Bloodborne Pathogens

Session ObjectivesYou will be able to:• Identify bloodborne pathogens (BBPs)• Understand how diseases are transmitted• Determine your risk of exposure• Protect yourself from exposure through

prevention• Respond appropriately if exposed• Understand your right to medical evaluations

Positions Who May Have Occupational Exposure

• Deputies/Detectives• Corrections/Juvenile Detention Officers• Shelter Home Youth Workers• Public Health Nurses• Custodial Workers• Highway Workers• Park Maintenance Workers• Airport Maintenance Workers• Library Branch Workers• Aging Disability Resources Specialists• Site Managers• Nutrition/Transportation Drivers• Designated First Responders• Medical Examiner and Deputy Medical Examiners• Etc.

What Are Bloodborne Pathogens?• Disease-causing microorganisms in human

blood:• Viruses, bacteria, parasites, fungi

• Primary workplace pathogens• Human immunodeficiency virus (HIV)• Hepatitis B virus (HBV)• Hepatitis C virus (HCV)

HIV • Leads to AIDS

• Attacks and depletes the human immune system

• Does NOT survive outside the body

Hepatitis B Virus • 1-1.25 million people

infected

• Chronic liver disease, liver cancer, death

• Vaccine is available

• Can survive outside the body; 1 week in dried blood

Hepatitis C Virus (HCV)• 3.9 million Americans are infected

• 70% suffer chronic liver disease

• 8,000 to 10,000 deaths/year

• Drug treatment effective in only 10% to 40% of persons

• Can survive outside the body

Transmission of Pathogens• Contact with infected

blood

• Body fluids containing infected blood

• Cut by a contaminated sharp objects or needles

Infectious Bodily Fluids• Blood

• Saliva

• Vomit

• Urine

• Other Bodily fluids

Routes of Entry• Mucous membranes

• Eyes• Nose• Mouth

• Non-intact skin• Cuts• Abrasions• Dermatitis• Hangnails

Routes of Exposure• Co-worker suffers a bleeding

injury

• Administering first aid

• Touching a contaminated surface

• Assigned to clean up blood

Routes of Exposure (cont.)

• Contact with contaminated paper products or equipment in restrooms

• Using a tool covered with dried blood

• Cuts from other contaminated sharps (broken glass, razor, etc.)

• Bite which punctures/penetrates the skin

Bloodborne Diseases—Any Questions?Any questions about:

• The definition of bloodborne pathogens?

• Transmission of bloodborne pathogens?

• How you could be exposed?

Protect Yourself• Review your Department ECP• Take universal precautions• Use personal protective equipment• Follow safe work practices• Get the Hepatitis B vaccination• Follow decontamination and disposal

procedures

Universal Precautions• Treat all blood and

bodily fluids as if infected

• Use barrier protection (gloves, masks, aprons, eyewear) to avoid contact with infected bodily fluids

• Immediately clean up and decontaminate surfaces and equipment

From: osha.gov

Protective Barriers• Gloves• Eye protection• Clothing or aprons• Nose and mouth

protection• CPR mask• Impromptu barriers

Safe Work Practices• Remove contaminated PPE and clothing

• Disinfect contaminated equipment/surfaces

• Wash up immediately after exposure

• Dispose of contaminated items

Avoid Puncture Wounds• Use tongs, forceps, or

similar tools to pick up contaminated items, especially to protect against sharp objects

• Never pick-up broken glass or sharps with your hands

Removal of Gloves

Safe Work Practices—Do’s• Remove contaminated PPE and clothing

before leaving the work area• Disinfect contaminated equipment• Wash up immediately after exposure• Seek immediate medical attention• Double-glove to reduce contamination risk• Dispose of contaminated items properly

Safe Work Practices—Don’ts• No eating, drinking, cigarettes, cosmetics or

other personal items in any work areas where there is the possibility of exposure to blood

• Do not place or store food on bathroom shelves, cabinets, countertops, or work surfaces in any work areas where blood or bodily fluids may occur

ECP, Precautions and Safe Practices—Any Questions?

• Are there any questions about the ECP?

• Any questions about universal precautions or PPE?

• Any questions about safe practices?

Decontamination• Wear appropriate

gloves (latex free)

• Bleach solution – ¼ cup bleach per gallon of water

• Immediately dispose of PPE, towels, rags, and other contaminated items

Biohazard Waste Disposal• Liquid or semi-liquid blood or

other potentially infectious materials (OPIM)

• Contaminated items that would release blood or OPIM if compressed

• Contaminated sharp objects

• Items caked with dried blood or OPIM, capable of release during handling

Label Waste Containers• Labels communicate

a hazard

• Universal biohazard symbol

• Red containers may be substituted for labels

Biohazard Disposal—Unregulated Waste• Blood or OPIM absorbed without the release of

liquid when compressed

• Band-aids or tissues

• Gauze, paper towels, and disposable PPE

• Absorb all liquid

• Double bag waste

Exposure Incident• Wash cuts and skin

thoroughly • Rinse nose and mouth• Flush eyes with clean

water or sterile solution• Clean all contaminated

surfaces• Report accidents

involving blood• Go to emergency room

Post-Exposure Evaluation• Report incident to your supervisor• Complete County’s injury/accident report

form• Complete “determination of exposure to

blood/body fluids” form accurately and with as much information as possible

• Document route(s) of exposure and how exposure occurred

Post-Exposure Follow-Up• Physician needs to determine that there was a significant

exposure

• The County allows an employee to seek a second opinion with their personal physician at the County’s expense.

• County provides risk counseling and offers post-exposure protective treatment for disease when medically indicated

• Physician provides written opinion of findings to County (CONFIDENTIAL) and copy to employee within 15 days of the evaluation.

Post-Exposure Follow-Up• Obtain consent from the source individual to have

blood test – County will pay charges

• Exposed employee should also have their blood tested as soon as possible after exposure incident

• Court Order can be obtained from District Attorney’s Office if source person does not consent

Court Ordered HIV Testing of Source Person Applies

• Wisconsin Statute provides a provision to have source person blood tested for the presence of HIV.

• The District Attorney will help determine if the necessary conditions apply to obtain a court-order, such as using universal precautions, proper forms, significant exposure certification, affected person category, consent to test source person, consent attempted and refused, etc.

Court Ordered HIV Testing of Source Person Applies"Affected persons" includes the following categories of workers:

• EMT's, fire fighters, peace officers, correctional officers, State Patrol officers, health care providers, and employees of health care providers, first responders, jailers and keepers of a jail, persons employed at a State juvenile secured correctional facility, staff members of State crime laboratory.

• "Peace officer" is further defined as any person vested by law with a duty to maintain public order or to make arrests for crimes, whether the duty extends to all crimes or is limited to specific crimes.

• "First responder" means a person who, as a condition of employment or as a member of an organization that provides emergency medical care before hospitalization, provides emergency medical care to a sick, disabled or injured individual before the arrival of an ambulance, but who does not provide transportation for a patient.

Court Ordered HIV Testing of Source Person Applies

Significant Exposure Involving Autopsy or Corpse

• In the case of significant exposure involving an autopsy or a corpse, testing may be ordered by a coroner, medical examiner or physician if certain conditions are met and a request for testing and disclosure is made.

Hepatitis B Vaccination• Endorsed by medical communities• Safe when given to infants, children,

and adults• Offered to all potentially exposed employees• Provided at no cost • Vaccination declination

Hepatitis B VaccinationSchedule

• Series of 3 shots

• Given at 0, 1 and 6 months

Blood Titre Test• The County provides at no cost

• Shows if the Hepatitis B series was effective

• Highly recommended because immunity does not always occur with the 1st series.

• If results are not effective - - recommend another full series of Hep B Vaccine

Decon, Disposal, and Incidents—Any Questions?

• Any questions about decontamination and disposal of blood or OPIM?

• Any questions about exposure incidents?

• Any questions about the Hepatitis B vaccination?

Key Points to Remember• Bloodborne pathogens can cause fatal disease

• Be aware of exposure at work

• Take universal precautions• Use PPE and safe work practices• Decontaminate yourself and equipment

• Understand and follow exposure incident procedures

• Report incidences of exposure

Quiz

Name two of the most common Bloodborne Pathogens.

Quiz

After exposure to potentiallyinfected bodily fluids,

you should immediately:

QuizHIV and Hepatitis B can be

transmitted when infected bodily fluids directly

contact the eyes or non-intact skin.

True or False

Quiz

The risk of exposure toBloodborne Pathogens is only

possible when blood is present in the bodily fluid.

True or False

Quiz

Treating all bodily fluids as though they are infectedis known as

______________________ precautions.

Quiz

HIV stays alive in dried blood.

True or False

Quiz

Name one way youmight be exposed to

human blood at your workplace.

Quiz

What minimum PPEshould be worn when

controlling normal bleeding?

Quiz

Besides the disinfectant/cleanerprovided in first-aid kits, what other

solutions can be used todecontaminate equipment

or surfaces?

Quiz

How do you dispose of absorbedbodily fluids?

QUESTIONS?

Hepatitis B Vaccine Decision Video