Bloodborne Pathogen Standard for

VDH Employees

• The Bloodborne Pathogen (BBP) Standard was written by the Occupational Safety and Health Administration (OSHA)

• Purpose: To protect you and reduce your risks for occupational exposure to disease

• Describes policies and practices that employers must establish to protect employees who have contact with blood/body fluids in their job

Bloodborne Pathogen Standard

Who does it cover?

“You are covered under the standard if it is reasonably anticipated that you could be exposed to bloodborne pathogens as a result of performing your job duties.”

OSHA

Anyone, regardless of age, race, or socioeconomic status, can carry a bloodborne disease.

Often, without knowing it.

Bloodborne Pathogens

Bloodborne pathogens are diseases that are carried in the blood and other body fluids that can be transmitted by contact with infected blood. The most common include:

• Hepatitis B• Hepatitis C• HIV

Bloodborne Pathogens

Bloodborne pathogens are spread by contact with blood and other body substances such as:

• Semen and vaginal fluids

• Cerebrospinal fluid (spinal cord)

• Synovial (joint) and pleural fluid (lung)

• Peritoneal (stomach), pericardial

(heart) and amniotic fluid (uterus)

• Saliva (dental procedures)

Bloodborne Pathogens

Transmission

Bloodborne diseases are spread by:

• Direct contact with blood or body fluids (e.g., needle stick, splash to face)

• Indirect contact with blood or body fluids (e.g., touching dried blood or body fluids on surfaces)

Hepatitis B

• A serious liver disease

• 1.25 million people chronically infected

• 30% of people infected don’t have symptoms

• Most cases resolve, 10% can be chronic

• Healthcare workers (HCW) are at increased risk

Hepatitis B

• Symptoms include loss of appetite, fatigue, jaundice, abdominal pain and nausea

• Treatment available to control virus

• Can be prevented by vaccination

Hepatitis C

• A serious liver disease

• 4.1 million infected

• 3.2 million chronically infected

• Chronic infection: 55-85% of cases

• 80% of people do not have symptoms

• 70% of cases develop liver failure

Hepatitis C

• Increased risk for liver cancer

• Many people do not have symptoms for 20 years after first infected

• Anti-virals available to treat some forms

• No vaccine available

HIV

• Disease that causes the immune system to lose its ability to fight infection

• 900,000 infected

• Chronic infection

• Clinical symptoms vary; initial infection may cause flu-like illness

HIV

• Some people progress to Acquired Immunodeficiency Syndrome (AIDS)

• Anti-virals available to treat illness

• No vaccine

Exposure Control Plan

• A document that describes how VDH addresses components of the BPP Standard. It includes:

– Who is covered under the standard– Ways to reduce your risk of exposure– Procedures to follow if there is an

occupational exposure

• Located on the VDH internal Web Site: http://vdhweb/epi/icguide_index_06.asp

Engineering Controls

Systems or mechanical devices that minimize hazards in the workplace.

Examples:

• Self-sheathing or retractable needles

• Sharps disposal containers

Engineering Controls

Sharp safety rules:• Use needles with safety

devices

• Never recap, break or bend needles

• Never reuse disposable sharps

• Dispose of all needles in a regulated, color-coded, labeled sharps container

• Sharps containers should be changed when 2/3 full.

Work Practice Controls

Practices in the workplace that protect you from disease and prevent transmission to your residents and coworkers. These include:

• Hand Hygiene

• Personal Hygiene

Work Practice Controls

• Hand Hygiene includes both hand washing and hand decontamination.

• Hand washing involves the use of soap, water, friction, and drying.

• Hand decontamination involves removing surface organisms by a waterless hand sanitizer.

Hand Hygiene

Work Practice Controls

• Artificial nails should not be worn; natural nails should be no longer than ¼ inch

• Hand hygiene is appropriate:– Between patients– Every time you remove your gloves– When entering and leaving a treatment room

Whenever hands are in contact with bloodor other body fluids wash them

immediately

Hand Hygiene

Work Practice Controls

Self-protective practices that protect you from disease:

• Do not leave food and drinks in refrigerators, freezers or on counter tops where blood or potentially infectious materials can be present, e.g., nurses station

• Do not use petroleum-based lubricants with latex gloves

• Do not eat, drink, apply cosmetics or handle lip balm in an area where you might be exposed to blood or body fluids

Personal Hygiene

Standard Precautions

• A set of precautions that are designed to protect you from exposure to disease

• All patients, ALL body fluids, ALWAYS

• Includes:– Hand washing– Personal protective equipment (PPE)– Work practice controls– Post exposure prophylaxis (PEP)– Needle safety– Handling of linen and regulated medical waste

Personal Protective Equipment

Protective wear that serves as a barrier between you and the infection:

• Gloves• Gowns• Masks•Goggles/Faceshields• Resuscitation Devices

Protective Equipment

• Varies with task

• Maintained, replaced and disposed of by VDH

• Fit properly

• Supplied at no cost to employee

• Free of flaws

• VDH must offer training on use

• Must be cleaned carefully and as soon as possible to prevent contamination

• Utility gloves can be reused if not damaged

Housekeeping

• Facility cleaning schedule

• Procedure for cleaning up blood spills

• Use standard precautions when handling all linen (including sheets, clothes)

• Regulated medical waste policy/procedure

Hepatitis B Vaccine

• Single most significant factor in preventing hepatitis B infection in HCW

• Must be offered to all employees who have exposure to blood or body fluids on the job

• Safe, effective

• Series of three shots

• Long-term immunity

Occupational Exposure:

If you should get stuck by a needle or if you have direct skin or mucous membrane contact with blood or other body fluids, you will be provided with counseling and follow-up care.

Exposures should be reported immediately (within two hours) so that appropriate care can be initiated.

Immediate Response

Occupational Exposure:

• Don’t panic

• Wash the area with soap and water

• Flush eyes or mucous membranes with water

• Report the incident immediately to your supervisor and record date and time of incident

Post-Exposure Counseling & Follow-up

Occupational Exposures

• You will be offered counseling by trained medical staff to determine your risk of acquiring a bloodborne disease

• If there is a risk, appropriate testing and follow-up of the patient and employee will be initiated

• Keep all follow-up appointments

Summary

• The Bloodborne Pathogen Standard applies to anyone who has exposure to blood/body fluids while performing job duties.

• VDH provides engineering and workplace controls to help prevent occupational exposure, including personal protective equipment and safe needle devices.

• The hepatitis B vaccine must be offered to anyone who has exposure to blood and body fluids while performing their regular job duties.

Summary

• Occupational exposures should be reported immediately to your supervisor because follow-up testing should be initiated as soon as possible.

• You are responsible for following the policies and procedures written by VDH and for using the safety measures available to you to reduce your risk of exposure to bloodborne diseases.