Infection Control and Management of Hazardous Materials

Not a regulatory agency. Its role is to issue specific recommendations based on sound scientific evidence on health-related matters

Centers for Disease Control and Prevention (CDC)

Regulatory agency. Its role is to issue specific regulations, also called standards, to protect the health of employees in the United States

Occupational Safety & Health Administration (OSHA)

The most important infection control law in dentistry. It is designed to protect employees against occupational exposure to blood-borne, disease-causing organisms, such as the hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV)

Bloodborne Pathogens (BBP) Standard

Referred to in OSHA's BBP standard. Based on the concept that all human blood and certain fluids (including saliva) are to be treated as if known to be infected with the bloodborne diseases such as HBV, HCV, or HIV infection

Universal Precautions

The CDC expanded on the concept of Universal Precautions and changed the term. It not only applies to contact with blood but also with all body fluids (except sweat), non-intact skin, and mucous membranes

Standard Precautions

Defined by the BBP Standard as "any reasonably anticipated skin, eye or mucous membrane contact, or percutaneous injury, with blood or any other potentially infectious materials"

Occupational exposure

Through the skin, such as needle-sticks, cuts, and human bites

Percutaneous

Contact with mucous membranes, such as the eyes or mouth

Permucosal

Requires the dentist and/or employer to provide training in infection control and safety issues to all personnel who can come in contact with blood, saliva, or contaminated instruments or surfaces. Requires the dentist and/or employer to offer the HBV vaccination series to all employees whose assignments include category I or II tasks (the vaccine must be offered within 10 days of assignment to an occupational exposure category I or II). Prohibits an employee from taking protective clothing home to be laundered. Laundering contaminated protective clothing is the responsibility of the employer

BBP Standard

Contaminated needles and other disposable ___ such as scalpel blades, orthodontic wires, and broken glass, must be placed into a container that is puncture resistants, closable, leakproof, and color-coded or labeled with the biohazard symbol

Sharps

When wearing gloves, when should you wash your hands?

Before and immediately after wearing gloves

OSHA's BBP Standards requires the employer to provide (without charge) employees with appropriate ____ such as protective clothing, surgical masks, face shields, protective eyewear, disposable patient treatment gloves, and heavy-duty utility gloves

Personal protective equipment (PPE)

Worn to protect the eyes against damage from aerosolized pathogens, such as herpes simplex viruses and staphylococci, and from flying debris, such as scrap amalgam and tooth fragments, and splattered solutions and caustic chemicals

Protective eyewear

Gloves worn for invasive procedures involving the cutting of bone or significant amounts of blood or saliva, such as oral surgery or periodontal treatment

Sterile surgical gloves

Gloves are used when the treatment room is being cleaned or disinfected, when contaminated instruments are being cleaned or handled, and for surface cleaning and disinfecting

Utility gloves

Waste that presents a danger to humans or the environment (eg, toxic chemicals). Handling requirements: follow specific state and local regulations

Hazardous waste

Waste that has been in contact with blood or other body fluids (eg, used barriers, patients' napkins). Disposed of general waste (in most states)

Contaminated waste

Waste that is capable of transmitting an infectious disease, eg, blood and blood-soaked materials, pathologic waste, and sharps. Handling requirements: follow specific state and local regulations. Containers must be labeled with the biohazard label

Infectious waste or regulated waste (biohazard)

Blood or saliva that can be squeezed out, or dried blood that may flake off an item. Handling requirements: follow specific state and local regulations

Infectious waste or regulated waste (biohazard)
- Blood and blood-soaked materials

Soft tissue and extracted teeth. Handling requirements: follow specific state and local regulations. Never dispose of extracted teeth with amalgam restorations with waste that will be incinerated (burned)

Infectious waste or regulated waste (biohazard)
- Pathologic waste

Contaminated needles, scalpel blades, orthodontic wires, endodontic instruments (eg, reamers, files). Containers should be closable, leakproof, puncture-resistant, and color-coded red and marked with the biohazard symbol. The container should be located as close as possible to the work area

Infectious waste or regulated waste (biohazard)
- Sharps

Issued by OSHA and requires employers to inform their employees about the identity and hazards of chemicals that they see in the workplace. Also known as the "Employee Right-to-Know Law"

Hazards Communication Standard (HCS)

In 2012, OSHA revised the HCS and adopted the

Globally Harmonized System (GHS) of Classification and Labeling of Chemicals

1. Written program
2. Chemical inventory
3. Safety data sheets (SDSs)
4. Labeling
5. Employee training

Hazard Communication Standard

Contains health and safety information about every product in the office that contains chemicals. Provides comprehensive technical information and is a resource for employees working with chemicals and describing the physical and chemical properties of chemicals, their health hazards, routes of exposure, and precautions for safe handling and use, as well as emergency and first-aid procedures and spill control measures. The manufacturer is required to supply the dental office with a __ for the product

Safety Data Sheet (SDSs)

As of June 1, 2015, all labels will be required to have a harmonized ___, ____ and ___ for each hazard class and category. Secondary containers that hold chemicals are also required to be labeled, such as automatic x-ray film processors and manual processing tanks, ultrasonic cleaning tanks, and chemical vapor sterilizers

Signal word, pictogram, and hazard statement

Chemicals are classified into categories that compare hazard severity within a hazard class. Once a chemical is classified, warnings are automatically assigned so that each chemical in the same category will have the same label requirement and language. The two most important considerations are that: 
1. OSHA HCS labels are used.
2. All employees are properly trained to understand and read the label

Hazard classification

Order of putting on PPE

Mask, protective eyewear, gloves

Order of taking off PPE

Gloves, protective eyewear, mask