Bloodborn Pathogens

What is a Pathogen

• Infectious diseases caused by living organisms

  • E.g. Bacteria of viruses

• Communicable diseases: be spread from one person to another

How Bloodborne Pathogens are Spread

1. Pathogen is present

2. Sufficient number of pathogen present

3. Pathogen passes through entry site

4. Person is susceptible to the pathogen

Diseases

• Hepatitis B

  • Transmitted via blood/blody fluids

  • Needle stick risk is 6-30% per incident

  • People with HBV show little or no sign and symptoms of the disease

  • Diagnosis is usually made by blood test

  • Prolonged undetected/untreated HBV, cirrhosis of the liver may occur

  • Signs and Symptoms

    • Jaundice

    • Abdominal Pain at RUQ

    • Fatigue

    • Loss of Appetite

    • Nausea and Vomiting

    • Low grade fever

    • Pale or clay colored stools

    • Dark urine

    • Generalized Itching Ascites

    • Bleeding Varices (Esophageal)

• Hepatitis C

  • Transmitted via blood or bodily fluid

  • Needle sick risk is 1.8% per occurrence

  • Known exposure routes:

    • IV drug use

    • Transfusion or transplant from infected donor

    • Occupational exposure

      • needle stick

    • Unsafe injection technique

    • Birth from infected mother

    • Sex with infected partner

      • Increases probabality w/ multiple partners

  • Signs and Symptoms

    • Short, mild, flu-like illness

    • Nausea and vomiting

    • Diarrhea

    • Loss of appetite

    • Wight loss

    • Haundice

    • Itchy skin

• HIV/AIDS

  • Occupationally transmitted via blood or blood contaminated bodily fluids

  • Risk of acquiring HIV after a needle stick injury is 0.3%

  • Common routes of transmission

    • Open cuts

    • Breaks in the skin

    • Mucous membranes

    • Direct injection

  • Signs and symptoms

    • Stage I

      • Flu-like illness within 3-6 weeks after exposur

      • Fever

      • Headaches

      • Tiredness

      • Nausea

      • Diarrhea

      • Enlarged lymph nodes

    • Stage II

      • Lasts for 6 or more years in 65-85% of cases

      • Patient has no symptoms

      • Disease continues to multiply

    • Stage III

      • Diarrhea

      • Weight loss

      • Sinus infection

      • Fatigue

      • Nausea and vomiting

      • Prone to opportunistic infections such as

        • Thrush

          • Infection with a naturally occuring yeast found in the body

          • Causes white patches in the mouth, throeat, and esophagus

        • Kaposi’s Sarcoma

          • A cancer that does not occur within normal immune systems

Specific Measures to Decrease Risk

• Administrative Controls

  • Company creates an Exposure Plan, monitors, and tracks employees for compliance

  • Company determines who is at risk and puts engineering controls in place to mitigate exposure

• Engineering Controls - Physical barriers put into place to reduce exposure to bloodborne pathogens

  • Employee must use appropriate PPE like: Gloves, gown, face shields, mask, eye protection, mouthpieces, resuscitation bags, pocket masks.

    • Mask + eye protection must be used when there is anticipation for splashing of infectious materials that can contaminate the eyes, nose, or mouth

    • Appropriate protective clothing must be worn in potential occupational exposure

    • Surgical caps/hoods or shoes covers must be worn when gross contamination can be anticipated

    • All disposable PPE is single use

    • Replace damaged PPE

    • Dispose of biohazard waste only in approved containers

  • Laundry

    • Bag contaminated laundry where it is used and not sorted?

  • Biohazard Marking

    • Containers must be closable

    • Prevent lakage

    • Closed prior to removal to prevent leakage

    • Puncture resistant

    • Labeled or color coded in red bags

  • Disposal

    • Regulated waste that has been decontaminated does not need special labeling

  • Specimen Handling

    • Specimen of potentially infectious materials shall be placed in container that prevents leakage during

      • Collection

      • Handling

      • Processing

      • Storage

      • Transport

      • Shipping

  • Labeling

    • If piece of equipment is contaminated, must be labeled to identify which portions

• Work Practice Controls - Policies and procedures on how certain tasks are completed

  • Needles

    • If needles ever need to be recapped, utilize the one-handed technique or a mechanical device

    • Should never be:

      • Bent

      • Removed

      • Broken

      • Sheared

      • Recapped

      • Reused

    • Place directly in a sharps container after use

  • Universal Precautions Policy

    • Must be observed at all times

    • All body fluids should be considered infectious materials

    • After removing gloves/PPE wash your hands

    • After exposure to bloody or potentially infectious materials immediately or ASAP:

      • Wash affected skin with soap and water

      • Affected mucus membranes must be flushed

    • Hand Washing

      • Get between fingers and fingernails

      • Washing should last 20-30 seconds

      • Use of alcohol gel when handwashing is unavailable (temp solution)

• House Keeping

  • Decontamination

    • Equipment that may have become potentially contaminated with infectious materials must be:

      • Examined prior to servicing

      • Decontaminated

    • Visually inspect all equipment for specs of dried blood or bodily fluids

      • Pathogens can become encapsulated and remain active in the dried material

    • All equipment and working surfaces must be cleaned and decontaminated after contact with blood or other potentially infectious materials (OPIM)

    • All reusable items must be cleaned and decontaminated after use

      • Bp cuffs

      • Stethoscope

      • Ect.

    • Reusuable equipment that is contaminated must be cleaned before the next use

      • Clean with 1:10 bleach solution

    • Don’t clean single use items

• HBV Vaccine