Bloodborne Pathogens Standard

Requirements
TOSHA believes the information in this presentation
to be accurate and delivers this presentation as a
community service. As such, it is an academic
presentation which cannot apply to every specific
fact or situation; nor is it a substitute for any
provisions of 29 CFR Part 1910 and/or Part 1926
of the Occupational Safety and Health Standards
as adopted by the Tennessee Department of Labor
and Workforce Development or of the
Occupational Safety and Health Rules of the
Tennessee Department of Labor and Workforce
Development.
Bloodborne Pathogens
Pathogenic micro-
organisms present
in human blood that
can lead to diseases
Human immuno-
deficiency virus (HIV)
Hepatitis B (HBV)
Hepatitis C (HCV)
Other Bloodborne Pathogens
Syphilis
Malaria
Brucellosis
Babesiosis
Leptospirosis
Arborviral Infections
Relapsing Fever
Creutzfeld-Jacobs Disease--Mad-cow
Viral Hemorrhagic Fever--Ebola
Potentially Infectious Materials All
Can Transmit Hepatitis B, C, and HIV

Blood Any visibly

contaminated body
Semen
fluid
Vaginal secretions
Any body fluid where
Cerebrospinal fluid differentiation is
Pleural fluid difficult
Pericardial fluid Any unfixed tissue or
Peritoneal fluid organ
Amniotic fluid Aqueous and vitreous
Saliva in dental proc. humors in the eyes
Other Body Fluids
These body fluids do NOT have enough virus in
them to transmit disease UNLESS they are
contaminated with blood
Urine
Feces
Tears
Sweat
Vomitus
Spit
Modes of Transmission
Stick or Cut
Splash to mucous membranes of the eyes,
nose, mouth
Non-intact skin exposure
Universal Precautions
Must be observed
All blood and body fluids are treated as if
known to be infected with HIV, HBV, HCV,
etc.
Do not come into contact with another
person's blood or body fluids
Exposure Control Plan
Employer's plan describing how compliance with
the standard is achieved
Describes what employees are covered
Describes tasks that are covered
Describes post-exposure follow-up procedures
Must be reviewed and updated annually
Must be accessible to employees
Every employee should know the procedure to
follow to obtain a copy
 Exposure Control Plan
Safer Medical Devices
The Exposure Control Plan must be updated every
12 months to reflect evaluation, consideration, and
selection of appropriate devices
Document in the plan the devises evaluated and
those currently used
Front line employees must be involved in the
selection of devices
Handwashing
The single most important aspect of
infection control
Wash hands when contaminated with blood
or body fluids and after removing personal
protective equipment
Use antiseptic hand cleaner clean
paper/cloth towels or antiseptic towelettes
when "in the field"
Wash hands with soap and water asap
 Needles/Sharp Objects
Use sharps with sharps injury prevention or needleless
systems for all procedures involving sharps
Place in puncture resistant, labeled, leak-proof containers for
transport, storage, and/or disposal
Keep the container closed
Do not bend, break, recap, or remove needles
Do not pick up contaminated broken glass directly with the
hands
Do not reach by hand into containers where contaminated
sharps are placed
Do not overfill sharps containers
Eating/Drinking
Do not eat or drink in
areas where there is
exposure to blood or
body fluids
Do not store food in
refrigerators, freezers,
cabinets, on shelves or
countertops where
blood or other body
fluids are present
Personal Protective Equipment
(PPE)
Wear PPE to prevent blood or body fluids
from getting on your clothes, skin,
underclothes, etc.
Must be provided at no cost to the employee
Employer must enforce the use
Must be removed prior to leaving the work
area and placed in designated area
PPE
Parental exposure gloves
stick or cut gowns
Mucous membrane glasses/ goggles
splash masks
Non-intact skin pocket masks
spill or splash
shoe covers
Decontamination
Clean and decontaminate all equipment and
environmental and working surfaces after
contact with blood and/or body fluids
Decontaminate with appropriate disinfectant
EPA registered tuberculocidal disinfectant
EPA registered disinfectant with label stating it
is effective against HIV and HBV
Household bleach, diluted 1:10-1:100, made
fresh daily
Contaminated Laundry
Remove contaminated clothing when it
becomes contaminated
Place immediately in bag or container that
is labeled
Prevent leakage
Regulated Waste
Sharps containers
Needles
Blades
Broken glass
Red bags
Liquid or semi-liquid blood or
Items caked with dried blood
Items that could release blood
Pathological waste
Microbiological waste
Hepatitis B Vaccination
the HBV vaccination must be offered after
the employee has received training and
within 10 working days of job assignment
At no cost
Provided by PLHCP
According to US Public Health Service most
current recommendations
Immunization of Health Care Workers:
Recommendations of ACIP and HICPAC, MMWR,
Vol. 46, No. RR-18
 HBV Vaccination
Employees who do not take the shots must sign a
declination statement
Highly recommended
Few contraindications
Three-shot seriestiter 1-2 months after last shot
No booster currently recommended
Each person must have a health care professional's
written opinion
A copy must be provided to the employee within 15
days of completion of the evaluation
An employee can decline now, take the shots later
Written Opinion
Each person must have a health care
professional's written opinion for hepatitis B
vaccination
A copy must be provided to the employee
within 15 days of completion of the evaluation
Post-Exposure Follow-up
After exposure incident
Stick or cut
Splash
Non-intact skin exposure
At no cost
Begin ASAP after exposure incident
Report exposure incident to your supervisor
or designated personnel immediately
Post-Exposure Follow-up
Investigation of the incident
ID source individual, obtain consent, and
test their blood to determine HBV, HCV,
and HIV infectivity ASAP
Results of source individual's test given to
exposed person
Obtain and test exposed person's blood for
HBV, HCV, and HIV serological status
 Post-Exposure Follow-up
Post-exposure prophylaxis as indicated by CDC
Updated U.S. Public Health Service Guidelines for
the Management of Occupational Exposures to
HBV, HCV, and HIV and Recommendations for
Postexposure Prophylaxis June 29, 2001, Vol 50,
No. RR-11
Updated U.S. Public Health Service Guidelines for
the Management of Occupational Exposures to HIV
and Recommendations for Postexposure
Prophylaxis, September 30, 2005, Vol 54, RR-09
Counseling and Evaluation of reported illnesses
Written Opinion
The employee must be provided a copy of
the Health Care Professional's Written
Opinion for Post-Exposure Follow-up
within 15 days of completion of the
evaluation
Labels
Containers with
contaminated items
Can substitute red
Training
For all employees listed in the Exposure
Determination
At no cost to employees
During working hours
At the time of initial assignment
Annually--within 1 year of last training date
Must be opportunity for interactive questions and
answers
Train employees on adopted safer needle devices
before implementation
 Training
Five Easy Questions
What is universal precautions?
What do you do when there is a blood spill?
Personal protection
Clean-up and disposal procedures
Disinfection (hazard communication applies)
What do you do with contaminated sharps and
laundry?
Have you been offered the HBV vaccination free
of charge?
Where is the Exposure Control Plan?
 Additional Training
Copy of the BBP standard, 29 CFR 1910.1030, must be
accessible to you
Explanation of methods of recognizing tasks that may
involve exposure to blood and/or body fluids
Information on types, use, location, removal, handling,
decontamination, and disposal of ppe
Basis of selection of ppe
Actions to take and persons to contact in a bloodborne
emergency that you do not know how to handle
Procedure to follow if exposure incident occurs
Opportunity for interactive Q & A
Records
Medical records
Name and social security number
HBV vaccination status
Results of exposure incident follow-up
Health care professional's written opinions
Info provided to health care professional
Confidential
Records
Training
Dates
Contents
Names and qualifications of trainers
Names and titles of persons attending
Records
Sharps Injury Log
Per the Tennessee Sharps Injury
Prevention law
Keep a log of all sharps injuries with
Type and brand of device involved in the
incident
Department or work area where the incident
occurred
Explanation of how the incident occurred
Resources
www.osha.gov www.tennessee.gov/labor-wfd/tosha
www.cdc.gov
www.cdc.gov/niosh
Memphis Office 901-543-7259
Jackson Office 701-423-5641
Nashville Office 615-741-2793
1-800-249-8510
Knoxville Office 865-594-6180
Kingsport Office 423-224-2042
Chattanooga 423-634-6424
Consultative Services 1-800-325-9901