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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•
•
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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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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