Bloodborne

PathogensTraining

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Introduction
• Approximately 5.6 million workers in health care
and other facilities are at risk of exposure to
bloodborne pathogens such as human
immunodeficiency virus (HIV – the virus that
causes AIDS), the hepatitis B virus (HBV), and the
hepatitis C virus (HCV)
• OSHA’s Bloodborne Pathogens standard
prescribes safeguards to protect workers against
the health hazards from exposure to blood and
other potentially infectious materials, and to
reduce their risk from this exposure

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Who is covered by the standard?
• All employees who may “reasonably anticipate”
contact with blood and other potentially
infectious materials as the result of performing
their job duties
• Employer evaluates positions and job duties to
determine if potential for exposure exists

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Definitions

• Bloodborne pathogens are micro-organisms that

are present in human blood and can cause
disease in humans.
• These pathogens include:
• hepatitis B virus (HBV)
• human immunodeficiency virus (HIV)
• other pathogens:
• hepatitis C virus (HCV)

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Definitions
• Other potentially infectious material (OPIM)
refers to any body fluid that is visibly
contaminated with blood or:

• 1. Saliva
• 2. Urine
• 3. Feces
• 4. Vomit
• 5. Vaginal Secretions
• 6. Semen

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Transmission of Bloodborne
Pathogens

• Contaminated object/instrument pierces skin

barrier
• Contaminated blood or body fluid contact with
non-intact skin
• Unprotected sexual contact with infected person
• Infected mother to unborn child

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What is an occupational exposure?

• Skin, mucous membrane (eye, nose, mouth) , or

skin contact with blood or other infectious
material while performing job duties

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How does exposure occur?

• Most common: needlesticks

• Cuts from other contaminated sharps (scalpels,
broken glass, etc.)
• Contact of mucous membranes (for example, the
eye, nose, mouth) or broken (cut or abraded) skin
with contaminated blood or body fluids

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What is HBV?
• Hepatitis means "Inflammation of the liver“

• Hepatitis B is caused by a virus which attacks and

replicates in liver cells

• Can live in dry environment for at least 7 days

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Cause and development of HBV
• Hepatitis B virus damages the liver, causing
symptoms that range from mild to fatal

• Over 12,000 health-care workers infected annually

• 10% of infected workers are carriers

• 500-600 are hospitalized when infected

• 25% of infected individuals develop acute

hepatitis

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Hepatitis symptoms and diagnosis

• Only a qualified physician can diagnose hepatitis

• Symptoms may include:

• Unexplained, persistent fatigue

• Loss of appetite or unexplained weight loss
• Nausea, vomiting, fever, abdominal or
joint pain
• Jaundice

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What is HIV?

• Human Immunodeficiency Virus which

attacks the immune system.

• HIV can live in a dry environment for

only a few hours.

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AIDS = Acquired
Immunodeficiency Syndrome
• Results from destruction of the immune system.
• Caused by HIV = Human Immunodeficiency Virus
• Outcome of infection with the virus varies:

• Some have no symptoms

• Some have less severe symptoms

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 HIV symptoms and diagnosis

• Only a qualified physician can diagnose AIDS

• Symptoms may include:

• Unexplained, persistent fatigue

• Prolonged unexplained fever, chills, night sweats
• Loss of appetite or unexplained weight loss
• Pink-to-purple, flat or raised blotches or bumps
• Persistent white spots or unusual blemishes in the
mouth
• Persistent diarrhea
• Prolonged, persistent dry cough

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HBV and HIV comparisons

Mode of Transmission HBV HIV

Blood Yes Yes
Semen Yes Yes
Vaginal Secretions Yes Yes
Saliva (from a bite) Yes No
Target in the body Liver Immune
System
Risk of infection (Needlestick) 6-30% .5%
High virus count in blood Yes No
Vaccine Available Yes No

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Exposure Control Plan
• Identifies jobs and tasks where occupational exposure to
blood or other potentially infectious material occurs
• Describes how Benhaven will:
• Use engineering and work practice controls
• Ensure use of personal protective equipment
• Provide training
• Provide medical surveillance
• Provide hepatitis B vaccinations
• Use signs and labels
• Benhaven’s Exposure Control Plan will be located and
accessible at each site.

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Universal Precautions

• Treat all human blood and certain body fluids as if

they are infectious
• Must be observed in all situations where there is a
potential for contact with blood or other
potentially infectious materials

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Engineering and
Work Practice Controls
• These are the primary methods used to control the
transmission of HBV and HIV
• When occupational exposure remains after
engineering and work practice controls are put in
place, personal protective equipment (PPE) must be
used
• This control reduces the likelihood of exposure by
altering how a task is performed: Wash hands after
removing gloves and as soon as possible after
exposure, No food or smoking in work areas

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Personal Protective Equipment

• Specialized clothing or
equipment worn by an
employee for protection
against infectious materials
• Must be properly cleaned,
laundered, repaired, and
disposed of at no cost to
employees
• Must be removed when leaving
area or upon contamination

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Examples of PPE

• Gloves
• Gowns
• Face shields
• Eye protection
• Shoe booties
• Mouthpieces and
resuscitation devices

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Housekeeping

• Work surfaces must be decontaminated with an

appropriate disinfectant
• After completion of procedures
• When surfaces are contaminated
• Complete as needed and or as assigned during or
at the end of the work shift
• Alert outside cleaning services of areas that need
extra attention or disinfecting

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Laundry
• Handle contaminated laundry as little
as possible and use PPE
• Do not overfill washer/dryer-
interferes with proper
cleaning/disinfecting
• Use hot water when washing visibly
soiled clothing
• Dry clothing in dryer at hottest
setting for maximum time
• Must be placed and/or transported in
blue bag or container

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Hepatitis B Vaccination Requirements

• Must make available, free of charge at a

reasonable time and place, to all employees at
risk of exposure within 10 working days of initial
assignment unless:
• employee has had the vaccination
• employee declines getting the vaccine and
signs the declination form
• vaccine can not be given for medical
reasons
• The vaccination must be administered by a
licensed healthcare professional
• HBV vaccine has been part of the routine
childhood immunization schedule since 1994

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Hepatitis B Vaccination
Requirements (cont’d)

• Must be provided even if employee initially

declines but later decides to accept the
vaccination
• Employees who decline the vaccination must sign
a declination form
• Employees are not required to participate in
antibody prescreening program to receive
vaccination series
• Vaccination booster doses must be provided if
recommended by the U.S. Public Health Service

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What to do if an exposure occurs?

• Wash exposed area with soap and water

• Flush splashes to nose, mouth, or skin with
water
• Irrigate eyes with water or saline
• Report the exposure
• Immediately seek medical treatment

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Post-Exposure Evaluation and
Follow-Up
• Should an exposure incident occur, contact your direct
supervisor and supervising nurse
• An immediately available confidential medical evaluation and
follow-up will be conducted. Following the initial first aid (clean
the wound, flush the eyes or other mucous membrane, etc.),
the following activities will be performed:
• Document routes of exposure and how exposure occurred
• Obtain consent and decide to have the source individual tested
as soon as possible to determine HIV, HCV, HBV infectivity;
document that the source individual’s test results were
conveyed to the employee’s health care provider
• Identify and document the source individual
• Arrange for source individual to be tested if consent is given
• If potential source refused testing, the potentially infected
individual may be sent for testing

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Sharps Injury Log

• Employers must maintain a sharps injury log for

the recording of injuries from contaminated
sharps
• The log must be maintained in a way that ensures
employee privacy and must contain, at a
minimum:
• Type and brand of device involved in the incident
• Location of the incident
• Description of the incident

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 Summary

• OSHA’s Bloodborne Pathogens standard prescribes

safeguards to protect workers against the health
hazards from exposure to blood and other
potentially infectious materials, and to reduce their
risk from this exposure
• Implementation of this standard not only will
prevent hepatitis B cases, but also will significantly
reduce the risk of workers contracting AIDS,
Hepatitis C, or other bloodborne diseases

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