December 2013
Bloodborne Pathogens Training
Directions: Please read over the following material and take the quiz.
*The NHRC Department of Respiratory Disease Research
requires that all personnel, both onsite and offsite, who
work with patient specimens or have patient contact,
receive bloodborne pathogen training. Bloodborne pathogen
training is a critical component of laboratory safety and must
be completed upon orientation and followed by subsequent
annual refresher courses. The following training is in
compliance with the OSHA Bloodborne Pathogens Standard
(29 CFR 1910.1030) and will be used as our annual refresher
course. Upon completion of this training, you will be required to
take a quiz.
Introduction:
Needle sticks and other sharps injuries are a major healthcare
industry concern. In 1991, OSHA created Bloodborne
Pathogen Standard 29 CFR 1910.1030 which combined
engineering and work practice controls, training, and other
factors to minimize transmission of bloodborne pathogens in
the workplace.
In November of 2000, the Needlestick Safety and Prevention
Act was passed by Congress.
It is estimated that up to 800,000 needle stick infections
occur yearly
Bloodborne Diseases
Bloodborne pathogens are pathogenic microorganisms
(e.g. viruses, bacteria, or parasites) that may be present in
human blood and can cause disease in humans.
There are several bloodborne diseases that you could be
exposed to on the job. The most significant are:
Human Immunodeficiency Virus (HIV)
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)
Human Immunodeficiency Virus (HIV)
HIV attacks the body’s immune system and may cause
Acquired Immune Deficiency Syndrome (AIDS).
Currently, there is no vaccine or cure for HIV.
Needle sticks are a rare cause of occupational HIV
transmission (.04% of people are infected in the workplace).
It is still important to be careful when working with needles
because HIV can lead to AIDS which is fatal.
Human Immunodeficiency Virus (HIV):
A person with HIV may:
Carry the virus without developing symptoms for many years.
Develop AIDS, or AIDS-related symptoms including:
neurological problems, cancer, and other opportunistic
infections.
Suffer from flu-like symptoms, fever, diarrhea, and fatigue as
well as weakness, sore-throat, white coating on the tongue,
weight loss, and swollen lymph glands.
Hepatitis B (HBV)
Hepatitis means “inflammation of the liver.”
HBV is a major bloodborne hazard that infects approximately
8,700 healthcare workers a year, resulting in more than
200 deaths.
There is a vaccine available to prevent HBV.
Blood to blood transmission is the most common form of HBV
infection.
If someone becomes infected with HBV he/she:
May not develop symptoms for up to 9 months.
May suffer from symptoms such as fatigue, stomach pain,
jaundice, and darkened urine.
HBV may severely damage the liver, causing cirrhosis and
sometimes death
Hepatitis C (HCV)
HCV is the most common bloodborne infection in the US,
infecting more than 4 million Americans, most of which are
unaware that they are infected. As many as 2.7 – 10% of
new HCV cases are occupationally acquired.
HCV is a potentially fatal bloodborne virus that can lead to
liver failure or cancer.
There is no vaccine against HCV.
Symptoms include: Jaundice, fatigue, darkened urine,
abdominal pain, and loss of appetite or nausea, although
many people remain asymptomatic.
Modes of Transmission
HIV, HBV, and HCV are transmitted through blood or other
bodily fluid. This includes:
Semen
Vaginal secretions
Saliva
Cerebrospinal fluid
Amniotic fluid
Peritoneal fluid
Pleural fluid
Synovial fluid
Any fluid that is contaminated with blood
Vehicles of Transmission
Bloodborne pathogens may enter the body and infect a person
through a variety of means including:
Hypodermic Needles
Sexual Contact
Accidental puncture with contaminated needles, broken glass
or any other sharp object that can pierce skin.
Contact between broken or damaged skin and infected bodily
fluids.
Indirect transmission such as touching a contaminated object
to your mouth, eyes, nose, or other mucous membranes.
Universal Precautions
HIV, HBV, and HCV infect people of all ages, socioeconomic
classes, race, and background. This means you cannot
identify every patient who may transmit the infection.
Universal precautions resolve this uncertainty by requiring
you to treat all human blood and bodily fluids as if they were
known to be infected.
Respiratory Pathogens
It is possible that you may be exposed to respiratory
pathogens, such as M. tuberculosis (TB) and B. pertussis,
at this workplace.
Although we do not culture TB, we do process throat cultures
which could be infected.
Once a year, every employee must get a PPD skin test to
check for the presence of TB.
The greatest potential for B. pertussis and other respiratory
pathogen infection is through aerosol generation during the
manipulation of cultures.
Respiratory Pathogens:
Reducing the Risk
Workers may be protected from Respiratory Pathogens by:
Using careful work practices
Having good personal hygiene
(gowns, gloves, hand washing)
Using engineering controls (hoods)
Receipt of an annual influenza vaccination
Reducing Your Risk
There are five major tactics to help reduce your risk of exposure
and infection:
1. Work Practices & Personal Hygiene
2. Personal Protective Equipment
3. Engineering Controls
4. Good Housekeeping
5. Hepatitis B Vaccine
Work Practices
If you come in contact with infectious materials, wash the
exposed area immediately in order to lessen the chance of
becoming infected.
In laboratory and patient care areas you should wash your
hands frequently, including when you:
Remove your gloves
Come in contact with blood or other bodily fluids
Change workstations
Enter a “clean” area
To Avoid Needle Sticks
Use a needle with Engineered Sharps
Injury Protection (SESIP) attached to
the blood tube holder and dispose of
the entire unit into a sharps container.
Do not bend, break, and NEVER re-cap needles.
Do not remove contaminated needles from blood tube
following a blood draw.
Place contaminated sharps in an
appropriate puncture-resistant container.
Code Regulations
Code 1910.1030 requires you to:
Keep a confidential sharps injury log.
Use the most up to date safety needles which are appropriate
for your workplace.
Involve employees in choosing the needle safety devices.
Have a yearly re-examination of your exposure control plan.
Sharps Disposal Containers
Sharps disposal containers should be:
Functional – durable, closeable, leak and puncture resistant
Accessible – close to where work is being done
Visible – properly labeled and color coded
Accommodating – conveniently located and easy to reach with
an opening large enough for both the needle and SESIP
Handling Sharps
Do not overfill the sharps containers. Fill only to the
indicated line or ¾ (75%) of the container, whichever comes first.
Never reach into any container that is used for sharps.
Place leaking or punctured sharps containers inside a
secondary container to prevent further leakage.
Always use a utensil (tongs, dustpan, etc.) to pick up
contaminated broken glass, needles, or other sharps.
Assume all used needles and other sharps are contaminated
Personal Hygiene
Other precautions to protect yourself include:
Always minimize splashing, spraying, and spattering.
Do not eat, drink, smoke, apply cosmetics,
or handle contact lenses where you may
potentially be exposed to infectious materials.
Never pipette or use suction by mouth!
Don’t store food or drinks where blood and
other infectious materials may be present.
Avoid petroleum-based lubricants because they can eat away
at latex gloves. Hand cream is okay, but only after you have
thoroughly washed your hands.
Personal Protective Equipment
Personal Protective Equipment (PPE) protects you from contact
with potentially infectious materials. PPE includes:
Masks/Eye Protection: always use when
you perform procedures likely to generate
splashes of blood or other bodily fluids.
Gowns/Coats: use for procedures likely to
generate splashes of blood or other bodily fluids.
Gloves: always use before touching or if likely
to come in contact with blood, bodily fluids,
non-intact skin, mucous membranes, and when
performing venipuncture.
PPE should be worn at all times in the operating room except in
approved “clean areas”.
PPE should never be worn outside of the area of potential
exposure.
Contaminated PPE must be taken care of appropriately
by either disposing, decontaminating, or laundering it.
Gloves
Gloves are a very important way of protecting yourself.
Always use latex or approved non-latex gloves.
Always check the gloves for holes before putting them on.
There are also specific rules to be followed for glove removal:
With both hands gloved, peel one glove off from wrist to fingers
and hold it in the gloved hand.
With the exposed hand, peel the second glove from the inside,
tucking the first glove inside the second.
Immediately dispose of both gloves in a bio-hazardous materials
container.
Wash your hands thoroughly.
Engineering Controls
Engineering Controls are the primary means of minimizing or
eliminating employee exposure to BBP and include the use of
safer medical devices. Some examples are:
Self-sheathing needles
Sharps disposal containers
Bio-hazardous waste bags
Biological Safety Hoods
Autoclaves
Good Housekeeping
Good Housekeeping means using your common sense and
knowledge to keep your work areas clean and to protect
yourself and your colleagues. General rules are:
Clean and decontaminate all equipment and surfaces at
the end of each shift using an appropriate decontaminant.
Replace protective coverings on equipment
Place contaminated sharps into the proper
leak-proof containers.
Please read and follow all biohazard labels.
Always dispose of hazardous materials (including sharps)
in the proper RED (NOT orange) container or bag.
HBV Vaccination
If your occupation has the potential for HBV exposure, your
employer will offer the vaccine at no cost to you.
The vaccine is administered in three injections: one at
employment start, one at three month, the final at
six months. A post vaccination serology test (titer) should
be scheduled to check antibody levels.
All three injections must be received for the vaccine to be
effective.
Today’s vaccines are safe and are 85-97% effective.
Exposure Incident Procedures
An exposure incident is a spill, splash, needle stick, ingestion,
or accident, in which you have direct and unprotected contact
with human blood, fluids, or tissue.
In the event of an exposure incident an
employee should:
Wash or flush the area immediately.
Notify the employee’s supervisor.
Seek further medical treatment as necessary.
Ensure the incident is reported to your employer.
REMEMBER: Report an exposure incident as soon as
possible
Specific Exposure Procedures
Contaminated skin: scrub and soak the area for
at least 10 minutes using a providone iodine solution
(e.g. Betadine) and water.
Percutaneous injury (needle stick, cut, wound, etc.):
Vigorously scrub and soak the area for at least
20 minutes with a Betadine solution and water
before seeking additional treatment.
Mucous Membrane: Flush any exposed area for
at least 15 minutes at an emergency eyewash
station before seeking additional treatment.
Emergency Procedures
In case of an emergency, contact Robby or Raelene as soon as possible.
All treatments of work-related injuries will be paid for by
your employer.
Bloodborne Pathogen QUIZ
Circle The Best Response
In what year was the Needlestick Safety and Prevention Act passed by Congress?
a. 1998
b. 2000
c. 2001
d. 2003
e. 2004
Hepatitis refers the inflammation of the:
a. heart
b. lungs
c. liver
d. kidneys
e. intestines
The most significant bloodborne diseases are:
a. HIV
b. HBV
c. HCV
d. All of the above
HCV is a potentially fatal virus that can lead to:
a. liver disease
b. liver disease and cancer
c. HIV
d. HBV
In the event of an exposure incident, the employee should
a. Report the incident as soon as possible
b. Wash of flush the area immediately
c. Notify the employee’s supervisor as soon as possible
d. Seek further medical care as needed
e. All of the above
What type of PPE are we required to use while dealing with blood:
a. gloves
b. masks including eye protections
c shoe covers
d. gowns
e. a,b,c,
f. all of the above
A sharps container shall never be filled more than:
a. 60% full
b. 75% full
c. 80% full
d. It can filled up as long as the safety guard can still be locked in place
What is a symptom of the HIV virus?
a. unexpected weigh gain
b. coughing up blood
c. white coating on the tongue
d. muscle tremors
It is estimated that how many needle sticks occur yearly?
a. 500,000
b.800,000
c. 700,000
d. 250,000
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