Bloodborne Pathogens &

Communicable Diseases
Jennifer Long
Industrial Hygienist
United Federation of Teachers
M600 - Fashion Institute
6/7/2018
Course Objectives
• What are Bloodborne Pathogens?
• Why are they harmful?
• OSHA Bloodborne Pathogen Standard
• How does the standard apply at the school-level?
• What must you do to protect yourself and your
workers?
• Communicable disease in the school setting
What is a bloodborne
pathogen
Bloodborne pathogens are infectious microorganisms in human blood that can
cause disease in humans.

What is other potentially

infectious materials (OPIM)?
Other potentially infectious materials (OPIM) means any other body fluids
including semen, vaginal secretions, cerebrospinal fluid, etc that is visibly
contaminated with blood, and all body fluids in situations where it is difficult
or impossible to differentiate between body fluids.
Body Fluids : What Body Fluids Transmit Bloodborne
Diseases?
Blood CAN transmit: • Urine, tears, sweat, vomit
CANNOT transmit bloodborne
• - HIV diseases (unless contaminated
• - Hepatitis B with blood). These fluids may
transmit some other diseases.
• - Hepatitis C
• - Other rarer diseases

Semen/vaginal fluid CAN transmit:

• - HIV
• - Hepatitis B
• - Hepatitis C

Casual Contact CANNOT Transmit

Bloodborne Diseases
How Can I Get Infected at Work?
• Helping with certain
medical tasks.
• A bite from a child or
a parent.
• Breaking up fights.
• Diapering, toileting,
feeding, cleaning up
vomit.
The ABCs of Bloodborne Diseases

A. AIDS/HIV
B. Hepatitis B
C. Hepatitis C
AIDS/HIV
• HIV is a virus that attacks the immune system.

• When your immune system doesn’t function well due to HIV,

you can develop other diseases. This is called AIDS.

• HIV is fragile. It is killed by sun, alcohol and bleach. It lives

for less than one hour outside the body only in wet blood.
Hepatitis B
• Virus that attacks the liver.
• Symptoms include jaundice, fever, weight loss,
weakness.
• Hepatitis B is stronger than HIV. It can live outside the
body in dried blood for 7 days.
• Easily prevented by vaccine.
Hepatitis C
• Virus that attacks the liver.
• No symptoms for up to 20 years, but those infected can still
transmit the virus.
• Once symptoms occur, it s very serious because the liver is so
damaged.
• No vaccine exists.
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Purpose: To prevent needlesticks and exposure to blood
and body fluids that contain blood.
WHAT IS REQUIRED:
 Identify workers at risk.
 Develop and implement a written program to protect workers
(Exposure Control Plan)
 Training Workers.
 Provide Hepatitis B vaccination.
 Practice Universal Precautions.
 Provide gloves, masks and other personal protective
equipment.
 Provide prompt evaluation and treatment when exposed.
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 1: Appoint a (Site Employee Safety Administrator
(SESA)
• Principal appoints a SESA
• SESA should be an administrative level person
• He/she will be responsible for:
– Maintaining the School’s compliance
– Categorizing at-risk employees who may come in contact with
blood or other potentially infectious materials (OPIM)
– Following up with training to at-risk employees
– Scheduling Hepatitis B Vaccination
– Point person in any bloodborne pathogen related incidents
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 2: Identify workers at risk

Depending on Job Title and specific Job Duties, a list will be

automatically generated for all of the school’s employees by the BBP CT.
• The SESA must identify all employees whose work is likely to involve
routine contact with blood or OPIM (At-Risk Employees)
Category A Category B Category C
All D/75 Staff,, etc…) Principals and Classroom Teachers
assistant Principals

Designated CPR/First Custodians

Aid responder or Epi-
Pen Administrator
School nurses Lab Teachers
PE Teachers
• *If an Employee feels he or she belongs in different category, the
SESA has the authority to change his or her category as needed.
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 3: Complete the Exposure Control Plan

• A generic exposure control plan can be downloaded and made

site specific when the SESA completes the prompts provided
by the BBP CT.
• A completed site specific Exposure Control Plan Poster should
then be printed and posted on the Health and Safety Bulletin
Board.
Link to blank template:
http://schools.nyc.gov/NR/r
donlyres/FCF562AD-4A5E-
441F-975E-
EFCC4119D551/0/NYCDO
EBLOODBORNEPATHOG
ENSEXPOSURECONTRO
LPLAN20062007.pdf
What is an Exposure Control Plan?
An Exposure Control Plan is the focal point of any bloodborne pathogens
exposure prevention program. It details in writing your plan for reducing
exposures to blood and explains what steps to take if an exposure
occurs. The plan specifies all steps taken your facility to protect your
workers.

Why is an Exposure Control Plan Important?

First — and most important — your Exposure Control Plan helps you
protect your workers from exposure to bloodborne pathogens.

Your Exposure Control Plan must be:

•Specific to your facility
•Updated yearly, and
•Accessible to workers.
Basic Elements of an Exposure
Control Plan
Written policy for protecting employees from bloodborne pathogens exposures

Administration of bloodborne pathogens program

Be sure to designate a responsible individual.

Employee exposure determination

Include a list of all job classifications in which employees are most likely exposed to blood and
body fluids and a second list of job classifications in which employees may be exposed to blood
and body fluids.

Hepatitis B vaccination provisions Universal precautions

Treat all blood and other body fluids as if they are infectious.

Employee education and training

Be sure to include both initial and annual training.

Facility-specific methods for control of bloodborne pathogens

Engineering controls (e.g., safer sharps)
Work practice controls (housekeeping, hand washing, labeling,
and disposal procedures)
Personal protective equipment (PPE)

Post-exposure reporting, evaluation, counseling, and follow-up procedures

Procedures for evaluating circumstances surrounding an exposure incident
Recordkeeping, including compliance monitoring and annual plan updates
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 4: Train At-Risk Employees

• Once the at-risk-employees have been categorized by

the SESA, the employee will receive an email to his or
her DOE email address.
• Employees will receive a link to an internet based
training session
• Must be released (for duration of training) and
completed during school time
– * New At-Risk-Employees must receive the training and be
offered the Hepatitis B Vaccine within 10 days of assignment. *
All At-Risk Employees must receive ANNUAL training.
• Training should include UNIVERSAL PRECAUTION.
Universal Precaution
All blood or body
fluids are
considered
infectious;
therefore, each
employee who
performs any
procedure
related to blood
or other body
fluids must
adhere to all
necessary
precautions.
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 6: In-house PPE and Housekeeping

• Provide Personal Protective Equipment (PPE)

– Example: Gloves, aprons and sleeves must be provided
to employee free of charge.
• Housekeeping
– All surfaces contaminated with blood or OPIM must be
decontaminated with a bleach solution or EPA approved
disinfectant.
– A cleaning schedule must be posted in medical and change
rooms.
– SESA will develop a cleaning schedule.
Prevention is Protection and It’s Easy!
• Use Universal Precautions – assume everyone
could be infected.
• Wear gloves when coming into contact with any
blood or body fluids.
• Gloves in all sizes and powder-free if needed.

• Wash your hands before you put your gloves on

and after you take them off.
• Access to running water and soap

• Get the Hepatitis B vaccine.

This is your right under the law!

Blood and Body Fluids: Properly Remove Disposable Gloves
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 5: Provide Hepatitis B Vaccinations

• Once at-risk employees have

completed online training:
– They will be offered the Hepatitis B vaccine
(free of charge) via email from DOE email
account
– SESA must schedule an appointment
during school time for vaccinations to
take place.
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 7: Post Exposure follow-up

• Any employee, regardless of category, must be

offered the opportunity to seek free medical
attention if he or she has been exposed to
blood or other potentially infectious materials.
• An employee can go to designated Health and
Hospital Corporation (HHC) facilities or to his
or her own doctor.
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 7: Post Exposure follow-up

• If there has been a bloodborne pathogens exposure, the

employee should:
– Wash the affected are with soap and Water IMMEDIATELY.
(Needlestick or blood splash in the eye or mouth should be
flushed with water).
– Notify the Chapter Leader and SESA.
– Get a “P-Card” from school to get free transportation to and from
an HHC facility or personal physician.
– Receive a “Post-Exposure Medical Services Referral” form to
receive free treatment at the HHC facility or from one’s personal
physician.
– Receive a copy of the “DOE Exposure Incident Package”
– Go to a designated HHC facility or personal physician for
treatment
– There are no out-of-pocket expenses for treatment at an HHC
facility. The out-of-pocket expenses for co-pays for treatment by
one’s personal physician will be reimbursed by the DOE.
Health and Hospital
Corporation (HHC)
OSHA Bloodborne Pathogen Standard
(29CFR 1910.1030)
Step 8: Recordkeeping

• Recordkeeping
• SESA need to keep will keep records of employee:
– Training and vaccination
– Vaccine acceptance or declination
– All email notifications
– Non-responsive employees
– Records must be made available to representatives from PESH
and employee representative (Chapter Leader) with employee’s
consent.
• Records must be kept at school.
Summary
• You can be infected with HIV, Hepatitis B or
Hepatitis C if the virus enters your bloodstream.
• Use Universal Precautions. Assume everyone is
infected.
• Wear gloves and wash your hands.
• Get the Hepatitis B vaccine.
Bugs, Bites & Other
Childhood Diseases
MICROBES UNDER THE
MICROSCOPE

•Streptococci
Bacteria •Protozoa
 COMMON DISEASES & INFECTIONS WITH THEIR MICROBIAL
CAUSES
Bacteria Fungus Protozoa Virus
Athlete’s foot
Chickenpox
Common cold
Diarrheal disease
Flu
Genital herpes
Malaria
Meningitis
Pneumonia
Sinusitis
Skin diseases
Strep throat
Tuberculosis
Urinary tract infection
Vaginal infections
Viral hepatitis
INCUBATION PERIOD
• Incubation is the period between exposure to
the microbe and when infection or disease
occurs and the symptoms actually begin.
• There are people who may be infectious for
some illnesses and able to spread the infection
during the incubation period, but are without
symptoms themselves.
• For example, Fifth’s Disease is a mild rash,
spread by exposure to airborne droplets.
However, the incubation period is prior to the
onset of the rash.
Acute vs. chronic conditions
 •MODES OF
TRANSMISSION

•AAA CHOOO •Touching

•Through the infectious material
air
Pets & tiny critters
 •DEFENSE
MECHANISMS
Second line of defense

First line of defense

Handwashing
Experts agree that the single most effective practice to
prevent the spread of germs is good handwashing
• Upon arrival at work.
• Before handling food or
feeding children.
• After using the toilet.
• Before and after assisting a
child in using the toilet.
• After changing diapers.
• After contact with runny
noses, vomit or saliva.
• After handling pets
• After removing gloves.
• Before going home.
PREVENTION: VACCINATION
•Here are some examples
of vaccinations:
 Childhood vaccines: measles,
mumps & rubella
 Chickenpox
 Tetanus
 Diphtheria
 Flu
 Hepatitis B
PREVENTION: CUSTODIAL CLEANING
 NEW YORK STATE MANDATES
"GREEN CLEANING

GUIDELINES AND SPECIFICATIONS FOR THE PROCUREMENT AND USE OF

ENVIRONMENTALLY SENSITIVE CLEANING AND MAINTENANCE PRODUCTS
FOR ALL PUBLIC AND NONPUBLIC ELEMENTARY AND SECONDARY
SCHOOLS IN NEW YORK STATE AND FOR THE PROCUREMENT AND USE OF
ENVIRONMENTALLY PREFERRED CLEANING PRODUCTS FOR STATE
AGENCIES/PUBLIC AUTHORITIES IN NEW YORK STATE

• These Guidelines and Specifications were developed in consultation with

representatives of the Department of Environmental Conservation, Department of
Health, Department of Labor and State Education Department, as directed by
Chapter 584 of the Laws of New York, 2005 and Executive Order No. 134, 2005.
(Even though EO 134 is a distinct and separate document, the guidelines and
specifications established for the New York State school districts, along with the
approved cleaning product lists developed as a result of the legislation that required
all schools to use green cleaning products, are also applicable for the selection and
use of cleaning products for State Agencies under EO134.)

Purpose of Guidelines and Specifications

•The primary focus of this process is to protect children and employee health by
enabling schools to select products that clean effectively and minimize any adverse
impacts on children and employee health and the environment. Even more so than
adults, children can be vulnerable to, and may be severely affected by, exposure to
chemicals, hazardous wastes, and other environmental hazards.
Common childhood
illnesses encountered in
schools
• Common Cold & •Impetigo

Influenza •Conjunctivitis

• Chickenpox •Ringworm

• Fifth Disease •Pediculosis (Lice)

• Whooping Cough •Strep Throat
COMMON COLD/INFLUENZA
•Viruses are
Transmitted by:
– Direct Contact
– Inhaling Air-
Borne Droplets
– Indirect Contact
with Hands and
Articles Freshly
Soiled
CHICKEN POX
•Adults are at a Higher Risk of
Complication:
• HIV Infected Individuals can
Develop Shingles Soon After
Infection
• Newly Infected Pregnant
Women can Pass the Virus to a
Fetus
• The CDC now Recommends
that School Staff who have
Never had Chicken Pox be
Immunized
FIFTH DISEASE
•Children are Most Infectious
before the Rash Appears.
•A Newly Infected
Mother whose Fetus
Becomes Infected May
Develop Anemia and a
Swelling of the Fetus,
Leading to Many Organ
Complications and Can
be Fatal.
STREP THROAT and SCARLET FEVER
• Untreated Infected People can
Transmit the Bacteria for 2-3 Weeks
• Both Strep Throat and Scarlet Fever
are Effectively Treated with
Antibiotics
• Treatment with Antibiotics will End
Transmission within 24 Hours
•Group A strep bacteria can live in a
person’s nose and throat. The bacteria
spread through contact with droplets
from an infected person’s cough or
sneeze.
IMPETIGO
•Strep can also Cause
Impetigo
•A Bacterial Skin
Infection that Occurs
around the Mouth, Nose,
and Throat
• Spread by Direct
Contact with Infected
Skin
• Treated with Antibiotics
CONJUNCTIVITIS
•Also Known as “Pink Eye”
• It can be a Viral, Bacterial,
or Fungal Infection
• Prevention with Good
Hygiene: Keep Hands Clean
and Away from Eyes.
• Viral and Bacterial forms
are Highly Contagious and
Spread by Direct or In-direct
Contact
RINGWORM

• Ringworm is a Fungal
Infection affecting: the Scalp,
Skin, Fingers, Toenails, or
Feet
• Ringworm of the Scalp
makes the Hairs Become
Brittle and Break Off,
Leaving a Bald, Scaly Patch.
• Person to Person
Transmission and Contact
with Contaminated Items
Lice

• Spread by Direct
Contact with an
Infected Person or
with the Objects they
Use
•Larvae attached • Treatment is a
to hair shaft Thorough
Examination and Use
of a “Nit Comb”
•Adult
Louse
Reportable Disease
•Article 11 of the NYC Health Code requires that a number of
diseases and conditions, which have the potential to adversely
affect the health of the general public are reported. The code
requires that physicians, hospitals and institutions, clinical
laboratories and other designated professionals report these
diseases to the NYC Department of Health.

•Outbreaks
•Section 11.03 of the NYC Health Code defines a suspected
outbreak among 3 or more persons of any disease or
condition and of any unusual manifestation of a disease in
an individual should be reported to the DOH immediately.
Paraprofessionals Contract

Effective October 13, 2007 through October 31, 2009

Article Nineteen — Leaves
A. Sick Leave

4. Paraprofessionals serving in schools shall not suffer loss of sick leave

days for absence due to illness from the following children’s diseases:
rubeola (measles), epidemic parotitis (mumps) and varicella (chicken
pox). It is understood that this paragraph does not apply to rubella
(German measles).

5. The Board will approve absences without loss of sick bank days for
paraprofessionals who contract Hepatitis B as a result of working with
children who have been evaluated as presenting a substantial risk of
exhibiting acting out behavior.

6. Employees who are absent due to allergic or positive reaction from a

skin test shall not suffer loss of sick leave days.
Reporting Procedures
• Once confirmed, a letter/DOH fact sheet may be sent out to
the staff and parents by the DOH/DOE School Health
• The DOH/DOE School Health may also meet with the staff

Health DOH/
Chapter District
DOE
Leader Rep &
School
Safety Health
Reporting Procedures
Reporting of Communicable Diseases and Suspected Outbreaks to the
Department of Health and Mental Hygiene (DOHMH)

General Guidelines
For immediate reporting of any suspected or confirmed illness caused by a potential biological
threat agent (e.g., anthrax, smallpox, tularemia or plague) or other disease of urgent public health
concern (e.g., avian influenza or SARS), please call the following numbers and ask to speak to the
DOHMH Doctor on Call:
Business Hours (Monday through Friday 9 AM to 5 PM): Call the Bureau of Communicable
Disease at 212-788-9830

At all other times (Nights, weekends or holidays): Call the Poison Control Center at 1-212-
POISONS ( 212-764-7667)

NOTE: Section 11.03(b) of the New York City Health Code require the immediate reporting by
telephone of a suspected outbreak among 3 or more persons of any disease or condition (whether
it is listed below or not), and of any unusual manifestation of disease in an individual.

Bureau of Communicable Diseases

Telephone: 212-788-9830
Fax: 212-788-4268

http://www.health.ny.gov/forms/instructions/doh-389_instructions.pdf
Course Objectives
• What are Bloodborne Pathogens?
• Why are they harmful?
• OSHA Bloodborne Pathogen Standard
• How does the standard apply at the school-level?
• What must you do to protect yourself and your
workers?
• Communicable disease in the school setting
Contact Us
Safety and Health
United Federation of Teachers
52 Broadway
New York, NY 10004
• p: (212) 598-7758
• f: (212) 677-6612