1 Bloodborne Pathogens Awareness Training. Version 1 2 Introduction This is an awareness level...

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Bloodborne Pathogens Bloodborne Pathogens Awareness TrainingAwareness Training

Version 1Version 1 22

Introduction Introduction

This is an awareness level This is an awareness level course that will provide course that will provide general information on general information on bloodborne pathogens to bloodborne pathogens to help minimize serious help minimize serious health risks to people who health risks to people who may be exposed to blood may be exposed to blood and other potentially and other potentially infectious materials.infectious materials.


Course AgendaCourse Agenda

Section 1Section 1: Bloodborne Pathogens: General: Bloodborne Pathogens: General Information, Regulations,Information, Regulations, Transmission, and ExposureTransmission, and Exposure

Section 2Section 2: Exposure Control Plan and: Exposure Control Plan and Compliance MethodsCompliance Methods

Section 3Section 3: Hepatitis B Vaccination and: Hepatitis B Vaccination and Post-Exposure Follow-UpPost-Exposure Follow-Up

Section 4Section 4: Labeling, Training, and: Labeling, Training, and RecordkeepingRecordkeeping

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Section 1Section 1

Bloodborne Pathogens: Bloodborne Pathogens: General Information, General Information,

Regulations, Transmission, Regulations, Transmission, and Exposure and Exposure


Bloodborne PathogensBloodborne Pathogens

Bloodborne pathogens pose a Bloodborne pathogens pose a potential risk to approximately 8 million potential risk to approximately 8 million U.S. workers in health care and other U.S. workers in health care and other areas of the workforceareas of the workforceOSHA’s Bloodborne Pathogens OSHA’s Bloodborne Pathogens standard, published in standard, published in Title 29 of the Title 29 of the Code of Federal Regulations Code of Federal Regulations 1910.10301910.1030 prescribes safeguards to prescribes safeguards to protect these workers against protect these workers against exposure to bloodborne pathogens exposure to bloodborne pathogens and other potentially infectious and other potentially infectious materials (OPIM) and reduce the risk materials (OPIM) and reduce the risk from exposurefrom exposure


What is a bloodborne pathogen?What is a bloodborne pathogen?Bloodborne pathogens (BBPs) means Bloodborne pathogens (BBPs) means pathogenic microorganisms that are pathogenic microorganisms that are present in human blood and can cause present in human blood and can cause disease in humans. These pathogens disease in humans. These pathogens include, but are not limited to, hepatitis B include, but are not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV), and virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV)human immunodeficiency virus (HIV)Blood means human blood, human blood Blood means human blood, human blood components, and products made from components, and products made from human bloodhuman bloodOther potentially infectious materials Other potentially infectious materials (OPIM) such as other body fluids (OPIM) such as other body fluids contaminated with visible bloodcontaminated with visible blood


Definition of OPIMDefinition of OPIM

Other potentially infections materials (OPIM)Other potentially infections materials (OPIM) also include also include the following human body fluids: semen, vaginal the following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations contaminated with blood, and all body fluids in situations where it is difficult to differentiate between body fluids.where it is difficult to differentiate between body fluids.It also includes any unfixed tissue or organ (other than It also includes any unfixed tissue or organ (other than intact skin) from a human (living or dead) and HIV- or intact skin) from a human (living or dead) and HIV- or HBV-containing culture medium or other solutions, and HBV-containing culture medium or other solutions, and blood, organs, or other tissue from experimental animals blood, organs, or other tissue from experimental animals infected with HIV or HBV.infected with HIV or HBV.


RegulationsRegulations

Issued in 1991, OSHA’s Bloodborne Pathogens Issued in 1991, OSHA’s Bloodborne Pathogens standard, published in standard, published in Title 29 of the Code of Federal Title 29 of the Code of Federal Regulations 1910.1030,Regulations 1910.1030, is part of the Occupation Safety is part of the Occupation Safety and Health Act of 1970 (OSH Act) under the US. and Health Act of 1970 (OSH Act) under the US. Department of LaborDepartment of LaborUpdated in January, 2001 (changes effective April, 2001) Updated in January, 2001 (changes effective April, 2001) as a result of the Needlestick Safety and Prevention Act as a result of the Needlestick Safety and Prevention Act issued in November 2000issued in November 2000Includes additional guidelines for HIV and HBV research Includes additional guidelines for HIV and HBV research laboratories and production facilities laboratories and production facilities Many states administer their own occupational safety Many states administer their own occupational safety and health programs through plans approved under the and health programs through plans approved under the OSH ActOSH Act


Bloodborne Pathogen Bloodborne Pathogen Standard SummaryStandard Summary

Establish an Exposure Control PlanEstablish an Exposure Control PlanUse engineering controlsUse engineering controlsEnforce work practice controlsEnforce work practice controlsProvide personal protective equipmentProvide personal protective equipmentMake Hepatitis B vaccinations availableMake Hepatitis B vaccinations availableProvide post-exposure follow-upProvide post-exposure follow-upUse labels and signs to communicate Use labels and signs to communicate hazardshazardsProvide information and training to Provide information and training to employeesemployeesMaintain employee medical and training Maintain employee medical and training recordsrecords


OSHA EnforcementOSHA EnforcementInspectionInspection

Penalties/SanctionsPenalties/Sanctions– Serious ViolationSerious Violation– Other-Than-Serious ViolationOther-Than-Serious Violation– Willful ViolationWillful Violation– Repeated ViolationRepeated Violation– Failure to Correct Prior ViolationFailure to Correct Prior Violation

Compliance AssistanceCompliance Assistance


Who is covered by the standard?Who is covered by the standard?The standard applies to all employees who may The standard applies to all employees who may reasonably anticipate occupational exposure to reasonably anticipate occupational exposure to blood or other potentially infectious materials blood or other potentially infectious materials (OPIM).(OPIM).““Good Samaritan” acts such as assisting a co-Good Samaritan” acts such as assisting a co-worker with a laceration or nosebleed would not worker with a laceration or nosebleed would not be considered occupational exposure.be considered occupational exposure.If an employer designates and trains employees If an employer designates and trains employees to render first aid or medical assistance as a part to render first aid or medical assistance as a part of their job duties, they are covered by the of their job duties, they are covered by the protections of this standard.protections of this standard.


Why is protection so important?Why is protection so important?Bloodborne pathogens have the Bloodborne pathogens have the potential to cause serious illness potential to cause serious illness and death. These pathogens and death. These pathogens include, but are not limited to:include, but are not limited to:– Hepatitis B VirusHepatitis B Virus– Hepatitis C VirusHepatitis C Virus– Human Immunodeficiency Virus Human Immunodeficiency Virus

(HIV)(HIV)

Prevention is the best method of Prevention is the best method of protection against exposure to protection against exposure to bloodborne pathogensbloodborne pathogens


Transmission of Transmission of Bloodborne PathogensBloodborne Pathogens

Transmission of bloodborne pathogens in Transmission of bloodborne pathogens in the occupational setting is primarily the occupational setting is primarily through percutaneous (needlestick/sharps) through percutaneous (needlestick/sharps) or mucous membrane exposure to or mucous membrane exposure to infected blood and body fluidsinfected blood and body fluids


Hepatitis B Virus InfectionHepatitis B Virus InfectionA serious liver disease that can cause lifelong infection, A serious liver disease that can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, cirrhosis (scarring) of the liver, liver cancer, liver failure, and deathand deathSymptoms can include:Symptoms can include:– Jaundice, fatigue, abdominal pain, loss of appetite, nausea, Jaundice, fatigue, abdominal pain, loss of appetite, nausea,

vomiting, joint painvomiting, joint pain– About 30-40% of people infected with HBV have no signs or About 30-40% of people infected with HBV have no signs or

symptomssymptoms

TransmissionTransmission– By percutaneous (needlestick/sharps) or mucous membrane By percutaneous (needlestick/sharps) or mucous membrane

exposure to blood and body fluids infected with HBV (acute or exposure to blood and body fluids infected with HBV (acute or chronic HBV)chronic HBV)

Incubation period 45 to 180 days (avg. 60-90 days)Incubation period 45 to 180 days (avg. 60-90 days)Can live on a dry surface for at least 7 days and still be capable of Can live on a dry surface for at least 7 days and still be capable of causing infectioncausing infection


Hepatitis C Virus InfectionHepatitis C Virus InfectionA serious liver disease that can lead to long-term A serious liver disease that can lead to long-term infection, chronic liver disease, cirrhosis (scarring of the infection, chronic liver disease, cirrhosis (scarring of the liver), liver cancer, and deathliver), liver cancer, and deathSymptoms can include:Symptoms can include:– Jaundice, fatigue, dark urine, abdominal pain, loss of appetite, Jaundice, fatigue, dark urine, abdominal pain, loss of appetite,

nauseanausea– About 80% of people infected with HCV have no signs or About 80% of people infected with HCV have no signs or

symptomssymptoms

TransmissionTransmission– By percutaneous (needlestick/sharps) or mucous membrane By percutaneous (needlestick/sharps) or mucous membrane

exposure to blood and body fluids infected with HCV (acute or exposure to blood and body fluids infected with HCV (acute or chronic HCV)chronic HCV)

Incubation period is 6 to 7 weeksIncubation period is 6 to 7 weeksLimited data on survival of HCV in the environmentLimited data on survival of HCV in the environment


HIV InfectionHIV Infection

HIV is the Human Immunodeficiency Virus that causes HIV is the Human Immunodeficiency Virus that causes AIDS; many people with HIV infection will develop AIDS AIDS; many people with HIV infection will develop AIDS as a resultas a resultSymptoms may include:Symptoms may include:– Rapid weight loss; dry cough; recurring fever or profuse night sweats; Rapid weight loss; dry cough; recurring fever or profuse night sweats;

profound and unexplained fatigue; swollen lymph glands in armpits, profound and unexplained fatigue; swollen lymph glands in armpits, groin, or neck; diarrhea lasting >1 week; white spots/blemishes on the groin, or neck; diarrhea lasting >1 week; white spots/blemishes on the tongue, mouth, throat; pneumonia; red, brown, pink, or purplish blotches tongue, mouth, throat; pneumonia; red, brown, pink, or purplish blotches on or under skin or inside the mouth, nose, or eyelids; memory loss, on or under skin or inside the mouth, nose, or eyelids; memory loss, depression, and other neurological disordersdepression, and other neurological disorders

TransmissionTransmission– By percutaneous (needlestick/sharps) or, infrequently, mucous By percutaneous (needlestick/sharps) or, infrequently, mucous

membrane exposure to blood or body fluids containing blood infected membrane exposure to blood or body fluids containing blood infected with HIVwith HIV

HIV antibody usually develops within 6 months of exposureHIV antibody usually develops within 6 months of exposureDoes not survive well outside the body—environmental transmission is Does not survive well outside the body—environmental transmission is remoteremote


What is Exposure?What is Exposure?

Occupational ExposureOccupational Exposure means reasonably means reasonably anticipated skin, eye, mucous membrane, or anticipated skin, eye, mucous membrane, or percutaneous contact with blood or other percutaneous contact with blood or other potentially infectious materials (OPIM) that may potentially infectious materials (OPIM) that may result from the performance of an employee’s result from the performance of an employee’s duties duties Exposure IncidentExposure Incident means a specific eye, means a specific eye, mouth, or other mucous membrane, non-intact mouth, or other mucous membrane, non-intact skin, or percutaneous contact with blood or skin, or percutaneous contact with blood or OPIM that results from the performance of an OPIM that results from the performance of an employee’s duties employee’s duties


Who is at risk for exposure?Who is at risk for exposure?Employers are responsible for determining the Employers are responsible for determining the hazard risk for exposure to bloodborne pathogens hazard risk for exposure to bloodborne pathogens in their companyin their company– Assistance in determining a hazard risk in your Assistance in determining a hazard risk in your

company is available through OSHAcompany is available through OSHAExamples of who may be at risk:Examples of who may be at risk:– Nurses, physicians, emergency personnel Nurses, physicians, emergency personnel

(emergency room employees, paramedics, EMTs), (emergency room employees, paramedics, EMTs), and other healthcare workers, especially those and other healthcare workers, especially those providing first-response medical careproviding first-response medical care

– Laboratory and blood bank technologists and Laboratory and blood bank technologists and technicianstechnicians

– Dentists and other dental workersDentists and other dental workers– Law enforcement personnel and firefightersLaw enforcement personnel and firefighters– Houskeeping personnel and laundry workersHouskeeping personnel and laundry workers– Medical waste treatment employeesMedical waste treatment employees– Medical examiners and morticiansMedical examiners and morticians


How can exposure happen?How can exposure happen?The most common means of The most common means of exposure is from exposure is from percutaneous injuries percutaneous injuries (through the skin) with (through the skin) with contaminated sharps contaminated sharps (needles and scalpels) (82%)(needles and scalpels) (82%)Contact with mucous Contact with mucous membranes of the eyes, membranes of the eyes, nose, or mouth (14%)nose, or mouth (14%)Exposure of broken or Exposure of broken or abraded skin (3%)abraded skin (3%)Human bites (1%)Human bites (1%)


How can exposure be prevented?How can exposure be prevented?

Universal PrecautionsUniversal Precautions– Treat all blood and body fluids as potentially infectiousTreat all blood and body fluids as potentially infectious

Immunization with the Hepatitis B Virus VaccineImmunization with the Hepatitis B Virus VaccineEngineering ControlsEngineering Controls– Safer medical devices for medical procedures and Safer medical devices for medical procedures and

sharps disposalsharps disposal

Work Practice ControlsWork Practice Controls– Safer techniques for medical proceduresSafer techniques for medical procedures– Personal Protective Equipment (PPE)Personal Protective Equipment (PPE)

Appropriate barriers such as gloves, gowns, eye and face Appropriate barriers such as gloves, gowns, eye and face protectionprotection


Section 1 Q & ASection 1 Q & A

Any questions on information Any questions on information covered in this section?covered in this section?

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Section 2Section 2

Exposure Control Plan andExposure Control Plan and

Compliance MethodsCompliance Methods


Exposure Control PlanExposure Control Plan

Each employer must establish an Exposure Control Plan Each employer must establish an Exposure Control Plan (ECP) to eliminate or minimize employee exposures(ECP) to eliminate or minimize employee exposuresMust be writtenMust be writtenMust be reviewed annually and updated, as necessary, Must be reviewed annually and updated, as necessary, to reflect changes in:to reflect changes in:– Technology that will help eliminate or reduce exposureTechnology that will help eliminate or reduce exposure– Employee tasks, assignments, procedures which affect Employee tasks, assignments, procedures which affect

exposure exposure

Annually document that employer has considered and Annually document that employer has considered and implemented safer medical devices (if feasible) implemented safer medical devices (if feasible) – Employers must solicit input from frontline workers (potentially Employers must solicit input from frontline workers (potentially

exposed) in identifying, evaluating, and selecting engineering exposed) in identifying, evaluating, and selecting engineering controlscontrols

Plan must be accessible to employeesPlan must be accessible to employees


Exposure Control PlanExposure Control Plan

Exposure DeterminationExposure Determination– Identify worker exposure to blood or Identify worker exposure to blood or

OPIMOPIM– Review all processes and procedures Review all processes and procedures

with exposure potentialwith exposure potential– Re-evaluate when new processes or Re-evaluate when new processes or

procedures are usedprocedures are used

Exposure determination must be Exposure determination must be made without regard to the use of made without regard to the use of personal protective equipmentpersonal protective equipment


Engineering andEngineering andWork Practice ControlsWork Practice Controls

Employer Responsibility:Employer Responsibility:

Review/evaluate available engineering Review/evaluate available engineering controls (safer medical devices) at controls (safer medical devices) at least annuallyleast annually– Document review/evaluation in ECPDocument review/evaluation in ECP

Review new devices and technologies Review new devices and technologies at least annuallyat least annually– Must solicit input from non-managerial Must solicit input from non-managerial

employees in the selection of controlsemployees in the selection of controls– Document review in ECPDocument review in ECP


Engineering andEngineering andWork Practice ControlsWork Practice Controls

Employer Responsibility:Employer Responsibility:Implement engineering controls/devices as Implement engineering controls/devices as appropriateappropriate– Document evaluation and implementation in ECPDocument evaluation and implementation in ECP– Controls Controls mustmust be used if they reduce employee be used if they reduce employee

exposure either by removing, eliminating, or isolating exposure either by removing, eliminating, or isolating the hazardthe hazard

Train employees on safe use and disposalTrain employees on safe use and disposal– Document in ECPDocument in ECP

Train employees to use current and new devices Train employees to use current and new devices and/or proceduresand/or procedures– Document in ECPDocument in ECP


Compliance MethodsCompliance Methods

Universal PrecautionsUniversal Precautions

Engineering and Work Engineering and Work Practice ControlsPractice Controls

Personal Protective Personal Protective EquipmentEquipment

HousekeepingHousekeeping– LaundryLaundry– Regulated WasteRegulated Waste


Universal PrecautionsUniversal Precautions

OSHA’s required method of control to protect employees OSHA’s required method of control to protect employees from exposure to all human blood and OPIMfrom exposure to all human blood and OPIMRefers to a concept of bloodborne disease control which Refers to a concept of bloodborne disease control which requires that all human blood and certain human body requires that all human blood and certain human body fluids are treated as if known to be infectious for HIV, fluids are treated as if known to be infectious for HIV, HBV, HCV and other bloodborne pathogensHBV, HCV and other bloodborne pathogensMust be observed in all situations where there is a Must be observed in all situations where there is a potential for contact with blood or OPIMpotential for contact with blood or OPIMIntended to prevent percutaneous, mucous membrane, Intended to prevent percutaneous, mucous membrane, and non-intact skin exposure to bloodborne pathogensand non-intact skin exposure to bloodborne pathogens


Engineering ControlsEngineering Controls

Primary methods used to control Primary methods used to control transmission of bloodborne pathogens transmission of bloodborne pathogens Controls that reduce employee exposure Controls that reduce employee exposure to bloodborne pathogens in the to bloodborne pathogens in the workplace by isolating or removing the workplace by isolating or removing the hazard from the workplacehazard from the workplace– Sharps disposal containersSharps disposal containers– Self-sheathing needlesSelf-sheathing needles– Safer medical devicesSafer medical devices

Sharps with engineered sharps injury Sharps with engineered sharps injury protectionsprotectionsNeedleless systemsNeedleless systems

OSHA does not approve or endorse any OSHA does not approve or endorse any medical device productmedical device product


Work Practice ControlsWork Practice ControlsControls that reduce the likelihood of exposure Controls that reduce the likelihood of exposure by altering the manner in which a task is by altering the manner in which a task is performedperformed– HandwashingHandwashing

After removing glovesAfter removing glovesAs soon as possible after exposure As soon as possible after exposure Use of gloves does not eliminate the need for Use of gloves does not eliminate the need for handwashing!handwashing!

– Needle and Sharps SafetyNeedle and Sharps SafetyDo not recap needles with 2-handed techniqueDo not recap needles with 2-handed techniqueDo not bend or break sharpsDo not bend or break sharpsUse appropriate containers for disposal or re-useUse appropriate containers for disposal or re-use

– Perform procedures involving blood or OPIM to Perform procedures involving blood or OPIM to minimize splashing, spraying, spattering and minimize splashing, spraying, spattering and generation of dropletsgeneration of droplets

– No food or smoking in work areasNo food or smoking in work areas


Personal Protective EquipmentPersonal Protective EquipmentSpecialized clothing or equipment worn by an Specialized clothing or equipment worn by an employee for protection against potentially employee for protection against potentially infectious materialsinfectious materials

General work clothes (e.g., uniforms, pants, General work clothes (e.g., uniforms, pants, shirts or blouses) not intended to function as shirts or blouses) not intended to function as protection against a hazard are not considered protection against a hazard are not considered to be personal protective equipment (PPE)to be personal protective equipment (PPE)

Employers must provide “appropriate” PPE at no Employers must provide “appropriate” PPE at no cost to employeescost to employees


Personal Protective EquipmentPersonal Protective EquipmentPPE must be properly used, cleaned, PPE must be properly used, cleaned, decontaminated, laundered, repaired, and decontaminated, laundered, repaired, and disposed of at no cost to employeesdisposed of at no cost to employees– The manufacturer’s instructions for use, cleaning, and The manufacturer’s instructions for use, cleaning, and

decontamination must be followed in order for PPE to decontamination must be followed in order for PPE to remain effectiveremain effective

Must be removed when leaving the area or upon Must be removed when leaving the area or upon contamination with potentially infectious contamination with potentially infectious materialsmaterials– DO NOT take PPE home to launder, clean, or DO NOT take PPE home to launder, clean, or

disinfectdisinfect


Personal Protective EquipmentPersonal Protective EquipmentExamples of PPE:Examples of PPE:– GlovesGloves– Gowns, Aprons, Laboratory CoatsGowns, Aprons, Laboratory Coats– Surgical caps, hoods, shoe coversSurgical caps, hoods, shoe covers– Face shields or masks and eye Face shields or masks and eye

protectionprotection– Mouthpieces, resuscitation bags, Mouthpieces, resuscitation bags,

pocket masks, or other ventilation pocket masks, or other ventilation devicesdevices


HousekeepingHousekeeping

Ensure that the worksite is maintained in a Ensure that the worksite is maintained in a clean and sanitary conditionclean and sanitary condition

Determine and implement an appropriate Determine and implement an appropriate written schedule for cleaning and method of written schedule for cleaning and method of decontamination based upon:decontamination based upon:– Location within the facilityLocation within the facility– Type of surface to be cleanedType of surface to be cleaned– Type of soil presentType of soil present– Tasks or procedures being performed in the areaTasks or procedures being performed in the area


HousekeepingHousekeeping

Work surfaces must be decontaminated Work surfaces must be decontaminated with an appropriate disinfectant:with an appropriate disinfectant:– After contact with blood or OPIMAfter contact with blood or OPIM– Completion of proceduresCompletion of procedures– Immediately or as soon as feasible with Immediately or as soon as feasible with

obvious contamination or after any spill of obvious contamination or after any spill of blood or OPIMblood or OPIM

– At the end of the work shift At the end of the work shift


LaundryLaundry

Handle contaminated laundry as little as Handle contaminated laundry as little as possible using appropriate PPE possible using appropriate PPE

Place and transport in labeled or color-Place and transport in labeled or color-coded bags or containers at the location coded bags or containers at the location where usedwhere used– Wet laundry with potential for leakage must be Wet laundry with potential for leakage must be

placed and transported in bags or containers placed and transported in bags or containers that prevent leakage of fluids to the exteriorthat prevent leakage of fluids to the exterior

No sorting or rinsing at location where No sorting or rinsing at location where usedused


Regulated WasteRegulated Waste

Liquid or semi-liquid blood or OPIMLiquid or semi-liquid blood or OPIM

Contaminated items that would Contaminated items that would release blood or OPIM in a liquid or release blood or OPIM in a liquid or semi-liquid state if compressedsemi-liquid state if compressed

Items that are caked with dried Items that are caked with dried blood or OPIM and are capable of blood or OPIM and are capable of releasing these materials during releasing these materials during handlinghandling

Contaminated sharpsContaminated sharps

Pathological and microbiological Pathological and microbiological wastes containing blood or OPIMwastes containing blood or OPIM



Must be placed in closeable, leak-Must be placed in closeable, leak-proof containers built to contain all proof containers built to contain all contents during handling, storing, contents during handling, storing, transporting, or shipping and be transporting, or shipping and be appropriately labeled or color-appropriately labeled or color-codedcodedClose prior to removal Close prior to removal If outside contamination of the If outside contamination of the regulated waste container occurs, it regulated waste container occurs, it should be placed in a second should be placed in a second container that meets the above container that meets the above requirementsrequirements



Additional requirements for discarding and Additional requirements for discarding and containing contaminated sharps:containing contaminated sharps:– Discard immediately or as soon as feasibleDiscard immediately or as soon as feasible– Containers must be puncture resistant and Containers must be puncture resistant and

leak-proof on sides and bottomleak-proof on sides and bottom– During use, sharps containers should beDuring use, sharps containers should be

Easily accessible to personnel in the immediate Easily accessible to personnel in the immediate area where sharps are used/foundarea where sharps are used/foundMaintained upright throughout useMaintained upright throughout useReplaced routinely and not be allowed to overfillReplaced routinely and not be allowed to overfill



Any questions on Any questions on information covered in this information covered in this section?section?

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Section 3Section 3

Hepatitis B Vaccination and Hepatitis B Vaccination and

Post-Exposure Follow-upPost-Exposure Follow-up


Hepatitis B VaccinationHepatitis B Vaccination

Employers must make the Hepatitis B Employers must make the Hepatitis B Vaccine available to all employees at Vaccine available to all employees at risk of exposure:risk of exposure:– Within 10 working days of initial assignmentWithin 10 working days of initial assignment– Free of chargeFree of charge– At a reasonable time and placeAt a reasonable time and place– Vaccination must be performed by or under Vaccination must be performed by or under

the supervision of a licensed healthcare the supervision of a licensed healthcare professionalprofessional

The following are exceptions:The following are exceptions:– Employee has had the vaccinationEmployee has had the vaccination– Antibody testing reveals immunityAntibody testing reveals immunity– Vaccine is contraindicated for medical Vaccine is contraindicated for medical

reasonsreasons


Hepatitis B VaccinationHepatitis B Vaccination

Employees who decline vaccination must sign a Employees who decline vaccination must sign a declination formdeclination formEmployers must provide the vaccination to Employers must provide the vaccination to Employees who decline and then at a later date Employees who decline and then at a later date decide to accept the vaccinationdecide to accept the vaccinationEmployers cannot require employees to Employers cannot require employees to participate in an antibody prescreening program participate in an antibody prescreening program in order to receive the vaccinationin order to receive the vaccinationEmployers must provide a booster dose(s) of the Employers must provide a booster dose(s) of the vaccine if it is recommended by the US Public vaccine if it is recommended by the US Public Health Service at a future dateHealth Service at a future date


What happens if an What happens if an exposure occurs?exposure occurs?

Wash exposed area with soap and Wash exposed area with soap and waterwater

Flush splashes to the nose, mouth or Flush splashes to the nose, mouth or skin with waterskin with water

Irrigate eyes with water, saline, or Irrigate eyes with water, saline, or sterile irrigantssterile irrigants

Report the exposureReport the exposure

Seek the assistance of a health care Seek the assistance of a health care professional to determine what professional to determine what follow-up actions or treatment may follow-up actions or treatment may be neededbe needed


Post-Exposure Follow-upPost-Exposure Follow-upEmployer must immediately make available to the Employer must immediately make available to the employee a confidential medical examination and follow-employee a confidential medical examination and follow-upupDocument date and time of exposureDocument date and time of exposureDocument routes of exposure and how the exposure Document routes of exposure and how the exposure occurredoccurredIdentification of the source individual (if feasible and Identification of the source individual (if feasible and allowable by applicable laws)allowable by applicable laws)– Obtain consent from source individual for blood to be tested as Obtain consent from source individual for blood to be tested as

soon as feasible (unless there is a known HBV or HIV infection)soon as feasible (unless there is a known HBV or HIV infection)– Results to be made available to the exposed employeeResults to be made available to the exposed employee

Obtain exposed employee’s consent for blood to be Obtain exposed employee’s consent for blood to be collected and tested as soon as feasiblecollected and tested as soon as feasible


Post-Exposure Follow-upPost-Exposure Follow-upRecord injuries from contaminated sharps in a Record injuries from contaminated sharps in a sharps injury logsharps injury logProvide risk counseling and offer post-exposure Provide risk counseling and offer post-exposure protective treatment for disease, when protective treatment for disease, when recommended by a healthcare professional in recommended by a healthcare professional in accordance with current US Public Health accordance with current US Public Health Service guidelinesService guidelinesProvide written opinion of findings to employer Provide written opinion of findings to employer and copy to employee within 15 days of the and copy to employee within 15 days of the evaluationevaluation



Any questions on Any questions on information covered in information covered in this section?this section?

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Section 4Section 4

Labeling, Training, and Labeling, Training, and RecordkeepingRecordkeeping


Biohazard Warning LabelsBiohazard Warning LabelsWarning labels must be Warning labels must be predominantly fluorescent orange or predominantly fluorescent orange or orange-red with lettering and orange-red with lettering and symbols in a contrasting colorsymbols in a contrasting color

Warning labels are required for:Warning labels are required for:– Containers of regulated wasteContainers of regulated waste– Refrigerators and freezers containing Refrigerators and freezers containing

blood or OPIMblood or OPIM– Other containers used to store, Other containers used to store,

transport or ship blood or OPIMtransport or ship blood or OPIM

Red bags or red containers may be Red bags or red containers may be substituted for labelssubstituted for labels


TrainingTraining

Employers must ensure that all employees with Employers must ensure that all employees with occupational exposure participate in a training occupational exposure participate in a training programprogram– Provided at no cost and during working hoursProvided at no cost and during working hours– Provided at the time of initial assignment to tasks with Provided at the time of initial assignment to tasks with

occupational exposure (and at least annually)occupational exposure (and at least annually)– Provide additional training when existing tasks are modified Provide additional training when existing tasks are modified

or new tasks are required which affect the employee’s or new tasks are required which affect the employee’s potential exposurepotential exposure

Maintain training records for 3 yearsMaintain training records for 3 years


Training ElementsTraining Elements

Copy of the standard with explanation of the contentsCopy of the standard with explanation of the contentsEpidemiology and symptoms of bloodborne disease; Epidemiology and symptoms of bloodborne disease; modes of transmission of bloodborne pathogensmodes of transmission of bloodborne pathogensExposure Control Plan specific to the siteExposure Control Plan specific to the siteRecognition of hazardsRecognition of hazardsUse of engineering controls, work practices and PPEUse of engineering controls, work practices and PPEExposure Incidents and Post-exposure follow-upExposure Incidents and Post-exposure follow-upLabels/signs/color codingLabels/signs/color codingOpportunity for live question and answer sessionOpportunity for live question and answer session


RecordkeepingRecordkeepingMedical RecordsMedical Records

Medical Recordkeeping for Employee Medical Recordkeeping for Employee Exposure must include:Exposure must include:– Employee’s name and social security numberEmployee’s name and social security number– Employee’s hepatitis B vaccination statusEmployee’s hepatitis B vaccination status– Results of all examinations, medical testing, Results of all examinations, medical testing,

and follow-up proceduresand follow-up procedures– Copy of information provided to the Copy of information provided to the

healthcare professionalhealthcare professional– Employer’s copy of the healthcare Employer’s copy of the healthcare

professional’s written opinionprofessional’s written opinion


RecordkeepingRecordkeepingMedical RecordsMedical Records

Employee medical records:Employee medical records:– Must be kept CONFIDENTIALMust be kept CONFIDENTIAL– Not disclosed or reported to any Not disclosed or reported to any

person within or outside the person within or outside the workplace without the employee’s workplace without the employee’s written consent (unless required by written consent (unless required by law and/or this regulation)law and/or this regulation)

– Maintained for the duration of Maintained for the duration of employee’s employment plus 30 employee’s employment plus 30 yearsyears


RecordkeepingRecordkeepingTraining RecordsTraining Records

Training Record maintenance is Training Record maintenance is required for 3 years from the training required for 3 years from the training date. The following information must date. The following information must be included:be included:– Dates of the trainingDates of the training– Contents or summary of the trainingContents or summary of the training– Names and qualifications of persons Names and qualifications of persons

conducting the trainingconducting the training– Names and job titles of all persons Names and job titles of all persons

attending the trainingattending the training


RecordkeepingRecordkeepingSharps Injury LogSharps Injury Log

Employers must establish and maintain a sharps Employers must establish and maintain a sharps injury log to record injuries from contaminated injury log to record injuries from contaminated sharpssharpsThe log must be maintained in a way to ensure The log must be maintained in a way to ensure employee privacyemployee privacyThe log must at a minimum contain:The log must at a minimum contain:– Type and brand of device involved in the incidentType and brand of device involved in the incident– Location where the incident occurredLocation where the incident occurred– Explanation of how the incident occurredExplanation of how the incident occurred

Requirement applies to any employer who is Requirement applies to any employer who is required to maintain a log of occupational injuries required to maintain a log of occupational injuries and illnesses under 29 CFR 1904and illnesses under 29 CFR 1904



Any questions on Any questions on information covered in this information covered in this section?section?


SummarySummary

OSHA’s Bloodborne Pathogens Standard is intended to OSHA’s Bloodborne Pathogens Standard is intended to provide safeguards to protect workers against the health provide safeguards to protect workers against the health hazards from exposure to blood and other potentially hazards from exposure to blood and other potentially infectious materials (OPIM) and to reduce the risk from infectious materials (OPIM) and to reduce the risk from exposureexposure– Create a safer work environment through the use of engineering Create a safer work environment through the use of engineering

and work practice controlsand work practice controls– Reduce the risk of exposure by the proper use of personal Reduce the risk of exposure by the proper use of personal

protective equipment and through proper housekeeping and protective equipment and through proper housekeeping and waste handling and disposalwaste handling and disposal

– Provide guidance on handling an exposure incident Provide guidance on handling an exposure incident

Implementation of this standard is expected to prevent Implementation of this standard is expected to prevent hepatitis B cases and significantly reduce the risk of hepatitis B cases and significantly reduce the risk of occupationally-acquired HIV, hepatitis C, and other occupationally-acquired HIV, hepatitis C, and other bloodborne pathogensbloodborne pathogens


Q & AQ & A

Any questions on any Any questions on any information covered in this information covered in this course?course?

Test your knowledge of Test your knowledge of Bloodborne Pathogens…..Bloodborne Pathogens…..


ReferencesReferences

29 CFR 1910.1030 Bloodborne Pathogens29 CFR 1910.1030 Bloodborne Pathogens

OSHA’s website at: OSHA’s website at: http://http://www.osha.govwww.osha.gov

CDC website at: CDC website at: http://http://www.cdc.govwww.cdc.gov

NIOSH website at: NIOSH website at: http://www.cdc.gov/niosh/topics/bbp/http://www.cdc.gov/niosh/topics/bbp/


Where to Get More InformationWhere to Get More InformationRegional OSHA office for Pennsylvania Regional OSHA office for Pennsylvania

(Region III, DE, DC, MD, PA, VA, WV):(Region III, DE, DC, MD, PA, VA, WV):Regional OfficeRegional Office

U.S. Department of Labor/OSHAU.S. Department of Labor/OSHAThe Curtis Center-Suite 740 WestThe Curtis Center-Suite 740 West170 S. Independence Mall West170 S. Independence Mall WestPhiladelphia, PA 19106-3309Philadelphia, PA 19106-3309TELE: (215) 861-4900TELE: (215) 861-4900FAX: (215) 861-4904 FAX: (215) 861-4904

Pittsburgh Area OfficePittsburgh Area OfficeFederal Office Building, Room 1428Federal Office Building, Room 14281000 Liberty Avenue1000 Liberty AvenuePittsburgh, Pennsylvania 15222-4101Pittsburgh, Pennsylvania 15222-4101(412) 395-4903(412) 395-4903(412) 395-6380 FAX(412) 395-6380 FAX

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