OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.
-
Upload
alison-miles -
Category
Documents
-
view
220 -
download
1
Transcript of OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.
![Page 1: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/1.jpg)
![Page 2: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/2.jpg)
OSHA’s Bloodborne Pathogens StandardOSHA’s Bloodborne Pathogens Standard
Bonnie DiSalvo, MS
ASHMUSDA/ARS/NAA
![Page 3: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/3.jpg)
BLOODBORNE PATHOGENS
Pathogenic organisms that are present in human blood and can cause disease in humans. These include, but are not limited to: Hepatitis B Virus (HBV), HCV and Human Immunodeficiency Virus (HIV)
![Page 4: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/4.jpg)
““Occupational Exposed Worker”Occupational Exposed Worker”
“Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious material that may result from the performance of employee duties.”
““Occupational Exposed Worker”Occupational Exposed Worker”
“Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious material that may result from the performance of employee duties.”
![Page 5: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/5.jpg)
OTHER POTENTIALLY INFECTIOUS MATERIAL (OPIM for
short)
• Saliva in dental procedures• Any body fluid visibly
contaminated with blood• All body fluids in situations where
it is difficult or impossible to differentiate between body fluids
![Page 6: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/6.jpg)
Standard Requirements
• Written Exposure Control Plan
• Universal Precautions
• Engineering and work practice controls
![Page 7: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/7.jpg)
Standard Requirements (con’t)
• Basic housekeeping
• Medical prevention plan
• Training
• Labeling requirements and record keeping
• PPE
![Page 8: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/8.jpg)
EXPOSURE CONTROL PLAN1910.1030(c)
• Employee exposure determination• The schedule and method of implementing
paragraphs (d) to (h) of the standard• The procedures for evaluating
circumstances surrounding an exposure incident
To eliminate or minimize employee exposure, the employer shall develop a written Exposure Control Plan that contains
![Page 9: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/9.jpg)
EXPOSURE CONTROL PLAN• Reviewed and
updated annually• Reflect changes in
technology that would reduce or eliminate exposure
• Document consideration of devices
![Page 10: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/10.jpg)
EXPOSURE CONTROL PLAN• Solicit input from
non-managerial employees– Identification–Evaluation–Selection
• Effective engineering and work practice controls
• Document (c)(1)(v)
![Page 11: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/11.jpg)
The Written ECP Should* Include:
• Use of universal precautions• Engineering and work practice controls• PPE• Medical evaluations and vaccinations• Training
*These elements are required by the standard, but not necessarily in the ECP
![Page 12: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/12.jpg)
November 2000 Law Requires
• Sharps Injury Log
• Documented non-managerial employee input on safer medical devices
• Documented evaluation and implementation of “safer medical devices” at least annually
![Page 13: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/13.jpg)
UNIVERSAL PRECAUTIONS
An approach to infection control. According to the concept of Universal Precautions, all human blood and body fluids are treated as if known to be infectious for HIV, HBV, HCV and other bloodborne pathogens.
![Page 14: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/14.jpg)
Universal/Standard Precautions:
This includes cell or tissue culture, culture medium, solutions or tissues from humans, experimental animals infected with HIV/HBV/HCV
For our research facilities, blood and tissue products are treated under the standard
Universal/Standard Precautions:
This includes cell or tissue culture, culture medium, solutions or tissues from humans, experimental animals infected with HIV/HBV/HCV
For our research facilities, blood and tissue products are treated under the standard
![Page 15: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/15.jpg)
ENGINEERING CONTROLS
• Controls that isolate or remove the hazard from the workplace
• Examples:–Sharps disposal containers, self-
sheathing needles, safer medical devices, such as sharps with engineered sharps injury protection and needle-less systems
![Page 16: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/16.jpg)
1910.1030(d)(2)(i) ENGINEERING CONTROLS AND WORK
PRACTICES• Engineering and work practice controls
to be instituted as the PRIMARY means of eliminating or minimizing exposure.–The employer MUST use engineering
and work practice controls to eliminate exposure or reduce it to the lowest feasible extent.
![Page 17: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/17.jpg)
1910.1030(d)(2)(i) ENGINEERING CONTROLS AND WORK
PRACTICES
The employer should be using or at least have considered, and documented in the exposure control plan why he/she CANNOT use engineering and work practice controls for work operations involving exposure to blood or OPIM.
![Page 18: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/18.jpg)
(d) Work Practices:
Hand washing Personal hygiene Personal attire Not wearing personal protective equipment
(PPE) out of the work area Changing PPE when contaminated Decontaminating/cleaning regularly & after
spills
(d) Work Practices:
Hand washing Personal hygiene Personal attire Not wearing personal protective equipment
(PPE) out of the work area Changing PPE when contaminated Decontaminating/cleaning regularly & after
spills
Work Practice ControlsWork Practice Controls
![Page 19: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/19.jpg)
![Page 20: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/20.jpg)
Sharps Disposal Containers
• Must be labeled or color-coded, puncture resistant, leak-proof, and close-able
• Should have well marked fill line, be translucent or have translucent lid
Classified as medical device (SMDA)
![Page 21: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/21.jpg)
Sharps Disposal Containers
• Establish collection schedules
• Provide placement of containers
• Review disposal procedures
![Page 22: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/22.jpg)
NEEDLE SHIELDS THAT CONTAIN THE HAZARD
Attached to syringe needle
Attached to holder
Attached to needle
![Page 23: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/23.jpg)
Housekeeping Written schedule for cleaning
and decontaminating Documented eye wash checks Material decontamination before
exit from lab Removal of PPE from lab is
prohibited Home laundering of PPE is
prohibited Segregated waste
Housekeeping Written schedule for cleaning
and decontaminating Documented eye wash checks Material decontamination before
exit from lab Removal of PPE from lab is
prohibited Home laundering of PPE is
prohibited Segregated waste
![Page 24: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/24.jpg)
Medical Prevention Plan
(f) Vaccination, Post-Exposure Follow-up Hepatitis B vaccine made available to all
workers with potential risk of exposure Offered within 10 days of employment No cost to worker “Declination” signed if employee
declines vaccine; may accept at a later date
Medical Prevention Plan
(f) Vaccination, Post-Exposure Follow-up Hepatitis B vaccine made available to all
workers with potential risk of exposure Offered within 10 days of employment No cost to worker “Declination” signed if employee
declines vaccine; may accept at a later date
![Page 25: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/25.jpg)
(f) Vaccination, Post-Exposure Follow-up Report the incident immediately
Inform supervisor Go to clinic/medical services provider
Confidential medical evaluation Route of exposure Circumstances of the incident Source known
Important to start drug therapy within 2 hours Testing of victim/source only with consent
(baseline blood stored for 90 days)
(f) Vaccination, Post-Exposure Follow-up Report the incident immediately
Inform supervisor Go to clinic/medical services provider
Confidential medical evaluation Route of exposure Circumstances of the incident Source known
Important to start drug therapy within 2 hours Testing of victim/source only with consent
(baseline blood stored for 90 days)
Medical Prevention PlanMedical Prevention Plan
![Page 26: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/26.jpg)
Decontamination
• What needs to be?
• What does not need to be?
• Create a schedule
• Requirements for medical equipment
• EPA disinfectants, 1:10 dilutions bleach, 2% glutaraldehyde
![Page 27: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/27.jpg)
1910.1030(d)(3) PERSONAL PROTECTIVE EQUIPMENT
• (d)(3)(i) - PPE must be provided at NO COST to the employee
• (d)(3)(ii) This paragraph addresses that PPE must be used properly per training received
• (d)(3)(iii) - discusses provisions of appropriate PPE, including hypoallergenic gloves as readily available alternative to latex
![Page 28: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/28.jpg)
Personal Protective Equipment (PPE)
• Appropriate PPE– Testing standards
• ASTM ES 21 and ES 22
– Types– When used and by whom– Special needs– No respiratory protection required
![Page 29: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/29.jpg)
![Page 30: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/30.jpg)
![Page 31: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/31.jpg)
(g) Labeling and Training Signs posted at all work area entrances:
Biohazard symbol Infectious agent Entry requirements Name & telephone # of responsible
person
(g) Labeling and Training Signs posted at all work area entrances:
Biohazard symbol Infectious agent Entry requirements Name & telephone # of responsible
person
ComplianceCompliance
![Page 32: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/32.jpg)
(h) Record Keeping Occupational exposure/sharps injury
record Confidential Kept for duration of employment,
+ 30 years Includes:
Name & social security number Vaccination status Examination results
(h) Record Keeping Occupational exposure/sharps injury
record Confidential Kept for duration of employment,
+ 30 years Includes:
Name & social security number Vaccination status Examination results
ComplianceCompliance
![Page 33: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/33.jpg)
(h) Record Keeping Training records
Kept for 3 years Dates Contents Names & qualifications of instructors Names & job titles of students Annual documentation
(h) Record Keeping Training records
Kept for 3 years Dates Contents Names & qualifications of instructors Names & job titles of students Annual documentation
ComplianceCompliance
![Page 34: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/34.jpg)
Sharps Injury Log Information
• Type and brand of device involved
• Where incident occurred
• Description of how incident occurred
• Employee confidentiality must be maintained
![Page 35: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/35.jpg)
Incident Reporting
• Set up a policy
• Record incidents in Sharps Injury Log
• Effective January 2002, Included on OSHA logs (positives only)
![Page 36: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/36.jpg)
Postexposure Evaluation and follow-up Incident reports
• Document route of exposure
• Identify source
• Test source blood
• Give test results to worker
• Upon consent , test worker’s blood
![Page 37: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/37.jpg)
Postexposure Evaluation(cont.)
• If no consent for HIV tests save blood for 90 days
• Advise worker to seek medical attention
• Provide counseling
• Evaluate test results to give treatment if needed
![Page 38: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/38.jpg)
Physician's Written Opinion
• Complete within 15 days
• Worker must be informed of results and risks
• Employers have access to report
![Page 39: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/39.jpg)
Types of Prophylaxis• HBV
– vaccine, serum immunoglobulin
• HIV– zidovudine– lamivudine (3TC)– Indinavir (IDV) when increased risk
• HCV– None
![Page 40: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/40.jpg)
![Page 41: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/41.jpg)
BIOHAZARD SYMBOL
BIOHAZARD
![Page 42: OSHA’s Bloodborne Pathogens Standard Bonnie DiSalvo, MS ASHM USDA/ARS/NAA.](https://reader035.fdocuments.in/reader035/viewer/2022062407/56649ce05503460f949a977d/html5/thumbnails/42.jpg)
Treat as regulated medical waste
Follow State , federal and localregulations
For perception issues on uncontaminated sharps and lab waste-discuss