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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)?

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bloodborne pathogens

Bloodborne Pathogens

Suzanne Reister, Program Manager

Paula Vanderpool, Program Assistant

North Central Washington Workers’ Comp Trust

509-667-7100

bloodborne pathogens1
Bloodborne Pathogens

Department of Safety & Health (DOSH)

Chapter 296-823 WAC

course objectives
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?
slide4

Bloodborne Pathogens (BBPs)

Present in

Blood

Other Potentially Infectious Materials

or

bloodborne pathogens bbps
Bloodborne Pathogens (BBPs)

OPIM

  • 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
  • any unfixed tissue or organ (other than intact skin) from a human (living or dead)
  • semen
  • vaginal secretions
transmission of bbps
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
transmission of bbps1
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
Exposure Control Plan

Exposure

Control

Plan

To eliminate/minimize your risk of exposure

  • Exposure determination
  • Exposure controls
  • Training
  • Hepatitis B Vaccine
  • Post exposure evaluation & follow-up
  • Recordkeeping
slide10

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
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
slide12

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
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 procedures1
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
Exposure Controls

UNIVERSAL PRECAUTIONS

– A system of infection control:

TREAT ALL HUMAN BLOODANDOPIM AS IF KNOWN TO BE INFECTIOUS WITH A BLOODBORNE DISEASE.

exposure controls1
Exposure Controls

Equipment and Safer Medical Devices

  • Physical guard

Sharps disposal containers

  • Closable
  • Puncture-resistant
  • Leak-proof
  • Labeled or color-coded
  • DO NOT OVERFILL!
exposure controls2
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 controls3
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 controls4
Exposure Controls

Safe Work Practices

Clean-up of spills and broken glassware/sharps (cont.)

  • Clean the area with 10% bleach orEPA-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
slide20

Nitrile and vinyl gloves

Exposure Controls

Personal Protective Equipment (PPE)

  • Gloves
  • Latex
  • Nitrile
  • Vinyl
  • Utility
exposure controls5
Exposure Controls

Personal Protective Equipment (PPE)

  • Protective clothing
  • Lab coat
  • Gown
  • Apron
  • Shoe cover or boot
exposure controls6
Exposure Controls

Personal Protective Equipment (PPE)

  • Eye-Face Protection and Masks
  • Safety glasses with side shields
  • Splash goggles
  • Face shield
  • Mask
exposure controls7
Exposure Controls

Personal Protective Equipment (PPE)

  • Resuscitation Devices
slide24

DISINFECTANT

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
exposure controls8
Exposure Controls

Laundry

  • Contaminated articles: (list items that are laundered)
  • Handle as little as possible
  • Wear PPE when handling and/or sorting:
    • Gloves
    • Gown
slide26

Predominantly fluorescent orange or orange/red background

Lettering and symbol in contrasting color to background

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
slide27

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 controls9
Exposure Controls

Regulated Waste - Containers

  • Easily accessible
  • Labeled or color-coded
  • Leak-proof, closeable
  • Puncture-resistant for sharps
  • Replaced routinely (do no overfill!)
slide29

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
Training
  • Provided to occupationally exposed employees:
    • At time of initial assignment
    • At least annually thereafter
    • Cover specific required elements
    • Interactive
    • Qualified trainers
training content
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 content1
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
slide33

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
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
Recordkeeping

Medical Records

  • 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
recordkeeping1
Recordkeeping

Training Records

  • Dates
  • Content summary
  • Trainer name & qualifications
  • Attendee’s names & job titles
  • Maintain for 3 years
plan evaluation
Plan Evaluation
  • Review and/or update annually
  • Whenever necessary to reflect changes that affect occupational exposure, including improved safety devices
your plan specifics
Your Plan Specifics
  • Exposure determination
  • Identify who is responsible for:
    • review, update, implementation of your plan
    • providing PPE, equipment
    • providing required training
    • investigating exposure incidents
    • maintaining required records
    • providing information about the vaccine
summary
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