Biohazard

Safety
in
Healthcare
Objectives
In this course you will learn:
◦ Characteristics of blood-borne pathogens (BBPs) and
other potentially infectious materials (OPIM)
◦ Routes of transmission of infectious agents
◦ Exposure control methods to prevent exposure
◦ Infectious or biomedical waste disposal procedures
◦ How to address accidents and injuries when working with
BBPs and OPIMs
Universal (Standard)
Precautions
“Precautions to protect against exposure must be
taken when there is any potential for exposure to
bodily fluids. It is assumed that all bodily fluids have
the potential to transmit disease”

The Universal Precaution Rule:

Treat all human blood, bodily fluids and other
potentially infectious materials
as if they are infectious.
Blood-borne Pathogens
(BBP)
Blood-borne pathogens (BBP) are specific microorganisms transmitted in
human blood or bodily fluids, which can cause disease in people.
There are three major BBPs:
◦ Hepatitis B (HBV)
◦ causes inflammation of the liver that might lead to liver failure
◦ completely preventable by a vaccine
◦ Hepatitis C (HCV)
◦ also causes inflammation of the liver,
◦ no vaccine to prevent infection
◦ Human Immunodeficiency Virus (HIV)
◦ HIV is a human retrovirus that causes AIDS (Acquired Immune
Deficiency Syndrome).
◦ There is no vaccine to prevent HIV infection.
Other Potentially Infectious
Materials
Besides blood-borne pathogens, there are other potentially
infectious materials (OPIM) found in the public health settings:
◦ Bacteria, Fungi, Rickettsia, Parasites
◦ Other Viruses, including oncogenic (cancer causing) viruses
◦ Recombinant DNA from infectious agents
◦ Cell or tissue cultures of human origin
Routes of exposure
Blood-borne Pathogens such as HBV, HCV and HIV are
transmitted through contact with human blood and bodily
fluids. Contacts include:
◦ “sharps” exposures in occupational settings
◦ sexual activity
◦ sharing of needles
◦ mother-to-child exposures at birth
◦ HIV is passed from one person to another through blood-
to-blood and sexual contact. Infected pregnant women
can pass HIV to their babies during pregnancy, delivery,
and breast feeding.
Routes of exposure
Unbroken skin is a good barrier against BBPs. However, infectious
materials can enter your system through skin openings such as:
◦ Open sores
◦ Cuts
◦ Abrasions
◦ Acne
◦ Sunburn
◦ Blisters
BBPs may also be transmitted through mucous membranes of the
◦ Eyes
◦ Nose
◦ Mouth
Other routes of
exposure
Other types of potentially infectious material (OPIM) can be
transmitted by the following routes:
◦ Inhalation/aerosol exposures
◦ Ingestion, especially of contaminated food or drink
◦ Vector-borne transmission, by mosquito or other biting
insects
Exposure control
Exposure Controls consist of those policies and practices
that prevent occupational exposures to infectious
materials, including:
◦ Administrative Controls
◦ Exposure control plan (ECP)
◦ Individual Laboratory Risk assessments
◦ Universal (Standard) Precautions
◦ Personal Protective Equipment (PPE)
◦ Engineering Controls (HVAC, bio-safety cabinets, self-
sheathing needles, safer medical devices, and needleless
systems)
Exposure control plan
(ECP)
The BBP Standard requires employers to develop written
documents to explain how they will implement the standard,
provide training to employees, and to eliminate or minimize
occupational exposure to blood-borne pathogens to protect the
health and safety of their workers.

The ECP must be tailored to the specific requirements of the

institution; plans must be accessible to all employees, either on-
line or in an area where they are available for review on all shifts.
Exposure control plan
(ECP)
The ECP includes:
◦ Determination of employee exposure and
◦ Implementation of various methods of exposure control, including:
◦ Universal (Standard) precautions
◦ Engineering and work practice controls
◦ Personal protective equipment
◦ Waste segregation, treatment and disposal, including sharps
◦ Hepatitis B vaccination
◦ Post-exposure evaluation and follow-up
◦ Communication of hazards to employees and training
◦ Recordkeeping: Training records, employee health records,
exposure/incident records
◦ Procedures for evaluating circumstances surrounding exposure
incidents
Exposure control plan (ECP)
cont…
Administrative Controls:
◦ Administrative controls, including risk assessments, are
steps taken by supervisors and individual employees,
including:
◦ Conducting a risk assessment of the materials in use
◦ Adhering to vaccination schedules and training
schedules
◦ Training personnel to handle specific infectious
materials and their hazards
◦ Promoting individual awareness of personal protective
equipment use and engineering controls (sample
containers) to minimize or eliminate potential exposure
Exposure control plan (ECP)
cont…
Sharps Precautions
◦ You must exercise care when using needles, scalpels, glass
pipettes and other sharp instruments or devices. Follow these
rules of thumb when handling sharps:
◦ Do not recap, bend, break, or otherwise manipulate used
needles by hand.
◦ Do not remove used needles from disposable syringes.
◦ Place used sharps in labeled or color-coded puncture-
resistant, leak-proof, closable, sharps containers for disposal.
◦ Do not overfill sharps containers.
◦ Consider the use of alternative, non-sharps equipment
whenever possible.
Exposure control plan (ECP)
cont…
Personal Protective Equipment (PPE)
◦ Whenever you may be exposed to infectious materials you must
wear the appropriate personal protective equipment. PPE places a
barrier between you and potentially infectious material.
◦ Here are some basic rules to follow:
◦ PPE should be readily accessible
◦ Always wear PPE in exposure situations-Wear a lab coat, gloves
and eye protection whenever splashing is imminent
◦ Remove and replace PPE that is torn or punctured, or that loses its
ability to function as a barrier to potentially infectious materials
◦ Remove PPE before leaving the work area
◦ Dispose of contaminated PPE properly-in biohazard containers
Exposure control plan (ECP)
cont…
Types of Personal Protective Equipment (PPE):
◦ Gloves
◦ Protective clothing such as, but not limited to, gowns,
aprons, lab coats, clinic jackets, or similar outer garments
◦ Eye protection devices, such as masks, goggles or glasses
with solid side shields, or chin-length face shields
Exposure control plan (ECP)
cont…
Hand Hygiene
◦ Most common mode of transmission of pathogens is via
hands!
◦ Often infections acquired in healthcare and research settings
are due to not washing your hands.
◦ Employees must wash their hands with soap and water:
◦ immediately, or as soon as feasible, after removal of gloves
or other PPE.
◦ whenever they leave the work area, go on break, or before
eating.
◦ following contact with blood or other potentially infectious
materials.
Exposure control plan (ECP)
cont…
Engineering controls
◦ Containment is the concept of managing materials to
reduce or eliminate potential exposures to personnel, the
general public and the outside environment.
◦ Primary containment consists of good microbiological
techniques, appropriate vaccinations or immunizations,
appropriate PPE and safety equipment.
Exposure control plan (ECP)
cont…
Engineering Controls
◦ Needlestick Prevention:
◦ Sharps disposal containers, self-sheathing needles, safer
medical devices, such as sharps with engineered sharps
injury protections and needleless systems are used to
isolate or remove certain blood-borne pathogens
hazards from the workplace.
Accidents and Injuries
If you are exposed to blood or other potentially infectious
or hazardous materials, follow these steps:
◦ If you experience a needlestick or sharps injury,
immediately wash needlesticks or cuts with soap and
water.
◦ Splashes to the nose, mouth, or skin should be flushed
with water.
◦ Irrigate eyes using eyewash, for 10 to 15 minutes.
◦ Report the incident to your supervisor.
◦ Immediately seek medical treatment.
Summary
Treat all human blood, bodily fluids and other potentially
infectious materials as if they are infectious
There are 3 major Blood-borne pathogens: Hepatitis B,
Hepatitis C and HIV.
The most common mode of transmission of pathogens is
the hands
Wear proper PPE in exposure situations