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MIOSHA Part 554 Bloodborne Infectious Diseases Train the Trainer Program Module 1

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Title: MIOSHA Part 554 Bloodborne Infectious Diseases Train the Trainer Program Module 1


1
MIOSHAPart 554 Bloodborne Infectious
DiseasesTrain the Trainer ProgramModule 1
  • Presented By
  • Consultation Education Training (CET) Division
  • Michigan Occupational Safety Health
    Administration Michigan Department of Energy,
    Labor Economic Growth
  • www.michigan.gov/miosha
  • (517) 322-1809

2
Welcome
  • Welcome to the MIOSHA Bloodborne Infectious
    Diseases Online Training Program.
  • This program is designed to provide an overview
    of the MIOSHA bloodborne standard.
  • It does NOT fullfill all the training
    requirements in the Bloodborne Standard nor is it
    intended to replace facility specific training.

3
Intended Use Train the Trainer
  • Provide bloodborne infectious diseases
    information to those who provide training to
    employees who are at risk of occupational
    exposure.
  • Provide additional resources to assist trainers
    in becoming more knowledgeable in topics related
    to bloodborne infectious diseases.

4
  • Module 1will provide an overview of the MIOSHA
    Bloodborne Infectious Diseases Standard Rules 1-9.

5
Overview of the Bloodborne Standard
Module 1
Module 2
  • Rule 1 Scope
  • Rule 2 Definitions
  • Rule 3 Exposure determination
  • Rule 4 Exposure control plan
  • Rule 5 Universal precautions
  • Rule 6 Engineering controls
  • Rule 7 Work practices
  • Rule 8 Protective work clothing and equipment
  • Rule 9 Housekeeping
  • Rule 10 Regulated waste
  • Rule 11 Laundry
  • Rule 12 HIV and HBV research laboratories and
    production facilities
  • Rule 13 Vaccinations and postexposure follow-up
  • Rule 14 Communication of hazards to employees
  • Rule 15 Recordkeeping
  • Rule 16 Information and training
  • Appendices

6
Rule 1 Scope
  • These rules apply to all employers that have
    employees with occupational exposure to blood and
    other potentially infectious materials.

7
Rule 2 Definitions
  • Bloodborne Pathogens pathogenic microorganisms
    present in human blood including HBV, HIV and
    HCV.
  • Contaminated presence or the reasonably
    anticipated presence of blood or other
    potentially infectious materials (OPIM).

8
Rule 2 Definitions Continued
Other Potentially Infectious Materials (OPIM)
  • Materials included
  • Semen
  • Vaginal secretions
  • Amniotic fluid
  • Synovial fluid
  • Saliva in dental procedures
  • NOT included
  • Vomit
  • Urine
  • Feces
  • Sweat
  • Tears
  • Spit

Unless visually contaminated with blood or OPIM
9
Rule 2 Definitions Continued
  • Contaminated Sharps contaminated object that can
    penetrate the skin, including
  • Needles
  • Scalpels
  • Broken glass
  • Broken capillary tubes
  • Exposed ends of dental wires

10
Rule 2 Definitions Continued
  • Engineering Controls controls (e.g., sharps
    disposal containers, self-sheathing needles,
    safer medical devices, such as sharps with
    engineered sharps injury protections and
    needleless systems) that isolate or remove the
    bloodborne pathogen hazard from the workplace.

11
Rule 2 Definitions Continued
  • Exposure reasonably anticipated skin, eye,
    mucous membrane, or parenteral contact with blood
    or OPIM that may result from the performance of
    an employees duties.
  • Exposure Incident specific eye, mouth, other
    mucous membrane, nonintact skin, or parenteral
    contact with blood or other potentially
    infectious materials that results from the
    performance of an employees duties.
  • Does not include incidental exposures which may
    take place on the job, which are neither
    reasonable nor routinely expected

12
Assessing Risk
  • Exposed person without HBV immunity (vaccine) via
    needlestick from confirmed HBV source
  • 6-30 acquire HBV if no post-exposure follow-up
  • Post-exposure administration of Hepatitis B
    immune globulin and vaccine is gt90 effective in
    preventing HBV infection.
  • HIV exposure via needlestick from positive source
    is average of 0.3 become HIV
  • NIOSH Alert Publication No. 2000-108 Preventing
    Needlestick Injuries in Health Care Settings
    (External link)

13
Rule 2 Definitions Continued
  • Needleless Systems means a device that does not
    use needles for
  • Collection or withdrawal of bodily fluids
  • Administration of medication or fluids
  • Other procedure involving potential for
    occupational exposure
  • Sharps with engineered sharps injury protections
    devices that have built-in safety feature or
    mechanism that effectively reduces the risk of an
    exposure incident.

14
Examples of Safer syringes
15
Examples of Phlebotomy Safer Devices
16
Examples of Retracting lancets with safety
features
17
Rule 2 Definitions Continued
  • Regulated Waste
  • Liquid or semiliquid blood or OPIM
  • Contaminated items that would release blood or
    OPIM if compressed.
  • Items which are caked with dried blood or OPIM
  • Contaminated sharps
  • Pathological and microbiological waste that
    contains blood or OPIM
  • Note If material is dripping or caked (with
    dried blood), it must be disposed as regulated
    waste.

18
  • The next slide will provide questions to assist
    with reviewing the Bloodborne Infectious Diseases
    Standard Rule 2 Definitions

19
Rule 2 Definitions Questions and Answers
Questions and answers will appear below. There
will be delays to allow time to answer the
questions.
  • True or False
  • Hepatitis C is a bloodborne pathogen.
  • True
  • Blood exposure on intact skin is considered an
    exposure incident.
  • False. Rule 2 (o) Definition for exposure
    incident includes nonintact skin.
  • Fecal material is classified as an other
    potentially infectious material.
  • False, unless visually contaminated with blood.
    Rule 2(s)(J)

20
Rule 3 Exposure Determination
  • Evaluate routine and reasonably anticipated tasks
    to determine employee exposure to blood or OPIM
  • Classify employees as either category A or B

21
Rule 3 Exposure Determination
  • Category A involves exposure or reasonably
    anticipated exposure during routine and
    nonroutine required tasks. Includes
    emergency/1st aid responders.
  • Category B do not require tasks that involve
    exposure to blood or other potentially infectious
    material.
  • Determine without regard to protective equipment.
  • Determine/document rationale.
  • Maintain list of all A job classifications.

22
Rule 4 Exposure Control Plan
  • Exposure Determination (Category A or B)
  • Summary of the training program.
  • Procedures for evaluating exposure incidents
  • Task specific Standard Operating Procedures
    (SOPs) to include
  • Employee recognition of exposure
  • Personal Protective Equipment (PPE) selection,
    use, maintenance,
  • and disposal
  • Contingency Plans
  • Task-specific SOPs for management of inadvertent
    exposures such as needlesticks

23
Rule 4 Exposure Control Plan Continued
  • Review at least annually
  • Tasks and procedures
  • Changes in technology that eliminate or reduce
    exposure
  • Document consideration and implementation of
    medical devices that are
  • Appropriate does not cause death, injury or
    illness in the patient
  • Commercially available
  • Effective reduces or eliminates potential for
    employee exposure to blood and OPIM

24
Rule 4 Exposure Control Plan
  • Employer shall solicit input from non-managerial
    employees involved in direct patient care in the
  • Identification
  • Evaluation and,
  • Selection of effective engineering and work
    practice controls. Must document in the plan

25
  • The next slide will provide questions to assist
    with reviewing the Bloodborne Infectious Diseases
    Standard
  • Rule 3 Exposure Determination
  • Rule 4 Exposure Control Plan

26
Rule 4 Exposure Control PlanQuestions and
Answers
Questions and answers will appear below. There
will be delays to allow time to answer the
questions.
  • True or False
  • Annual review of the exposure control plan is
    required.
  • True. Rule 4(d)
  • Non-managerial employees are to be involve in the
    selection of effective engineering controls.
  • True. Rule 4(h)
  • The exposure control plan must include task
    specific standard operating procedures.
  • True. Rule 4(b)(v)

27
Rule 6 Engineering Controls
  • SHALL be used in combination with work practice
    controls to minimize or eliminate employee
    exposure
  • Provide hand washing facilities which are readily
    accessible to employees or appropriate
    antiseptic hand cleanser with clean cloth

28
Rule 7 Work Practices
  • PPE shall be removed before leaving the work area
  • Garment penetrated with blood or OPIM shall be
    removed immediately
  • Wash hands immediately after removing gloves or
    other protective clothing
  • Wash hands after contact with blood or OPIM

If blood or OPIM are present, hands must be
washed. If no contact with blood or OPIM,
waterless cleansers may be used. See Federal OSHA
documentation (External link).
29
Rule 7 Work Practices Continued
  • Needles shall not be sheared, bent or broken,
    recapped, resheathed or removed unless no
    alternative is feasible
  • Eating, drinking, smoking, applying cosmetics or
    lip balm, or handling contact lenses is
    prohibited where there is reasonable anticipation
    for exposure.
  • Reuse of tube holders is prohibited. See Federal
    OSHA document (External link).

30
Rule 7 Work Practices Continued
  • Food and drink shall not be stored in
    refrigerators, freezers, shelves.or in areas of
    possible contamination
  • All procedures shall be performed in a manner
    that minimizes splashing, spraying and
    aerosolization of blood or OPIM
  • Mouth pipetting is prohibited.

31
  • The next slide will provide questions to assist
    with reviewing the Bloodborne Infectious Diseases
    Standard
  • Rule 6 Engineering Controls
  • Rule 7 Work Practices

32
Rule 6-7 Engineering and Work Practice Controls
Questions and Answers
Questions and answers will appear below. There
will be delays to allow time to answer the
questions.
  • True or False
  • Use of engineering controls is optional.
  • False. Rule 6 (1) states that engineering
    controls shall be used.
  • Employees are required to wash hands following
    exposure to blood.
  • True. Rule 7(2)(d)
  • Blood collection needles may be removed from
    blood collection tube holders before disposal.
  • False. Review Rule 7 and Federal OSHA Document
    (External link)

33
Rule 8 Protective work clothing and equipment
  • PPE shall be provided and used
  • Employer shall ensure that an employee uses PPE
  • Assure appropriate PPE readily accessible at no
    cost
  • Provide for cleaning, laundering, or disposal of
    PPE
  • Repair or replacement of PPE
  • Gloves shall be worn

34
Rule 9 Housekeeping
  • An employer shall assure that the worksite is
    maintained in a clean and sanitary condition.
  • Work surfaces
  • Coverings
  • Equipment
  • Bins, pails, etc
  • Broken glassware
  • Specimens
  • Reusable items

35
Appropriate Disinfectants
  • One to ten through one to one hundred
    concentration of household bleach to water (made
    fresh within 24 hours not stored in glass
    containers)
  • Environmental Protection Agency (EPA) registered
    disinfectants effective against Mycobacterium
    spp. (Tuberculocides)

36
EPA Lists
  • All on the following EPA lists are appropriate
  • List A Sterilants
  • List B Tuberculocides
  • List D Against HBV HIV-1
  • List E TB, HIV-1 and HBV
  • NOT LIST C (Effective against HIV-1 only)
  • EPA Approved Disinfectants (External Link)

37
  • The next slide will provide questions to assist
    with reviewing the Bloodborne Infectious Diseases
    Standard
  • Rule 8 Protective work clothing and equipment
  • Rule 9 Housekeeping

38
Rule 8-9 PPE and Housekeeping Questions and
Answers
Questions and answers will appear below. There
will be delays to allow time to answer the
questions.
  • The employer is required to ensure employees wear
    personal protective equipment.
  • True. Rule 8(1)(b)
  • Bleach is the only appropriate disinfectant.
  • False. Rule 9 (1)(a) states that an appropriate
    disinfectant be used. EPA registered
    disinfectants at least effective against HIV and
    HBV are appropriate.

39
Contact MIOSHA for Additional Information
  • Questions www.michigan.gov/askmiosha
  • Consultation Education and Training Division
    (517) 322-1809
  • General Industry Safety and Health Division
    (Compliance) (517) 322-1831
  • Link to additional online resources.
  • Return to the MIOSHA homepage.

40
Thank you for participating
  • Continue to Bloodborne Infectious Diseases
    Training program Module-2
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