blood borne pathogens osha 1910.1030. blood borne pathogens requirements –employer must have...
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BLOOD BORNE BLOOD BORNE PATHOGENSPATHOGENS
OSHA 1910.1030OSHA 1910.1030
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
REQUIREMENTSREQUIREMENTS– Employer must have written policyEmployer must have written policy– Employer must train all employeesEmployer must train all employees– Employer must provide necessary PPEEmployer must provide necessary PPE– Employer will provide workplace practicesEmployer will provide workplace practices
and engineering controls to reduce exposuresand engineering controls to reduce exposures
_ Employer will insure appropriate medical treatment to _ Employer will insure appropriate medical treatment to exposed employees at no cost.exposed employees at no cost.
_ All medical information will be kept confidential _ All medical information will be kept confidential
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
Firefighters may be exposed to blood and/or Firefighters may be exposed to blood and/or other potentially infectious materials OPIM.other potentially infectious materials OPIM.
Communicable Diseases- capable of being Communicable Diseases- capable of being passed from person to person.passed from person to person.
Examples:Examples: Hepatitis A,Hepatitis A,Hepatitis B,Hepatitis B,
Hepatitis C,Hepatitis C, Hepatitis Non A, Non B,HIVHepatitis Non A, Non B,HIV
Non-communicable diseases- food poisoningNon-communicable diseases- food poisoning
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
Modes of TransmissionModes of Transmission– Direct contact through skin or mucous Direct contact through skin or mucous
membranes. membranes. Blood or OPIM through open cuts or wounds.Blood or OPIM through open cuts or wounds.
Blood or OPIM into eyes, mouth, nares.Blood or OPIM into eyes, mouth, nares.
Unprotected homosexual or heterosexual contact.Unprotected homosexual or heterosexual contact.
– Casual contact, eating utensils, beds, toilets is Casual contact, eating utensils, beds, toilets is not a means of disease transmission.not a means of disease transmission.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
Risk of transmission extremely low or non-Risk of transmission extremely low or non-existent;existent;– FecesFeces - nasal secretions- nasal secretions– SalivaSaliva - sputum- sputum– SweatSweat - tears- tears– UrineUrine - vomitus- vomitus
Unless visible blood is present.Unless visible blood is present.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
Putting yourself at riskPutting yourself at risk– Having homosexual or heterosexual contact Having homosexual or heterosexual contact
via oral, anal or vaginal route with someone via oral, anal or vaginal route with someone who is infected.who is infected.
– Sharing a needle with an infected person.Sharing a needle with an infected person.– An infected female may pass disease to her An infected female may pass disease to her
baby during pregnancy or childbirth.baby during pregnancy or childbirth.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
Occupational Risk FactorsOccupational Risk Factors– Uncontrolled situations, fights, shootings, Uncontrolled situations, fights, shootings,
vehicle extrications.vehicle extrications.– Home deliveries of childrenHome deliveries of children– Cardiac arrestsCardiac arrests– Industrial AccidentsIndustrial Accidents
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
Protecting yourselfProtecting yourself– PPEPPE
- Minimum is a pair of gloves- Minimum is a pair of gloves
Eye protection may be requiredEye protection may be required
Full gown, booties may be requiredFull gown, booties may be required
If it’s wet and it isn’t yours don’t touch it!!!If it’s wet and it isn’t yours don’t touch it!!!
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
DiseasesDiseases– HBV- Caused by a virus.HBV- Caused by a virus.
Attacks the liverAttacks the liver
Severity ranges from mild to fatal.Severity ranges from mild to fatal.
25% of infected individuals develop acute hepatitis25% of infected individuals develop acute hepatitis
Of infected individuals 6-10% well become carriersOf infected individuals 6-10% well become carriers
Carriers are at risk of developing chronic liver Carriers are at risk of developing chronic liver disease.disease.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
HBV (cont.)HBV (cont.)– Active hepatitisActive hepatitis– CirrhosisCirrhosis– Primary liver cancerPrimary liver cancer– Infectious to othersInfectious to others
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
How widespread is HBVHow widespread is HBV– 1 out 20 people in the US will become 1 out 20 people in the US will become
infected some time during their lives.infected some time during their lives.– Estimated 1.25 million chronically infected Estimated 1.25 million chronically infected
Americans.Americans.
Greater risk if parents born in Southeast Asia, Greater risk if parents born in Southeast Asia, Africa, Amazon Basin of South America, the Africa, Amazon Basin of South America, the Pacific Islands or the Middle East.Pacific Islands or the Middle East.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
Hepatitis cHepatitis c– Caused by a virus.Caused by a virus.– Attacks the liver.Attacks the liver.
Long Term EffectsLong Term Effects- Chronic liver disease- Chronic liver disease- Cirrhosis- Cirrhosis- Liver Cancer- Liver Cancer- Fatal- Fatal
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
HIV- Human Immunodeficiency VirusHIV- Human Immunodeficiency Virus– Some individuals exhibit no signs.Some individuals exhibit no signs.– More severe symptoms include loss of More severe symptoms include loss of
appetite, weight loss, fever, night sweats, appetite, weight loss, fever, night sweats, skin rashes, diarrhea, tiredness, lack of skin rashes, diarrhea, tiredness, lack of resistance to infection, swollen lymph nodes.resistance to infection, swollen lymph nodes.
– May progress to AIDS- lowers the body’s May progress to AIDS- lowers the body’s defense against disease.defense against disease.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
HBV Vaccination ProgramHBV Vaccination Program– Free to all membersFree to all members– Declinations must be signed if not receiving Declinations must be signed if not receiving
vaccinationvaccination– Boosters and Titer if indicated/ required by Boosters and Titer if indicated/ required by
OSHA/CDC will be offered free f charge.OSHA/CDC will be offered free f charge.– If vaccination initially refused may be If vaccination initially refused may be
rescinded anytime during employment. rescinded anytime during employment.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
ExposuresExposures– Actual- needle stick, blood or OPIM in open Actual- needle stick, blood or OPIM in open
cut or in mouth, nose, eyes.cut or in mouth, nose, eyes.– Medical treatment- hospital or Occupational Medical treatment- hospital or Occupational
MedicineMedicine– Injury report form.Injury report form.– Communicable disease report form.Communicable disease report form.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
SuspectedSuspected– Blood or OPIM in contact with intact skin.Blood or OPIM in contact with intact skin.– Wash area with soap and water or appropriate Wash area with soap and water or appropriate
cleansing agent.cleansing agent.– Document incident.Document incident.
BLOOD BORNE PATHOGENSBLOOD BORNE PATHOGENS
Equipment MaintenanceEquipment Maintenance– Protect yourself during equipment decon and Protect yourself during equipment decon and
cleansing.cleansing.– Some viral agents may survive up to 7 days in dried Some viral agents may survive up to 7 days in dried
blood.blood.– Gloves should always be worn.Gloves should always be worn.– Eye protection may be required when using solutions.Eye protection may be required when using solutions.
BE SMART. STAY SAFE.BE SMART. STAY SAFE.
AIRBORNE PATHOGENS AIRBORNE PATHOGENS
Communicable diseasesCommunicable diseases– TuberculosisTuberculosis– SARSSARS– Whooping coughWhooping cough– FluFlu
Spread by inhalation of airborne droplets from Spread by inhalation of airborne droplets from cough of infected persons.cough of infected persons.
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
TuberculosisTuberculosis– An infectious diseaseAn infectious disease– Characterized by inflammatory infiltrations Characterized by inflammatory infiltrations
and the formation of tubercules, abcesses, and the formation of tubercules, abcesses, fibrosis and calcificationsfibrosis and calcifications
– Most commonly affects respiratory systemMost commonly affects respiratory system
Spread through airborne droplets containing Spread through airborne droplets containing tubercle bacilli.tubercle bacilli.
AIRBOREN PATHOGENSAIRBOREN PATHOGENS
Tb (CONT.)Tb (CONT.)– Can also affect the gastrointestinal and Can also affect the gastrointestinal and
genitourinary tracts, nervous system, bones, genitourinary tracts, nervous system, bones, joints, lymph nodes and skin.joints, lymph nodes and skin.
Infection is usually acquired from contact with Infection is usually acquired from contact with an infected person.an infected person.
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
The Path of TransmissionThe Path of Transmission– The air droplets are inhaled by people in the The air droplets are inhaled by people in the
close proximity of the infected person.close proximity of the infected person.– In some individuals the tubercle bacilli will In some individuals the tubercle bacilli will
enter the alveoli and establish an infection.enter the alveoli and establish an infection.– Within weeks of the initial infection, it can Within weeks of the initial infection, it can
spread through the lymphatic system to spread through the lymphatic system to distant tissues and organs.distant tissues and organs.
– Develops an active infection/Develops an active infection/
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
– Latent TB InfectionLatent TB InfectionTubercle bacilli enters the body through alveoliTubercle bacilli enters the body through alveoli
Immune response limits multiplication and spread Immune response limits multiplication and spread of the bacterium.of the bacterium.
Some bacterium remain dormant and viable for Some bacterium remain dormant and viable for years or decades.years or decades.
May become “active”.May become “active”.
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
Signs and SymptomsSigns and Symptoms– Productive cough (usually greater than two Productive cough (usually greater than two
weeks in duration).weeks in duration).– Extreme weight loss (greater than 15 lbs. in Extreme weight loss (greater than 15 lbs. in
one week).one week).– Persistent feverPersistent fever– Night sweatsNight sweats– Bloody sputumBloody sputum– AnorexiaAnorexia
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
Groups with High Risk of Contracting TBGroups with High Risk of Contracting TB– Persons with HOV infectionPersons with HOV infection– Alcoholics and IV drug usersAlcoholics and IV drug users– Residents of long term care facilitiesResidents of long term care facilities– Low income populationsLow income populations– Foreign born persons from high prevalence Foreign born persons from high prevalence
countries.countries.
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
Medical Conditions With Increased RiskMedical Conditions With Increased Risk– HIV InfectionHIV Infection– Immunosuppressive therapyImmunosuppressive therapy– Diabetes MellitusDiabetes Mellitus– Prolonged Corticosteroid therapyProlonged Corticosteroid therapy– End stage renal diseaseEnd stage renal disease– Hematological diseasesHematological diseases– Carcionmas of oropharynx and upper GI tract Carcionmas of oropharynx and upper GI tract
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
Procedures posing increased risk of Procedures posing increased risk of exposureexposure– Endotrachael intubationEndotrachael intubation– Administration of aerosolized treatmentsAdministration of aerosolized treatments– Suctioning/sputum collectionSuctioning/sputum collection– Any cough producing procedureAny cough producing procedure
Administration of oxygenAdministration of oxygen
Auscultation of deep lung sounds.Auscultation of deep lung sounds.
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
Minimizing the RiskMinimizing the Risk– TB screening processTB screening process– Personal protective equipmentPersonal protective equipment– Adjusting field practicesAdjusting field practices
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
Screening for TB InfectionScreening for TB Infection– Intradermal Mantoux testIntradermal Mantoux test
Initial physicalInitial physical
Known or suspected exposureKnown or suspected exposure
As determined by risk assessment.As determined by risk assessment.
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
Screening Results- Positive PPD ResultsScreening Results- Positive PPD Results– Chest X-rayChest X-ray– Clinical evaluationClinical evaluation– Preventative therapyPreventative therapy– Monitor for signs and symptoms of TB.Monitor for signs and symptoms of TB.– Reported to State Department of Health- Reported to State Department of Health-
required by regulation.required by regulation.
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
PPE- PPE- – N-95 MasksN-95 Masks
Requires annual fit testingRequires annual fit testing
– ““Simple” surgical masks for TB patientSimple” surgical masks for TB patient– Cleaning proceduresCleaning procedures
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
N-95 MasksN-95 Masks– Worn in high risk areasWorn in high risk areas
Convalescent homes/roomsConvalescent homes/rooms
JailsJails
TrailersTrailers
Any close living arrangementAny close living arrangement
AIRBORNE PATHOGENSAIRBORNE PATHOGENS
Reporting unprotected exposuresReporting unprotected exposures– Immediately seek medical advice from the Immediately seek medical advice from the
receiving hospital.receiving hospital.– Injury report formInjury report form– Communicable disease form.Communicable disease form.– Contact Infectious disease control officer.Contact Infectious disease control officer.
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