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Title: Bloodborne Pathogens (BBP) Exposure Control Program


1
Bloodborne Pathogens (BBP)Exposure Control
Program
For Facilities Services Workers At UNC Chapel
Hill
In accordance with Occupational Safety and
Health Administration (OSHA) Bloodborne Pathogen
Standard29 CFR 1910.1030
2
INTRODUCTION
3
  • Here are important phone numbers you need to know
    related to this training module
  • Important Contact Numbers
  • UEOHC (Clinic) 966-9119
  • Emergency 911
  • Questions regarding this training 962-5507
  • We will review these numbers again during the
    training and we will learn when to use them.

4
Why is bloodborne pathogen training required
every year?
  • Its the law
  • Its UNCs responsibility
  • Knowing this information can protect your health
    and the health of others

5
1. Its the law
  • The Occupational Safety and Health Administration
    (OSHA) is a federal agency charged with enforcing
    health and safety legislation. OSHA makes sure
    that employers such as UNC keep you, the
    Facilities Services Worker, safe from workplace
    hazards. Some occupations at UNC are more likely
    to come into contact with hazards than others.
    The hazards we are concerned about in this
    program are germs called bloodborne pathogens.

6
1. Its the law (continued)
  • Human blood and body fluids may contain
    bloodborne pathogens. So could materials or
    waste from certain laboratories. The germs are
    called bloodborne pathogens because they get into
    your blood (mostly by puncturing your skin) and
    make you sick.
  • On March 6, 1992 OSHA created the Bloodborne
    Pathogen (BBP) Standard to make sure all
    employers work to keep their workers safe from
    bloodborne pathogens.
  • A copy of the actual Bloodborne Pathogens
    Standard is available at the OSHA website
    http//www.osha.gov/pls/oshaweb/owadisp.show_docum
    ent?p_tableSTANDARDSp_id10051 or by contacting
    EHS.

7
2. Its UNCs responsibility
  • Employers like UNC demonstrate they are following
    the Bloodborne Pathogens Standard by implementing
    an Exposure Control Plan. The Exposure Control
    Plan lists the steps the employer is taking to
    keep workers safe. It is the plan to control
    every workers exposure to bloodborne pathogens.
  • This training reviews UNCs Exposure Control Plan
    for members of the Facilities Services department
    who are expected to have job-related exposures to
    bloodborne pathogens. Housekeeping staff have a
    separate exposure control plan and should refer
    to that document at www.ehs.unc.edu/ih/biological/
    bbp.shtml .

8
2. Its UNCs responsibility (continued)
  • All UNC employees identified with the potential
    for occupational exposure must be familiar with
    the Exposure Control Plan. They must know its
    location and comply with the Exposure Control
    Plan by completing bloodborne pathogens training
    every year and obtaining or declining the
    Hepatitis B vaccination.

9
3. Knowing this information can protect your
health and the health of others
  • Facilities Services workers are potentially
    exposed to bloodborne pathogens when they repair
    equipment or handle materials without a Safety
    Clearance Form as part of normal job duties in
    laboratories, clinics, or morgues. These areas
    also contain waste that may contain bloodborne
    pathogens .

To access the EHS approved Safety Clearance Form,
click HERE.
10
3. Knowing this information can protect your
health and the health of others (continued)
  • Some buildings on campus are more likely than
    others to have BSL-2 laboratories and clinics.
    Brinkhous Bullitt also contains the morgue. In
    these areas, Facilities Services Workers may
    encounter contaminated needles, broken glass, or
    other contaminated laboratory materials or
    equipment.
  • Facilities Services Workers may be requested to
    work on plumbing fixtures that may be
    contaminated with biological waste.

11
EXPOSURE DETERMINATION FOR FACILITIES SERVICES
WORKERS (excluding Housekeeping)
12
How do I determineOccupational Exposure?
  • The OSHA definition of Occupational Exposure is
  • Reasonably anticipated skin, eye, mucous
    membrane or parenteral contact with blood or
    other potentially infectious materials that may
    result from the performance of an employees job
    duties.

Parenteral contact is piercing mucous membranes
or skin barrier through needlesticks, human
bites, cuts and abrasions.
for definitions of blood or OPIM (other
potentially infectious materials), read on
13
Bloodborne pathogens live and grow best in human
blood. However, other human body fluids also may
carry these germs. When making an Exposure
Determination, Facilities Services Workers must
also consider that these fluids are able to
provide an environment for bloodborne pathogens
to live and grow
What are Other Potentially Infectious Materials?
so if you may come into contact with this
material as part of my job description, you need
to be enrolled in the Bloodborne Pathogens
program.
  • Semen
  • Vaginal secretions
  • Any fluid surrounding organs in the body
  • Saliva in dental procedures
  • Also considered Other Potentially Infectious
    Materials are
  • Any body fluid visibly contaminated with blood
  • All body fluids when it is difficult to
    differentiate between body fluids
  • Any unfixed organ or tissue from a human, living
    or dead (clinics morgues) and
  • Other experimental human material (from
    laboratories) whether purposely infected or
    otherwise.

14
Exposure Determination
  • EHS, in cooperation with Facilities Services,
    identifies and tracks the status of occupational
    exposure determinations to bloodborne pathogens
    according to the OSHA Standard for all Facilities
    Services employees according to job duties and/or
    location.
  • Each determination must be made without regard to
    use of personal protective equipment and should
    be conducted upon orientation and no later than
    10 days after the date of employment (OSHA).

This determination must made without regard to
use of PPE.
15
Exposure Determination
  • All Facilities Services Positions must have a
    completed Appendix C of the Hazards Management
    Plan returned to EHS for enrollment in the UNC
    Bloodborne Pathogens program within 10 days from
    the date of hire.

16
  • The following questions aid in making an Exposure
    Determination for Facilities Services trades
    workers
  •  
  • 1. Does the Facility Services employee work as
    part of a spill clean-up crew for blood, sewage,
    or other potentially infectious materials?
  • 2. Is the Facilities Services employee expected
    to handle or otherwise manipulate the following
    items without a Safety Clearance Form as part of
    their job duties
  •  
  • Biohazard Waste
  • Plumbing from a BSL-2 or BSL-3 laboratory, clinic
    or morgue.
  • Lab equipment from a BSL-2 or BSL-3 laboratory,
    clinic or morgue.
  • Lab equipment or materials labeled with the
    biohazard warning label or labeled with a red bag
    bearing the biohazard warning symbol 
  •  
  • 3. Do the job duties of the Facility Services
    employee require him/her to otherwise come in
    contact with blood or other potentially
    infectious materials?

17
  • As a Facilities Services Worker, if you have
    concerns about your exposure to bloodborne
    pathogens, you should discuss them with your
    supervisor and EHS.
  • Your supervisor and EHS can help determine ways
    to make your job safer.

18
GENERAL RISKS AND TRANSMISSION
19
Epidemiology
  • Simply put, epidemiology is the science of
    tracking the spread of disease among a
    population.

The population of concern in this training is
Facilities Services workers who are potentially
exposed to bloodborne pathogens at UNC-CH. And
the diseases of concern here are those caused by
bloodborne pathogens.
20
What are Bloodborne Pathogens?
Bloodborne Pathogens are germs that live and grow
best in human material. They enter your body
through a puncture in your skin or through your
eyes, nose or mouth.
Many diseases are linked to bloodborne pathogens,
but few bloodborne pathogens are frequently
responsible for infections in the workplace.
  • OSHA defines bloodborne pathogens as
  • Pathogenic microorganisms that are present in
    human blood that can cause disease in humans.

21
Only workers with documented training in
bloodborne pathogens should handle the clean up
of this type of spill or work in these areas.
As part of this training, the worker should
know some basic concepts about these diseases so
that s/he can discuss them with a supervisor,
family members, and a doctor.
  • The risks and infections of the following
    bloodborne pathogens will be discussed in this
    training
  • hepatitis B virus (HBV)
  • hepatitis C virus (HCV)
  • human immunodeficiency virus (HIV)

22
Hepatitis B virus
23
Viral Hepatitis
  • Hepatitis means inflammation of the liver.
    Viral hepatitis is inflammation of the liver
    caused by a virus.
  • Your liver helps your body digest food, store
    energy, and get rid of poisons. It acts as a
    filtration system for your body.
  • As the filter begins to fail, impurities build up
    in your body and symptoms can occur such as
    jaundice (yellowing color of the skin and eyes),
    dark urine, extreme fatigue, anorexia, nausea,
    abdominal pain, and sometimes joint pain, rash,
    and fever.

24
  • In the United States, HCV is the most common type
    related to occupational exposure to bloodborne
    pathogens.
  • Viral Hepatitis
  • 5 types
  • Hep A
  • Hep B Virus (HBV)
  • Hep C Virus (HCV)
  • Hep D
  • Hep E

25
Hepatitis B in the U.S.
  • Annually, there are 10,000 new cases of Hepatitis
    B virus (HBV) reported in the U.S., with an
    estimated one to two million carriers of HBV.
  • The hepatitis B virus takes about 2 months to
    show up in your blood. It may stay in your blood
    for months or years. Nine out of every 10 adults
    will get rid of the virus from their bodies after
    a few months. We say they have acute hepatitis B.
    One out of every 10 adults will never get rid of
    the virus from their bodies. We say they have
    chronic hepatitis B. They are called carriers.
  • Most people with chronic hepatitis B will remain
    carriers of the virus if they do not get treated.
    The best things carriers can do is make sure
    their babies get all of their hepatitis B shots,
    make sure they do not spread it to their sex
    partners, and get good medical care.
  • (Source www.cdc.gov)

26
Hepatitis B Vaccination
  • A safe and effective vaccine to prevent Hepatitis
    B has been available since 1982. All UNC
    employees enrolled in this Bloodborne Pathogens
    program must meet the requirements for Hepatitis
    B vaccination or sign a declination.
  • OSHA requires that vaccination or declination be
    made
    available within 10 working days

    of initial assignment.

27
  • Do you still need to schedule or decline the
    Hepatitis B vaccine?
  • This requirement needs to be met within 10
    working days after your exposure determination is
    made.
  • The vaccine is offered by UNC at no cost to you.
  • To obtain the Hepatitis B vaccination, complete
    these steps
  • Fill out the Hepatitis B vaccination consent form
    available here.
  • If you don't have a medical record number, call
    966-2555 to get one.
  • Schedule your appointment with the University
    Employee Occupational Health Clinic at 966-9119.
  • To Decline the Hepatitis B vaccination Complete
    this form and follow the directions on the form
    to submit it to the University Employee
    Occupational Health Clinic.

Go on, do it now.
28
Hepatitis C Virus
  • Hepatitis C virus is the most frequently
    occurring bloodborne pathogen infection. At
    least 85 out of 100 people infected with HCV
    become chronically infected, and chronic liver
    disease develops in an average of 67 out of 100.
  • Symptoms include jaundice, loss of appetite,
    fatigue, intermittent nausea, abdominal pain and
    vomiting.
  • There is no vaccine for Hepatitis C.

A healthy and diseased human liver
29
--Common Practice--
  • Wash Your Hands Often!
  • Wash your hands with soap and water for 20
    Seconds. The suds scrub dirt and germs away.
    Wash your hands front and back and between the
    fingers. Soap up your wrists too.
  • Hands are to be washed immediately or as soon as
    feasible after removal of gloves or other
    personal protective equipment.
  • Use a utility or restroom sink for handwashing,
    do not use sinks in food preparation areas.
  • If handwashing facilities are not immediately
    available use antiseptic hand cleanser and/or
    disposable wipes for the short term...
  • but wash your hands as soon as handwashing
    facilities are available.

30
HIV
  • The clinical symptoms of HIV infection ranges
    from those who have no symptoms to those with
    severe immunodeficiency or Acquired Immune
    Deficiency Syndrome (AIDS).
  • Initial infection can be followed by an acute
    flu-like illness with non-specific symptoms such
    as fever, swollen lymph nodes, rash, malaise,
    sore throat, and headache.
  • Other symptoms can include anorexia, chronic
    diarrhea, weight loss, and fatigue.
  • Opportunistic infections and malignant diseases
    without a known cause for immune deficiency can
    also be indicative.

31
HIV
  • HIV is a fragile virus. It cannot live for very
    long outside the body. As a result, the virus is
    not transmitted through day-to-day activities
    such as shaking hands, hugging, or a casual kiss.
    You cannot become infected from a toilet seat,
    drinking fountain, doorknob, dishes, drinking
    glasses, food, or pets. You also cannot get HIV
    from mosquitoes.

HIV can enter the bloodstream similarly to HBV
if potentially infectious materials (like blood)
come into contact with an unprotected break in
your skin such as an open wound, acne, rash, etc.
or if you experience a splash into your eyes
and/or nose.
32
  • As a properly trained UNC employee, when you come
    into contact with any material that you suspect
    is contaminated with human blood, body fluids, or
    OPIM, keep this information in mind. It will
    help you understand the importance of the
    following sections in this document.

33
REPORTING AN INCIDENT AT UNC
34
REPORTING AN INCIDENT AT UNC
Now that weve discussed what it means to be
exposed, lets look what to do in the event of a
potential exposure.
  • An important part of this training program is to
    make sure all employees know (1) if they have an
    exposure incident and (2) what to do after they
    have an exposure incident. An exposure incident
    could happen three ways
  • When blood or other potentially infectious
    material (OPIM) get into an unprotected break in
    your skin, open wound, acne, rash or scratch.
  • When blood or OPIM splashes or gets into your
    eyes, nose, or mouth or
  • If you are cut or stuck by an object (it must
    break the skin) that is contaminated with blood
    or OPIM.

35
What is a BBP Exposure?
  • The OSHA Definition
  • A specific eye, mouth, other mucous membrane,
    non-intact skin or parenteral contact with blood
    or OPIM that results from the performance of an
    employees duties.

BBP Exposure Blood, OPIM contact with
Eye, Nose, Mouth, Shaving cut, rash, etc.
Also, remember UNC requires you to report ANY
incident resulting in injury from the performance
of your duties.
36
  • What to do for needlesticks, cuts from
    contaminated objects, animal bites or scratches
  • Remove contaminated gloves and if possible, allow
    the wound to bleed freely for a minute.
  • Wash the wound with soap and water for 5 minutes
    and apply sterile gauze or a bandage, if
    necessary.
  • Decontaminate and remove protective clothing and
    proceed immediately to UEOHC or call HealthLink.
    If the injury requires immediate medical
    attention, go to the Emergency Room.

37
What to do for splash to eyes, nose, or mouth
  • Rinse the area with continuous clean running
    water.
  • Eyes should be irrigated for at least 5 minutes
    using an emergency eyewash station if available
    or a sink.
  • Decontaminate and remove protective clothing and
    proceed immediately to UEOHC or call HealthLink.

38
Report Exposures Immediately
Immediately report the incident to your
supervisor and/or call the University Employee
Occupational Health (UEOHC) at 6-9119.
Emergency Contact Numbers UEOHC Clinic
966-9119 Emergency 911
  • After any exposure event during work hours,
    employees must be seen by the University Employee
    Occupational Health Clinic (UEOHC) for treatment
    and documentation of exposure.
  • After hours, all calls to the UEOHC are routed
    to HealthLink (966-6900) through UNC Hospitals.
    You should request that the MD on call for UEOHC
    after hours bloodborne pathogen exposures be
    called. The on-call MD will determine the need
    for immediate treatment and if needed, direct the
    worker to meet him/her in the ER, or otherwise
    arrange for appropriate blood tests to be drawn
    and medications to be dispensed.

39
Post-Exposure Evaluation
  • Following the incident, UNC will provide you with
    a post exposure medical evaluation.
  • This evaluation may include
  • Documenting routes of exposure
  • Documenting circumstances of the incident
  • Identifying sources of contamination
  • Blood tests with consent from employee
  • Post exposure prophylaxis and counseling

Employees are not billed for work-related
injuries and medical records are kept separate
and confidential from performance reviews.
40
Spill Clean Up for Bloodborne Pathogen Training
41
Bloodborne Pathogens Spills
  • Spills may occur when an injured person drips
    blood on the floor, when sewage overflows, or
    when containers of blood or other potentially
    infectious materials (OPIM) are dropped in the
    clinic or laboratory.
  • Employees designated to participate in emergency
    and decontamination procedures are exposed to
    blood or OPIM they are to be thoroughly familiar
    with proper cleaning and decontamination
    procedures so that the contamination is contained
    and exposure to other people is minimized.

42
Remember Your Sharps Precautions During a Spill
  • Contaminated broken glassware is cleaned up by
    mechanical means (e.g. tongs, forceps, pieces of
    cardboard).

43
BBP Spill Clean Up Kits typically include
  • 2 disposable towelettes (w/ MSDS),
  • 2 scoops/scrapers,
  • 2 biohazard bags with ties,
  • 1 disposable towel,
  • 1 instruction sheet,
  • 1 can 12 oz. Disinfectant spray (w/ MSDS)
  • 1 pair disposable latex gloves,
  • 1 disposable faceshield,
  • 1 disposable face mask,
  • 1 pair disposable shoe covers,
  • 1 disposable apron, 1 absorbent pack (w/ MSDS),

44
Spill Clean Up
--Steps--
First, evacuate the area and allow 30 minutes for
germs in the air to settle prior to spill
cleanup. Locate the Blood and Bodily Fluid
Clean-Up Kit. Instructions are located on the
inside top lid. Instructions are in English and
Spanish.
45
Spill Clean Up
  • Open the kit and put on the following Personal
    Protection Equipment (PPE)
  • Disposable exam gloves
  • Disposable face mask
  • Disposable face shield
  • Disposable apron (unfold apron fully)
  • Disposable shoe covers

46
Spill Clean Up
  • 2. Open clean-up absorbent pack and sprinkle
    entire contents of absorbent material evenly over
    bodily fluid spill (will absorb 80-100 times its
    weight).

47
Spill Clean Up
  • 3. After the spill gels (1-2 minutes), use
    scoop/scraper to pick up material and put into
    Red Biohazard Bag and tie shut. Keep Personal
    Protection Equipment on.

48
Spill Clean Up
--Steps--
Follow the directions to apply the enclosed
disinfectant (OSHA recommends a disinfectant
registered to kill tuberculosis e.g. phenolic)
over the spill area and allow for the contact
time indicated on the product.
49
Spill Clean Up
  • 5. Use disposable wiping cloth to wipe up all
    the disinfectant, and then discard in second Red
    Biohazrd Plastic Bag.

50
Spill Clean Up
  • 6. Place all items including PPE and first Red
    Biohazard Plastic Bag into the second Red
    Biohazard Plastic Bag. To minimize contamination
    to your face, remove PPE in the following order
    (1) disposable shoe covers (2) disposable apron
    and (3) disposable exam gloves.

51
Spill Clean Up
--Steps--
7. To minimize contamination to your face use
antiseptic towelettes to clean hands before
removing the disposable face shield and, lastly,
the disposable face mask.
52
Spill Clean Up
  • Close the red/orange biohazard bag securely with
    twist tie to prevent leakage. Contact EHS to
    dispose of the waste in accordance with local
    regulations . Finally, wash hands as soon as
    possible.

53
What to do with Biohazard Waste after You Clean
Up a Spill
  • Never throw untreated biohazard waste in the
    regular trash!
  • The disposal of this waste generated on the UNC
    campus is subject to federal, state, and local
    regulations and University policies. After spill
    clean-up is complete and you have closed the
    red/orange biohazard bag securely with twist tie
    to prevent leakage, place the waste in a low
    traffic area and contact your supervisor.
  • The supervisor is responsible for contacting the
    Department of Environment, Health and Safety at
    962-5507. After the location and other pertinent
    information is given, EHS will remove the waste
    for proper disposal.

54
Biohazard Waste
  • Often, Biohazard waste and sharps are generated
    and collected in research labs on UNC campus.
    Researchers are responsible for properly treating
    this waste according to procedures outlined in
    the UNC Biological Waste Disposal Policy.
  • Most researchers treat their waste in an
    autoclave, a machine that acts like a large
    pressure cooker to steam sterilize the waste.

Autoclaving is the most dependable procedure for
the destruction of all forms of germs including
bloodborne pathogens. Prior to autoclaving,
autoclave tape is placed over the biohazard
symbol in an x pattern. This special tape
initially looks like masking tape, but after it
has been exposed to heat and moisture it changes
color to indicate that treatment has occurred.
55
Biohazard Waste
  • It is UNC policy that facilities workers never
    handle waste from a laboratory that has not yet
    been treated by the lab workers. If the waste is
    to be relocated, contact the lab or contact EHS
    (962-5507). Never handle untreated waste that is
    not in the white removal bins. Once the waste
    has been treated, the waste is placed in large
    white trash bins that indicate (1) the waste has
    been properly treated and, (2) the waste is ready
    for removal from this site.

56
PREVENTING INCIDENTS AT UNC
57
PREVENTING INCIDENTS AT UNC
Now that weve discussed how to respond in the
event of a potential exposure, lets look at how
to protect ourselves and others from exposure.
Make sure you know whats expected to prevent
exposures and protect the campus community. It
all starts with universal precautions.
58
These measures were included in annual training
requirements and reduced incidents of
work-related Hepatitis B infections.
In the mid-1980s, health care facilities began
adopting universal precautions against exposure
to body fluids. These were followed in 1992 with
the OSHA BBP Standard.
  • (Source CDC 2002a.)

59
What are Universal Precautions?
  • Universal Precautions is the basis of every
    Bloodborne Pathogens training program. It is a
    simple approach to protecting yourself on the
    job.
  • Because an Exposure Determination has already
    been made for your position, whenever you suspect
    the material is contaminated with bloodborne
    pathogens, you always respond as if bloodborne
    pathogens are present.
  • This means that if you anticipate human blood,
    body fluids (except sweat), or OPIM, you always
    wear appropriate personal protective equipment
    and follow the specific requirements designated
    for Facilities Services employees. You also
    follow universal precautions when handling
    equipment or material with a biohazard label.

60
Biohazard Labels
Biohazard labels are used to alert others of the
potential presence of biohazardous materials such
as human blood, body fluids, and OPIM. These
labels are fluorescent orange or red/orange with
contrasting letters and have the universal
biohazard symbol.
61
Biohazard Labels
  • At UNC, biohazard labels are commonly used on
  • Containers of biohazard waste
  • Refrigerators and freezers used to store human
    specimens
  • Containers used to store, transport and ship
    human specimens
  • Any equipment that could be potentially
    contaminated with human blood, OPIM, and other
    material that could allow bloodborne pathogens to
    live or to grow.

We use the biohazard symbol at UNC to provide a
method for hazard communication between lab
workers, visiting professors, Facilities Services
workers, Housekeeping personnel, vendors, and
others who may come into contact with this
material.
62
Biohazard Labels
  • The Universal Biohazard Symbol may be posted on
    entryways to laboratories on campus. These
    laboratories are called Biosafety Level 2 or
    BSL-2 labs. Posted BSL-2 areas are laboratories
    designated to work with bloodborne pathogens or
    with material that may allow germs that cause
    illness to humans, including bloodborne
    pathogens.
  • It is safe to enter areas that are labeled with a
    BIOHAZARD symbol. DO NOT handle anything labeled
    as biohazardous in these areas without special
    training. For example, it is very important that
    all open sores are covered and protected if work
    is required in these areas. Wear gloves and face
    protection when working in areas where contact
    with blood or OPIM is possible. Untreated waste
    in orange or red autoclave bags should never be
    handled by Facilities Services workers in BSL-2
    areas.

63
  • The OSHA Standard requires employers like UNC to
    minimize hazards to workers. These precautions
    are commonly called controls.
  • Facilities Services Workers must observe certain
    controls according to the bloodborne pathogen
    exposure control plan at UNC such as engineering
    controls and work practice controls.

64
  • Engineering controls are equipment or devices
    used to control exposures and at UNC include
    sharps disposal containers, safer needle devices,
    and biological safety cabinets.

65
Engineering Controls
Lets face it, no matter how good we think our
technique is, we are bound to have a bad day once
in a while and make a mistake.
Engineering Controls are designed to minimize the
impact of human errors when we are handling
material that may contain bloodborne pathogens.
Engineering Controls specifically isolate or
remove the hazard from the workplace.
  • Facilities Services workers should be familiar
    with three engineering controls used at UNC that
    isolate or remove the hazard of bloodborne
    pathogens
  • Sharps disposal containers
  • Safe needle devices
  • Biological safety cabinets

66
Disposal of Biohazard Waste SHARPS
Because percutaneous exposure (through the skin)
is a primary route of transmission of bloodborne
pathogens, extreme caution should be taken with
contaminated needles or sharp instruments.
  • Needles/contaminated sharps
  • Must never be bent, recapped or removed unless
    there is no alternative
  • May only be recapped using a mechanical device or
    one handed technique
  • Must never be sheared or broken

67
Needles Sharps Precautions
Contaminated sharps must be placed in hard walled
plastic containers labeled with the biohazard
symbol as shown. When the container is no more
than 2/3 full, place autoclave indicator tape
over the biohazard symbol in an X pattern as
shown. Containers must be placed in biohazard
bag prior to autoclaving.
68
Safer Needle Devices
  • When possible, safer needle devices should be
    used in the laboratory.
  • Some examples of safer devices (including
    animation of how they work) can be found on the
    OSHA website at the Safer Needles Section
    http//www.osha.gov/SLTC/etools/hospital/hazards/s
    harps/sharps.htmlSafer

69
Biological Safety Cabinets
  • Biological Safety Cabinets are used in
    laboratories when conducting procedures with a
    potential for creating aerosols or splashes of
    blood/OPIM.

70
Work Practice Controls
  • Work Practice Controls specifically reduce the
    likelihood of exposure by altering the manner in
    which a task is performed.

71
Hand washing. Hands are to be washed immediately
or as soon as feasible after removal of gloves or
other personal protective equipment. Use a
utility or restroom sink for handwashing, do not
use sinks in food preparation areas. If
handwashing facilities are not immediately
available use antiseptic hand cleanser and/or
disposable wipes. Wash your hands as soon as
handwashing facilities are available.
  • Prevent Ingestion. Eating, drinking, smoking,
    applying cosmetics or lip balm, and handling
    contact lenses are prohibited during duties where
    there is reasonable likelihood of occupational
    exposure to blood or other potentially infectious
    material or in BSL-2 areas.
  •  
  • Storage of food and drink is prohibited in
    refrigerators, freezers, shelves, cabinets or on
    countertops or bench tops where blood or other
    potentially infectious materials are present.

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  • Sharps Precautions. Disposing of sharps in the
    proper container helps keep others safe.
    Remember, any contaminated object that can
    penetrate the skin, including needles, scalpels
    and glass objects requires extra attention.

Contaminated needles. Contaminated needles are
not to be bent, broken, recapped, or removed from
the syringe. If you have no way to tell if the
needle is contaminated or not, use Universal
Precautions assume the needle is contaminated.
Contaminated needles are to be placed in the red
plastic sharps containers described previously
and autoclaved before disposal.
Broken glassware which may be contaminated with
human blood or OPIM must not be collected
directly with the hands. Wear gloves and use
tongs or a brush and dust pan. While small shards
of contaminated broken glass can be placed into
the sharps cans identified above, large
contaminated broken glass items must be
autoclaved separately in a hard-walled container
(such as a cardboard box) lined with an orange
biohazard bag bearing an autoclave tape indicator
x. The autoclaved glass waste is to be
disposed of in a larger cardboard box lined with
a plastic bag, clearly marked with the "GLASS AND
SHARPS" label.
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Work Practice Controls
  • Minimize Splashes. Your technique is important.
    Germs can spread more readily when we cause
    splashing, spraying, spattering, and airborne
    droplets of blood or other potentially infectious
    materials. A good approach to cleaning a spill
    of material that minimizes spread by airborne
    droplets is to (1) place paper towels over the
    spill site, and then (2) douse the area with
    disinfectant. This will reduce further splashing
    any potentially infectious material.

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PPE
  • Personal protective equipment (PPE) is
    specialized clothing or equipment worn by an
    employee for protection against a hazard.
  • General work clothes (including uniforms) are not
    PPE.

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PPE
  • Whenever your duties create the potential for
    exposure to blood or OPIM, personal protective
    equipment such as gloves and eye protection for
    cleaning spills must be available and utilized.
  • It is UNCs responsibility as an employer to
    provide PPE in the appropriate sizes that is
    readily accessible to your worksite or issued to
    you as a properly trained employee. If a
    garment(s) is penetrated by blood or OPIM, the
    garment(s) must be removed immediately or as soon
    as feasible.

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PPE
  • All PPE must be removed and placed in a
    designated container (for storage,
    decontamination, or disposal) prior to leaving
    the spill work area.

77
PPE
  • PPE is NOT worn outside of the work area.
  • Gloves must be removed prior to washing hands and
    leaving the spill area.
  • DO NOT wear gloves on elevators (even if they are
    clean) or use them to open doors or touch
    equipment (i.e. phones, computers) that others
    will be handling without gloves.

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  • LAUNDRY
  • Although soiled clothing or uniforms may contain
    organisms that cause disease, the risk of actual
    disease transmission is negligible. Therefore,
    these safe and simple measures for handling and
    washing linens are recommended
  • 1. Handle uniforms soiled with blood as little as
    possible, using gloves and appropriate protective
    clothing.
  • 2. Place uniforms soiled with blood in bags that
    prevent leakage.
  • 3. Contaminated uniforms cannot be taken home for
    cleaning. Facilities Services employees should
    contact Mark Baker (2-1261) so that arrangements
    can be made for laundering.

79
Safety Resources
  • Below is a list of Safety Resources that can
    provide you with more safety information.

OSHA Topics Page http//www.osha.gov/SLTC/bloodb
ornepathogens/index.html OSHA's Bloodborne
Pathogens Standard http//www.osha.gov/pls/oshaweb
/owadisp.show_document?p_tableSTANDARDSp_id1005
1 Exposure to Blood What Health Care Workers
Need to Know (CDC) http//www.cdc.gov/ncidod/hip/
Blood/Exp_to_Blood.pdf Sharps Safety Workbook
for Designing, Implementing, and Evaluating a
Sharps Injury Prevention Program
(CDC) http//www.cdc.gov/sharpssafety/
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CDC OSHA Standards
  • OSHA on Bloodborne Pathogens
  • Topics Page
  • http//www.osha.gov/SLTC/bloodbornepathogens/inde
    x.html
  • OSHA's Bloodborne Pathogens Standard
    http//www.osha.gov/pls/oshaweb/owadisp.show_docum
    ent?p_tableSTANDARDSp_id10051
  • Exposure to Blood What Health Care Workers Need
    to Know (CDC)
  • http//www.cdc.gov/ncidod/hip/Blood/Exp_to_Blood.
    pdf
  • Sharps Safety Workbook for Designing,
    Implementing, and Evaluating a Sharps Injury
    Prevention Program (CDC
  • http//www.cdc.gov/sharpssafety/

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Questions??
  • If you have any questions, please contact
    Environment, Health and Safety at 962-5507
    between 8 am and 5 pm.

Dont forget to take the exam to get credit for
this course!
82
  • Click here to complete the exam.
  • After completion, click here to complete the
    Sewage Spill Response Training for Facilities
    Services.
  • Sewage Spill response training is only required
    for workers that
  • Conduct a live sewer tie-ins
  • Perform an unstoppage procedure from a sewer
    line, or
  • Participate in sewage spill clean-up.
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