Transcript Document
Bloodborne Pathogens
Suzanne Reister, Program Manager
Paula Vanderpool, Program Assistant
North Central Washington Workers’ Comp Trust
509-667-7100
Bloodborne Pathogens
Department of
Safety & Health
(DOSH)
Chapter 296-823
WAC
Course Objectives
• What are Bloodborne Pathogens
(BBPs)?
• What must I do to protect my
workers?
• What is, and how do I write an
Exposure Control Plan?
• What are the requirements of
WAC 296-823?
Bloodborne Pathogens (BBPs)
Present in
Blood
or
Other
Potentially
Infectious
Materials
Bloodborne Pathogens (BBPs)
• body fluids such as pleural,
cerebrospinal, pericardial,
peritoneal, synovial, and
amniotic
• saliva in dental procedures (if
blood is present)
• any body fluids visibly
contaminated with blood
• body fluid where it is difficult
to differentiate
OPIM
• any unfixed tissue or
organ (other than intact
skin) from a human
(living or dead)
• semen
• vaginal secretions
Transmission of BBPs
Bloodborne
Pathogens can enter
your body through:
• a break in the skin
(cut, burn, lesion,
etc.)
• mucus membranes
(eyes, nose, mouth)
• sexual contact
• other modes
Bloodborne Pathogen Diseases
Main bloodborne pathogens and diseases of
concern
• Hepatitis B Virus (HBV)
–
Hepatitis B
• Hepatitis C Virus (HCV)
–
Hepatitis C
• Human Immunodeficiency–
Virus (HIV)
AIDS
Transmission of BBPs
Occupational Exposure
• means reasonably anticipated skin, eye, mucous
membrane, or parenteral (piercing of the skin)
contact with blood or OPIM that may result from
the performance of an employee's duties
Exposure Incident
• is a specific contact with blood or
OPIM that is capable of transmitting a
bloodborne disease
Exposure Control Plan
To eliminate/minimize your risk of
exposure
• Exposure
determination
• Exposure controls
• Training
• Hepatitis B Vaccine
• Post exposure
evaluation & follow-up
• Recordkeeping
Exposure Determination
Who is at risk on-the-job?
In which job classifications are ...
• All employees occupationally exposed?
• Some employees occupationally exposed?
• List the classifications
• List the tasks with exposure
*Determine exposure without considering the
use of PPE.
Exposure Determination
• Jobs Where All Employees Have Potential
Exposure:
–
–
–
–
School nurse
First aid provider
Custodian
Teachers and parapros who work with
aggressive students (biting, scratching) or
with students who have special medical
problems
– Coaches
Exposure Determination
• Jobs Where Some Employees Have Exposure:
–
–
–
–
Preschool and Early childhood teachers and parapros
Intervention Specialists
Maintenance (plumbers)
Therapists, Psychologists, Speech and Language
Pathologists
– Teachers; especially elementary
– Bus Drivers
– Secretaries
Tasks and Procedures
• First aid procedures
• Athletic procedures commonly involving
damage to skin or mucous membranes
• Vocational educational procedures involving
equipment and tools which, unless properly
operated, may cause injury to the skin or
mucous membranes, i.e. wood & metal
shops, arts & crafts, etc.
• Laundering of contaminated clothing,
uniforms, towels, etc.
Tasks and Procedures
• Cleaning procedures involving blood or body
fluid visibly contaminated with blood
• Toilet procedures
• Plumbing procedures involving maintenance
and repair of bathrooms or cleaning solution
disposal areas
• Interaction with students known to bite and
scratch
• Use and disposal of hypodermic needles
Exposure Controls
– A system of infection control:
TREAT ALL HUMAN
BLOOD AND OPIM AS IF
KNOWN TO BE
INFECTIOUS WITH A
BLOODBORNE DISEASE.
Exposure Controls
Equipment and Safer Medical Devices
• Physical guard
Sharps disposal
containers
- Closable
- Puncture-resistant
- Leak-proof
- Labeled or colorcoded
- DO NOT OVERFILL!
Exposure Controls
Safe Work Practices
Wash hands after
each glove use and
immediately or
ASAP after
exposure.
Remove PPE before
leaving work area.
Flush body parts
with water after
contact with blood or
OPIM
Exposure Controls
Safe Work Practices
Clean-up of spills and broken glassware/sharps
contaminated with blood or OPIM
• Wear protective eyewear and mask
if splashing is anticipated
• Remove glass and other sharps
materials using a brush and dust
pan, forceps, etc. Do not use
your hands
• Properly discard all materials into a
sharps or puncture-resistant
biohazardous waste container
• Use paper/absorbent towels to
soak up the spilled materials
Exposure Controls
Safe Work Practices
Clean-up of spills and broken glassware/sharps
(cont.)
• Clean the area with 10% bleach
or EPA-registered disinfectant
• Saturate the spill area with
disinfectant. Leave for 10
minutes (or as specified by
product manufacturer) or allow
to air dry
• Properly dispose of paper
towels and cleaning materials
into proper waste containers
Exposure Controls
Personal Protective Equipment (PPE)
• Gloves
- Latex
- Nitrile
- Vinyl
- Utility
Nitrile and vinyl gloves
Exposure Controls
Personal Protective Equipment (PPE)
• Protective clothing
- Lab coat
- Gown
- Apron
- Shoe cover or boot
Exposure Controls
Personal Protective Equipment (PPE)
• Eye-Face Protection and Masks
- Safety glasses
with side
shields
- Splash goggles
- Face shield
- Mask
Exposure Controls
Personal Protective Equipment (PPE)
• Resuscitation Devices
Exposure Controls
Housekeeping
Maintain a clean and sanitary workplace
• Written cleaning and
decontamination schedule
and procedures
• Approved disinfectant –
bleach, EPA-approved
• Contaminated waste
disposal methods
• Laundry
DISINFECTANT
Exposure Controls
Laundry
Contaminated articles:
(list items that are
laundered)
Handle as little as possible
Wear PPE when handling
and/or sorting:
- Gloves
- Gown
Exposure Controls
Communication of Hazards
Biohazard Labels and Signs
• Must have biohazard
symbol
• Labels attached securely
to any containers or items
containing blood/OPIM
• Red bags/containers may
substitute for labels
Predominantly
Lettering and symbol
fluorescent orange in contrasting color
or orange/red
to background
background
Exposure Controls
Regulated Waste
• Liquid or semi-liquid blood or OPIM
• Contaminated items that would release blood or
OPIM in a liquid or semi-liquid state if
compressed
• Items caked with dried blood or OPIM that are
capable of releasing these materials
during handling
• Contaminated sharps
Exposure Controls
Regulated Waste - Containers
•
•
•
•
Easily accessible
Labeled or color-coded
Leak-proof, closeable
Puncture-resistant for
sharps
• Replaced routinely
(do no overfill!)
Hepatitis B Vaccine
• No cost to potentially
exposed employee
• Made available after BBP
training and within 10 days
of assignment
• 3 shots: 0, 1, & 6 months
• If decline, must sign
Declination Form
– vaccine available at later
date if desired
Training
• Provided to occupationally exposed
employees:
–
–
–
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At time of initial assignment
At least annually thereafter
Cover specific required elements
Interactive
Qualified trainers
Training Content
• An accessible copy of the WAC rule
• Explanation of epidemiology and symptoms
of bloodborne diseases
• Transmission of bloodborne diseases
• Explanation of the exposure control plan
• Information about PPE
• Information about the Hepatitis B vaccine
Training Content
• The use and limitations of methods that will
prevent or reduce exposure (work practices,
PPE equipment, etc.)
• What to do when an exposure incident
occurs and post-exposure evaluation
• Explanation of signs, labeling, color-coding
• An opportunity for questions and answers
with trainer at time of the training
Post-exposure evaluation
School District’s Responsibility:
• Provide immediate medical evaluation and
follow-up to exposed employee
• Test blood of source person if HBV/HCV/HIV
status unknown-consent required
• Provide results to exposed employee
• Test blood of exposed employee
• Provide information to Health Care
Professional (HCP)
Post-exposure evaluation
School District’s Responsibility: (cont.)
• Provide exposed employee with
copy of the evaluating HCP
written opinion within 15 days of
completion of evaluation
• Provide employee with
information about laws on
confidentiality for the source
individual
• Provide post-exposure treatment
as needed, including counseling
• Investigate the exposure incident
Recordkeeping
Medical Records
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•
•
•
•
•
For employees with exposure
Confidential
Hepatitis B vaccination status
Post-exposure evaluations
HCP’s written opinions
Information provided to HCP as
required
• Maintain for length of
employment + 30 years
Recordkeeping
Training Records
• Dates
• Content summary
• Trainer name & qualifications
• Attendee’s names & job titles
• Maintain for 3 years
Plan Evaluation
• Review and/or update annually
• Whenever necessary to reflect
changes that affect
occupational exposure,
including improved safety
devices
Your Plan Specifics
• Exposure determination
• Identify who is responsible for:
–
–
–
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–
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review, update, implementation of your plan
providing PPE, equipment
providing required training
investigating exposure incidents
maintaining required records
providing information about the vaccine
Summary
• Determine who has occupational
exposure
• Establish a written exposure control plan
• Use exposure control methods
• Provide personal protective equipment
• Provide employee training
• Make Hepatitis B vaccine available
• Post-exposure evaluation and follow-up
• Maintain medical and training records