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2009 Safety Training

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Title: 2009 Safety Training


1
2009 Safety Training
  • Information to help staff remain safe and healthy
    on the job.

2
Table of Contents
  • Expectations and Process
  • Hazardous Materials
  • Office Ergonomics
  • Bloodborne Pathogens
  • Safe Driving
  • Emergency Preparedness

3
Expectations and Process
  • These materials have been compiled to help
    Tacoma-Pierce County Health Department staff
    consider ways to work safely and without harm to
    themselves or to colleagues or clients.
  • The training materials and final exam will be
    maintained on the departments network for staff
    to access and complete during work hours.

4
Expectations and Process
  • All Tacoma-Pierce County Health Department are
    expected to complete 2009 Safety Training
  • Read through the materials
  • Take the test
  • Send the test to Joby, MS 005.
  • To receive credit for completing this process,
    Joby must receive your test by close of business
    on August 21, 2009.

5
Expectations and Process
  • If you do not pass the test, Joby will contact
    you so you can re-take it.
  • When you have completed the process, Joby will
    send a document to Human Resources for your
    personnel file.
  • If you have not completed this process by August
    21, 2009, Joby will contact your Manager of
    non-compliance.

6
Hazardous Materials
  • What do you know about the chemicals you
    encounter in the workplace?

7
Hazardous Materials
  • You Have a Right to Know!
  • In 1983, the Federal Government established the
    OSHA Hazard Communication Standard. This standard
    is designed to protect employees who use
    hazardous materials on the job.
  • The Hazard Communication Standard states that
    companies which produce and use hazardous
    materials must provide their employees with
    information and training on the proper handling
    and use of these materials.
  • You, as an employee, have a Right to Know about
    the hazardous materials used in your work area
    and the potential effects of these materials upon
    your health and safety.

8
Hazard Communication Standard
  • The OSHA Hazard Communication Standard is
    composed of five key elements. These five key
    elements are
  • Materials Inventory - A list of the hazardous
    materials present in your work area.
  • Material Safety Data Sheets - A detailed
    description of each hazardous material listed in
    the Materials Inventory.
  • Labeling - Containers of hazardous materials must
    have labels which identify the material and warn
    of its potential hazard to employees.
  • Training - All employees must be trained to
    identify and work safely with hazardous
    materials.
  • Written Program - A written program must be
    developed which ties all of the above together.

9
Hazardous Materials
  • Definition Any substance which has been
    determined to be either a health hazard or a
    physical hazard.
  • Location Everywhere. It has been estimated that
    over a half million chemical products are used by
    business and industry every year. Some of these
    chemical products pose little danger to you,
    while others are deadly. Modern manufacturing
    would not be possible without chemicals. However,
    like machinery or electrical equipment, you must
    know how to use chemicals safely.
  • The first step in using chemicals safely is to
    recognize those materials that may be hazardous
    to your health or physical safety.

10
Faced with a Chemical
  • Employees often ask themselves the following
    questions
  • 1.  How can this material hurt me?
  • 2.  What can I do to protect myself?
  • 3.  Where can I find the answers to the first
    two questions?

11
Information
  • Your most immediate source for information can be
    found on labels attached to containers which hold
    various hazardous materials. OSHA requires that
    the following information be included on ALL
    labels   1.  The product name
  • 2.  A warning statement, message or symbol and
  • 3.  On commercial labels, manufacturers name
    and address. Many manufacturers also include a
    statement describing safe handling procedures.
  • Your second source of information is Materials
    Safety Data Sheets (MSDSs). Material Safety Data
    Sheets will be discussed in the next section.

12
Sample Label
  • Sample
  • 1. Warning - may produce damage to central and
    peripheral nervous systems by skin contact or by
    inhaling vapors.
  • 2. CONTAINS n-hexane (CAS110-54-3).
  • 3. Avoid inhaling vapors or skin contact. Use
    only in a well ventilated area. When using, do
    not eat, drink or smoke. If swallowed, do NOT
    induce vomiting. Call physician immediately.
  • 4. ABC Rubber Cement Company. Altonia, ill.
  • Heres what you should find on a label
  • 1. A warning statement, message or symbol.
  • 2. The product name.
  • 3. Safe handling procedures.
  • 4. Manufacturer's name and address.

13
Labels
  • In addition to commercial labels, many
    organizations use labels such as those shown
    below.
  • At the top of the label will be the chemical
    trade name of the hazardous material.
  • Each colored bar or small diamond represents a
    different class of hazard. The hazard classes
    found on labels include Health, Flammability,
    Reactivity, and in some cases, Special Hazards.
  • Each hazard class uses a different color and a
    rating scale from 0 - 4.

14
Health Hazards
  • The first hazard class is Health Hazards. This
    hazard class is colored BLUE.
  • The rating scale for Health Hazards is listed
    below  
  • 0 - No Hazard 1 - Slight Hazard 2 -
    Dangerous 3 - Extreme Danger 4 - Deadly

15
Flammability
  • The second hazard class - in RED - is
    Flammability Hazards.
  • The rating scale for flammability hazards is
    based on the temperature at which the material
    gives off enough vapors to sustain ignition.
  • 0 - Will Not Burn 1 - Ignites Above 200
    Degrees Fahrenheit 2 - Ignites Below 200
    Degrees Fahrenheit  3 - Ignites Below 100
    Degrees Fahrenheit  4 - Ignites Below 73
    Degrees Fahrenheit

16
Reactivity
  • The third hazard class - YELLOW - is the
    Reactivity of the material
  • 0 - Stable 1 - Normally Stable 2 - Unstable
    3 - Explosive 4 - May Detonate

17
Special Hazards
  • Diamond shaped label WHITE - includes a fourth
    hazard class called Special Hazards, which
    include
  • Water Reactive OX - Oxidizer Radioactive
    COR - Corrosive ACD - Acid ALK - Alkali

18
MSDS
  • Material Safety Data Sheets
  • While labels are an effective way to display
    information about hazardous materials, there will
    be times when you will want more information than
    can be included on a label.
  • You can find additional information about the
    hazardous materials you work with in what is
    called a Material Safety Data Sheet, or MSDS for
    short. You should take time to read and
    understand the MSDSs describing the hazardous
    materials present in your work area.
  • Look! Youll find a notebook of MSD Sheets in
    your work area. If you cant find it, talk with
    your Safety Monitor.

19
MSDS
  • An MSDS contains the following information
  • Identity (name of substance)
  • Physical Hazards (target organ)
  • Health Hazards
  • Routes of Body Entry
  • Permissible Exposure Limits (PEL)
  • Carcinogenic Factors (cancer causing)
  • Safe-Handling Procedures
  • Date of Sheet Preparation
  • Control Measures (personal protective equipment)
  • Emergency First Aid Procedures (emergency
    telephone number)
  • Contact Information (for the preparer of the
    sheet)
  • Special Instructions

20
MSDS Sample
  • This is a sample page from the MSDS for Nitric
    Acid, 70 percent.
  • Product identification, other names aqua fortis,
    azotic acid, nitric acid 70 percent.
  • Formula CAS Number 7697-37-2. Molecular weight
    63.00.
  • Hazardous ingredients, not applicable.
  • Chemical formula, HNO3.
  • Precautionary measures danger, strong oxidizer,
    contact with other materials may cause fire.
    Causes severe burns, may be fatal if swallowed.
    Harmful if inhaled. Do not get in eyes, on skin,
    or on clothing. Use only with adequate
    ventilation.
  • Wash thoroughly after handling. Do not store near
    combustible materials. Store in a tightly closed
    container. Remove and wash contaminated clothing
    properly.

21
When Do You Use an MSDS?
  • You should use an MSDS whenever you need
    additional information about a hazardous
    material.
  • For example, if you spill nitric acid on the
    floor, refer to the "Safe-Handling Procedures"
    section of the nitric acid MSDS.
  • Safe-Handling Procedures Section - Nitric Acid,
    70
  • Isolate or enclose the area of the leak or spill.
    Wear protective clothing and respiratory
    equipment.
  • For small spills flush with water, and neutralize
    with alkaline material (soda ash, lime, et
    cetera).
  • For larger spills and lot sizes neutralize with
    alkaline, pick up with absorbent material (sand,
    earth, vermiculite) and dispose in an approved
    waste facility. Provide forced ventilation to
    dissipate fumes.
  • Reportable Quantity (RQ) (CWA/CERCLA) 1000
    pounds
  • Insure compliance with local, state and federal
    regulations.

22
NOTE Read MSDS Early
  • Some chemicals, such as sodium hydroxide, are
    very dangerous. If you have an accident, you may
    not have time to look up the information you need
    in an MSDS.
  • Take the time to read the MSDSs for the
    hazardous materials present in your work area
    before you work with them.
  • Where can you find an MSDS?
  • Every work area should have one check with your
    Safety Monitor.
  • Maintenance staff also have an MSDS notebook
    send a HelpDesk Request to Clarence if your MSDS
    notebook does not contain the chemical youre
    working with.

23
Physical Hazards
  • Two major classes of hazardous materials include
  • Physical Hazards substances which threaten your
    physical safety.
  • Health Hazards cause measurable changes in your
    body.
  • Physical hazards are those substances which
    threaten your physical safety. The most common
    types of physical hazards are Fire
    Explosion Chemical Reactivity
  • Physical Hazards use these symbols

24
Materials Using Fire Symbol
  • Three classes of materials use the fire symbol.
  • 1. Flammables can be gas, liquid or solid,
    ignite easily and burn rapidly. Liquid flammables
    have a flashpoint under 100 degrees F.
  • 2. Combustibles similar to flammables, but they
    do not ignite as easily. Liquid combustibles have
    a flash point above 100 degrees F.
  • 3. Pyrophoric can burst into flames
    spontaneously at temperatures below 130 degrees
    F.
  • When you work with a material that uses the fire
    symbol, read the warning label and the MSDS for
    safe handling procedures.
  • With flammables, combustibles, and
  • pyrophorics, do not expose these materials
  • to sparks, flames or other heat sources.
  • You must also not smoke or light a match
  • or flame near them.

25
Materials Using the Explosive Symbol
  • Classes
  • 1. Explosives materials which release a
    tremendous amount of energy in the form of heat,
    light and expanding pressure within a very short
    period of time. 
  • 2. Water Reactives react with water and may
    explode, or they may release a flammable gas.
  • 3. Unstable Reactives can react or can become
    self-reactive when subjected to shock, pressure
    or temperature.
  • If you use an explosive material, read
  • the warning label and the MSDS for
  • safe handling procedures. Always check
  • with your supervisor before handling
  • anything with the explosive symbol on it.

26
Materials Using the Flaming "O"
  • Classes
  • 1.  Oxidizers cause other substances to burn
    more easily through a chemical reaction or
    change.
  • 2. Organic Peroxides contain oxygen and act as
    powerful oxidizers.
  • Whenever you work with a material that uses
  • the Flaming "O" symbol, be sure to read
  • the warning label and the MSDS for
  • safe handling procedures.

27
Materials Using the Cylinder
  • Many gases such as nitrogen, oxygen, and
    acetylene are used in the manufacturing process.
    In order to transport, store and use these gases,
    they are "bottled" under great pressure in tanks
    called gas cylinders.
  • Great care should be taken when you
  • handle gas cylinders to insure that
  • they are not damaged when they are
  • moved or used. In addition, you should
  • read the warning label and the MSDS
  • for safe handling procedures
  • concerning the gas contained in a
  • gas cylinder.

28
Health Hazards
  • Health Hazards are one of two major classes of
    hazardous materials covered by the OSHA
    Communication Standard. The other major hazard
    class is Physical Hazards. In this session, we
    will be looking at various types of health
    hazards and what you need to know to use these
    materials safely. To help you identify materials
    which are health hazards, the symbols shown below
    are often used.

29
Definitions
  • The term toxicity is used to describe the ability
    of a substance to cause a harmful effect.
    EVERYTHING is toxic at some dose. Even water! If
    someone drinks too much water at any one time, it
    can cause death.
  • There is a balance between toxicity and dose.
    Dose is the AMOUNT of something you are exposed
    to, or come in contact with. The less the
    toxicity, the greater the dose you can tolerate
    without ill effects. The greater the toxicity,
    the less dose you can tolerate without becoming
    sick.
  • Hazard Potential is the likelihood that a
    specific chemical or substance (toxic material)
    will cause an ill effect at a given dose. The
    following screens will help you to understand the
    relationship between toxicity, dose, and hazard
    potential.

30
Hazard Potential
  • Hazard potential is the most accurate way to rate
    how dangerous a substance is when used under a
    given set of circumstances. Neither the toxicity
    or the dose rating alone provides you with enough
    information on how to use a hazardous material
    safely. Your real concern must always be with a
    hazardous material's hazard potential.
  • The effects of health hazards are classified as
    either
  • Acute
  • Chronic

31
Health Hazards
  • Acute Health Hazards are those whose effects
    occur immediately or soon after you come in
    contact with them.
  • For example, you accidentally spill a strong acid
    on your hand. The acid will begin to burn your
    hand immediately. Or, you begin to work with a
    paint solvent in a closed area, and the fumes
    make you feel dizzy.
  • Chronic Health Hazards, on the other hand, are
    those whose effects take years or decades to
    occur after many exposures.
  • An example of a chronic health hazard would be
    asbestos. The dangerous effects for people who
    have been overexposed to asbestos take years to
    appear and have been linked to a number of fatal
    lung diseases.

32
Health Hazards
  • It's important to remember that hazardous
    materials present a health hazard only when they
    come into contact with the body. Chemicals can
    enter the body in three ways 1. Inhalation
    2. Skin absorption 3. Ingestion

33
Health Hazards
  • Inhalation is the most common route of exposure
    for most health hazards. This includes breathing
    in dust, fumes, oil mist, and vapors from
    solvents and various gases.
  • Some chemicals are absorbed into the body through
    skin contact. If a chemical is readily absorbed
    into the skin, then the notation "skin" will
    appear along with the occupational exposure
    limits on the MSDS. Wearing aprons, gloves, eye
    protection, and other protective clothing is
    important when working with some chemicals.
  • It is possible to accidentally eat chemicals that
    are health hazards. To insure that you do not
    accidentally eat any of the chemicals you work
    with 1.  Never eat foods in areas where
    chemicals are used. 2. Never smoke in areas were
    chemicals are used. 3. Wash your hands and face
    with soap and water after working with chemicals.

34
More Definitions
  • Any chemical that may be harmful to your health
    is called a health hazard. The following is a
    brief description of the major types of health
    hazards.
  • Corrosives - cause tissue damage and burns on
    contact with the skin and eyes.
  • Primary Irritants - cause intense redness or
    swelling of the skin or eyes on contact, but with
    no permanent tissue damage.
  • Sensitizers - cause an allergic skin or lung
    reaction.
  • Acutely Toxic Materials - cause an adverse
    effect, even at a very low dose.
  • Carcinogens - may cause cancer.
  • Teratogens - may cause birth defects.
  • Organ Specific Hazards - may cause damage to
    specific organ systems, such as the blood, liver,
    lungs, or reproductive system.

35
Symbols
  • The Medical symbol is a general symbol used to
    identify materials which are health hazards.
  • The Skull and Crossbones is a symbol that has
    been used for centuries. Today it is used to
    identify hazardous materials which are poisonous.

36
Symbols
  • This symbol is used to identify materials which
    are Corrosives. Corrosives cause tissue damage
    and burns on contact with skin or eyes.
  • This symbol is used to identify
  • Materials which are Radioactive.
  • This symbol is used to identify hazardous
    Biological materials.

37
Protecting Your Health
  • Product Substitution Because many chemicals do
    similar jobs, it is important to select chemicals
    that do a good job, while being less toxic.
  • Engineering Controls Well designed work areas
    minimize exposure to materials which are
    hazardous. If you have to work with chemicals,
    make sure your health is protected with
    appropriate exhaust systems before you open a
    container with toxic materials in it.
  • Personal Protective Equipment Masks, eye
    protection, gloves, aprons, and other protective
    equipment and clothing are designed to protect
    you while you work.  USE THEM!

38
Protect Your Health
  • Knowing how to work safely with chemicals that
    pose a hazard is an important activity. This is
    the reason for this training, safety meetings,
    and MSDSs. You have a right to know, but you also
    have a responsibility to use the knowledge and
    skills to work safely.
  • Monitor yourself and others. Be on the lookout
    for any physical symptoms which would indicate
    that you or your coworkers have been overexposed
    to any hazardous chemical. Symptoms, such as skin
    rashes, dizziness, eye or throat irritations or
    strong odors, should be reported to your
    supervisor.

39
Office Ergonomics
  • Adjusting Your Workstation to Fit Your Body

July 20 August 21, 2009
40
What is Ergonomics?
  • ERGOwork
  • NOMICS rules or laws
  • Ergonomics literally means the laws of work

July 20 August 21, 2009
41
What is Ergonomics?
  • OSHA defines ergonomics as the science of
    designing the job to fit the worker, instead of
    forcing the worker to fit the job.
  • Ideally, ergonomics
  • Makes the job safer by preventing injury and
    illness
  • Makes the job easier by adjusting the job to the
    worker
  • Makes the job more pleasant by reducing physical
    and mental stress and,
  • Saves money.

July 20 August 21, 2009
42
Ergonomic Factors
  • There are two categories of ergonomic factors
  • Environmental May include things like excessive
    noise, improper lighting, temperature extremes,
    etc., resulting in problems with hearing, vision,
    general comfort and health.
  • Physical These stressors place pressure or
    stress on parts of the body, such as joints,
    muscles, nerves, tendons, bones.
  • Sometimes these injuries are referred to as
    Cumulative Trauma Disorders or Repetitive
    Strain Injuries.

43
Physical Risk Factors
  • The main risk factors for office-related
    injuries
  • Repetition
  • Awkward positions or posture
  • Excessive pressure or force
  • The majority are caused by repetitive motions
    that would not result in injury if only performed
    once, such as
  • Thousands of keystrokes typing.
  • Hours of filing, day after day.
  • Stamping or stapling dozens of papers.
  • Frequent lifting.
  • Repeated motions with computer mouse.

July 20 August 21, 2009
44
Risk Factors Awkward Positions
  • You can prevent problems by avoiding the
    following. How many of these things do you do
    regularly?
  • Lean forward at or over your desk.
  • Type with one or both wrists at an odd angle.
  • Raising your shoulders while you type.
  • Reach to use your computer mouse.
  • Twist your neck to look at you computer monitor
    or talk on the phone
  • Lift objects from below your waist without
    bending your knees or from somewhere above your
    shoulders without other support.

July 20 August 21, 2009
45
Risk Factors Excessive Force
  • Or, some people
  • Type with too much force or pounding the keys.
  • Manually stamp items, with a hammer-like hand.
  • Use improper grips to lug heavy items around.

July 20 August 21, 2009
46
But the good news is....
  • There are simple ways to help yourself!

July 20 August 21, 2009
47
Prevention Strategies
  • When working at your desk, your elbows should be
    at a comfortable angle while "hanging" at the
    sides from the shoulders. The shoulders should
    remain relaxed in a lowered position while
    typing.
  • Avoid leaning forward at your desk. Instead
  • Maintain the natural s curve of your spine
  • Support your lower back against your chair
  • Keep your feet supported on the floor or use a
    foot rest.

July 20 August 21, 2009
48
Ergonomics for your work station
  • The above image has been borrowed, for internal
    use only, from the University of Missouri.

49
Prevention Strategies
  • Avoid typing with wrists at an odd angles
  • keep them in the neutral position, not bent up or
    down, or side-to-side
  • Your keyboard should be slightly lower than
    normal desk height.
  • If it is not low enough, try raising your chair
    height.
  • But prevent your legs from dangling by using a
    footrest.
  • If your keyboard is at an angle, keep the "home
    row" (thats the asdfghjkl line) of keys at
    elbow level.

July 20 August 21, 2009
50
Prevention Strategies
  • The keyboard should be slightly lower than normal
    desk height.
  • If it is not low enough, try raising your chair
    height. Prevent your legs from dangling by using
    a footrest.
  • Keep "home row" of keys at elbow level.
  • Adjust your chair!

July 20 August 21, 2009
51
Prevention Strategies
  • Do not pound the keys on your computer keyboard.
    Use a light touch.
  • Use two hands to perform double key operations
    like Ctrl-C or Alt-F instead of twisting one hand
    to do it.
  • Position frequently-used equipment so that you
    dont have to reach for it.
  • Place your computer monitor in front of you, not
    off at an angle.
  • Hold the mouse lightly.
  • Take lots of breaks to stretch and relax.
  • Keep your hands and arms warm.

July 20 August 21, 2009
52
Prevention Strategies
  • Pay attention to the signals your body provides
    you.
  • If your neck hurts at work, examine your body
    position to try to figure out what might be
    causing the soreness. Are you holding your neck
    at an awkward angle while you type or talk on the
    phone?
  • See a medical provider if you experience symptoms
    of cumulative trauma disorders
  • Tingling or numbness in the hands or fingers
  • Pain in fingers, hands wrists, or even shooting
    up into the arms or forearms
  • Loss of strength or coordination in the hands
  • Numbness or discomfort in the hands that wakes
    you up at night.

July 20 August 21, 2009
53
But What About Headaches?
  • Sometimes office-related headaches are caused by
  • Dry eyes
  • Glare from your computer monitor or
  • Tired/strained eye muscles.
  • Prevent problems by
  • Positioning your monitor at a comfortable
    distance, 12 18 inches from your face.
  • Adjusting lights or your monitor to avoid glare.
  • Adjusting VDT brightness and contrast.
  • Keeping your monitor clear of dust.
  • Simply looking up and away every few minutes.

July 20 August 21, 2009
54
Back Pain
  • Besides setting up your work station to prevent
    back problems, learn to lift correctly to save
    your back.
  • To pick something up
  • Stand close to the load.
  • Bend your knees (not your back).
  • Let your legs push your body up slowly and
    smoothly.
  • To put something down
  • Do not twist your body.
  • Lower the load, bending your knees and letting
    your legs, not your back, do the work.
  • Place the load on the edge of a surface and slide
    it down flat.

July 20 August 21, 2009
55
Get Some Help
  • Being independent can be a virtue, but not when
    the load is too heavy for one.
  • A two-person lift works best is
  • Both people are about the same height.
  • One person is in charge of saying when to move
    where.
  • You lift and raise at the same time.
  • You keep the load at the same level while
    carrying it.
  • You set the load down using your knees at the
    same time.

July 20 August 21, 2009
56
Exercise and Stretch
  • The TPCHD Wellness Committee offers a weekly
    Stretch Class. Drop by to learn some stretches
    that you can try at home.
  • On the next few pages youll find exercises you
    can do at your desk to help you relax muscles. If
    you have a medical condition that would prevent
    your doing these, please, just skip this part.
    Otherwise, try a few gently at first and see
    if it helps your muscles.

July 20 August 21, 2009
57
Exercise and Stretch, Continued
  • Shoulder Shrug
  • Raise your shoulders toward your ears until you
    feel slight tension in your neck and shoulders.
    Hold this feeling of tension for 3 to 5 seconds.
    Keep breathing slowly. Then relax your shoulders
    downward into their normal position. Do this 2 or
    3 times.
  • Hand and Forearm Stretch
  • Sit with your elbows on a table. Put your palms
    together, and slowly lower your wrists to the
    table until you feel a stretch (your elbows will
    move outward a bit). Keep your palms together
    throughout the stretch. Hold 5 to 10 seconds,
    breathing slowly. Relax. Repeat 3 times.

July 20 August 21, 2009
58
Exercise and Stretch, Continued
  • Back/Side Stretch
  • Interlace your fingers and lift your arms over
    your head. Keep your elbows straight and press
    your arms as far back as you can over your head.
    To stretch your sides, slowly lean to the left
    and then to the right.
  • Standing Back Bends
  • Stand up. Place your hands in the small of your
    back and slowly bend backwards until you feel a
    gentle stretch in your trunk. Remember that
    stretching should not cause any pain. Hold the
    stretch for 3 seconds and
  • repeat 10 times.

59
Exercise and Stretch, Continued
  • Ankle Flex and Stretch
  • Hold one foot off the floor with your leg
    straight. Alternately flex your ankle (move your
    toes to point towards your knees) and extend
    (point your toes out straight). Repeat with the
    other leg.
  • Resting Eye Muscles
  • Give your eyes a rest periodically by looking
    away from your computer screen for a few moments.
    Post a picture of a place you enjoy and gaze at
    that for 10 15 seconds while you breathe
    deeply. Realign your posture when you return to
    your computer work.

60
Bloodborne Pathogens
July 20 August 21, 2009
61
Why should you know about BBPs?
  • Infection from a bloodborne pathogen (BBP) can
    result in chronic infection, serious illness, and
    death.

July 20 August 21, 2009
62
Bloodborne Pathogens (BBPs)
Bloodborne Pathogens microorganisms that are
present in blood or other potentially infectious
materials (OPIM) and can cause disease.
Blood includes human blood, human blood
components, products made from human blood, and
also medications derived from blood (e.g., immune
globulins, albumin, etc.).
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General background
PATHOGEN a microorganism that can cause disease.
Four main groups of microorganisms
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Transmission of Diseases
The first step in preventing disease is to keep
the organism from entering the body. There are
three primary routes of entry
  • Contact
  • Bloodborne
  • IngestionFood, water
  • InhalationAir

Infected person coughs or sneezes and spreads the
pathogen through the air to others.
Infected person doesnt wash hands properly after
using toilet, handles or prepares food/water and
contaminates it.
Infected person transmits pathogen through a
route that involves blood/ mucous membrane/
sexual contact.
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Transmission of BBPs
Occupational Exposure
  • Means contact with blood or other potentially
    infected materials (OPIM) on the skin, eyes,
    mucous membrane, or through the skin (parenteral)
    that may result from the performance of an
    employees duties.

Exposure Incident
  • Is a specific contact with blood or OPIM that is
    capable of transmitting a bloodborne disease.

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Transmission of BBPs
Risk of infection depends on several factors
  • The pathogen involved.
  • The type/route of exposure.
  • The amount of virus in the infected blood at the
    time of exposure.
  • The amount of infected blood involved in the
    exposure.
  • Whether post-exposure treatment was taken.
  • Specific immune response of the infected
    individual.

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Bloodborne Pathogen Diseases
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68
Hepatitis - General Overview
The liver is a large, dark red gland located in
the upper right abdomen behind the lower ribs.
It functions in removing toxins (poisons) from
the blood, in the digestion of fats, and in other
body processes.
  • Virus attacks liver, causing
  • inflammation, enlargement, and tenderness.
  • Acute and chronic infections.
  • Possible liver damage ranging from mild to fatal.

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Courtesy of Schering Corporation
69
HBV - Hepatitis B
General Facts about the Virus
  • Its hearty, able to live for at least seven days
    in dried blood.
  • Its 100 times more contagious than HIV.
  • Approximately 78,000 new infections occur
    annually in the US.
  • Currently, 1.25 million carriers.
  • 5,000 deaths/year.
  • No cure exists, but there is a preventative
    vaccine.

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HBV - Hepatitis B
  • Symptoms
  • flu-like symptoms
  • fatigue
  • abdominal pain
  • loss of appetite
  • nausea, vomiting
  • joint pain
  • jaundice

Normal eyes
Jaundiced eyes
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HBV - Hepatitis B
How is HBV Transmitted?
  • Unprotected sex with multiple partners.
  • Sharing needles during injecting drug use.
  • From infected mother to child during birth.
  • In the workplace Piercing the skin with an
    infected needle or other sharp instrument.

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HCV - Hepatitis C
General Facts about the Virus
  • The most common chronic bloodborne infection in
    the U.S.
  • 3.9 million (1.8) Americans infected 2.7
    million chronically infected.
  • About 25,000 new infections per year.
  • Leading cause of liver transplantation in U.S.
  • 8,000-10,000 deaths from chronic disease/year.
  • No broadly effective treatment.
  • No vaccine available.

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HCV - Hepatitis C
  • Symptoms
  • flu-like symptoms
  • jaundice
  • fatigue
  • dark urine
  • abdominal pain
  • loss of appetite
  • nausea

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74
HCV - Hepatitis C
How is HCV Transmitted?
  • Injecting drug use.
  • Hemodialysis (long-term).
  • Blood transfusion and/or organ transplant before
    1992.
  • From infected mother to child during birth.
  • Sexual or household exposures rare.
  • Occupational exposure to blood, mostly through
    needle sticks.

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Human Immunodeficiency Virus (HIV)
General Facts about the Virus
  • Its fragile, living only a few hours in a dry
    environment.
  • Attacks the human immune system, causing AIDS.
  • More than 1 million infected persons in U.S.
  • No cure no vaccine available yet.

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Human Immunodeficiency Virus (HIV)
Symptoms of HIV Infection/AIDS
  • Many have no symptoms or only mild flu-like
    symptoms.
  • Most people infected with HIV eventually develop
    AIDS.
  • The incubation period can be 10-12 years.
  • Other, opportunistic, infections AIDS-related
    diseases can occur.
  • Treatments are available and successful for a
    period of time a cure is not yet available.

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Human Immunodeficiency Virus (HIV)
How is HIV Transmitted?
  • Sexual contact.
  • Sharing needles and/or syringes.
  • From HIV-infected women to their babies during
    pregnancy or delivery.
  • Breast-feeding.
  • At work via needle sticks.

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Exposure Risk
  • Workplace exposure to BBPs occur most frequently
    through
  • Handling of any waste products
  • Administering first aid
  • Post-accident cleanup
  • Janitorial or maintenance work
  • Industrial accident.

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Prevent Universal Precaution
  • Treat all blood and bodily fluids as though they
    are contaminated
  • Dispose of all contaminated material in
    appropriate types and clearly marked containers
  • Clean up spills and decontaminate immediately
  • Use personal protective equipment whenever you
    may come in contact with blood, bodily fluids,
    and potentially materials contaminated.

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Use Personal Protective Equipment
  • If you will be working where you may come into
    contact with bodily fluids, use personal
    protective equipment (PPE)
  • Latex or Nitrile gloves - Goggles
  • CPR mouth barriers - Aprons
  • Respirators
  • Always check PPE for defects or tears before
    using.
  • If PPE becomes torn or defective remove it and a
    get new one.
  • Remove PPE before leaving a contaminated area.
  • Do not reuse disposable equipment.

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Wash your hands
  • Wash your hands frequently this is just a good
    general rule.
  • Especially wash your hands immediately after
    removing PPE.
  • Use soap and warm water and wash all hand
    surfaces for at least 20 seconds.
  • A hand sanitizer can be used but wash with soap
    and water as soon as possible.

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Segregate Sharps and Waste
  • Collect sharps in red, plastic disposal boxes
    marked with Biohazard Symbol.
  • Dont fill container (2/3 full is good).
  • Dont poke your hand/fingers into container.
  • Ensure everything is closed securely before
    transporting.
  • Collect materials contaminated with human fluids
    in marked Bags
  • Dont overfill.
  • Store in appropriate place away from people.
  • As soon as possible, take to maintenance area in
    D Street, bottom floor, for transportation to
    disposal area.

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Exposure Incident
  • If you are involved in an incident where you are
    in contact with potentially infectious bodily
    fluids
  • Wash the area immediately and
  • Report the situation to your supervisor.
  • Complete an On the Job Injury Form
  • Found in libshare/common/safety/report forms.
  • TPCHDs Human Resources staff can help you with a
    post-exposure medical evaluation.

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84
BBP Summary
  • Microorganisms exist in our work environment that
    can cause disease.
  • Prevent illness from BBP by applying universal
    precautions
  • Assume any bodily fluid is infected
  • Use PPE to protect yourself
  • Wash your hands frequently
  • Dispose of materials in a way that protects you,
    colleagues and the public
  • Segregate sharps and medical wastes and take to
    disposal area promptly
  • Report any exposure to your supervisor and HR.

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Safe Driving
86
TPCHD Policy
  • While performing duties as an employee, in a
    departmental or personal vehicle
  • Obey all laws and safe-driving recommendations.
  • Use rules of common sense.
  • Wear seat belts.
  • Avoid backing up and u-turns, unless legal and
    necessary.
  • Report accidents on the forms provided.

87
Rules of Common Sense
88
Routine Safety Check
  • Look at the car
  • Tires okay?
  • Any leaks?
  • Stuff hanging from the underside?
  • Check lights, including turn signals.
  • Adjust mirrors and seats to fit you.
  • Anything able to slide to your neck, feet, lap?
    Move it before you move the car.

89
Drive Defensively
  • Always buckle up.
  • Expect other drivers to make mistakes. Plan what
    you would do if a mistake happened.
  • Leave at least 4 seconds between you and the car
    ahead. Encourage the tailgater behind to pass
    you.
  • Be aware of bicyclists, walkers, and cars at
    intersections and dashing in front of you.
  • Leave early dont speed.

90
Drive Defensively
  • If you drink, dont drive.
  • If you are taking meds, or are tired, dont
    drive.
  • Obey the speed limit.
  • To avoid being hit from the rear, slow down
    gradually tap your brakes a couple of times.
  • Always use your turn signals.
  • Yield to drivers who are determined to get there
    first.
  • Keep checking your rearview and both side mirrors
    for oncoming traffic even if no one is supposed
    to be driving on one side of you.
  • Carry emergency equipment a jack, flares,
    flashlight, first-aid kit.

91
Use Caution
  • If the roads are wet, drive like its snowing.
  • If the roads have snow, drive like theyre icy.
  • If the roads are icy, dont drive if at all
    possible.

92
Accident?
  • Check to see if you are injured, then the other
    party. Dial 911.
  • Contact law enforcement.
  • Carry list of contact numbers, personal
    information, insurance, and medical needs.
  • Fill out TPCHD forms as soon as possible and
    route as indicated on the form.

93
Emergency Response
94
Consider Potential Scenarios
  • Earthquake A 7.1 earthquake hits the Puget Sound
    region, knocking down buildings, and bridges over
    freeways shutting down electricity leaving many
    people homeless and injured.
  • Winter storm For the third year in a row, this
    area is hit with a 100-year storm, causing
    flooding and requiring evacuation of long-term
    care facilities as well individual residences.
  • Flu Pandemic The federal government requires
    local public health will ensure vaccination of
    key children and adults against flu. This will
    include all healthcare workers, all school and
    childcare staff, all children from 6 months to 17
    years, and all people under 65 years old with
    complicating illnesses that can intensify flu
    symptoms.

95
Scenarios Possible
  • All three scenarios are possible for the
    fall/winter of 2009 2010.
  • If those things happen, what are the roles of
    public health?
  • Monitoring, assessing, and following up on
    peoples health.
  • Ensuring the safety of workers responding to an
    incident.
  • Ensuring that the public food and water supplies
    are safe.
  • Educating the public, providing medical, public
    health, and mental/behavioral health advice.
  • Establishing and maintaining a registry of people
    exposed to or contaminated by a given agent.
  • Coordinating the efforts of other medical/health
    agencies, including long-term care, hospital, and
    other facilities.

96
Incident Command
  • What is the over-riding system for responding to
    an incident? Incident Command.
  • A standardized, hierarchical, all-hazard incident
    management concept.
  • ICS is based upon a flexible, scalable response
    organization providing a common framework within
    which people can work together effectively.
  • It is designed to give standard response and
    operation procedures to reduce the problems and
    potential for miscommunication on such incidents.

97
Incident Command
98
Hierarchical
  • The Incident Command System requires that someone
    or an identified and unified group is in charge
    called Incident Command or Unified Command.
  • At TPCHD, the top position is called an Incident
    Manager.
  • Second in line is the Deputy Incident Manager.
  • If you function in the Incident Command System,
    your boss is the person in the hierarchy above
    you, not your regular day-to-day supervisor.
  • If you are called to serve in the Emergency
    Response Organization, give your day-to-day
    supervisor a call to say you are in the Incident
    Command System.
  • Then do not report, or ask permission or support
    from your day-to-day supervisor for anything
    until you are released from your emergency
    response work. Instead, report to your ICS
    supervisor and ask questions of her/him.

99
Emergency Response Organization
  • Tacoma-Pierce County Health Department has
    pre-established positions, with descriptions of
    tasks each position is responsible for in the
    Emergency Plan Implementing Procedures (EPIP).
  • If you are called in to serve in a position in
    the Emergency Response Organization, it is your
    first responsibility (after signing in) to read
    the relevant EPIP.
  • Staff consistently try to respond to an incident
    based on what they believe is the best response.
    After-Action Reports show this is not a good
    approach.
  • The best response is found in the EPIP. Take the
    time to read that book first youll find one in
    each conference room and in the Emergency
    Operations Facility.

100
Personal Response
  • In order to be effective in responding as a
    public health professional, you have to prepare
    yourself and your family.
  • Develop a plan for where you will meet your
    household and family members if an earthquake or
    other environmental disaster hits.
  • Know how you will care for yourself and your
    family if a communicable disease creates an
    emergency.
  • Agree on how to communicate during an emergency.
  • Set aside food, clothing, medications, and other
    items so that your family can function for seven
    to tens days.
  • Carry in your car extra food and clothing in case
    you cannot get home and have to stay at work.

101
Prepare
  • There will be emergencies that will require a
    public health response.
  • Prepare yourself and your family with a plan,
    that you talk about and practice.
  • Understand that you may be called in to function
    within the TPCHD Emergency Response Organization,
    which may mean longer shifts and will most likely
    mean reporting to someone who is not your regular
    supervisor. Be ready to work under a hierarchy
    that is different from day-to-day.
  • When called in, report when and where you are
    assigned, sign in, and read the relevant EPIPs
    before you take any action.

102
Take the Test
  • This ends your 2009 Safety Training.
  • Please find the exam answer form. You can fill it
    out and return it
  • Save on your commuter, fill it out and send it to
    Joby attached to an email.
  • Print a copy, complete it, and fax it to Joby
    (253-798-7627).
  • Print a copy, complete it, and send it to Joby
    via mail MS 005.
  • The exam is due to Joby by August 21, 2009.
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