Transcript Slide 1

Bloodborne Pathogens
Introduction
Welcome to this training presentation on Bloodborne Pathogens.
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Course Outline
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Why Take Bloodborne Pathogens Training?
Definition
At-Risk Employees
Types of Bloodborne Pathogens
Bloodborne Pathogen Transmission
Engineering Controls
Exposure Control Plan
Training Requirements
Work Practice Controls
Regulated Waste
HBV Vaccination
Emergency Response
Medical Recordkeeping
Summary
Why Take Bloodborne Pathogens Training?
Employees in many industries are at risk:
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Approximately 5.6 million employees in the health care, dentistry,
hospitality and other industries can reasonably be expected to
come into contact with blood or other potentially infectious
materials (OPIM). They are at risk for bloodborne pathogen
exposure.
Regulations and standards have been set:
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The Occupational Safety and Health Administration (OSHA) has set
a bloodborne pathogens standard which mandates safeguards to
protect employees against the health hazards associated with the
exposure to blood, needles, bodily fluids and OPIM.
Why Take Bloodborne Pathogens Training?
Introductory training:
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This training will satisfy the training requirements for initial
employee training and annually thereafter.
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For those employees who work with cultures of HIV, hepatitis B,
hepatitis C, human blood or other potential infectious material
known to be infected with the above bloodborne pathogens, this is
an introductory training and will not satisfy the additional
requirements for working with these specimens.
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For additional training on working with human blood and OPIM,
contact your supervisor.
Definition
What are bloodborne pathogens?

Bloodborne pathogens are
pathogenic micro-organisms
that may be present in human
blood and can cause disease
in humans.

Pathogens found in blood and
OPIM include the following: human
immunodeficiency virus (HIV),
which causes AIDs; hepatitis B virus (HBV); hepatitis C virus
(HCV); syphilis and malaria.

There are many bloodborne pathogens and although this
training only specifically addresses a few, they should all be
considered.
At-Risk Employees
The Bloodborne Pathogens Standard:
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Covers all employees who could be
“reasonably anticipated” to face contact
with blood and other potentially
infectious materials as the result of
performing their job duties.
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Does not cover those who engage in
“Good Samaritan” acts, such as
assisting a coworker with a nosebleed,
because it is not considered an
occupational exposure.
 However, if an employer allows trained employees to assist with
first aid treatment on a “Good Samaritan” basis, it is considered
best practice to implement the key elements of a bloodborne
pathogen program.
At-Risk Employees
Who is at risk for exposure?
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Physicians, nurses and emergency room personnel
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Orderlies, housekeeping personnel and laundry employees
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Dentists and other dental employees
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Laboratory and blood bank technologists and technicians
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Medical examiners
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School employees
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Law enforcement personnel
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Firefighters
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Paramedics and emergency medical technicians
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Anyone providing first-response medical care
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Medical waste treatment employees
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Home healthcare employees
Types of Bloodborne Pathogens
Bloodborne pathogens include:
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Malaria
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Syphilis
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Brucellosis
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Hepatitis B (HBV) and C
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Human immunodeficiency virus (HIV)
Human immunodeficiency
virus (HIV)
Types of Bloodborne Pathogens
Hepatitis B virus (HBV):
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Is a viral infection and causes inflammation of the liver.
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Transmits primarily through blood to blood contact.
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Can also cause jaundice, vomiting and, in rare cases, death.
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Leads to serious conditions such as cirrhosis and liver cancer.
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Can survive in dried blood for up to seven days.
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Has no known cure or treatment.
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Has an available vaccine.
Hepatitis B virus
Types of Bloodborne Pathogens
HBV symptoms:
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Mild flu-like symptoms
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Fatigue
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Possible stomach pain
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Loss of appetite
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Nausea
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Jaundice
Types of Bloodborne Pathogens
Hepatitis C virus (HCV):
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Similar to HBV, can cause jaundice, fatigue,
abdominal pain, loss of appetite,
intermittent nausea and vomiting.
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Can lead to chronic liver disease and death.
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Has no cure or vaccine. Medications can
suppress the virus, but treatments have a
low success rate.
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Survives outside the body for several days.
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Can be carried by people, called carriers,
who do not have symptoms of the disease.
Types of Bloodborne Pathogens
Human Immunodeficiency Virus (HIV):
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Attacks the body's immune system, weakening it so that it cannot
fight other deadly diseases.
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Causes acquired immunodeficiency syndrome (AIDS). AIDS is a
fatal disease and, while treatment for it is improving, there is no
known cure.
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The HIV virus is very fragile and will not survive for more than a
few hours outside of the human body.
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Employees providing first aid or medical care in situations
involving fresh blood or other potentially infectious materials are
particularly at risk.
Types of Bloodborne Pathogens
HIV symptoms:
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Symptoms of HIV infection can vary, but often include the
following:
– Weakness
– Fever
– Sore throat
– Nausea
– Headaches
– Diarrhea
– White coating on the tongue
– Weight loss
– Swollen lymph glands
Bloodborne Pathogen Transmission
Pathogen sources:
Generally, bloodborne pathogens are transmitted through contact
with infected human blood and other potentially infectious materials
(OPIM), such as:
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Semen.
Vaginal secretions.
Cerebrospinal fluid (brain spinal cord).
Synovial fluid (joints).
Pleural fluid (chest cavity).
Peritoneal fluid (abdomen).
Amniotic fluid (fluid around fetus).
Saliva (if blood is present).
• Any unfixed tissue or organ from a human, living or dead,
except intact skin.
• Any blood, cultures or animal tissue infected with or containing
HIV, HBV or HCV.
Bloodborne Pathogen Transmission
Entry methods:
Unbroken skin forms an impervious barrier against bloodborne
pathogens. However, infected blood can enter your system through
the following:
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Open sores
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Small cuts or scratches
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Abrasions
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Acne
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Damaged or broken skin, such as sunburn or blisters
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Dried and cracked skin
Bloodborne Pathogen Transmission
Common exposure routes:
 A splash or splatter of human
blood or OPIM coming into contact
with mucous membranes, such as
the eyes, nose, mouth or broken
skin.
 Parenteral contact. This is when
the pathogen enters directly into
blood or muscle tissue and
can occur via:
 Injection from a needle.
 Cuts from other contaminated
sharps like scalpels, broken
glass, etc.
Engineering Controls
Engineering controls:
These controls reduce exposure by removing
the hazard or isolating the employee.
Examples of engineering controls include:
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Sharps disposal containers.
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Self-sheathing or retracting needles.
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Medical safety devices.
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Needleless systems, as shown here.
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Sharps with engineered injury protection.
Engineering Controls
A sharps container must be:
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Red or labeled with a biohazard sign.
Leak-proof.
Puncture-resistant.
Located as close as possible to the
work surface.
Kept upright during use.
Inspected and replaced when twothirds full.
Closed when full.
Transported in a secondary container
if leakage is possible.
Disposed of as regulated waste,
following local and federal
requirements.
Engineering Controls
Medical safety devices:
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Needleless systems: Devices that do not use needles, such as
Luer taper systems, for the collection or withdrawal of body fluids
or for the administration of medication or fluids.
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Sharps that have engineered sharps injury protection:
These have a built-in safety feature or mechanism that reduces
the risk of an exposure incident. They include non-needle sharps
and needle devices used for withdrawing body fluids, accessing a
vein or artery or administering medications or other fluids.
Your program must review these devices to determine the safest approach.
Exposure Control Plan
An exposure control plan:
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Is a written document that describes how the employer will
comply with requirements and implement policies and procedures.
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Identifies the jobs and tasks where occupational exposure to
blood or other potentially infectious material occurs.
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Describes how the employer will:
 Use engineering and work practice controls.
 Assure use of personal protective equipment.
 Provide training.
 Provide medical surveillance.
 Provide hepatitis B vaccinations.
 Use signs and labels.
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Must be accessible and communicated to employees.
Exposure Control Plan
Reviewing the plan:
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The exposure control plan is reviewed at least annually and
updated to reflect the relevant changes in:
 Tasks
 Procedures
 Assignments
 Technology
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The annual review documents how the employer considers and
implements safer medical devices.
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The review must solicit input from potentially exposed employees
on the identification, evaluation and selection of engineering and
work practice controls.
St. Francis School District Exposure Control Plan
Training Requirements
Training must be:
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Provided at no cost to employees
during working hours.
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Provided at the time of the initial
assignment to a job with
occupational exposure and at
least annually thereafter.
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Provided additionally when
existing tasks are modified or
new tasks are required which
affect an employee’s occupational
exposure.
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Recorded and maintained for
three years.
Work Practice Controls
Using universal precautions involves:
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Treating all human blood or OPIM as contaminated with
bloodborne pathogens.
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Treating all materials that have been contaminated with human
blood or OPIM as potentially infectious with bloodborne pathogens.
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Minimizing handling and manipulation of materials contaminated
with human blood or OPIM.
Following universal precautions is an integral part of
preventing exposure to bloodborne pathogens.
Work Practice Controls
Implementing work practice controls:
These are steps to take in order to complete job tasks safely
by reducing the likelihood of exposure through choices.
Recommended controls include:
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Covering any cuts or abrasions, especially those near
your hands.
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Not touching the face or mouth when a potentially
infectious material is present.
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Not eating, drinking, smoking or applying cosmetics,
including lip balm when a potentially infectious material is
present.
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Following universal precautions: employees should
assume that all human blood is infectious.
Work Practice Controls
Sharps safety:
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Do not bend or break needles.
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Do not recap needles.
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Place needles in a sharps container as soon as possible.
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Use forceps or another device to pick-up sharps, such as broken
glass or a loose needle.
If a sharps injury does occur, report it to your supervisor and
record the incident on the Sharps Injury Log
Work Practice Controls
Biohazard warning labels must be placed on:
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Containers of regulated waste.
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Containers used to store, transport or
ship blood or other potentially
infectious materials.
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Refrigerators, freezers and other
storage locations that contain blood
and other potentially infectious
materials.
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Laundry containers being sent for
cleaning.
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Sharps containers.
Red bags or containers may be substituted for labels.
Work Practice Controls
Housekeeping:
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A written schedule must be developed for cleaning and
decontamination at the work site based on:
– The location within the facility.
– The type of surface to be cleaned.
– The type of soil present.
– The tasks or procedures being performed.
Work Practice Controls
Housekeeping (continued):
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Work surfaces must be decontaminated with
an appropriate disinfectant:
– After the completion of procedures.
– When surfaces are contaminated.
– At the end of the work shift.
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Follow instructions on the product label for
dilution, contact time on the surface and
required personal protective equipment
(PPE).
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A diluted bleach solution, 1% household
bleach, is considered to be an effective
disinfecting agent.
Work Practice Controls
Spill clean up:
• If a spill occurs, cordon off the area.
• Put on the required personal protective equipment (PPE).
• Place absorbent materials, such as paper towels, on the spill.
• Pour disinfectant on and around the spill area, allowing the
disinfectant to flow into the spill.
• Allow the disinfectant to sit for the required contact time.
• At the end of the contact time, collect the absorbent material.
• Wipe up excess disinfectant with absorbent material.
• Place absorbent material and disposable PPE in a red bag or bag
with a biohazard symbol to be disposed of as regulated waste.
Work Practice Controls
Personal protective equipment (PPE):
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PPE is specialized clothing or equipment that is worn by an
employee for protection against infectious materials.
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Always wear personal protective equipment (PPE) in potential
exposure situations.
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Replace PPE that is torn, punctured or soiled.
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Reusable PPE must be properly cleaned,
laundered, disinfected, repaired and disposed
of at no cost to employees.
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Wash hands immediately after removing
PPE.
Work Practice Controls
Examples of PPE:
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Gloves
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Gowns or laboratory coats
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Face shields
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Eye protection
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Boots
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Mouth barriers
Employees must receive training on the use, maintenance, care
and limitations of the PPE that they are expected to use.
Work Practice Controls
Proper procedures when using PPE:
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Remove PPE prior to leaving the work
area.
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Follow universal precautions when
removing PPE, being careful to not
contaminate other areas.
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Wash hands immediately after
removing PPE.
Work Practice Controls
Hand washing:
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Hand washing is one of the most
important (and easiest) practices
used to prevent the transmission of
bloodborne pathogens.
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Wash hands or other exposed skin
thoroughly as soon as possible
following an exposure incident.
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Wash hands after removing gloves.
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Use antimicrobial soap.
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Do not use harsh or abrasive soap.
Work Practice Controls
Laundry:
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Remove clothing that is contaminated with blood as soon as
possible.
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Use universal precautions when handling contaminated laundry by
handling laundry as little as possible and protecting yourself with
the proper PPE.
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Place clothing in approved and labeled bags or containers with the
biohazard symbol.
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If the laundry will soak through the container, place in a
secondary container and label with the biohazard symbol.
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Water soluble bags provide the greatest protection.
− They dissolve in laundry to minimize handling of contaminated
items.
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Sorting or rinsing before transportation is not allowed.
Regulated Waste
Regulated waste items include:
 Blood or other potentially
infectious materials (OPIM) in a
liquid or semi-liquid form.
 Contaminated items that could
release blood or other potentially
infectious materials in a liquid or
semi-liquid state if compressed.
 Items with dried blood or other
potentially infectious materials.
Regulated Waste
Disposing of regulated waste:
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Place items in closeable, leak-proof
containers. These are:
– Built to contain all contents during
handling, storing, transporting or
shipping.
– Appropriately labeled or color-coded.
– Closed prior to transport, storage or
handling.
– Placed inside a secondary container for
shipping, transport or storage, if
contamination occurs.
HBV Vaccination
Hepatitis B vaccinations:
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Employees who are routinely
exposed to bloodborne
pathogens, such as doctors,
nurses or first aid responders,
must be offered the hepatitis B
vaccine series.
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The vaccine series consist of
three shots which build
immunity to HBV. The three
shot series is administered
over a period of time.
HBV Vaccination
Hepatitis B vaccination requirements:
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The hepatitis B vaccine must be:
 Offered free of charge.
 Provided at a reasonable time and in an accessible location.
 Included for all employees at risk of exposure.
 Administered within 10 working days of initial assignment.
 Performed by a licensed professional.
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Employees do not have to be vaccinated if:
 They have already been vaccinated.
 An antibody testing reveals their immunity.
 They opt out after being offered the immunization.
HBV Vaccination
Hepatitis B vaccination requirements (continued):
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Opting out employees:
 Employees who decline the vaccination must sign a declination
form.
 The vaccine must be made available if an employee initially
declines and later decides to accept the vaccination.
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Employees are not required to participate in antibody prescreening
programs to receive the vaccination series.
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Vaccination booster doses must be provided if recommended by
the U.S. Public Health Service.
Emergency Response
What to do if an exposure occurs:
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Wash the exposed area thoroughly with soap and running water.
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Use non-abrasive, antimicrobial soap.
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Flush the nose, mouth or skin
with splashes of water.
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Irrigate eyes with water or
saline.
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Report the exposure.
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Seek medical attention.
Emergency Response
First aid procedures:
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Always use universal precautions.
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It is important to put an impermeable barrier between you and
potentially infectious material. Minimize your exposure by wearing
the following:
 Gloves
 Splash goggles
 Pocket mouth-to-mouth resuscitation masks
 Other barrier devices
Emergency Response
First aid procedures (continued):
 When performing first aid,
always use a mouth barrier to
protect yourself from coming
into contact with bodily fluids.
 Mouth barriers should have
one-way valves to keep fluids
from coming up.
 Commercially available
products can be small enough
to fit on a key chain and
include latex gloves.
Emergency Response
Post-exposure follow-up:
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Routes of exposure and how the exposure occurred must be
documented.
Exposure to Blood/Bodily Fluids Form
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Consent from the source individual and the exposed employee will
be obtained and blood will be tested as soon as possible after the
exposure incident.
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Risk counseling and post-exposure protective treatment for
diseases will be provided when medically indicated. This is in
accordance with current U.S. Public Health Service Guidelines.
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A written opinion of the findings will be provided to the employer
with a copy to the employee within 15 days of the evaluation.
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Hepatitis B prophylaxis administration will also be available.
Medical Recordkeeping
For every incident, the following must be recorded:
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The name and social security number of the employee.
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The employee’s hepatitis B vaccination status.
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The results of examinations, medical testing and post-exposure
evaluation.
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Follow-up procedures.
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Information provided to the health care professional.
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The health care professional’s written opinion.
Medical Recordkeeping
Maintain records:
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Employee medical records must be
kept confidential and not disclosed
or reported without the employee’s
written consent (unless required by
law).
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Medical records must be maintained
for the employee’s duration of
employment plus 30 years,
according to OSHA’s rule governing
access to employee exposure and
medical records.
Medical Recordkeeping
Sharps injury log:
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Employers must maintain a sharps injury log for the recording of
injuries from contaminated sharps.
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The log must be maintained in a way that assures employee
privacy and must contain, at a minimum:
− The type and brand of device involved in the incident.
− The location of the incident.
− A description of the incident.
Summary
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All employees who could reasonably
expect to come in contact with
human blood or OPIM must follow
universal precautions and be trained
on bloodborne pathogens.
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Implementation of a bloodborne
pathogen program will not only
prevent hepatitis B cases, but also
will significantly reduce the risk of
employees contracting HIV, hepatitis
C or other bloodborne diseases.
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A written exposure control plan and
a training program must be in place
to assure that employees are aware
of hazards and work practices for
bloodborne pathogens.
Summary
Best practices:
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Always know what hazards you are working with.
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Use proper PPE in situations with bloodborne pathogens.
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Report all suspected exposures.
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Don't handle sharps or broken glass with your hands.
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Never fill a sharps containers more than two-thirds full.
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Read labels on the handling of decontaminants prior to use.
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Properly dispose of pathogen waste, PPE and sharps containers as
regulated waste.
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