OSHA: Bloodborne Pathogens

Your employer is legally required to take which of the following actions to protect you against health hazards related to bloodborne pathogens?

- Provide PPE. - Use controls to prevent injury. - Label hazards correctly. - Provide free medical evaluations if an injury occurs.

Ways bloodborne pathogens are NOT transmitted by:

- Touching an infected person - Coughing or sneezing - Using the same equipment, materials, toilets, water fountains, or showers as an infected person

Which of the following devices is considered contaminated?

- Used IV tubing with NO visible blood. - A used needle. - A syringe detached from the used needle. - Used IV tubing with visible blood.

Emmanuel has had a sharps exposure at work and has reported the incident. His employer has offered him an immediate confidential medical evaluation and follow-up care. What can he expect from the exam?

- offered at no cost & at a reasonable time/place - Performed by/under supervision of a licensed physician/other healthcare professional - laboratory tests must be conducted by an accredited laboratory & at no cost to him

Containers for contaminated sharps must have certain features. What are these?

- puncture-resistant - leak-proof - biohazard labeled or color-coded red - closable - kept upright

How many patients can you use a single-use injection device with before it goes into the disposal container?

1

4 ways bloodborne pathogens can be spread:

1. Injection 2. Skin Abrasions 3. Mucous Membranes 4. Sexual Contact

After the actual use of sharps devices, what is the next leading cause of sharps injuries?

Activities after use & prior to disposal

Avoidance

Avoid eating, drinking, smoking, or applying cosmetics or contact lenses in an area with a likely source of a bloodborne pathogen.

Disposal

Dispose of all protective equipment in a biohazard bag.

Medical and Training Records

Employers also have an obligation to maintain worker medical and training records. The employer also must maintain a sharps injury log.

Work Practice Controls

Employers are required to identify and ensure the use of work practice controls. These are practices that reduce the possibility of exposure by changing the way a task is performed, such as appropriate practices for handling and disposing of contaminated sharps, handling specimens, handling laundry, and cleaning contaminated surfaces and items.

Universal Precautions

Employers are required to implement the use of universal precautions (treating all human blood and other potentially infectious material as if known to be infectious for bloodborne pathogens).

Training

Employers must ensure that their workers receive regular training that covers all elements of the standard including, but not limited to: information on bloodborne pathogens and diseases, methods used to control occupational exposure, Hepatitis B vaccine, and medical evaluation and post-exposure follow-up procedures. Employers must offer this training at the time of hiring, at least annually thereafter, and when new or modified tasks or procedures affect a worker's occupational exposure.

Post-exposure Evaluation and Follow-up

Employers must make available post-exposure evaluation and follow-up to any occupationally exposed worker who experiences an exposure incident.

PPE

Employers must provide personal protective equipment (PPE), such as gloves, gowns, eye protection, and masks. Employers must clean, repair, and replace this equipment as needed. Provision, maintenance, repair and replacement are at no cost to the worker.

Annual Plan Update

Employers must use input from frontline workers to update the exposure control plan annually. These updates must reflect changes in tasks, procedures, and positions that affect occupational exposure, and also technological changes that eliminate or reduce occupational exposure.

The Needlestick Safety and Prevention Act revised the bloodborne pathogens standard requiring employers to evaluate, select, and use what to eliminate or minimize exposure to contaminated sharps?

Engineering Controls

This bloodborne disease disables the body's immune system until it is no longer capable of fighting infection. It does this by attacking and destroying the infection-fighting CD4 cells of the immune system. The loss of CD4 cells makes it difficult for the body to fight infections and certain cancers. Once a person becomes immunocompromised, he or she can exhibit symptoms of weight loss, persistent low-grade fever, night sweats, and flu-like symptoms. The person is also more vulnerable to pneumonias, intestinal disorders, and fungal infections.

HIV

Sharps

Handle needles with care. Only properly trained individuals should draw blood or administer injections to prevent excess blood loss and resulting exposure.

Which type of vaccination are employers required to provide for their employees who may be exposed to bloodborne pathogens?

Hepatitis B Vaccine

Hepatitis C Virus

Hepatitis C infection can occur without symptoms or only mild ones. Chronic hepatitis develops in 75 to 80 percent of infected patients, and 70 percent of these individuals get active liver disease. Of those with active liver disease, 10 to 20 percent develop cirrhosis and 1 to 5 percent develop liver cancer.

Accidental puncture by a sharp object contaminated with a pathogen.

Injection

Found in the eyes, nose, or mouth.

Mucous Membranes

Human Immunodeficiency Virus (HIV)

Once a person becomes immunocompromised, he or she can exhibit symptoms of weight loss, persistent low-grade fever, night sweats, and flu-like symptoms. The person is also more vulnerable to pneumonias, intestinal disorders, and fungal infections.

If you are exposed to infected bodily fluid, what should you do after properly washing the area?

Report the incident to get a follow-up evaluation.

Hepatitis B Virus

Symptoms of Hepatitis B include jaundice, fever, nausea, and abdominal pain. Approximately 5 to 10 percent of patients develop chronic infection with Hepatitis B, which carries an estimated 20 percent lifetime risk of dying from cirrhosis and 6 percent risk of dying from liver cancer. The chance of becoming infected with Hepatitis B from a sharps injury is estimated to be between 6 and 30 percent.

PPE

Use appropriate PPE when you may be exposed to blood.

Labels and Signs to Communicate Hazards

Warning labels must be affixed to containers of regulated waste; containers of contaminated reusable sharps; refrigerators and freezers containing blood or other potentially infectious material; other containers used to store, transport, or ship blood or other potentially infectious material; contaminated equipment that is being shipped or serviced; and bags or containers of contaminated laundry, except as provided in the standard. Facilities may use red bags or red containers instead of labels. In HIV and Hepatitis B research laboratories and production facilities, signs must be posted at all access doors when other potentially infectious material or infected animals are present in the work area or containment module.

Sanitization

Wash and sanitize hands frequently and keep hands away from eyes, nose, and mouth until they are washed and sanitized.

If you are exposed to potentially infectious material via a sharps injury, what should you do immediately?

Wash the area with soap and water.

Hepatitis B Vaccinations

Your employer must provide Hepatitis B vaccinations to all workers with occupational exposure. This vaccination must be offered after the worker has received the required bloodborne pathogens training and within 10 days of initial assignment to a job with occupational exposure.

Engineering Controls

devices that isolate or remove the bloodborne pathogens hazard from the workplace and the standard requires that employers identify and use such engineering controls. They include sharps disposal containers, self-sheathing needles, and safer medical devices, such as sharps with engineered sharps-injury protection and needleless systems.

Now that the initial exposure has occurred and you have taken the immediate steps of cleaning the area and reporting the incident to your supervisor, what do you think needs to happen next?

medical evaluation

Chaundrise disposes of the syringe and needle after administering medication to her patient. Is this safe or unsafe?

safe

Luis notices that there is a lot of medication left over in the vial he has just used. Two more of his patients use the same medication so he plans to use it for them. Is this safe or unsafe?

unsafe

Olivia has finished adding medication to her patient's IV. She keeps the syringe for use with the next patient since the valves can prevent backflow and contamination of injection devices. Is this safe or unsafe?

unsafe

Exposure Control Plan

written plan to eliminate or minimize occupational exposures. The employer must write a plan that lists the jobs where workers may be exposed, along with a list of the tasks and procedures performed by those workers that result in their exposure.

Safe Device Characteristics

• Come attached with safety features that cannot be removed. • Are easy to use and have clear instructions. • Do not interfere with patient care. • Can be engaged with one hand. • Enable hands to remain behind the exposed sharp. • Are visibly different when activated.

types of sharps devices that can be used to protect you:

• Needle-free IV systems • Sheathed, blunting, or retractable needles • Blood transfer adapters • Non-breakable plastic vacuum and capillary tubes • Sharps disposal containers