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Fermilab Fire Department
Excellence Through Training
Bloodborne Pathogens Awareness
Objectives 1 of 2
Identify the laws relating to Bloodborne Pathogens (BBP)
Identify the definition of BBP
Identify local procedures for BBP and exposures to BBP
Identify precautions and PPE relating to BBP
Objectives 2 of 2
Identify Facts and Characteristics of BBP
Identify Methods BBP can be spread
Identify high risk behaviors/practices associated with BBP
Occupational Exposure to Bloodborne Pathogens
(Mandated Federal Law)
Adopted by reference in Illinois (IDOL)
“Bloodborne Pathogens” Defined . . .
Pathogenic microorganisms that are present in human blood and can cause disease in humans.
“Bloodborne Pathogens” Examples . . .
Human Immunodeficiency (HIV)
Hepatitis B (HBV)
Hepatitis C (HCV)
“Regulated Waste” Defined . . .
Liquid or semi-liquid blood or other potentially infectious materials;
Contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed;
Pathological and microbiological wastes containing blood or other potentially infectious materials (OPIM).
“Other Potentially Infectious Materials” Defined . . .
(1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids;
Effective March 6, 1992
Applies to ALL Employers With Employees “Reasonably Anticipated”to Have Occupational Exposure to Blood and Other Potentially Infectious Materials
Requirements of OSHA 1910.1030
Exposure control plan
Annual awareness training
Implementation of engineering and work practice controls
Proper labeling of blood or other potentially infectious materials
Free HBV vaccinations
Free medical evaluations for incidents of exposure
Persons who may be exposed . . .
Firefighter / EMTs
Firefighter / Paramedics
Day Care Workers
Tasks involving potential exposure . . .
Rescue / Extrication
BLS / ALS procedures (EMS)
Handling of deceased persons
Disinfecting / Decontaminating procedures
FERMILAB Exposure Control Plan
Engineering & work practices
Hepatitis B Vaccination
Post-exposure evaluation & follow-up
Information & training
Acquired Immunodeficiency Syndrome
Caused by HIV
Human Immunodeficiency Virus
Outcome of infection with the virus varies:
Some have no symptoms.
Some have less severe symptoms than those with AIDS.
AIDS results from destruction of the immune system which allows diseases to threaten life or health.
How Widespread Is HIV ?
CDC estimates that 33.6 million people worldwide are living with HIV / AIDS. (32.4 million adults) 2008
Approx. 5.6 million new HIV infections were reported in 2006. More than 15,000 infections each day.
One in every 100 adults aged 15 to 49 is HIV-infected.
CDC estimates that 650,000 to 900,000 US residents are currently living with HIV infection, of whom more than 200,000 are unaware of their infection.
Approx. 43,000 new HIV infections were reported in 2006
711,344 cases of AIDS have been officially reported to the CDC as of June 30, 2005
You Cannot “Catch” HIV:
Through the air
Through casual, everyday contact
(sharing bathrooms, kitchens, etc.)
Through nonsexual social situations
Through insects or mosquitoes
Through urine, feces, nasal secretions, sputum, vomitus, saliva, sweat or tears from an infected person
What Personal Behaviors/Practices Put You at Risk ?
Sexual contact with an infected person
Sharing infected needles
Infected woman to her child at birth
*The blood supply is thoroughly screened so that the risk of infection from transfusion is extremely small.
How Can You Prevent HIV Transmission in Your Personal Life?
Vaginal or oral sex with someone who uses IV drugs
Sex with someone you don’t know well
Sex with someone who has multiple sex partners
Sex without a condom - with an infected person
Sharing IV drug needles
Occupational Acquired HIV Infection & AIDS
Of the 427,795 infected adults reported to the CDC where the type of job was known, 21,760 were health care workers.
Of those, 74% have died.
There has only been one documented case of patients being infected by a health care worker in the United States.
This involved HIV transmission from one infected Dentist to six patients.
Protect yourself from HIV on the job by avoiding contact with blood and potentially infectious body fluids that can transmit the virus
The single most prominent source of HIV in the occupational setting
The risk of HIV infection through contact with feces, nasal secretions, saliva, sputum, sweat, tears, urine and vomitus is extremely low or nonexistent.
Workers May Be Exposed Through:
47 of the 55 reported health care workers who seroconverted to HIV after exposure were exposed through punctures / cuts.
Mucous membranes of the eyes, nose or mouth
Broken or non-intact skin
Risk of HIV Infection:
Needle stick: 0.3% following needle stick contaminated with blood from a known infected person.
Chapped / broken skin or mucous membranes: less, but not definitively known
Antibodies to HIV in an infected person’s blood can be detected by a test.
Persons usually develop antibodies within 6 to 12 weeks after becoming infected.
How Can You Protect Yourself?
Use Body Substance Isolation (BSI) procedures & equipment.
No preventative vaccine exists at the present time.
What Is Hepatitis B?
Caused by the Hepatitis B Virus (HBV).
Damages the liver, causing symptoms that range from mild or unapparent to severe or fatal.
25% of infected individuals develop acute hepatitis.
6% to 10% become HBV carriers. Carriers can develop liver disease and are infectious to others.
Hepatitis B . . .
12,000 health care workers become infected through occupational exposure each year.
500-600 infected health-care workers are hospitalized each year.
200-300 infected health-care workers die each year with associated diseases.
What Personal Behaviors Put You at Risk for HBV Infection ?
Sharing drug needles and syringes with infected person
Since blood supply is screened for HBV, the chance of being infected through transfusion is extremely small.
What Occupational Exposures Put a Worker at Risk for HBV Infection ?
Contact with blood or potentially infectious body fluids through:
Mucous membranes of eyes, nose and mouth
Saliva injected through a human bite can also transmit HBV.
Body Substance Isolation (BSI)
The same BSI equipment & procedures that will protect against exposure to HIV will protect the worker against HBV.
Blood tests are available to detect antibodies for HBV in an infected person.
Vaccines provide protection against HBV infection (90% protection for 7 or more years)
Vaccines are 70% to 80% effective when given within 1 week of exposure
Personal Protective Equipment
Disposables protect against blood and fluids
Normally provide no protection against sharps
Must be changed if soiled or torn
Must be changed between handling of different people
Masks, Eyewear & Gowns
Not necessary unless blood or other potentially infectious fluids are or could be present
Masks & eyewear should be worn together if splashes are anticipated
Gowns or aprons are worn to avoid soaking of clothes
There are no reported cases of HBV or HIV transmission from mouth-to-mouth resuscitation.
Because other diseases can be transmitted this way, protective devices should be used:
How Can You Protect Yourself Against HIV & HBV ?
If you perform tasks that put you in contact with blood, or other potentially infectious body fluids, you should be vaccinated against HBV.
Practice BSI if blood or other potentially infectious fluids are present.
Have PPE readily available.
HIV cannot live in a dry environment for more than a few hours
HBV can live in a dry environment for at least 7 days
Once the virus is dead - it’s dead. You cannot “reactivate” it by adding water.
Consider everything contagious
Personal Protective Equipment (PPE)
MUST be provided free of charge
PPE is carried on all EMS apparatus
Fire fighting gear offers little or no protection
If possible, use as much disposable equipment as possible.
Reusable equipment should be decontaminated with a germicidal solution as soon as possible / practical.
Consider patient’s clothing / belongings as contaminated if soiled.
Needles & Sharps Disposal
Needles should not be recapped or manipulated by hand.
Disposable blades and other sharps should be placed in a puncture-resistant container.
Puncture-resistant containers should be readily available at all times.
Scissors, glass, lancets should be considered.
Wash hands upon arrival at hospital or returning to quarters.
Use utility or designated sink -- not the food preparation area.
Wash thoroughly with soap & water or germicidal cleanser.
Antiseptic hand cleaners should be available for special situations.
Cleaning & Decontaminating Spills of Blood:
Wear gloves and clean with disposable towels. Place soiled linens in a red plastic bag.
Wear eye & face protection if splashing is a possibility.
Wear shoe covers if amount of blood is great.
Decontaminate with tuberculocidal solution or 10:1 solution of bleach. Wipe area with clean towels and let air dry.
Waste/unused cleaning solution should only be poured down sanitary drains. Sinks shall be disinfected after use.
Remove contaminated items, shoe coverings, etc. and place in a red plastic bag for proper disposal. Remove gloves last. Wash hands after removing gloves.
Handle soiled items as little as possible.
If possible, remove soiled linens at place of use and place in red plastic bags that prevent leakage.
Records MUST BE kept for the duration of employmentplus 30 years.
Exposures MUST BE reported as soon as possible so the post-exposure documentation can be completed and the post-exposure evaluation procedures initiated.
What is a Significant Exposure?
Refers to an exposure which carries the potential for transmission of HIV
“Significantly Exposed” means . . .
Sustained a contact which carries a potential for a transmission of HIV, by one or more of the following:
1) Transmission, into a body orifice or onto mucous membrane of blood; semen; vaginal secretions; cerebrospinal, synovial, pleural, peritoneal, pericardial or amniotic fluid; or other body fluid that is visibly contaminated with blood.
Guidelines & Procedures
Pre-hospital providers should have on record their past medical history
Each ambulance should have a hand washing product and surface cleaner available at all times.
Most EPA approved germicidals OK
10% bleach may be substituted but some equipment could be bleach sensitive.
Hand Washing should be done before & after contact with patient
Gloves should be worn when there is any risk with bodily fluids
Masks, gowns and protective eyewear should be worn when there is any risk of splattering or spraying of infectious material
Soiled clothing – linens should be placed into leak proof bag, sealed and transported to ER. Rescuer clothing laundered ASAP.
Sharps should be handled with extreme caution. DO NOT RECAP, BEND or CUT USED NEEDLES. Use appropriate puncture resistant containers.
Where possible, disposable equipment should be used on all patients. Where not possible equipment should be cleaned immediately with a commercial disinfectant or bleach solution.
CPR should use appropriate protection, avoid mouth-to-mouth, clean & disinfect if not disposable.
Exposure to blood or body substance, should:
Fill out “Exposure form”
Evaluation by ED within one hour
Follow-up determined by ED in accordance with Policy
Provider reports incident to Employer
Exposure to eyes should necessitate immediate irrigation & evaluation by Fermilab Office or ED if off hours.
Exposure to skin should necessitate washing with warm soap & water or commercial agent, & seek evaluation by Fermilab Medical Office or ED if off hours.
EXPOSURE CONTROL PLAN
FESHM CHAPTER #5072
Questions or Concerns?
nipulated by hand.
Sharps should be handled with extreme cauti