Department of University Safety and Assurances .
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Transcript of Department of University Safety and Assurances .
Department of University Safety and AssurancesDepartment of University Safety and Assurances
www.safety.uwm.eduwww.safety.uwm.edu
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Bloodborne PathogensBloodborne Pathogens
• Bloodborne Pathogens Bloodborne Pathogens are microorganismsare microorganisms (such as viruses)(such as viruses) transmitted through transmitted through blood, or other blood, or other potentially infectious potentially infectious material such as certain material such as certain bodily fluidsbodily fluids (semen, (semen, breast milk, etc.)breast milk, etc.) or or
tissues.tissues.
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• Bodily fluids, especially those Bodily fluids, especially those visibly contaminated with visibly contaminated with blood, are capable of causing blood, are capable of causing disease. disease.
• Pathogens can enter your Pathogens can enter your body through a cut in the skin, body through a cut in the skin, through your eyes or mouth.through your eyes or mouth.
• Can also be transmitted Can also be transmitted sexuallysexually
• Main diseases of concern are Main diseases of concern are Hepatitis B (and C) virus, and Hepatitis B (and C) virus, and HIV (AIDS virus).HIV (AIDS virus).
Bloodborne PathogensBloodborne Pathogens
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HIVHIV
• HIV attacks your HIV attacks your body’s ability to body’s ability to protect itself against protect itself against diseasedisease
• Initially no visible Initially no visible signs of having the signs of having the virusvirus
• Most people with Most people with HIV develop AIDS HIV develop AIDS (acquired immune (acquired immune deficiency syndrome)deficiency syndrome)
• There is There is nono vaccination for HIVvaccination for HIV
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• HIV attacks your body’s HIV attacks your body’s ability to protect itself ability to protect itself against diseaseagainst disease
• Initially no visible signs of Initially no visible signs of having the virushaving the virus
• Most people with HIV Most people with HIV develop AIDS develop AIDS (acquired (acquired immune deficiency syndrome)immune deficiency syndrome)
• There is There is nono vaccination vaccination for HIVfor HIV
Human Immunodeficiency Virus (HIV)Human Immunodeficiency Virus (HIV)
Immature HIV Virus
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HIVHIV
• Virus lives outside the Virus lives outside the body only a few hoursbody only a few hours
• 4 modes of transfer:4 modes of transfer:
1.1. BloodBlood
2.2. SemenSemen
3.3. Vaginal secretionsVaginal secretions
4.4. Breast milkBreast milk
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HIVHIV
10-50 virus particles per ml of blood10-50 virus particles per ml of blood
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Aids Statistics from CDCAids Statistics from CDC
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Persons Diagnosed With AIDSPersons Diagnosed With AIDS
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Adults & Adolescents Living with Adults & Adolescents Living with AIDSAIDS
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Adults & Adolescents Living with Adults & Adolescents Living with AIDSAIDS
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Proportion of AIDS Cases Among Proportion of AIDS Cases Among FemalesFemales
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CDC HIV Prevention ProgramCDC HIV Prevention Program
• CDC directs CDC directs largest portion of largest portion of its HIV prevention its HIV prevention effort to the effort to the African American African American communitiescommunities
• AIDS is the AIDS is the leading cause of leading cause of death among death among African African Americans ages Americans ages 25-4425-44
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HIV Risk Growing Among Women HIV Risk Growing Among Women and Teensand Teens
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HIVHIV
NewsweekSpecial Edition
Summer, 2005
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What is Hepatitis?What is Hepatitis?
• Hepatitis means inflammation of the Hepatitis means inflammation of the liver. Viral hepatitis is inflammation of liver. Viral hepatitis is inflammation of the liver caused by a virus. the liver caused by a virus.
• There are five identified types of viral There are five identified types of viral hepatitis and each one is caused by a hepatitis and each one is caused by a different virus.different virus.
• In the United States, HepatitisIn the United States, Hepatitis A, A, HepatitisHepatitis BB and Hepatitisand Hepatitis CC are the most are the most common types. common types.
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Types of Types of HepatitisHepatitis
• Hepatitis AHepatitis A• Hepatitis BHepatitis B• Hepatitis CHepatitis C• Hepatitis DHepatitis D• Hepatitis EHepatitis E• Hepatitis GHepatitis G
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Hepatitis AHepatitis A
• Hepatitis A continues to Hepatitis A continues to be one of the most be one of the most frequently reported frequently reported vaccine-preventable vaccine-preventable diseases in the US. diseases in the US.
• Although hepatitis A Although hepatitis A occurs in virtually every occurs in virtually every area of the United area of the United States, certain states States, certain states and counties have and counties have higher rates than higher rates than others. others.
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• Up to 100 times Up to 100 times easier to catch easier to catch than HIVthan HIV
• Unlike HIV, can Unlike HIV, can live outside of live outside of body for several body for several daysdays
Schematic of Hepatitis B Virus
Hepatitis BHepatitis B
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Is Hepatitis B a Serious Is Hepatitis B a Serious Problem?Problem?
• Yes. Each year thousands of people of all ages get Hepatitis B and about 5,000 dies of chronic liver problems caused by HBV virus infection.
• If you have had other types of Hepatitis, such as Hepatitis A or C, you can still get HBV.
• HBV is spread by:– Having sex with an infected
person– Direct contact with the blood of
an infected person.
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Hepatitis BHepatitis B
• Hepatitis B virus (HBV) is 100 more infectious Hepatitis B virus (HBV) is 100 more infectious than HIVthan HIV
• About 5% of Americans have been infected About 5% of Americans have been infected with HBV at some point during their lifetimewith HBV at some point during their lifetime
• People who get infected with HBV can also get People who get infected with HBV can also get infected with Hepatitis D virus (HDV). If this infected with Hepatitis D virus (HDV). If this happens, people often become very sickhappens, people often become very sick
» SourceSource
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HBV Cannot be Spread by:HBV Cannot be Spread by:
• Sneezing or Sneezing or coughingcoughing
• Kissing or huggingKissing or hugging• Breast feedingBreast feeding• Food or waterFood or water• Sharing eating Sharing eating
utensils or drinking utensils or drinking glassesglasses
• Casual contactCasual contact
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Concentration of Hepatitis B Virus in Concentration of Hepatitis B Virus in Various Body FluidsVarious Body Fluids
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Average Incubation PeriodAverage Incubation Period
• The average incubation The average incubation period period (The time between an (The time between an initial exposure to the virus initial exposure to the virus and the development of and the development of
symptoms)symptoms) for Hepatitis B for Hepatitis B is about 16 weeksis about 16 weeks
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HepatitisHepatitis
AcuteAcute:: 6-8 weeks, 90%6-8 weeks, 90%– 30-40% with acute HBV have no idea how or when 30-40% with acute HBV have no idea how or when
they became infectedthey became infected– 5-15% of infected carry virus for longer than 6 months 5-15% of infected carry virus for longer than 6 months
(carriers)(carriers)
Chronic:Chronic: Life, 10% Life, 10%
– Hepatitis B carriers are people infected with HBV and never fully recover. They carry the virus and can infect others for the rest of their lives
– Approximately one million people in the US carry HBV
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Hepatitis BHepatitis B
• 1,000,000 - 1,000,000,000 1,000,000 - 1,000,000,000 virus particles per virus particles per ml of bloodml of blood
• Virus can live outside the body for several daysVirus can live outside the body for several days
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Hepatitis BHepatitis B
• ““The risk of contracting Hepatitis B The risk of contracting Hepatitis B from a single needlestick from a single needlestick contaminated with blood from a contaminated with blood from a person with known Hepatitis B ranges person with known Hepatitis B ranges from 6% to 30%.”from 6% to 30%.”
• ““Approximately 10% of those infected Approximately 10% of those infected become chronic carriers who can become chronic carriers who can infect their families and friends. They infect their families and friends. They have up to 300 times greater than have up to 300 times greater than normal risk of developing liver cancer.”normal risk of developing liver cancer.”
• ““Every year, approximately 5,000 Every year, approximately 5,000 Americans, die of HBV or its Americans, die of HBV or its complications.complications.
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HIV vs. Hepatitis BHIV vs. Hepatitis B
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Hepatitis CHepatitis C
• An Estimated 3.9 An Estimated 3.9 million Americans million Americans have been infected have been infected with HBCwith HBC
• Hepatitis C virus Hepatitis C virus (HCV) infection is (HCV) infection is the most common the most common chronic bloodborne chronic bloodborne infection in the infection in the United StatesUnited States
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Hepatitis CHepatitis C
• Disease can incubate Disease can incubate for decadesfor decades
• By 2010 may affect By 2010 may affect more Americans each more Americans each year than AIDSyear than AIDS
• HCV not related to the HCV not related to the viruses that cause viruses that cause HBA and HBVHBA and HBV
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Sources of Infection -- Hepatitis CSources of Infection -- Hepatitis C
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Hepatitis CHepatitis C
• Risk Factors:Risk Factors:– Long-term kidney Long-term kidney
dialysisdialysis– Sex with multiple Sex with multiple
partnerspartners– Tattooing or body Tattooing or body
piercing with shared piercing with shared needles or unsterilized needles or unsterilized equipmentequipment
– Intranasal cocaine use Intranasal cocaine use with shared strawswith shared straws
Pamela Anderson claims her infection came from a tattoo needle
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Hepatitis C PreventionHepatitis C Prevention
• If you are thinking about If you are thinking about getting a tattoo or body getting a tattoo or body piercing,piercing, consider the risks.consider the risks. – You might get infected if tools You might get infected if tools
have someone else’s blood on have someone else’s blood on them or if the artist or piercer them or if the artist or piercer does not follow good health does not follow good health practices such as washing practices such as washing hands, using sterile equipment hands, using sterile equipment and disposable gloves.and disposable gloves.
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Some signs and symptoms of HBV Some signs and symptoms of HBV and HBC include:and HBC include:
• Flu-like symptomsFlu-like symptoms
• fatiguefatigue
• jaundicejaundice
• severe pain in jointssevere pain in joints
• lung diseaselung disease
• inflammation of liverinflammation of liver
• inflammation on and ulcers of the coloninflammation on and ulcers of the colon
• may be asymptomatic (i.e. no symptoms indicated)may be asymptomatic (i.e. no symptoms indicated)
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HBV and HCVHBV and HCV
• Liver is located behind Liver is located behind the lower ribs on the the lower ribs on the right side of your right side of your abdomen abdomen
• Weighs about 3 Weighs about 3 pounds and is roughly pounds and is roughly the size of a football.the size of a football.
• If infected with HBV, If infected with HBV, the liver often the liver often becomes tender and becomes tender and enlargedenlarged
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Hepatitis B (and C)Hepatitis B (and C)
• There is no cure for Hepatitis B or There is no cure for Hepatitis B or C…C…
• but unlike HIV, there is a but unlike HIV, there is a vaccination for Hepatitis Bvaccination for Hepatitis B. .
(There is no vaccination for Hepatitis C)(There is no vaccination for Hepatitis C)
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The ABC’s of HepatitisThe ABC’s of Hepatitis
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How Long Can the Virus Survive How Long Can the Virus Survive Outside the Body?Outside the Body?
• Hepatitis A is caused by Hepatitis A virus (HAV)HAV can live outside the body for months, depending on the environmental conditions
• Hepatitis B is caused by Hepatitis B virus (HBV) HBV can survive outside the body at least 7 days and still be capable of transmitting infection.
• Hepatitis C is caused by Hepatitis C virus (HCV)(HCV)Recent studies have shown that HCV can survive outside the body and still transmit infection for 16 hours, but not longer than 4 days.
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• OnlyOnly employees at moderate employees at moderate risk are included in the campus risk are included in the campus Bloodborne Pathogens Bloodborne Pathogens Exposure Control PlanExposure Control Plan. .
• Employees in the plan can Employees in the plan can receive HBV vaccinations at no receive HBV vaccinations at no cost.cost.
• There are specific training, There are specific training, engineering, and work practice engineering, and work practice controls for those potentially at controls for those potentially at risk of exposure to BBP on the risk of exposure to BBP on the jobjob..
How to Reduce Your RiskHow to Reduce Your Risk
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How to Reduce Your RiskHow to Reduce Your Risk
Universal Precautions/Universal Precautions/
Standard PrecautionsStandard Precautions::
– A system of infection control which A system of infection control which assumes that all human blood and certain assumes that all human blood and certain body fluids are treated as if known to be body fluids are treated as if known to be infectious.infectious.
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How Bloodborne Pathogens Spread How Bloodborne Pathogens Spread on the Jobon the Job
• By a sharp By a sharp object that is object that is contaminated contaminated by the virus by the virus when it cuts when it cuts or punctures or punctures your skin. your skin.
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How Bloodborne Pathogens Spread How Bloodborne Pathogens Spread on the Jobon the Job
• When you When you touch a touch a contaminated contaminated surface and surface and then touch then touch your eyes, your eyes, nose, mouth, nose, mouth, or open or open wounds or wounds or inflamed skininflamed skin
• When a contaminated object touches inflamed When a contaminated object touches inflamed skin, acne, skin abrasions skin, acne, skin abrasions
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Use Spill Kit for Clean-upUse Spill Kit for Clean-up
Kit Includes:Kit Includes:• Face MaskFace Mask• GlovesGloves• GogglesGoggles• Sharps Disposal Sharps Disposal
ContainerContainer• VobanVoban• Fluid Control SolidifierFluid Control Solidifier• Personal Safety Personal Safety
Equipment Cleaning Equipment Cleaning Pads Pads
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How to Reduce Your RiskHow to Reduce Your Risk
• Don’t Recap NeedlesDon’t Recap Needles
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How to Reduce Your RiskHow to Reduce Your Risk
• Do not bend, Do not bend, shear, break or shear, break or recap needlesrecap needles
• If you must If you must recap, use recap, use one-handed one-handed method method
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• Needles and Needles and other sharps must other sharps must be discarded in be discarded in rigid, leak-proof, rigid, leak-proof, puncture puncture resistance resistance containerscontainers
How to Reduce Your RiskHow to Reduce Your Risk
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• When emptying When emptying trash containers, do trash containers, do not use your hands not use your hands to compress the to compress the trash in the bag. trash in the bag.
How to Reduce Your RiskHow to Reduce Your Risk
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• Lift and carry Lift and carry the trash bag the trash bag away from away from your bodyyour body
How to Reduce Your RiskHow to Reduce Your Risk
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• Do not eat, drink, Do not eat, drink, smoke, apply smoke, apply cosmetics or cosmetics or handle contact handle contact lenses in areas lenses in areas where there is the where there is the possibility of possibility of exposure to BBP, exposure to BBP, such as in UWM such as in UWM labslabs
How to Reduce Your RiskHow to Reduce Your Risk
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Personal Protective EquipmentPersonal Protective Equipment
• Gloves, masks, eye protection, Gloves, masks, eye protection, CPR microshieldsCPR microshields
(PPE is provided by UWM)
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• Get Spill Kit from Get Spill Kit from Janitorial ClosetJanitorial Closet
• Put on gloves. Put on gloves.
Body Fluid Cleanup ProceduresBody Fluid Cleanup Procedures
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• If splashing is anticipated, If splashing is anticipated, wear protective eyewear wear protective eyewear and maskand mask
Body Fluid Cleanup ProceduresBody Fluid Cleanup Procedures
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• Remove Remove visible visible material with material with absorbent absorbent towelstowels
Body Fluid Cleanup ProceduresBody Fluid Cleanup Procedures
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• Area should be Area should be decontaminated for decontaminated for 10 minutes10 minutes
• Once the area has Once the area has been disinfected, been disinfected, dry area with dry area with absorbent towels absorbent towels and dispose of and dispose of towels in regular towels in regular trashtrash
Body Fluid Cleanup ProceduresBody Fluid Cleanup Procedures
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• Glove removal Glove removal and disposal and disposal techniquetechnique
Body Fluid Cleanup ProceduresBody Fluid Cleanup Procedures
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Glove Removal and DisposalGlove Removal and Disposal
• Grip one glove Grip one glove near the cuff & near the cuff & peel it down until peel it down until it comes off inside it comes off inside out. out.
• Cup in the palm of Cup in the palm of your gloved hand.your gloved hand.
• Place two fingers Place two fingers of your bare hand of your bare hand inside cuff of inside cuff of remaining glove.remaining glove.
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Glove Removal and DisposalGlove Removal and Disposal
• Peel that Peel that glove down so glove down so that it also that it also comes off comes off inside out and inside out and over the first over the first glove.glove.
• Dispose of Dispose of gloves in the gloves in the normal trash.normal trash.
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Wash Hands WellWash Hands Well
• Wet your hands and apply liquid, bar or Wet your hands and apply liquid, bar or powder soap.powder soap.
• Rub hands together vigorously to make a Rub hands together vigorously to make a lather and scrub all surfaces.lather and scrub all surfaces.
• Continue for 20 seconds! It takes that Continue for 20 seconds! It takes that long for the soap and scrubbing action to long for the soap and scrubbing action to dislodge & remove stubborn germs. dislodge & remove stubborn germs.
• Rinse hands well under running water.Rinse hands well under running water.• Dry your hands using a paper towel or air Dry your hands using a paper towel or air
dryer.dryer.• If possible, use your paper towel to turn If possible, use your paper towel to turn
off the faucetoff the faucet
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Exposure IncidentExposure Incident
What should you do if What should you do if you have an you have an exposure to blood exposure to blood and/or other body and/or other body fluids that might fluids that might contain Hepatitis B contain Hepatitis B virus (HBV), virus (HBV), Hepatitis C virus Hepatitis C virus (HCV), or (HIV) (HCV), or (HIV) virus?virus?
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Following an ExposureFollowing an Exposure
• If you have an exposure If you have an exposure incident – immediately incident – immediately wash the exposed area wash the exposed area with warm water and soap.with warm water and soap.
• If the exposure was in your If the exposure was in your eyes, immediately flush eyes, immediately flush with water (or saline with water (or saline solution) – make sure to solution) – make sure to completely irrigate the eye completely irrigate the eye area.area.
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Removal of Contaminated ClothingRemoval of Contaminated Clothing
• If a pullover shirt becomes If a pullover shirt becomes contaminated you must remove it in contaminated you must remove it in such a way as to avoid contact with such a way as to avoid contact with the contaminated surfacethe contaminated surface
• Rolling the shirt as it is pulled toward Rolling the shirt as it is pulled toward the head will reduce the chance of the head will reduce the chance of contact with the contaminated areacontact with the contaminated area
• After carefully rolling the shirt, pull it After carefully rolling the shirt, pull it over the head – avoiding contact with over the head – avoiding contact with mucous membranesmucous membranes
• If the shirt cannot be removed If the shirt cannot be removed without contamination, it is without contamination, it is recommended that the shirt be cut recommended that the shirt be cut and removedand removed
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Following an ExposureFollowing an Exposure
• Report the incident to your Report the incident to your supervisorsupervisor
• Immediately seek medical Immediately seek medical treatmenttreatment
• Complete Accident/Injury Complete Accident/Injury Report as soon as possible Report as soon as possible and turn in to your and turn in to your supervisorsupervisor
• Form is submitted to Form is submitted to Workers CompensationWorkers Compensation
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Hepatitis B VaccinationHepatitis B Vaccination
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Hepatitis B VaccinationHepatitis B Vaccination
• Beginning with the Beginning with the 1997-98 school 1997-98 school year, Wisconsin year, Wisconsin state law began to state law began to phase in the phase in the Hepatitis B Hepatitis B vaccination vaccination requirement.requirement.
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VaccinationVaccination
• Very low risk vaccineVery low risk vaccine• Three doses over 6 Three doses over 6
monthsmonths• Must receive all three Must receive all three
dosesdoses• >79% effective>79% effective• Free to employeesFree to employees
• May decline vaccine (but May decline vaccine (but must sign waiver)must sign waiver)
• May receive vaccine laterMay receive vaccine later
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Vaccination FormVaccination Form
You may choose one of You may choose one of the following options:the following options:
– Yes, I do wish to receive Yes, I do wish to receive the Hepatitis B vaccine the Hepatitis B vaccine
oror– I decline the Hepatitis B I decline the Hepatitis B
vaccination at this time vaccination at this time
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Adult Immunization ScheduleAdult Immunization Schedule
Persons with medical/exposure indications
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Vaccination AppointmentsVaccination Appointments
• Appointments for Appointments for your vaccination your vaccination can be scheduled can be scheduled at the Norris at the Norris Health CenterHealth Center
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Top 11 Most Frequently Asked Questions About Viral Hepatitis
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What is Chronic HBV?What is Chronic HBV?
• Life-long liver disease Life-long liver disease caused by infection with HBVcaused by infection with HBV
• These people are infected for These people are infected for life and can spread the life and can spread the disease to othersdisease to others
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Will I die from Hepatitis B?Will I die from Hepatitis B?
• Most people do not die from it.
• There are cases where Hepatitis B can cause liver damage (cirrhosis) that does not go away.
• Hepatitis B can also cause liver cancer, which may lead to death. Good medical care can make your risk less for these.
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Treatment for Chronic Hepatitis BTreatment for Chronic Hepatitis B
• Check with your doctor about Check with your doctor about treatment for chronic hepatitis B. treatment for chronic hepatitis B. Most people with chronic hepatitis Most people with chronic hepatitis B will remain carriers of the virus B will remain carriers of the virus if they do not get treated. if they do not get treated.
• The best things carriers can The best things carriers can do: do: – make sure their babies get all of their make sure their babies get all of their
hepatitis B shotshepatitis B shots– make sure they do not spread it to make sure they do not spread it to
othersothers– get good health careget good health care
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Booster Doses and Booster Doses and Post-vaccination Post-vaccination TestingTesting
• Vaccine-induced hepatitis B Vaccine-induced hepatitis B surface antibody levels may surface antibody levels may decline over time; however, decline over time; however, immune memory remains intact immune memory remains intact indefinitely following indefinitely following immunization. immunization.
• Persons with declining antibody Persons with declining antibody levels are still protected against levels are still protected against clinical illness and chronic clinical illness and chronic disease.disease.
• After routine vaccination of After routine vaccination of infants, children, adolescents or infants, children, adolescents or adults, post-vaccination testing adults, post-vaccination testing for adequate antibody response for adequate antibody response is not necessaryis not necessary
Source: CDC, 2003
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If my hepatitis B vaccination series is interrupted, do I have to start over?
• No. If the vaccination series is interrupted, resume with the next dose in the series.
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ConclusionConclusion
Questions?Questions?
