Bloodborne Pathogens

Bloodborne Pathogens
Needlestick/Sharps Injury Prevention
Office of Engineering Safety

Texas Engineering Experiment Station (TEES) & The Dwight Look College of Engineering
A safe, healthful, and secure environment for scholarship and research.
Bloodborne Pathogens Scope and Coverage
Original thrust was aimed at:

Hospitals First Responders (ambulance, fire, police) Dental practices
Non medical classifications:

Funeral directors and morticians Police crime labs Barbers and cosmetologists
Scope and Coverage also effects: Maintenance and Custodial workers Bloodborne Pathogens
Housekeeping and Laundry services

Waste Handling and Disposal services
OSHA Regulation 29CFR 1910.1030 History & Effective Dates Purpose of the Regulation Employer Requirements Scope and Coverage Exposure Control Plan
Bloodborne Pathogens 1991-
OSHA publishes the final regulation for Bloodborne Pathogens in December.

19921992-
OSHA regulation effective in March
Deadline for the completion of the written Exposure Control Plan (May)
2000-
Needlestick Safety and Prevention Act
Needlestick Safety and Prevention Act Timeline
P. L. 106-430 signed; November 6, 2000

Revised Standard published in Federal Register; Jan. 18, 2001 Effective date; April 18, 2001
Enforcement of new provisions; July 17, 2001

Adoption in OSHA state-plan states; October 18, 2001
Revisions to Standard
Additional definitions, paragraph (b) New requirements in the Exposure Control Plan, paragraph (c) Solicitation of input from non-managerial employees, paragraph (c) Sharps injury log, paragraph (h)
Bloodborne Pathogens Standard

Major Provisions by Paragraph Bloodborne Pathogens (b) (c) (d) Definitions Exposure Control Plan (ECP) Engineering and Work Practice Controls
- Personal Protective Equipment (PPE)

(e) (f) HIV and HBV Research Labs Vaccination, Post-Exposure Follow-up
(g)
(h)
Labeling and Training

Recordkeeping
To assure that no employee will suffer material health or functional impairment due to an exposure to hazardous agents while in the course of their employment.
Bloodborne Pathogens Requirements of the Employer Employee education and training Protective measures and equipment Written Documentation Record keeping
There is one exemption to the rule!
The Good Samaritan clause

A De minimus classification No penalties for violation
Occupational Exposure
Any reasonably anticipated skin, eye, mucous membrane, or parental contact with blood... .... or any other potentially infectious materials that may result from the performance of an employees duties.
Exposure Determination
The employer must:
Identify worker exposures to blood or other potentially infectious material

Review all processes and procedures with exposure potential Re-evaluate when new processes or procedures are used
Determination of Exposure Potentially Infectious materials include:
Semen Vaginal secretions Cerebrospinal fluid Synovial fluid Pleural fluid Pericardial fluid Peritoneal fluid Amniotic fluid Saliva in dental procedures
Needlestick Prevention and Bloodborne Pathogens
Needlestick incidents do happen!

Be prepared! All needlestick incidents are preventable!
Once the worker has been stuck he has been exposed! Record the incident!! Treat the worker!
Bloodborne Pathogens Employee Education and Training
Epidemiology of bloodborne diseases is the study of the incidence, distribution and control of Hepatitis B and HIV/AIDS
Hepatitis is an inflammation of the liver HIV/AIDS destroys the ability to fight infections
Bloodborne Pathogens Employee Education and Training Symptoms of Hepatitis B
Yellow Eyes & Skin (Jaundice) Abdominal pain Fever and Vomiting Dark Urine Fatigue
Bloodborne Pathogens Employee Education and Training Symptoms of AIDS
Fever Swollen Glands Diarrhea Extreme Weight Loss Skin Lesions Mental Disorientation
Needles come in all shapes and sizes.

Check manufacturers for the safest needle!
Methods of Compliance
Universal Precautions
Engineering Controls
Work Practice Controls Personal protective equipment Housekeeping
Employee Education and Training
Modes of Transmission of Bloodborne Pathogens

Parental
Intravenous Injection Accidental Needlestick

Sexual
Unprotected Sex
Mucous Membrane
Respiratory tract Alimentary tract (Nutrition/Digestive)
Bloodborne Pathogens Control Measures
Serve to reduce employee exposure in the workplace by either isolating the worker from the exposure or removing the hazard
Examples
Surgical gloves Self retracting needles Sharps Containers
Control Measures Work Practice Controls Bloodborne Pathogens
Reduce the likelihood of exposure through the alteration of the manner in which the task is performed.
Examples
Using Gloves Handwashing Method of removing contaminated gloves Recapping needle procedures
Bloodborne Pathogens Control Measures
Personal Protective Equipment (PPE)

Minimizes the risk of infectious materials entering into the workers body through
skin lesions or entry through the eyes, nose, or mouth
Examples
Gloves Gowns Face Shields
Bloodborne Pathogens Control Measures Universal Precautions
An approach to infection control All human blood and human body fluids are treated as if they are infected!
Bloodborne Pathogens HBV Vaccinations HBV Vaccinations are the most important part of HBV infection control Gloves and other PPE do not prevent puncture wounds or unanticipated exposures. Set of three inoculations
Good for ten years
Bloodborne Pathogens Post Exposure Evaluation & Follow Up Exposure Incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parental contact with blood or other infectious materials that result from the performance of an employees duties.
Post Exposure Evaluation & Follow Up Following a report of an exposure incident, the employer provide a confidential medical evaluation which will include: Bloodborne Pathogens
Documentation of route of exposure HIV/HBV status of the source individual Serological testing of the blood ASAP Post exposure vaccine (HBIG) if indicated Medical evaluation of the reported illness Counseling of the exposed individual
Bloodborne Pathogens Regulated Waste Disposal
Contaminated items that:

Would release blood or other potentially infectious materials
IF they are
Pourable Drippable Compressible
Bloodborne Pathogens Housekeeping and Laundry
Keep the worksite clean and sanitary

Use a hospital grade VIRUCIDE OR a 1:10 bleach to water solution
Bloodborne Pathogens Tags, Labels & Bags
Tags and Labels Fluorescent orange or red-orange Lettering in a contrasting color Biohazard symbol in a contrasting color.
Bags must have this label on them (or they must be red in color) and leak proof.
Record keeping The employer shall establish and maintain an accurate record for each employee with an occupational exposure incident. Records shall include: Bloodborne Pathogens
Name & Social Security Number of employee Copy of employees HBV vaccination records Copy of all medical testing and findings Copy of physicians written opinion
Bloodborne Pathogens Record keeping The employer shall maintain records for:
The duration of the employment PLUS 30 years Records must be kept CONFIDENTIAL!
Exposure Control Plan Must Address: Exposure Determination Bloodborne Pathogens
Employee Education and Training

Control Measures HBV Vaccinations Post Exposure Evaluation and Follow Up Regulated Waste Disposal Tags, Labels, and Bags Housekeeping and Laundry Record keeping
Contaminated needles and sharps

Bloodborne Pathogens Account for 20 infectious agents OSHAs primary concern
HIV HBV HCV
CDC
Hospital workers- 348,000 sticks a year! Non-Hospital Healthcare- 590,000 sticks a year
OVER 1600 needle sticks daily!
OSHA Bloodborne Pathogen Standard

Published in 1991 Did not address safer devices Did not address safer best practices
Needlestick Safety and Prevention Act November 6, 2000 Directed OSHA to revise their standard Federal Register can be found at www.osha.gov

Bloodborne Pathogens Four changes to OSHAs regulation Refined definitions Exposure Control Plan modification Mandatory employee input Updated recordkeeping
Exposure Control Plan: 1910.1030(c)
New Provisions
The ECP must be updated to include: Changes in technology that reduce/eliminate exposure Annual documentation of consideration and implementation of safer medical devices Solicitation of input from non-managerial employees
New Definition
means controls (e.g., sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needleless systems) that isolate or remove the bloodborne pathogens hazard from the workplace.
Engineering Controls - includes additional definitions and examples:

Sharps with Engineered Sharps Injury Protections [SESIP]
Needleless Systems
Solicitation of Non-Managerial Employees
New Provision
Identification, evaluation, and selection of engineering controls Must select employees that are: Responsible for direct patient care Representative sample of those with potential exposure
Engineering and Work Practice Controls
The employer must: Evaluate available engineering controls (safer medical devices) Train employees on safe use and disposal
Implement appropriate engineering controls/devices
The employer must:
Document evaluation and implementation in ECP

Review, update ECP at least annually Review new devices and technologies annually Implement new device use, as appropriate and available
The employer must:

Train employees to use new devices and/or procedures Document in ECP

Bloodborne Pathogens Definitions Engineering Controls Needleless Systems Sharps with Engineered Sharps Injury Protection
Definition
Engineering Control
Revised to include:
Safer medical devices All control methods to isolate or remove hazards Includes blunt suture needles, plastic wrapped capillary tubes Includes sharps containers and bio-safety cabinets
Engineering and Work Practice Controls: 1910.1030(d)
Employers must select and implement appropriate engineering controls to reduce or eliminate employee exposure.
Where engineering controls will reduce employee exposure either by removing, eliminating, or isolating the hazard, they must be used.
CPL 2-2.44D
Selection of engineering and work practice controls is dependent on the employers exposure determination.
Definition
Sharps with Engineered Sharps Injury Protection

A needle device or a non-needle device with a built in safety feature Non-needle sharp or a needle with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident.

Bloodborne Pathogens Definition Needleless Systems New methods that do not use needles to collect bodily fluids, blood or deliver medication
Hypodermic syringes with Self-Sheathing safety feature

Self-sheathed protected position
Hypodermic syringes with Retractable Technology safety feature

Retracted protected position
Phlebotomy needle with Self-Blunting safety feature

Blunted protected position
Add-on safety feature
Attached to syringe needle
Attached to blood tube holder
Retracting lancets with safety features

Before
During
After
Before
During
After
In use
After use
Disposable scalpels with safety features

Retracted position
Protracted position
Protracted position
Changes to the Exposure Control Plan

Annual review must reflect changes in technology Review of commercially available devices must be addressed

Bloodborne Pathogens Non-managerial employees must have input to Exposure Control Plan Review May include: Lab technicians Housekeeping Staff
Maintenance Workers
Direct patient care providers
Employee Input
A representative sample A range of exposure situations Document it!

Bloodborne Pathogens Recordkeeping Needlestick Log!! Confidential Use to determine high risk areas Evaluate devices
Sharps Injury Log
At a minimum, the log must contain, for each incident:

Type and brand of device involved
Department or area of incident

Description of incident Only mandatory for those keeping records under 29 CFR 1904
RecordkeepingNeedlestick Log must contain: Type of device Brand of device Department or work area Explanation of how the incident occurred
OSHA 200 system

Separate needlestick log required May or may not be recordable! OSHA 200 to be replaced by OSHA 300

Bloodborne Pathogens OSHA 300 system
Sharps injuries recorded on OSHA 300. Must include brand and type of device Must be able to segregate sharps injuries
Use a separate OSHA 300 form for the needlestick log OSHA 301 form for each incident! Computers must be able to sort by needlesticks!
Bubonic and Pneumonic Plague!
Hanta Virus
46 year old elementary school teacher Colorados fifth Hanta Virus victim in a year
She lasted five days

Lived on a ranch with husband and 3 children 200 cases nationwide
Wash Your Hands
After using toilet:
Women 74%
Men 61%
New York City- 60% Chicago- 78% New Orleans- 69%
Atlanta Braves Game Women 89% Men 46% Pass the popcorn!!
Prepared by:
http://engineering.tamu.edu/safety/
Needlestick/Sharps Injury Prevention
Office of Engineering Safety

Texas Engineering Experiment Station (TEES) & The Dwight Look College of Engineering
A safe, healthful, and secure environment for scholarship and research.

Bloodborne Pathogens

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Bloodborne Pathogens

Uploaded by

Copyright:

Available Formats

Bloodborne Pathogens

Needlestick/Sharps Injury Prevention

Office of Engineering Safety

A safe, healthful, and secure environment for scholarship and research.

Original thrust was aimed at:

Non medical classifications:

Housekeeping and Laundry services

OSHA publishes the final regulation for Bloodborne Pathogens in December.

OSHA regulation effective in March

Needlestick Safety and Prevention Act

Needlestick Safety and Prevention Act Timeline

P. L. 106-430 signed; November 6, 2000

Enforcement of new provisions; July 17, 2001

Bloodborne Pathogens Standard

- Personal Protective Equipment (PPE)

Labeling and Training

The Good Samaritan clause

The employer must:

Identify worker exposures to blood or other potentially infectious material

Needlestick Prevention and Bloodborne Pathogens

Needlestick incidents do happen!

Needlestick Prevention and Bloodborne Pathogens

Needlestick Prevention and Bloodborne Pathogens

Needles come in all shapes and sizes.

Modes of Transmission of Bloodborne Pathogens

Intravenous Injection Accidental Needlestick

Respiratory tract Alimentary tract (Nutrition/Digestive)

Personal Protective Equipment (PPE)

skin lesions or entry through the eyes, nose, or mouth

Good for ten years

Contaminated items that:

Keep the worksite clean and sanitary

Employee Education and Training

Needlestick Prevention and Bloodborne Pathogens

Contaminated needles and sharps

HIV HBV HCV

Needlestick Prevention and Bloodborne Pathogens

OVER 1600 needle sticks daily!

Needlestick Prevention and Bloodborne Pathogens

OSHA Bloodborne Pathogen Standard

Needlestick Prevention and Bloodborne Pathogens

Needlestick Prevention and Bloodborne Pathogens

Exposure Control Plan: 1910.1030(c)

Engineering Controls - includes additional definitions and examples:

Solicitation of Non-Managerial Employees

Engineering and Work Practice Controls

Implement appropriate engineering controls/devices

Engineering and Work Practice Controls

The employer must:

Document evaluation and implementation in ECP

Engineering and Work Practice Controls

The employer must:

Needlestick Prevention and Bloodborne Pathogens

Needlestick Prevention and Bloodborne Pathogens

Engineering and Work Practice Controls: 1910.1030(d)

Engineering and Work Practice Controls

Needlestick Prevention and Bloodborne Pathogens

Sharps with Engineered Sharps Injury Protection

Needlestick Prevention and Bloodborne Pathogens

Hypodermic syringes with Self-Sheathing safety feature

Self-sheathed protected position

Hypodermic syringes with Retractable Technology safety feature

Retracted protected position

Phlebotomy needle with Self-Blunting safety feature