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Bloodborne Pathogen Training

BIOL 232 Anatomy & Physiology 2

Reasons for training
1. Your health and safety
2. The health and safety of your instructor
and classmates
3. OSHA regulations
4. Your career

and fungi – Examples: HIV. bacteria.What are bloodborne pathogens? • Bloodborne – carried in the blood (and frequently semen. trypanosomiasis . vaginal secretions. HBV. feces. vomit. tears. saliva. urine. breast milk. HCV. syphilis. peritoneal fluid and amniotic fluid) • Pathogens – disease-causing microorganisms: viruses. malaria. protists.

NOT Bloodborne Pathogens: • Seasonal or pandemic flu • Common Cold and other URI’s • Chickenpox • Strep and staph infections .

Of greatest concern: Bloodborne viruses • Human immunodeficiency virus (HIV) • Hepatitis B virus (HBV) • Hepatitis C virus (HCV) • non-B. non-C Hepatitis .

Russia. Central Asia. where most (60%) of infected persons are women. India. – Highest number of infections in sub-Saharan Africa. Western Europe . – 25 million children will be orphaned by 2010. – Fastest infection rates in China.Human Immunodeficiency Virus • About 0. Indonesia.3% of the US population is infected (about 1 million people) – Approximately 25% of infected persons don’t know it – Women are the fastest-growing group to be infected • 42 million worldwide with 3 million deaths per year.

individuals also vary in susceptibility • Weak and short-lived outside of human body fluids (minutes-hours) .HIV continued • Infects multiple types of cells and especially Tlymphocytes (important immune cells) • Depletes the immune system of critical cells leading to secondary infection and failure of tumor suppression (due to loss of T-cells) • Multiple strains that vary in virulence.

HIV continued • Within a month of exposure the infected person may experience: – Fevers and chills – Sore muscles and joints – Night sweats – Swollen lymph nodes and rashes • Years later. occur more frequently and last longer • Treated with antiviral drugs which delays the progression of the disease and improve quality of life . symptoms reappear.

often including normally rare diseases – Pneumocystis carinii pneumonia – Kaposi’s sarcoma (cancer) – Candida (thrush. vaginal yeast infection) – Cytomegalovirus (usually eye infection) .HIV / AIDS • Acquired Immune Deficiency Syndrome • AIDS: secondary infections following HIV infection.

– Spread primarily either among children or via maternal-fetal transmission in regions with many chronic carriers. – Approximately 350 million are chronic carriers. • Worldwide. approximately 2 billion people have been infected at some point in their life. – Spread mainly via IV-drug needle sharing and unprotected sex in developed nations with low infection rates and routine childhood HBV vaccination. – Endemic in China.Hepatitis B Virus • About 0. .3% of the US population is infected (about 1 million people) annually.

fulminant hepatic failure and death may occur • Chronic infection – May cause chronic liver damage due to cirrhosis leading to death. nausea. jaundice. – Later symptoms include: abdominal pain.HBV continued • Infects the hepatocytes of the liver leading to inflammation and cell death mediated by cytotoxic T-lymphocytes . fatigue. loss of appetite. and dark urine. vomiting. • Acute (self-limiting) infection – Initial symptoms (within 1 week to 1 month after infection) are “flu-like”: fever and chills. – In some infection leads to chemotherapy-resistant liver cancer . body aches. – Individuals often recover on their own over a period of a few weeks. but 90% of cases are cured with treatment. – In severe cases.

• The virus also persists in the body and may be reactivated in cases of immunosuppression (e.g.g.. • If infected. • Vaccination recommended for infants and anyone at risk for exposure (e. transplant recipients) .g.. most patients do not require treatment because they will clear the infection on their own.. in dried blood for up to a week). healthcare workers) – mandatory in most cases.HBV continued • The virus can persist in the environment (e. • Antiviral treatment is only recommended for about 1% of patients.

10% from pre-screening transfusions.000 to 180.5 million people in the US are infected – 35.000 new cases per year – 10. about 35% of HIV-infected individuals are co-infected with HCV .000-20. 15% by sexual contact.000 deaths annually – Much higher rates of infection in prisons (34%) – In the US.Hepatitis C Virus • Infects 200-350 million people worldwide – Approximately 3-4 million new infections annually • Between 3 million and 7. 60% of infections are transmitted by IV-drug use. 5% healthcare work – In the US. 10% unknown.

loss of appetite. and dark urine due to fibrosis of the liver • Untreated chronic infection leads to cirrhosis of the liver and extrahepatic complications (such as glomerular nephritis) . fatigue. • Chronic infection leads to: abdominal pain. • 60-70% of infected persons are asymptomatic during the acute phase (first 6 months post-infection) • Few patients (10-60%) will clear the infection on their own. vomiting.HCV continued • Infects the hepatocytes of the liver leading to cell death mediated by cytotoxic T-lymphocytes. nausea. jaundice.

• Standard treatment: – PEGylated Interferon-α-2a (or 2b) and ribavirin for 24-48 weeks – New drugs being developed include viramidine..g. and protease inhibitors • There is no vaccine yet. .HCV continued • May be persistent in the environment (e. in dried blood for up to a week).

How Exposure Occurs Body fluid containing Mode of transmission Virus Needle stick Bacteria Sexual contact Protist Bite or scratch Fungus Ectoparasites (some) New infection .

splatters and sprays – entry through mucous epithelia.Modes of transmission in the workplace • Sharps – piercing intact skin (e. open cuts and abrasions are vulnerable to: . needle-stick) • Spills.g.

prior to 1985 (HIV).Modes of transmission outside of the workplace • Unprotected sex (HIV. maternal-infant (HIV. HBV. HBV. HBV) • Maternal-fetal. HCV) • Body piercing and tattooing with contaminated equipment (HIV. HCV) • Iatrogenic transmission (contaminated equipment) . prior to 1971 (HBV) • Needle-sharing (HIV. HBV) • Transfusion prior to 1992 (HCV).

000.000 infectious doses of HBV . about 8 million people have occupational exposure annually • About 8700 health professionals are infected by HBV annually • About 65 professionals are infected by HIV annually • 1ml of blood can contain up to 100.Why you need to be careful • In the US.

staff and faculty – Athletes. coaches and trainers – Custodial and maintenance staff • Certain occupations carry greater risks than others – Healthcare professionals – Emergency personnel and first responders – Medical researchers – Law enforcement .Who is at risk? • Who is at risk at ONU – Biology and allied health students.

RULE #1 Treat all human tissues and anything that contacts human tissues as if they are contaminated! Biohazardous Material .

• Do not handle contact lenses. • Do wear personal protective equipment. . no: – Eating – Drinking – Chewing gum • Do not apply cosmetics or lip balm.Universal Precautions • In the lab when we are working with human body fluids do not put anything in your mouth. • Do use alcohol-based hand sanitizers if available. • Do wash your hands after removing personal protective equipment. In other words.

Personal Protective Equipment • Gloves • Lab coat • Eyewear • Check all equipment for defects or damage before usage! • Replace damaged equipment • Remove equipment before leaving a contaminated area • Do not reuse disposable equipment (lab coats may present an exception) .

Engineering Controls • Self-sheathing needles • Biohazard disposal bags and boxes – gloves – wipes and paper towels – soft plastic items • Sharps disposal boxes – needles and lances – glass slides and cover slips – glass capillary tubes • Must have the biohazard symbol AND the word “Biohazard” or “Biohazardous” on the label. .

Work practice controls • Use personal protective equipment • Always clean your lab station when you are done for the day – Do not leave the lab without cleaning your station! – Don’t rely on your classmates or instructor to clean it for you – better to clean it twice than not at all! • Use 10% bleach solution prepared fresh daily • Wash your hands thoroughly with soap and water – finish up with a hand sanitizer such as an alcohol gel (e. Purell.. Germ-X) .g.

Hand-washing • If hands free towel-dispensers are not available. • Dry hands with disposable towels. • Wash all surfaces and rinse well. prepare towels in advance. • Remove rings and watches before washing. • Rub your hands vigorously under the running water for 10-15 seconds (10 sec minimum). • Use soap and copious quantities of running water. . • Position the hands lower than your arms.

.Hand-washing continued • When to wash hands: – After removing gloves and other PPE – After using the restroom – Before and after eating • Alcohol-based hand-sanitizer is not an acceptable substitute for hand-washing unless: – The skin is unsoiled AND – Hand-washing is not possible.

Exposure • Report any exposure immediately to your instructor – You may need to go to the Health Center or your family physician for evaluation – Health center: 315 West College Avenue (419) 772-2086 .