Title: Kentucky Education and Workforce Development Cabinet Occupational Health and Safety Program Bloodborne Pathogen Exposure
1Kentucky Education and Workforce Development
Cabinet Occupational Health and Safety
ProgramBloodborne Pathogen Exposure
2OSHAs 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.
3OSHAs Bloodborne Pathogens Standard
- SCOPE-Covers all employees with occupational
exposure to blood or other potentially infectious
materials as a function of their jobs.
4What are Bloodborne Pathogens?
- Bloodborne pathogens are micro-organisms in the
bloodstream that cause diseases.
5What 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.
6- HIV containing cell or tissue cultures, organ
cultures. - Blood, organs or other tissues from experimental
animals infected with HIV or HBV.
7Occupational Exposure
- Reasonably anticipated skin, mucous membrane or
parenteral contact with blood or other
potentially infectious materials that may result
from the performance of an employees duties.
8Occupational 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.
9Occupational Exposure
- Exposure determination is made without regard to
the use of personal protective equipment.
10Occupational Exposure
- OSHA 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.
11Occupational 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.
12Occupational 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.
13Occupational 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.
14Occupational 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.
15Occupational 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.
16Occupational 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.
17Occupational 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.
18Occupational Exposure
- Collateral Jobs
- Those positions that do not have occupational
exposure to blood or other potential infectious
body fluids.
19Occupational Exposure
- Employees in Collateral Jobs
- Maintenance Workers
- Good Samaritan Acts
- Office Staff
- Janitorial Employees
20Planning and Assessment
- Bloodborne Pathogen Plan for cabinet.
- Bloodborne Pathogen Plan for each central
office-Contained in the Cabinet Safety Plan.
21Planning and Assessment
- Bloodborne Pathogen Plan for each field
office-Contained in the Safety Plan for the
office.
22Bloodborne Pathogens
- The three most significant bloodborne pathogens
found in the workplace - HIV-Human Immunodeficiency Virus.
- Hepatitis-B Virus.
- Hepatitis-C Virus.
23Hepatitis B Control
- Each 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
24Hepatitis 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.
25Hepatitis 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.
26Staff Training
- Provided at no cost to the employee annually.
- Training Records
- Dates of each training session.
- Content specific syllabus and any information
distributed to employees.
27Staff Training
- Names and job titles of all persons attending the
training. - Records shall be retained for 3 years from the
date of training.
28Employee Medical Records Retained by Employer
- Documentation of up-to-date hepatitis B
vaccination. - Incident Reports.
- Results of post exposure testing and follow-up.
29Employee Medical Records Retained by Employer
- Copy of physicians written opinion.
- Copy of any written information provided to the
employee.
30Employee Medical Records Retained by Employer
- Records are confidential and cannot be disclosed
without the employees express written consent. - Records must be retained for 30 years following
end of employment.
31Employee Medical Records Retained by Employer
- Records must be kept separate from personnel
records.
32Blood
- Defined as human blood, human blood
components, and products made from human blood.
33Other Potentially Infectious Materials (OPIM)
- Saliva in dental procedures.
- Semen.
- Vaginal secretions.
- Internal body fluids.
34Other 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.
35Other Potentially Infectious Materials (OPIM)
- Amniotic Fluid-Bacteria and Fungal Germs.
- Cerebrospinal Fluid-Bacteria, Fungi, Viruses.
- Feces-Bacteria, Rotavirus, Hepatitis A Virus.
36Other Potentially Infectious Materials (OPIM)
- Nasal Discharge-Common cold virus, Influenza
Virus, HIV and Hepatitis B Virus. - Pericardial Fluid-Organisms that can cause
infections.
37Other Potentially Infectious Materials (OPIM)
- Peritoneal Fluid-Organisms that can cause
infections. - Pleural Fluid-Organisms that can cause disease.
38Other Potentially Infectious Materials (OPIM)
- Saliva-Common cold virus, Influenza Virus.
- Urine-Cytomegalovirus, Mononucleosis Virus.
39Other Potentially Infectious Materials (OPIM)
- Semen-Gonorrhea, Hepatitis B Virus, Hepatitis C
Virus, HIV. - Synovial-Bacteria, Fungi, Viruses, Blood in
Fluid.
40How Bloodborne Pathogens are Transmitted
- An employee must make contact with contaminated
fluids and permit a way to enter the body.
41How 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).
42How Bloodborne Pathogens Enter the Body
- Non-sterile technique when tattooing, body
piercing, sharing injections. - Open cuts, nicks, and skin abrasions, even
dermatitis and acne.
43How Bloodborne Pathogens Enter the Body
- Mucous membranes (i.e. mouth, eyes (contact
lenses), nose. - Sexual intercourse (any type).
44How Bloodborne Pathogens Enter the Body
- Indirect transmission (touching something that is
contaminated and then touching an opening in the
skin).
45Virus Survival
- HIV-can survive only a short time outside the
body. - HBV-can survive up to a week outside the body at
room temperature. - HCV-unknown.
46Hepatitis-B (HBV)
- Hepatitis means inflammation of the liver.
- HBV is the major infectious bloodborne hazard
on the job.
47Hepatitis-B (HBV)
- Affects approximately 8,700 employees a year,
resulting in more than 400 hospitalizations and
200 deaths.
48Hepatitis-B (HBV)
- Flu-like symptoms, becoming so severe as to
require hospitalization.
49Hepatitis-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.
50Hepatitis-B (HBV)
- Some people exhibit no symptoms at all and most
people recover in time.
51Hepatitis-B (HBV)
- A small percentage of people become carriers.
- Blood testing is available.
52Hepatitis 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.
53Hepatitis 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.
54Hepatitis 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.
55Hepatitis C (HCV)
- Blood test is available.
- There is no vaccine for HCV at this time.
56Human Immunodeficiency Virus (HIV)
- HIV attacks the immune system and eventually
causes AIDS. - HIV infection is treatable, but not curable.
57Human Immunodeficiency Virus (HIV)
- HIV continues to be infectious in blood and
sexual fluids even during treatment. - Blood testing is available.
58Human Immunodeficiency Virus (HIV)
- There is no vaccine for HIV at this time.
59Employees-Providing First Aid
- If 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.
60Employees-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.
61Employees-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.
62Other General Industry Employees
- While OSHA does not generally consider
maintenance and janitorial staff employed in
non-health care facilities to have occupational
exposure, it is the employers responsibility to
determine which job classification or specific
tasks and procedures involve occupational
exposure.
63Universal Precautions
- UNIVERSAL PRECAUTIONS is the term used when
handling all blood or other potentially
infectious material as if it were, in fact,
infectious. -
-
64Universal Precautions
- Since 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 anothers body fluids. -
65Universal Precautions for Home Visits
- Universal Precautions for home visits must be
observed.
66Universal 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.
67Universal Precautions for Home Visits
- Where differentiation between types of body
fluids is difficult or impossible, all body
fluids are to be considered potentially
infectious.
68Universal 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.
-
69Universal Precautions for Home Visits
- Wash hands thoroughly before and after each home
visit. - Do not clean blood spills in a clients home.
- Keep mouthpieces and resuscitation equipment.
70Universal Precautions for Home Visits
- No visits if customer has draining sores.
- No visits if customer has an infection
transmissible by the airborne route.
71Universal Precautions for Home Visits
- Restrict eating, drinking, smoking, apply
cosmetics or lip balm, and handling contact
lenses during a customers home visit.
72Universal Precautions
- Wash hands.
- Wear gloves (wash hands after glove removal).
- Wear impervious apron when splashing is possible.
73Universal Precautions
- Wear mask and eye protection.
- Handle sharp objects carefully and dispose
properly. - Dispose of all spills properly.
74Hand Washing
- Wash hands with soap and running water.
- Rinse hands under running water.
- Dry hands well with paper towel.
75Hand Washing
- Use a paper towel to turn off faucet.
- Dispose of single use towel.
- Wash/disinfect cloth towels.
76Hand Washing
- Apply hand cream after frequent washing to
prevent skin irritation, breakdown, and
subsequent infection. - Use waterless soap/wipes when soap and water are
not available.
77Hand 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.
78Hand Washing
- Wash hands immediately or as soon as feasible
after removal of gloves or other protective
equipment
79Hand 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.
80Personal 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.
81Personal Protective Equipment
- PPE will be considered appropriate only if it
does not permit blood or other potentially
infectious materials to pass through to reach the
employees work clothes, street clothes,
undergarments, and body.
82Personal 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.
83Personal 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.
84Personal Protective Equipment-Gloves
- Wear gloves when
- Actual or potential touching blood and/or body
fluids. - Actual or potential touching mucous membranes.
85Personal 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.
86Personal Protective Equipment-Gloves
- Using gloves
- Hands should be washed before gloving.
- Gloves must be changed after each contact.
87Personal 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.
88In the Event of an Accident
- There is a Hepatitis-B vaccine that
- can be used post
- exposure.
- It is about 90 effective and
- must
- be received as soon as possible.
89In 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.
90Procedures for Reporting and Managing Exposure
Incidents
- Employee
- Report the date, time, and type of exposure to
first line supervisor. - Treatment in accordance with recommended
guidelines, based on the type of exposure.
91Procedures for Reporting and Managing Exposure
Incidents
- Employee
- Adhere to follow-up treatment regimen and/or
testing as prescribed by the physician. - Follow-up will be paid for through Workers
Compensation.
92Procedures for Reporting and Managing Exposure
Incidents
- Employee and First Line Supervisor
- Initiate a consent form for treatment, if
indicated.
93Procedures for Reporting and Managing Exposure
Incidents
- First Line Supervisor
- Complete and submit Cabinet Accident Report.
- Complete Workers Compensation First Report of
Injury.
94Procedures for Reporting and Managing Exposure
Incidents
- First Line Supervisor
- Enter appropriate information into OSHA 300 Log.
- File and retain reports in employees medical
files.
95Procedures for Reporting and Managing Exposure
Incidents
- First Line Supervisor
- Provide to the physician 1) copy of the BBP Plan
and 2) description of the affected employees
duties as they relate to the occupational
exposure.
96Procedures for Reporting and Managing Exposure
Incidents
- First Line Supervisor
- Obtain physicians written opinion within 15
working days of the completion of the evaluation.
97Procedures for Reporting and Managing Exposure
Incidents
- First Line Supervisor
- Report the incident to the Kentucky Department
for Public Health, Division of Epidemiology and
Health Planning.
98Procedures for Reporting and Managing Exposure
Incidents
- First Line Supervisor
- All 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.
99Procedures for Reporting and Managing Exposure
Incidents
- Time Line
- If an exposure incident occurs, all other post
exposure follow-up procedures according to the
BBP Standard must be initiated immediately.
100Procedures for Reporting and Managing Exposure
Incidents
- Time Line
- Employer must ensure that the medical provider is
familiar with and follows the recommendations for
post exposure follow-up.
101Bloodborne 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. -
102Bloodborne and Body Fluid Cleanup
- Occurs most often when performing first aid or
coming into contact with someone who has been
injured on the job.
103Clean-Up Procedures When Blood or Body Fluids are
Present
- Put on disposable gloves and appropriate personal
protective equipment.
104Clean-Up Procedures When Blood or Body Fluids are
Present
- Remove any broken glass or sharp objects from the
area using mechanical means forceps, needle nose
pliers, and/or broom and dust pan.
105Clean-Up Procedures When Blood or Body Fluids are
Present
- Never Remove Sharps, Broken Glass, Etc. By Hand.
106Clean-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-110 mixture of household bleach and
water.
107Clean-Up Procedures When Blood or Body Fluids are
Present
- Take care not to splash disinfectant solution or
create aerosols while pouring.
108Clean-Up Procedures When Blood or Body Fluids are
Present
- Remove the paper towels and repeat the process
until all visual material is removed.
109Clean-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.
110Clean-Up Procedures When Blood or Body Fluids are
Present
- Blood 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.
111First Aid Site Clean-Up Procedures When Blood or
Body Fluids are Present
- Items such as gauze, bandages, band-aids, and/or
cotton balls are not required to have special
hazard labels, only double bagging.
112First Aid Site Clean-Up Procedures When Blood or
Body Fluids are Present
- If 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.
-
-
113First Aid Site Clean-Up Procedures When Blood or
Body Fluids are Present
- They may be double bagged and included with the
normal waste disposal.
114Clean-Up Procedures When Blood or Body Fluids are
Present
- Remove all personal protective equipment,
dispose, and immediately wash hands and other
contaminated body parts.
115Clean-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. -
116Clean-Up Procedures When Blood or Body Fluids are
Present
- Linen and clothing contaminated with blood or
body fluids must be handled with gloves.
117Thank You For Your Participation
- For additional assistance contact
- Richard T. Owen
- Education Cabinet Safety Coordinator
- 601 East Main Street
- Frankfort, Kentucky 40601
- 502-564-7346