bloodborne pathogens needlestick

www.spin-safety.orgCreated by Joe Teeples of Wisconsin Safety

Bloodborne Pathogens

Updated to include the

Needlestick Act

Created by Joe Teeples of Wisconsin Safety


OSHA Regulation 29CFR 1910.1030 History & Effective Dates Purpose of the Regulation Employer Requirements Scope and Coverage Exposure Control Plan


Bloodborne Pathogens 1991- OSHA publishes the final regulation for

Bloodborne Pathogens in December. 1992- OSHA regulation effective in March 1992- Deadline for the completion of the

written Exposure Control Plan (May) 2000- Needlestick Safety and Prevention Act



To assure that no employee will suffer material health or functional impairment due to an exposure to hazardous agents while in the course of their employment.


Employer Requirements Requirements of the Employer Employee education and

training Protective measures and

equipment Written Documentation Recordkeeping


Scope and Coverage Original thrust was aimed at:

– Hospitals– First Responders (ambulance, fire, police)– Dental practices

Non medical classifications:– Funeral directors and morticians– Police crime labs– Barbers and cosmetologists


Scope and Coverage also effects: Maintenance and Custodial workers Housekeeping and Laundry services Waste Handling and Disposal services


Needlestick Prevention

Needlestick incidents do happen!

Be prepared! All needlestick

incidents are preventable!


Needlestick Prevention Cont.

Once the worker has been stuck he has been exposed!

Record the incident!!

Treat the worker!



There is one exemption to the rule!

The Good Samaritan clause– A De minimus classification– No penalties for violation


Occupational Exposure

Any reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood...

.... or any other potentially infectious materials that may result from the performance of an employees duties.


Determination of Exposure “Potentially Infectious” materials include:

– semen– vaginal secretions– cerebrospinal fluid– synovial fluid– pleural fluid– pericardial fluid– peritoneal fluid– amniotic fluid– saliva in dental procedures


Employee Education and Training Epidemiology of bloodborne diseases is

the study of the incidence, distribution and control of Hepatitis B and HIV/AIDS– Hepatitis is an inflammation of the

liver– HIV/AIDS destroys the ability to fight

infections


Symptoms of Hepatitis B

Yellow Eyes & Skin (Jaundice) Abdominal pain Fever and Vomiting Dark Urine Fatigue


Symptoms of AIDS Fever Swollen Glands Diarrhea Extreme Weight Loss Skin Lesions Mental Disorientation


Needles come in all shapes and sizes. Check manufacturers for the safest needle!

Needlestick Prevention


Modes of Transmission Parenteral

– Intravenous Injection – Accidental Needlestick

Sexual– Unprotected Sex

Mucous Membrane– Respiratory tract– Alimentary tract (Nutrition/Digestive)


Most Common Means of Transmission

Currently unprotected sex is the most common means of transmission.


Control Measures Engineering Controls

– Serve to reduce employee exposure in the workplace by either isolating the worker from the exposure or removing the hazard

Examples– Surgical gloves– Self retracting needles– Sharps Containers


Control Measures Cont.. Work Practice Controls

– Reduce the likelihood of exposure through the alteration of the manner in which the task is performed.

Examples– Using Gloves– Hand washing– Method of removing

contaminated gloves– Recapping needle procedures


Control Measures Cont..

Personal Protective Equipment (PPE)– Minimizes the risk of infectious materials

entering into the workers body through • skin lesions or • entry through the eyes, nose, or mouth

Examples– Gloves– Gowns– Face Shields


Universal Precautions

An approach to infection control

All human blood and certain human body fluids are treated as if known to be infected!


HBV Vaccinations HBV Vaccinations are the most

important part of HBV infection control

Gloves and other PPE do not prevent puncture wounds or unanticipated exposures.

Set of three inoculations Good for ten years


Post Exposure Evaluation and Follow-up

Exposure Incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other infectious materials that result from the performance of an employees duties.


Post Exposure Evaluation and Follow-up Cont.

Following a report of an exposure incident, the employer provide a confidential medical evaluation which will include:– Documentation of route of exposure– HIV/HBV status of the source individual– Serological testing of the blood ASAP– Post exposure vaccine (HBIG) if indicated– Medical evaluation of the reported illness– Counseling of the exposed individual


Regulated Waste Disposal Contaminated items that:

– Would release blood or other potentially infectious materials•IF they are

– Pourable– Drippable– Compressible


Housekeeping and Laundry Keep the work-site in a

clean and sanitary condition.

Use a hospital grade VIRUCIDE

OR a 1:10 bleach to water solution


Tags, Labels & Bags Tags and Labels shall be

fluorescent orange or red-orange with lettering and the Biohazard symbol in a contrasting color.

Bags must have this label on them or they must be red in color and leak proof.


Recordkeeping The employer shall establish and

maintain an accurate record for each employee with an occupational exposure incident.

Records shall include:– Name & Social Security Number of

employee– Copy of employees HBV vaccination

records– Copy of all medical testing and

findings– Copy of physicians written opinion


Recordkeeping Cont.

The employer shall maintain records for:– The duration of the employment– PLUS 30 years– Records must be kept

CONFIDENTIAL!


Sharps Injury Log

The Sharps Injury Log must document:– Type and brand of device– Work area where incident occurred– Explanation of how incident occurred


Exposure Control Plan

Must Address:– Exposure Determination– Employee Education and Training– Control Measures– HBV Vaccinations– Post Exposure Evaluation and Follow Up– Regulated Waste Disposal– Tags, Labels, and Bags– Housekeeping and Laundry– Record keeping


Exposure Control Plan Cont.

Reviewed AND updated annually

Reflect technological changes DOCUMENT consideration of

safer medical devices Document solicitation from non-

managerial employees


New Legislation

Needlestick Safety and Prevention Act, November 6, 2000

OSHA directed to revise Bloodborne Pathogen regulation within 6 months

Congress exempts OSHA from procedural requirement for promulgation of regulation in order to comply with the Act


Four areas for revision

Modification of definitions Revision and Updating the

Exposure Control Plan Solicitation of Employee Input Recordkeeping


Definitions

Engineering Controls Needleless Systems Sharps with Engineered Sharps

Injury Protection

Wash Your Hands

Hand washing after using toilet:– Women 74%– Men 61%

New York City- 60% Chicago- 78% New Orleans- 69% Atlanta Braves Game-

– Women 89%– Men 46%– Pass the popcorn!!

Hanta Virus

46 year old elementary school teacher Colorado’s fifth Hanta Virus victim in a year She lasted five days – Lived on a ranch with husband and 3 children 200 cases nationwide

bloodborne pathogens needlestick

Health & Medicine