Risk Management Department

1. Risk Management Department Bloodborne Pathogens May, 2008

2. Bloodborne Pathogens Introduction In December of 1991, the Occupational Safety and Health Administration (OSHA) published the Occupational Exposure to Bloodborne Pathogens Final Rule (Standard 29 CFR 1910.1030). This standard provides guidelines for employers to reduce significant risk of infection for employees exposed to body fluids or tissue from infected persons.

3. Bloodborne Pathogens Introduction The standard addresses employee training and information on definitions, work practices, procedures, equipment, and policies relating to preventative and post-incident medical interventions. The objective is to minimize the exposure risk or, if necessary, to effectively treat employees involved in an incident where there is a possibility of exposure.

4. Bloodborne Pathogens Introduction In this training we will cover: • Who does this apply to? • What is a pathogen? • Methods of transmission • Protection from exposure • What to do if exposed

5. Bloodborne Pathogens Who does this apply to? Employers are required to identify job categories that have a greater risk of exposure to bloodborne pathogens in the scope of their duties. APS has conducted an analysis of job categories and has determined that certain positions are at greatest risk of occupational exposure.

6. Bloodborne Pathogens Who does this apply to? The requirements of this program apply specifically to these job categories: • Athletic Trainers • School Nurses • Health Assistants • Employees Assigned to the Juvenile Detention Center • School Police Officers and Campus Security Assistants • Special Education Educational Assistants in ISP Programs • Special Education Teachers in ISP Programs

7. Bloodborne Pathogens Who does this apply to? The Hepatitis B vaccination series shall be offered to these employees after they have received the required training and within 10 working days of initial assignment unless: • The employee has previously received the complete Hepatitis B vaccination series • Antibody testing has revealed that the employee is already immune • The vaccine is contraindicated for medical reasons

8. Bloodborne Pathogens Who does this apply to? If the employee initially declines Hepatitis B vaccination but at a later date while still covered under the standard decides to accept the vaccination, the Hepatitis B vaccination series shall be made available at that time.

9. Bloodborne Pathogens What is a Pathogen? A pathogen is defined as an organism, either bacteria or virus, that can cause an illness or disease. Pathogens of concern specifically include, but are not limited to: Hepatitis B Hepatitis C HIV Virus

10. Bloodborne Pathogens What is a Pathogen? Pathogens of Concern: Hepatitis B A serious illness affecting the liver Detectable by blood test Vaccine available

11. Bloodborne Pathogens What is a Pathogen? Pathogens of Concern: Hepatitis C Another illness affecting the liver Usually more severe than Hepatitis B Detectable by blood test No vaccine available

12. Bloodborne Pathogens What is a Pathogen? Pathogens of Concern HIV Virus A virus that attacks the immune system Can lead to AIDS Detectable by blood test No vaccine available

13. Bloodborne Pathogens Methods of Transmission Transmission may be direct or indirect DIRECT - Immediate contact with a pathogen (blood) INDIRECT - Touching an item infected with the pathogen then touching a vulnerable area on self (mouth, nose, eyes, cut in skin)

14. Bloodborne Pathogens Methods of Transmission • Pathogens may be present in the blood and other body fluids such as saliva, semen, and vaginal secretions. • Pathogens can also be present in cerebrospinal, synovial, pleural, peritoneal, pericardial, amniotic, and any other fluids contaminated with blood.

15. Bloodborne Pathogens Methods of Transmission • Pathogens can enter and infect the human body through openings in the skin including cuts, nicks, abrasions, dermatitis, or acne • Infection can also result from punctures or cuts caused by sharp contaminated objects such as needles, broken glass, exposed ends of dental wires, or any other object that can puncture or cut skin

16. Bloodborne Pathogens Methods of Transmission • Pathogens can also gain access to the body through mucous membranes of the eyes, nose, and mouth when these areas are touched with contaminated hands or implements. • Hepatitis B is particularly dangerous since it can survive on dried surfaces at room temperature for at least one (1) week.

17. Bloodborne Pathogens Protection from Exposure The concept of Universal Precautions requires us to consider every person a potential carrier of a bloodborne pathogen Universal Precautions means we follow all applicable protection rules in every instance, no exceptions! This way we minimize the possibility of exposure and infection

18. Bloodborne Pathogens Protection from Exposure We also need to follow these rules: • Engineering and work practice controls • Personal protective equipment • Housekeeping • Handling needles and sharps • Regulated waste • Communication of hazards

19. Bloodborne Pathogens Protection from Exposure Engineering and Work Practice Controls • Handwashing is the single most important means of preventing the spread of infection • Employees must wash hands and any other skin with soap and water and flush exposed mucous membranes with water immediately following contact with blood or other potentially infectious materials

20. Bloodborne Pathogens Protection from Exposure Personal Protective Equipment • Gloves shall beworn when anticipated to have contact with blood, other potentially infectious materials, mucous membranes, non‑intact skin and when touching or handling contaminated items or surfaces

21. Bloodborne Pathogens Protection from Exposure Personal Protective Equipment • Disposable gloves shall not be washed or disinfected for re‑use • Face protection should be worn whenever eye, nose or mouth contamination can be reasonably anticipated • Other appropriate protective clothing should be worn in occupational exposure situations

22. Bloodborne Pathogens Protection from Exposure Housekeeping • The work site is to be maintained in a clean and sanitary condition • All equipment and working surfaces must be properly cleaned and decontaminated after contact with blood or other potentially infectious materials

23. Bloodborne Pathogens Protection from Exposure Handling Needles and Sharps • Handle sharp objects carefully! • Do not cut, bend, break, or routinely reinsert used needles into original sheath

24. Bloodborne Pathogens Protection from Exposure Handling Needles and Sharps • Discard sharp objects intact, immediately or as soon as possible after use into an OSHA-approved sharps disposal container • Sharps containers will be easily accessible to employees and maintained upright throughout use

25. Bloodborne Pathogens Protection from Exposure Regulated Waste • Regulated waste means contaminated items that are capable of releasing infectious materials during handling • Regulated waste shall be placed in containers to contain all contents and prevent leakage of fluids during handling, storage, transport or shipping

26. Bloodborne Pathogens Protection from Exposure Communication of Hazards Warning labels shall be affixed to containers of contaminated sharps and regulated waste

27. Bloodborne Pathogens What to do if exposed Post-exposure medical consultation and care applies toall APS employees This involves appropriate medical follow-up consultation and care for an exposure incident as a workplace accident The most obvious exposure incident is a needle stick, however, any specific eye, mouth, other mucous membrane, non-intact skin or internal contact with blood or other potentially infectious materials should be reported and treated

28. Bloodborne Pathogens What to do if exposed Any employee who believes they have been exposed to Bloodborne Pathogens must: • Call Company Nurse at 1-877-740-5017 • Submit a Notice of Accident form to their supervisor

29. Bloodborne Pathogens You are finished! You have finished the Bloodborne Pathogens training Download the quiz from the Risk Management website’s training page Print the form and be sure to write your name, location and employee number in the spaces provided Complete the ten questions and have your supervisor send it to the Risk Management office