BLOOD BORNE PATHOGENS OSHA 1910.1030. BLOOD BORNE PATHOGENS REQUIREMENTS –Employer must have...

BLOOD BORNE BLOOD BORNE PATHOGENSPATHOGENS

OSHA 1910.1030OSHA 1910.1030

BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS

REQUIREMENTSREQUIREMENTS– Employer must have written policyEmployer must have written policy– Employer must train all employeesEmployer must train all employees– Employer must provide necessary PPEEmployer must provide necessary PPE– Employer will provide workplace practicesEmployer will provide workplace practices

and engineering controls to reduce exposuresand engineering controls to reduce exposures

_ Employer will insure appropriate medical treatment to _ Employer will insure appropriate medical treatment to exposed employees at no cost.exposed employees at no cost.

_ All medical information will be kept confidential _ All medical information will be kept confidential


Firefighters may be exposed to blood and/or Firefighters may be exposed to blood and/or other potentially infectious materials OPIM.other potentially infectious materials OPIM.

Communicable Diseases- capable of being Communicable Diseases- capable of being passed from person to person.passed from person to person.

Examples:Examples: Hepatitis A,Hepatitis A,Hepatitis B,Hepatitis B,

Hepatitis C,Hepatitis C, Hepatitis Non A, Non B,HIVHepatitis Non A, Non B,HIV

Non-communicable diseases- food poisoningNon-communicable diseases- food poisoning


Modes of TransmissionModes of Transmission– Direct contact through skin or mucous Direct contact through skin or mucous

membranes. membranes. Blood or OPIM through open cuts or wounds.Blood or OPIM through open cuts or wounds.

Blood or OPIM into eyes, mouth, nares.Blood or OPIM into eyes, mouth, nares.

Unprotected homosexual or heterosexual contact.Unprotected homosexual or heterosexual contact.

– Casual contact, eating utensils, beds, toilets is Casual contact, eating utensils, beds, toilets is not a means of disease transmission.not a means of disease transmission.


Risk of transmission extremely low or non-Risk of transmission extremely low or non-existent;existent;– FecesFeces - nasal secretions- nasal secretions– SalivaSaliva - sputum- sputum– SweatSweat - tears- tears– UrineUrine - vomitus- vomitus

Unless visible blood is present.Unless visible blood is present.


Putting yourself at riskPutting yourself at risk– Having homosexual or heterosexual contact Having homosexual or heterosexual contact

via oral, anal or vaginal route with someone via oral, anal or vaginal route with someone who is infected.who is infected.

– Sharing a needle with an infected person.Sharing a needle with an infected person.– An infected female may pass disease to her An infected female may pass disease to her

baby during pregnancy or childbirth.baby during pregnancy or childbirth.


Occupational Risk FactorsOccupational Risk Factors– Uncontrolled situations, fights, shootings, Uncontrolled situations, fights, shootings,

vehicle extrications.vehicle extrications.– Home deliveries of childrenHome deliveries of children– Cardiac arrestsCardiac arrests– Industrial AccidentsIndustrial Accidents


Protecting yourselfProtecting yourself– PPEPPE

- Minimum is a pair of gloves- Minimum is a pair of gloves

Eye protection may be requiredEye protection may be required

Full gown, booties may be requiredFull gown, booties may be required

If it’s wet and it isn’t yours don’t touch it!!!If it’s wet and it isn’t yours don’t touch it!!!


DiseasesDiseases– HBV- Caused by a virus.HBV- Caused by a virus.

Attacks the liverAttacks the liver

Severity ranges from mild to fatal.Severity ranges from mild to fatal.

25% of infected individuals develop acute hepatitis25% of infected individuals develop acute hepatitis

Of infected individuals 6-10% well become carriersOf infected individuals 6-10% well become carriers

Carriers are at risk of developing chronic liver Carriers are at risk of developing chronic liver disease.disease.


HBV (cont.)HBV (cont.)– Active hepatitisActive hepatitis– CirrhosisCirrhosis– Primary liver cancerPrimary liver cancer– Infectious to othersInfectious to others


How widespread is HBVHow widespread is HBV– 1 out 20 people in the US will become 1 out 20 people in the US will become

infected some time during their lives.infected some time during their lives.– Estimated 1.25 million chronically infected Estimated 1.25 million chronically infected

Americans.Americans.

Greater risk if parents born in Southeast Asia, Greater risk if parents born in Southeast Asia, Africa, Amazon Basin of South America, the Africa, Amazon Basin of South America, the Pacific Islands or the Middle East.Pacific Islands or the Middle East.


Hepatitis cHepatitis c– Caused by a virus.Caused by a virus.– Attacks the liver.Attacks the liver.

Long Term EffectsLong Term Effects- Chronic liver disease- Chronic liver disease- Cirrhosis- Cirrhosis- Liver Cancer- Liver Cancer- Fatal- Fatal


HIV- Human Immunodeficiency VirusHIV- Human Immunodeficiency Virus– Some individuals exhibit no signs.Some individuals exhibit no signs.– More severe symptoms include loss of More severe symptoms include loss of

appetite, weight loss, fever, night sweats, appetite, weight loss, fever, night sweats, skin rashes, diarrhea, tiredness, lack of skin rashes, diarrhea, tiredness, lack of resistance to infection, swollen lymph nodes.resistance to infection, swollen lymph nodes.

– May progress to AIDS- lowers the body’s May progress to AIDS- lowers the body’s defense against disease.defense against disease.


HBV Vaccination ProgramHBV Vaccination Program– Free to all membersFree to all members– Declinations must be signed if not receiving Declinations must be signed if not receiving

vaccinationvaccination– Boosters and Titer if indicated/ required by Boosters and Titer if indicated/ required by

OSHA/CDC will be offered free f charge.OSHA/CDC will be offered free f charge.– If vaccination initially refused may be If vaccination initially refused may be

rescinded anytime during employment. rescinded anytime during employment.


ExposuresExposures– Actual- needle stick, blood or OPIM in open Actual- needle stick, blood or OPIM in open

cut or in mouth, nose, eyes.cut or in mouth, nose, eyes.– Medical treatment- hospital or Occupational Medical treatment- hospital or Occupational

MedicineMedicine– Injury report form.Injury report form.– Communicable disease report form.Communicable disease report form.


SuspectedSuspected– Blood or OPIM in contact with intact skin.Blood or OPIM in contact with intact skin.– Wash area with soap and water or appropriate Wash area with soap and water or appropriate

cleansing agent.cleansing agent.– Document incident.Document incident.


Equipment MaintenanceEquipment Maintenance– Protect yourself during equipment decon and Protect yourself during equipment decon and

cleansing.cleansing.– Some viral agents may survive up to 7 days in dried Some viral agents may survive up to 7 days in dried

blood.blood.– Gloves should always be worn.Gloves should always be worn.– Eye protection may be required when using solutions.Eye protection may be required when using solutions.

BE SMART. STAY SAFE.BE SMART. STAY SAFE.

AIRBORNE PATHOGENS AIRBORNE PATHOGENS

Communicable diseasesCommunicable diseases– TuberculosisTuberculosis– SARSSARS– Whooping coughWhooping cough– FluFlu

Spread by inhalation of airborne droplets from Spread by inhalation of airborne droplets from cough of infected persons.cough of infected persons.

AIRBORNE PATHOGENSAIRBORNE PATHOGENS

TuberculosisTuberculosis– An infectious diseaseAn infectious disease– Characterized by inflammatory infiltrations Characterized by inflammatory infiltrations

and the formation of tubercules, abcesses, and the formation of tubercules, abcesses, fibrosis and calcificationsfibrosis and calcifications

– Most commonly affects respiratory systemMost commonly affects respiratory system

Spread through airborne droplets containing Spread through airborne droplets containing tubercle bacilli.tubercle bacilli.

AIRBOREN PATHOGENSAIRBOREN PATHOGENS

Tb (CONT.)Tb (CONT.)– Can also affect the gastrointestinal and Can also affect the gastrointestinal and

genitourinary tracts, nervous system, bones, genitourinary tracts, nervous system, bones, joints, lymph nodes and skin.joints, lymph nodes and skin.

Infection is usually acquired from contact with Infection is usually acquired from contact with an infected person.an infected person.


The Path of TransmissionThe Path of Transmission– The air droplets are inhaled by people in the The air droplets are inhaled by people in the

close proximity of the infected person.close proximity of the infected person.– In some individuals the tubercle bacilli will In some individuals the tubercle bacilli will

enter the alveoli and establish an infection.enter the alveoli and establish an infection.– Within weeks of the initial infection, it can Within weeks of the initial infection, it can

spread through the lymphatic system to spread through the lymphatic system to distant tissues and organs.distant tissues and organs.

– Develops an active infection/Develops an active infection/


– Latent TB InfectionLatent TB InfectionTubercle bacilli enters the body through alveoliTubercle bacilli enters the body through alveoli

Immune response limits multiplication and spread Immune response limits multiplication and spread of the bacterium.of the bacterium.

Some bacterium remain dormant and viable for Some bacterium remain dormant and viable for years or decades.years or decades.

May become “active”.May become “active”.


Signs and SymptomsSigns and Symptoms– Productive cough (usually greater than two Productive cough (usually greater than two

weeks in duration).weeks in duration).– Extreme weight loss (greater than 15 lbs. in Extreme weight loss (greater than 15 lbs. in

one week).one week).– Persistent feverPersistent fever– Night sweatsNight sweats– Bloody sputumBloody sputum– AnorexiaAnorexia


Groups with High Risk of Contracting TBGroups with High Risk of Contracting TB– Persons with HOV infectionPersons with HOV infection– Alcoholics and IV drug usersAlcoholics and IV drug users– Residents of long term care facilitiesResidents of long term care facilities– Low income populationsLow income populations– Foreign born persons from high prevalence Foreign born persons from high prevalence

countries.countries.


Medical Conditions With Increased RiskMedical Conditions With Increased Risk– HIV InfectionHIV Infection– Immunosuppressive therapyImmunosuppressive therapy– Diabetes MellitusDiabetes Mellitus– Prolonged Corticosteroid therapyProlonged Corticosteroid therapy– End stage renal diseaseEnd stage renal disease– Hematological diseasesHematological diseases– Carcionmas of oropharynx and upper GI tract Carcionmas of oropharynx and upper GI tract


Procedures posing increased risk of Procedures posing increased risk of exposureexposure– Endotrachael intubationEndotrachael intubation– Administration of aerosolized treatmentsAdministration of aerosolized treatments– Suctioning/sputum collectionSuctioning/sputum collection– Any cough producing procedureAny cough producing procedure

Administration of oxygenAdministration of oxygen

Auscultation of deep lung sounds.Auscultation of deep lung sounds.


Minimizing the RiskMinimizing the Risk– TB screening processTB screening process– Personal protective equipmentPersonal protective equipment– Adjusting field practicesAdjusting field practices


Screening for TB InfectionScreening for TB Infection– Intradermal Mantoux testIntradermal Mantoux test

Initial physicalInitial physical

Known or suspected exposureKnown or suspected exposure

As determined by risk assessment.As determined by risk assessment.


Screening Results- Positive PPD ResultsScreening Results- Positive PPD Results– Chest X-rayChest X-ray– Clinical evaluationClinical evaluation– Preventative therapyPreventative therapy– Monitor for signs and symptoms of TB.Monitor for signs and symptoms of TB.– Reported to State Department of Health- Reported to State Department of Health-

required by regulation.required by regulation.


PPE- PPE- – N-95 MasksN-95 Masks

Requires annual fit testingRequires annual fit testing

– ““Simple” surgical masks for TB patientSimple” surgical masks for TB patient– Cleaning proceduresCleaning procedures


N-95 MasksN-95 Masks– Worn in high risk areasWorn in high risk areas

Convalescent homes/roomsConvalescent homes/rooms

JailsJails

TrailersTrailers

Any close living arrangementAny close living arrangement


Reporting unprotected exposuresReporting unprotected exposures– Immediately seek medical advice from the Immediately seek medical advice from the

receiving hospital.receiving hospital.– Injury report formInjury report form– Communicable disease form.Communicable disease form.– Contact Infectious disease control officer.Contact Infectious disease control officer.

BLOOD BORNE PATHOGENS OSHA 1910.1030. BLOOD BORNE PATHOGENS REQUIREMENTS –Employer must have...

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