • Abdominal pain • Loss of appetite • Nausea • Vomiting • Joint pain • Jaundice

• In those persons who do develop symptoms, the average time period from exposure to symptom onset is 4–12 weeks (range: 2–24 weeks).

Co-Infection…

• Person is infected with both HIV and Hepatitis C

• CDC estimates that 3,000,000 people are co-infected in the U.S.

• 50%-90% of injection drug users are infected with Hepatitis C and HIV (CDC)

• A person who is co-infected may develop liver damage faster

Transmission Potential

• Contact with another person’s blood or bodily fluid that may contain blood

• Mucous membranes: eyes, mouth, nose

• Non-intact skin

• Contaminated sharps/needles

Your Exposure Potential

• Accidental Release

• Post-Accident Cleanup

• Administering First-Aid

• Handling of Returned Product

• Janitorial or Maintenance Work

• Handling of any Waste Products

Universal Precautions• Use of proper Personal Protective Equipment

(PPE)

• Treat all blood and bodily fluids as if they are contaminated

• Proper cleanup and decontamination

• Disposal of all contaminated material in the proper manner

Personal Protective Equipment (PPE)

• Anything that is used to protect a person from exposure

• Latex or Nitrile gloves

• Goggles

• CPR mouth barriers,

• Aprons

• N95 mask & respirators

PPE Rules to Remember

• Always check PPE for defects or tears before using

• If PPE becomes torn or defective remove and get new

• Remove PPE before leaving a contaminated area

• Do not reuse disposable equipment

Decontamination• When cleaning up surfaces

use diluted bleach solutions or other suitable commercial disinfectant (1:10)

• Do an initial wipe up

• Spray and allow it to stand for ten minutes, then wipe up

• Dispose of all wipes in biohazard containers

• PPE should be removed and disposed of in biohazard containers

Decontamination Procedures

• Use appropriate personal protective equipment

• Absorb grossly bloody materials with absorbent materials and place in a tied, red bag

• Decontaminate mop, broom or dust pan in a bleach solution

Hand Washing

• Wash hands immediately after removing PPE

• Use a soft antibacterial soap

• A hand sanitizer can be used, but wash with soap and water as soon as possible afterward

How to Remove Gloves

1. Wet hands 2. Use soap 3. Lather, rub Sing Happy Birthday twice (15- 20 seconds)

4. Rinse 5. Towel or air dry hands 6. Turn off water with towel or sleeve

Regulated Medical Waste…

• Liquid or semi-liquid blood or other potentially infectious materials and sharps.

Regulated Waste…

• Must be placed in closable leak-proof container built to contain all content during handling, storing, transporting or shipping and be appropriately labeled or color-coded

Signs and Labels

• Labels must include the universal biohazard symbol, and the term “Biohazard” must be attached to:

– Containers of regulated

biohazard waste– Refrigerators or

freezers containing blood or OPIM

– Containers used to store, transport, or ship blood or OPIM

Exposure Incident…

• A specific exposure to the

– Eyes– Mouth– Mucus membrane– Or broken skin

• As well as contact with blood or other potentially infectious material that results from the performance of an employee’s duties.

Exposure Incident…

• Keep Calm

• Tell a supervisor ASAP

• If body fluid enters eyes or mouth, wash with water for 20 minutes

• If body fluid comes in contact with broken or chapped skin or needle stick, wash with water and soap for 20 minutes

• What do you do?

Injury report

Worker’s Compensation

Known SourceIf you know the

source

UNKNOWN SourceIf you do not knowwho the source is

Sharps Log

Any needle sticks

Ryan White Law

• The Ryan White Law, mandates that the source patient test results be provided to the designated infection control officer of the employee involved in an exposure incident.

IF IT IS WET AND NOT YOURS DO NOT TOUCH IT WITHOUT GLOVES!

Question

• If you have any questions, contact:

– Christie Clare clarec@lanesville.k12.in.us

Course confirmation

• Print, sign and return slide # 51 to Christie Clare

BLOODBORNE PATHOGEN COURSE CONFIRMATION

Lanesville Community School CorporationI have viewed the bloodborne pathogen course. I understand that if I have any questions about the course or have an exposure to blood or body fluids, I should contact the school nurse at extension 205.

_______________________ (Printed Name)

_______________________ (Job Title)

_______________________ (Signature)

_______________________ (Date)

*You must print, sign and return this confirmation to Christie Clare after viewing the course.