Annual Bloodborne Pathogen Inservice

1. Annual Bloodborne Pathogen Inservice SAD #49 August 2008

2. Instructions for completing Bloodborne Pathogen Inservice Please read the following presentation of information Please print the short test at the end of the presentation, complete it and return it to the school nurse by the end of September.

3. Objectives of Bloodborne Pathogen Training Upon completion of the annual training, you will be able to: Describe what bloodborne pathogens are. Give three examples of persons who are at risk of exposure to bloodborne pathogens List three ways exposure to bloodborne pathogens commonly occurs Explain how to protect yourself from exposure to bloodborne pathogens List three important steps to take if you are exposed to bloodborne pathogens.

4. What are Bloodborne Pathogens? Bloodborne pathogens are viruses, bacteria and other microorganisms carried or “borne” in human blood that can cause disease. Examples of bloodborne pathogens are: Hepatitis B virus (HBV) Hepatitis C Virus (HCV) Human Immunodeficiency Virus (HIV)

5. Bloodborne pathogens Bloodborne viruses such as HBV, HCV and HIV Are transmissable in health care settings Can produce chronic infection Are often carried by people unaware of their infection.

6. What are Bloodborne Pathogens? There are other bloodborne pathogens, such as syphilis and malaria, but your greatest risks are from: Hepatitis B (HBV) HIV

7. Other Potentially Infectious Materials Human body fluids: Blood products Semen Vaginal secretions Cerebrospinal fluid (fluid surrounding the brain and spine) Fluid surrounding joints Fluid surrounding the heart, in the chest and abdomen and any body fluid with visible blood in it.

8. OSHA OSHA’s Bloodborne Pathogens standard prescribes safeguards to protect workers against the health hazards from exposure to blood and other potentially infectious materials, and to reduce their risk from this exposure.

9. Who is at risk? Employees at risk are those who may become exposed to blood or body fluids on skin, eyes, mucous membranes or parenteral contact with blood or other potentially infectious materials during the performance of an employee’s duties. “Parenteral contact” means contact piercing through your mucous membranes or skin by needlesticks, human bites or cuts.

10. Who is at risk? Anyone can be exposed to bloodborne pathogens– if he or she is exposed to blood or other body fluids.

11. How does exposure happen? Most common: needlesticks Cuts from other contaminated sharps (scalpels, broken glass, etc.) Contact of mucous membranes (for example, the eye, nose, mouth) or broken (cut or abraded) skin with contaminated blood or body fluids. Unprotected sex Infected mother to unborn child Blood transfusion Organ transplant NOT from casual contact

12. Hepatitis B Virus Hepatitis B Virus, or HBV, causes serious liver disease. About 30% of those infected have no symptoms Signs and symptoms: jaundice, fatigue, nausea, joint pain, loss of appetite, abdominal pain Symptoms are less common in children than adults

13. Hepatitis B Virus Long- term effects of exposure without vaccination: Chronic infection and chronic liver disease Death from chronic liver disease occurs in 15-25% of chronically infected people.

14. HBV Infection Occurs when blood or body fluids containing HBV enters the body of a person who is not immune HBV is spread through Sexual contact Sharing needles / syringes Needle sticks /sharps exposure on the job Infected mother to baby during birth

15. HBV Infection People at risk for HBV infection might also be at risk for infection with Hepatitis C (HCV) or HIV HBV is transmitted easily through blood, and is at a higher concentration than HIV. HBV is still present and contagious in dried blood. HIV is fragile and does not survive in the environment.

16. Hepatitis B Vaccine Effective in preventing Hepatitis B 95% of those vaccinated develop an immunity Three shot series given over 6 months Safe, effective and long-lasting

17. Hepatitis B Vaccine Hepatitis B is a routine vaccination of 0-18 year olds. People of any age should be vaccinated if their behavior or job puts them at risk for HBV infection. Hepatitis B vaccine can be given after a person has been exposed to HBV if given in an appropriate time frame.

18. Hepatitis C Virus (HCV) Causes chronic liver disease in 55%-85% of infected persons Deaths from chronic liver disease occur in 1-5% of infected persons Leading indication for liver transplant

19. HCV Infection 80% of people infected have no signs or symptoms Symptoms: Jaundice, fatigue, dark urine, abdominal pain, loss of appetite, nausea People at risk for HCV infection are also at risk for infection with HBV and HIV

20. HCV Infection Occurs when blood from an infected person enters the body of someone who is not infected HCV is spread through Sharing needles when abusing drugs (most common) Needlesticks or sharps exposure while on the job Passed from an infected mother to her baby during birth

21. HCV Infection There is no vaccine to prevent HCV Some drugs are available to treat chronic Hepatitis C, are used in combination with each other, and are not always effective.

22. HIV Human Immunodeficiency Virus (HIV) is the virus that causes AIDS. HIV attacks the immune system, making the body less able (or unable) to fight off infections. There is no vaccine or cure for HIV

23. HIV Infection HIV is spread by: Sexual contact with an infected person Sharing needles with an infected person During birth from infected mother to child Needlesticks or sharps exposure while on the job Infected blood getting into an open cut or mucous membrane of an uninfected person Note: Contact with saliva, tears or sweat has never been shown to result in the transmission of HIV.

24. Prevention of Exposure to Bloodborne Pathogens Wear gloves if you have to touch blood or other body fluids that could possibly contain visible blood, such as urine, feces or vomit. We use vinyl or PVC-free gloves in SAD #49 to minimize latex in the environment for our latex allergic students and staff members.

25. Prevention of Exposure to Bloodborne Pathogens Cover cuts, sores or breaks on any exposed skin WASH HANDS and any exposed skin with soap and running water immediately after accidental exposure with body fluids that might be contaminated. If soap and running water are not available, use antiseptic towelettes or hand cleansers, and wash with soap and water as soon as you can.

26. Prevention of Exposure to Bloodborne Pathogens Don’t eat, drink or smoke in areas where bloodborne pathogens might be present. Handle sharps (needles, cut glass, etc.) appropriately. Gloves will not protect against being stuck or cut. Never reach into trash to retrieve an object. Empty the contents on a newspaper and search with your eyes.

27. Prevention of Exposure to Bloodborne Pathogens 7.. Use Personal Protective Equipment (PPE) Wear gloves Remove gloves properly Wash hands after glove removal just in case Wear a mask / eye protection if body fluids could splash or spray into your eyes, nose or mouth. Use a CPR mask if need to do mouth- to mouth

28. Prevention of Exposure to Bloodborne Pathogens Never assume that someone’s body fluids or blood are “safe” to touch. Diseases can be carried in the blood without showing any signs or symptoms. If something is wet, don’t touch it! “Universal Precautions” , defined by the CDC, means blood and body fluids from all persons are considered potentially infectious, and protection against exposure needs to be used at all times.

29. Prevention of Exposure to Bloodborne Pathogens Wipe up spilled blood or other body fluids with disposable towels. Double bag bloody waste. Clean contaminated surfaces with a 10% bleach solution (1/4 cup bleach to a gallon of water)

30. What if you are exposed? Wash the area immediately with soap and running water. Don’t Panic Report the incident promptly to the school nurse who will help you to: 1. Complete the employee incident form, and 2. Get medical help (even if you think you do not need to be seen).

31. KEEP SAFE Please protect yourself, your co-workers and your students by taking precautions, not chances.

32. References About Bloodborne Pathogens, Channing L. Bete Co, Inc., 1992. Bloodborne Infections: A Practical Guide to OSHA Compliance, Johnson & Johnson Medical, 1992 Hepatitis B Fact Sheet, www. cdc.gov/hepatitis, May 24, 2005. Hepatitis B Frequently Asked Questions, www.cdc.gov/ncidod/diseases/hepatitis/b/faqb.htm, 8 / 17/2006 Hepatitis C Fact Sheet, www.cdc.gov/hepatitis, May 24, 2005 HIV and Its Transmission, CDC, July 1999 The Bloodborne Pathogens Standard 29 CFR 1910.1030, New York City Department of Education Division of Human Resources, Prepared by The Office of Occupational Safety and Health Updated 9/2002. Universal precautions for Prevention of Transmission of HIV and other Bloodborne Infections, updated 1996 www.cdc.gov/ncidod/dhqp/bp_universal _precautions.html

33. Now for the quiz . . . .