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Kentucky Education and Workforce Development
Cabinet
Occupational Health and Safety Program
Bloodborne Pathogen Exposure
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OSHA’s Bloodborne Pathogens
PURPOSE-Limits occupational exposure to blood and other
potentially infectious materials, since any exposure could result in
transmission of bloodborne pathogens which could lead to
disease or death.
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OSHA’s Bloodborne Pathogens Standard
SCOPE-Covers all employees with occupational exposure to
blood or other potentially infectious materials as a
function of their jobs.
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What are Bloodborne Pathogens?
Bloodborne pathogens are micro-organisms in the bloodstream that cause
diseases.
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What are Other Potentially Infectious Materials (OPIM)?
Human body fluids listed in the standard.
Unfixed tissue or organ (other than intact skin) from a living or dead human.
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HIV containing cell or tissue cultures, organ cultures.
Blood, organs or other tissues from experimental animals infected with HIV or HBV.
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Occupational ExposureReasonably anticipated skin,
mucous membrane or parenteral contact with blood or other
potentially infectious materials that may result from the
performance of an employee’s duties.
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Occupational Exposure
Employers are to evaluate each job task and procedure to
determine which employees may be expected to be
occupationally exposed to blood or other potentially
infectious materials.
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Occupational Exposure
Exposure determination is made without regard to
the use of personal protective equipment.
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Occupational ExposureOSHA expects an employer to take
into account all potential circumstances of exposure
(biting, contact with skin lesions, and/or potentially infectious
secretions) when determining occupational exposure.
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Occupational Exposure
Based on potential contact with blood and other potentially
infectious materials. The employer is to select the
appropriate personal protective equipment in
accordance with the standard.
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Occupational Exposure-First Aid Trained Employees
First aid trained employees assigned to provide emergency first aid as part of their specific job duties are
covered by the Bloodborne Pathogens Standard.
GOOD SAMARITAN ACTS-Not covered by the standard.
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Occupational Exposure-First Aid Trained Employees
Kentucky OSHA requires that employers with 8 or more
employees with in the establishment have persons
adequately trained to render first aid.
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Occupational Exposure-First Aid Trained Employees
Employers with fewer than 8 employees shall, in the absence of an infirmary, clinic or hospital
in near proximity to the workplace, have a person or
persons adequately trained to render first aid.
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Occupational Exposure-First Aid Trained Employees
OSHA Enforcement Procedures for the Occupational Exposure to
Bloodborne Pathogens states an employee trained in first aid and
identified by the employer as responsible for rendering medical
assistance as part of the job duties is covered by the Bloodborne Pathogen
Standard.
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Occupational Exposure-First Aid Trained Employees
An employee who routinely provides first aid to fellow employees with the knowledge of the employer may also fall de facto under the BBP Program even if the employer has no officially
designated employee as a first aid provider.
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Occupational Exposure-First Aid Trained Employees
Employers with designated first aid providers are required to offer the hepatitis B Vaccine to the
providers before they are exposed.
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Occupational Exposure
Collateral JobsThose positions that do not
have occupational exposure to blood or other potential infectious body fluids.
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Occupational Exposure
Employees in Collateral Jobs• Maintenance Workers• Good Samaritan Acts
• Office Staff• Janitorial Employees
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Planning and Assessment
• Bloodborne Pathogen Plan for cabinet.
• Bloodborne Pathogen Plan for each central office-Contained in the Cabinet Safety Plan.
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Planning and Assessment
• Bloodborne Pathogen Plan for each field office-Contained in the Safety Plan for the office.
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Bloodborne PathogensThe three most significant
bloodborne pathogens found in the workplace:
HIV-Human Immunodeficiency Virus.
Hepatitis-B Virus.Hepatitis-C Virus.
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Hepatitis B ControlEach employee with occupational
exposure will within 10 days of employment shall:
Provide evidence of receiving three doses of Hepatitis B vaccine; or
Provide evidence of a positive Antibody to Hepatitis; or
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Hepatitis B Control
Sign a form consenting to be vaccinated or to finish an incomplete vaccination series; or
Specifically decline vaccination by signing a Declination Form.
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Hepatitis B Control
Provided at no cost to the employee.
Provided at a reasonable time and place and performed by or under
the supervision of a licensed physician or other health care
professional.
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Staff TrainingProvided at no cost to the
employee annually. Training Records Dates of each training session. Content specific syllabus and
any information distributed to employees.
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Staff Training
Names and job titles of all persons attending the training.
Records shall be retained for 3 years from the date of training.
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Employee Medical Records Retained by Employer
Documentation of up-to-date hepatitis B vaccination.
Incident Reports.Results of post exposure
testing and follow-up.
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Employee Medical Records Retained by Employer
Copy of physician’s written opinion.
Copy of any written information provided to the employee.
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Employee Medical Records Retained by Employer
Records are confidential and cannot be disclosed without the employee’s express written consent.
Records must be retained for 30 years following end of employment.
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Employee Medical Records Retained by Employer
Records must be kept separate from personnel records.
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Blood
Defined as human blood, human blood components, and products made from
human blood.
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Other Potentially Infectious Materials (OPIM)
Saliva in dental procedures.
Semen.Vaginal secretions. Internal body fluids.
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Other Potentially Infectious Materials (OPIM)
Body fluids visibly contaminated with blood.
Body fluids in situations where it is difficult or impossible to identify type of fluid.
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Other Potentially Infectious Materials (OPIM)
Amniotic Fluid-Bacteria and Fungal Germs.
Cerebrospinal Fluid-Bacteria, Fungi, Viruses.
Feces-Bacteria, Rotavirus, Hepatitis A Virus.
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Other Potentially Infectious Materials (OPIM)
Nasal Discharge-Common cold virus, Influenza Virus, HIV and Hepatitis B Virus.
Pericardial Fluid-Organisms that can cause infections.
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Other Potentially Infectious Materials (OPIM)
Peritoneal Fluid-Organisms that can cause infections.
Pleural Fluid-Organisms that can cause disease.
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Other Potentially Infectious Materials (OPIM)
Saliva-Common cold virus, Influenza Virus.
Urine-Cytomegalovirus, Mononucleosis Virus.
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Other Potentially Infectious Materials (OPIM)
Semen-Gonorrhea, Hepatitis B Virus, Hepatitis C Virus, HIV.
Synovial-Bacteria, Fungi, Viruses, Blood in Fluid.
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How Bloodborne Pathogens are Transmitted
An employee must make contact with contaminated fluids and permit a way to
enter the body.
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How Bloodborne Pathogens Enter the Body
Direct blood inoculation-placenta, transfusion, blood products.
Accidental injury which breaks, punctures or cuts the skin or mucous membranes (Parenteral Contact).
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How Bloodborne Pathogens Enter the Body
Non-sterile technique when tattooing, body piercing, sharing injections.
Open cuts, nicks, and skin abrasions, even dermatitis and acne.
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How Bloodborne Pathogens Enter the Body
Mucous membranes (i.e. mouth, eyes (contact lenses), nose.
Sexual intercourse (any type).
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How Bloodborne Pathogens Enter the Body
Indirect transmission (touching something that is contaminated and then touching an opening in the skin).
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Virus SurvivalHIV-can survive only a short
time outside the body.HBV-can survive up to a
week outside the body at room temperature.
HCV-unknown.
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Hepatitis-B (HBV)
Hepatitis means “inflammation of the liver.”
HBV is the major infectious bloodborne hazard on the job.
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Hepatitis-B (HBV)
Affects approximately 8,700 employees a year, resulting in more than 400 hospitalizations and 200 deaths.
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Hepatitis-B (HBV)
Flu-like symptoms, becoming so severe as to require
hospitalization.
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Hepatitis-B (HBV)
Illness may last 6 months to 2 years. In some cases, HBV damages the
liver so severely it leads to cirrhosis and possible death.
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Hepatitis-B (HBV)
Some people exhibit no symptoms at all and most
people recover in time.
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Hepatitis-B (HBV)
A small percentage of people become carriers.
Blood testing is available.
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Hepatitis C (HCV)
• HVC is different from Hepatitis B.• HCV is transmitted directly by
blood, but unknown if other body fluids like sexual fluids or saliva will carry the virus.
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Hepatitis C (HCV)• Flu like symptoms can show up
within days or years after exposure.
• HCV can be ACUTE requiring liver transplant or death within weeks or months.
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Hepatitis C (HCV) CHRONIC requiring intensive
medical therapy. 70% of those infected will
eventually develop chronic liver disease, cirrhosis of the liver, and almost certain death.
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Hepatitis C (HCV)
• Blood test is available.• There is no vaccine for HCV at
this time.
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Human Immunodeficiency Virus (HIV)
• HIV attacks the immune system and eventually causes AIDS.
• HIV infection is treatable, but not curable.
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Human Immunodeficiency Virus (HIV)
• HIV continues to be infectious in blood and sexual fluids even during treatment.
• Blood testing is available.
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Human Immunodeficiency Virus (HIV)
• There is no vaccine for HIV at this time.
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Employees-Providing First AidIf employees are trained and
designated as responsible for rendering
first aid or medical assistance as part of their job
duties, they are covered by the OSHA Bloodborne
Pathogen Standard.
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Employees-Providing First Aid
All first aid providers who provide assistance in any situation involving the presence of blood or other potentially
infectious materials, regardless of whether or not a specific exposure incident occurs, must have the vaccine made available to them as soon as possible, but in no event
later than 24 hours after exposure.
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Employees-Providing First Aid
In an exposure incident as defined in the standard has
taken place, other post exposure follow-up procedures must be initiated immediately,
per the OSHA Standard.
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Other General Industry EmployeesWhile OSHA does not generally consider
maintenance and janitorial staff employed in non-health care facilities to
have occupational exposure, it is the employer’s responsibility to determine which job classification or specific tasks
and procedures involve occupational exposure.
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Universal Precautions
UNIVERSAL PRECAUTIONS is the term used when handling all blood or other potentially
infectious material as if it were, in fact, infectious.
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Universal PrecautionsSince there is no way of
knowing if an injured person or body fluid is infected, employees in ALL CASES must use universal
precautions when exposed to another’s body fluids.
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Universal Precautions for Home Visits
Universal Precautions for home visits must be observed.
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Universal Precautions for Home Visits
Employer and employee are to assume that all human blood and human body fluids are infectious
for HIV, HBV, and other bloodborne pathogens.
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Universal Precautions for Home Visits
Where differentiation between types of body fluids is difficult
or impossible, all body fluids are to be considered potentially
infectious.
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Universal Precautions for Home Visits
Treat all blood and body fluids as being potentially infectious.
Use appropriate Personal Protective Equipment.
Do not bend, break, shear or recap needles.
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Universal Precautions for Home Visits
Wash hands thoroughly before and after each home visit.
Do not clean blood spills in a client’s home.
Keep mouthpieces and resuscitation equipment.
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Universal Precautions for Home Visits
No visits if customer has draining sores.
No visits if customer has an infection transmissible by the airborne route.
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Universal Precautions for Home Visits
Restrict eating, drinking, smoking, apply cosmetics or lip balm, and handling contact lenses during a customer’s home visit.
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Universal Precautions• Wash hands.• Wear gloves (wash hands after
glove removal).• Wear impervious apron when
splashing is possible.
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Universal Precautions• Wear mask and eye protection.• Handle sharp objects carefully
and dispose properly.• Dispose of all spills properly.
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Hand Washing• Wash hands with soap and
running water.• Rinse hands under running
water.• Dry hands well with paper
towel.
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Hand Washing• Use a paper towel to turn off
faucet.• Dispose of single use towel.• Wash/disinfect cloth towels.
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Hand WashingApply hand cream after frequent
washing to prevent skin irritation, breakdown, and subsequent infection.
Use waterless soap/wipes when soap and water are not available.
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Hand Washing
When antiseptic hand cleansers or towelettes are used, hands will
be washed with soap and running water when the employee
returns to a location where hand washing facilities are available.
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Hand Washing
Wash hands immediately or as soon as feasible after removal of gloves or other protective
equipment
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Hand Washing
Employer must ensure that employees wash hands and any
other skin with soap and water, or flush mucous membranes with
water immediately, or as soon as feasible, following contact with
blood or body fluid.
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Personal Protective Equipment• Employers will provide to
employees with occupational exposure PPE appropriate for the risk.
• No cost to the employee.• PPE will be available for use at
each site.
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Personal Protective EquipmentPPE will be considered appropriate
only if it does not permit blood or other potentially infectious materials to pass through to reach the employee’s work
clothes, street clothes, undergarments, and body.
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Personal Protective Equipment-Eye Protection
Eye protection is to be worn whenever splashes, spray, spatter
or droplets of blood or other potentially infectious materials may be generated and eye, nose, and/or
mouth contamination can be reasonably anticipated.
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Personal Protective Equipment-Gloves
Gloves will be worn when it can be reasonably anticipated that the
employee may have hand contact with blood, other potentially infectious materials, mucous
membranes, and/or non-intact skin.
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Personal Protective Equipment-Gloves
Wear gloves when:Actual or potential touching
blood and/or body fluids.Actual or potential touching
mucous membranes.
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Personal Protective Equipment-Gloves
Wear gloves when:Actual or potential touching non-
intact skin. Actual or potential handling
items or surfaces soiled by blood and/or other body fluids.
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Personal Protective Equipment-Gloves
Using gloves:Hands should be washed before gloving.Gloves must be changed after each contact.
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Personal Protective Equipment-Gloves
Using gloves:Hands or other body parts must
be thoroughly washed with soap and water if contaminated with blood or body fluids.
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In the Event of an AccidentThere is a Hepatitis-B vaccine that
can be used post exposure.
It is about 90% effective and must be received as soon as possible.
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In the Event of Actual or Potential Exposure
• Stop work and wash the affected body areas thoroughly.
• If eyes or mouth are affected, flood with water at least 10 minutes.
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Procedures for Reporting and Managing Exposure Incidents
EmployeeReport the date, time, and type of
exposure to first line supervisor.Treatment in accordance with
recommended guidelines, based on the type of exposure.
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Procedures for Reporting and Managing Exposure Incidents
EmployeeAdhere to follow-up treatment
regimen and/or testing as prescribed by the physician.
Follow-up will be paid for through Worker’s Compensation.
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Procedures for Reporting and Managing Exposure Incidents
Employee and First Line Supervisor
Initiate a consent form for treatment, if indicated.
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Procedures for Reporting and Managing Exposure Incidents
First Line SupervisorComplete and submit Cabinet
Accident Report.Complete Workers’
Compensation First Report of Injury.
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Procedures for Reporting and Managing Exposure Incidents
First Line SupervisorEnter appropriate information
into OSHA 300 Log.File and retain reports in
employee’s medical files.
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Procedures for Reporting and Managing Exposure Incidents
First Line SupervisorProvide to the physician: 1)
copy of the BBP Plan and 2) description of the affected
employee’s duties as they relate to the occupational exposure.
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Procedures for Reporting and Managing Exposure Incidents
First Line SupervisorObtain physician’s written
opinion within 15 working days of the completion of the evaluation.
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Procedures for Reporting and Managing Exposure Incidents
First Line SupervisorReport the incident to the Kentucky Department for Public Health, Division of Epidemiology and Health
Planning.
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Procedures for Reporting and Managing Exposure Incidents
First Line SupervisorAll employees who are involved in any situation where there was the presence of blood or OPIM, regardless of whether
a specific exposure incident occurred, must be offered the full Hepatitis B
vaccination series as soon as possible, but no later than 24 hours after the
incident.
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Procedures for Reporting and Managing Exposure Incidents
Time LineIf an exposure incident occurs, all other post exposure follow-up procedures according to the BBP Standard must be initiated
immediately.
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Procedures for Reporting and Managing Exposure Incidents
Time LineEmployer must ensure that the
medical provider is familiar with and follows the
recommendations for post exposure follow-up.
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Bloodborne and Body Fluid Cleanup
These procedures are based on OSHA standard 29 CFR 1910.1030
for all employees who have come in contact with infected blood, blood
products and/or body fluids at work.
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Bloodborne and Body Fluid Cleanup
Occurs most often when performing first aid or coming
into contact with someone who has been injured on the job.
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Clean-Up Procedures When Blood or Body Fluids are
Present
Put on disposable gloves and appropriate personal
protective equipment.
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Clean-Up Procedures When Blood or Body Fluids are
PresentRemove any broken glass or sharp objects from the area
using mechanical means: forceps, needle nose pliers, and/or broom and dust pan.
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Clean-Up Procedures When Blood or Body Fluids are
PresentNever Remove Sharps, Broken
Glass, Etc. By Hand.
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Clean-Up Procedures When Blood or Body Fluids are Present
Contain the area by covering with paper towels and carefully pouring appropriate disinfectant solution around and on the area.
EXAMPLE-1:10 mixture of household bleach and water.
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Clean-Up Procedures When Blood or Body Fluids are
PresentTake care not to splash
disinfectant solution or create aerosols while pouring.
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Clean-Up Procedures When Blood or Body Fluids are
Present
Remove the paper towels and repeat the process until all visual material is removed.
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Clean-Up Procedures When Blood or Body Fluids are
Present
Re-wet the cleaned area with disinfectant and air dry until all visual material is removed.
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Clean-Up Procedures When Blood or Body Fluids are
PresentBlood contaminated items used for first aid and care of lacerations, nose bleeds, etc. shall be contained in a plastic lined container, closed, and disposed of with the daily trash in a large, heavy duty plastic bag of sufficient strength to preclude bursting and tearing during handling, storage or transport.
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First Aid Site Clean-Up Procedures When Blood or Body Fluids are
PresentItems such as gauze,
bandages, band-aids, and/or cotton balls are not required to have special hazard labels,
only double bagging.
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First Aid Site Clean-Up Procedures When Blood or Body
Fluids are PresentIf the first aid supplies are saturated to the point where liquid can be squeezed
in considerable amount, the supplies must be soaked in a disinfectant
solution to decontaminate them.
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First Aid Site Clean-Up Procedures When Blood or Body
Fluids are Present
They may be double bagged and included with the
normal waste disposal.
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Clean-Up Procedures When Blood or Body Fluids are Present
Remove all personal protective equipment, dispose, and
immediately wash hands and other contaminated body parts.
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Clean-Up Procedures When Blood or Body Fluids are Present
Place any soiled linen in a laundry bag. Soiled linen should be handled carefully as if it were contaminated.
Pre-soak linen with disinfectant cleaning solution and launder with
soap and water.
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Clean-Up Procedures When Blood or Body Fluids are Present
Linen and clothing contaminated with blood or body fluids must be handled
with gloves.
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Thank You For Your ParticipationFor additional assistance contact:
Richard T. OwenEducation Cabinet Safety
Coordinator601 East Main Street
Frankfort, Kentucky 40601502-564-7346
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