OFFSHC BBP

Bloodborne Pathogens

Bryan K. Stolte, Ph.D., C.I.H.
May 9, 2013

Introduction
Approximately 5.6 million workers in health care and
other occupations are at risk of exposure to bloodborne
pathogens (BBPs).
OSHA’s BBP Standard prescribes safeguards to protect
workers against the health hazards from exposure to
blood and other potentially infectious materials.
Exposure Control Plans must contain elements
necessary to comply with and implement changes
required by the OSHA standard.

2 | Presentation Title | Month 2006

All Rights Reserved © Alcatel-Lucent 2006, #####

Regulatory Requirements
OSHA 29 CFR 1910.1030
Effective March 6, 1992
Update effective January 1, 2002
Purpose: To eliminate or minimize occupational
exposure to BBPs.
www.osha.gov (search bloodborne pathogens)



Does the BBP Standard Apply to You?
If you may come into contact with blood, or potentially
contaminated biological fluids during the performance of
the following:
Emergency Response Team
- When you are a member of a MERT Team.
First Aid and CPR Responder
- When you have been provided with First Aid-CPR
training in accordance with the Installation First AidCPR Training Policy.
Then the answer is yes!



What are BBPs?
Microorganisms found in human blood and/or
contaminated body fluids that cause disease in humans.
Examples:
Human immunodeficiency virus (HIV) - Acquired
Immunodeficiency Syndrome (AIDS)
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)
Syphilis
Malaria



Potentially Contaminated Body Fluids
Potentially Infectious Material (PIM)
Sexually transmitted fluids
Body fluids visibly contaminated w/blood
Amniotic, pericardial, pleural fluid, synovial,
cerebrospinal, peritoneal, etc.
Saliva (when contaminated with blood)



Body Fluids considered uncontaminated
if free of blood
Urine
Vomit
Tears
Perspiration
List strictly academic. Employees must follow
“Universal Precautions” (i.e., think worse case scenario)
Universal Precautions – You must consider ALL blood
and body fluids as if they are infectious with HIV,
Hepatitis C, Hepatitis B and other BBPs.



HIV / AIDS - Modes of Transmission
and Incubation Period
The Human Immunodeficiency Virus (HIV-1) leads to
Acquired Immunodeficiency Syndrome (AIDS) for most
affected people.
Modes of Transmission
Exposure to contaminated blood or potentially infectious
body fluids, sexual contact, and sharing contaminated
needles.
Incubation Period: Less than 1 year to 15 years or longer



HIV / AIDS - Symptoms
Some symptoms can be related to other illnesses. The
only way to determine whether you are infected is to be
tested for HIV infection. Signs and symptoms for HIV
vary. If you have any illness or persistent changes in
health you must see your personal doctor.



Hepatitis B - Modes of Transmission
This virus is found in the blood and in potentially
infected body fluids. Hepatitis B is an infection of the
liver. The Hepatitis B virus can survive for 7 or more
days in dried blood on environmental surfaces or
contaminated instruments.
Exposure to contaminated blood or potentially infectious
body fluids, sexual contact, and sharing contaminated
needles. An infected mother can transmit the infection
to her fetus through the placenta.



Hepatitis B – Acute vs. Chronic Infections
When acute infections are experienced, if the body
can’t clear the virus within 6 months the individual is
considered chronically infected.
There is no cure for chronic infections.
Individuals that were able to clear the virus, will have
developed antibodies against Hepatitis B and will not be
able to transmit the virus.



Hepatitis B – Incubation Period and Symptoms
Incubation Period: 45 days to 180 days
Symptoms
Nausea, vomiting, loss of appetite, fatigue, vague
abdominal discomfort, diarrhea, jaundice, and joint
pain.
About 30% of affected individuals are asymptomatic.
Signs and symptoms are less common in children than
adults.
15 to 25 % become chronically infected.



Hepatitis C - Modes of Transmission
Hepatitis C is the most common chronic bloodborne
infection in the US. Infection may lead to chronic liver
disease. The Hepatitis C virus can survive from 16
hours to no more than 4 days on environmental surfaces
or contaminated instruments.
Exposure to contaminated blood or potentially
infectious body fluids, sexual contact and sharing
contaminated needles. An infected mother can transmit
the infection to her fetus through the placenta.



Hepatitis C – Chronic Infections
No protective antibodies are developed, therefore
infected individuals that respond to treatment can get
infected again.
The reason why most individuals remain infected is due to
changes in the virus during infection, which results in
changes that are not recognized by preexisting antibodies.
This appears to be how the virus establishes and maintains
long-lasting infection.



Hepatitis C – Incubation Period and Symptoms
Incubation Period: 2 weeks to 6 months
Symptoms
Abdominal pain, jaundice, dark urine, loss of appetite,
nausea, and fatigue.
About 80% of infected individuals are asymptomatic.
Chronic infection can develop in 75 to 85% of infected
individuals.



Malaria - Modes of Transmission,
Incubation Period and Symptoms
Malaria is a serious , sometimes fatal, disease caused by
a parasite.
Modes of Transmission – Bite of a malaria-infected
mosquito, blood transfusion, needle use.
Incubation Period: One week to one year
Symptoms
Initially shaking chills, fever, headache, muscle aches,
sweating, fatigue. May cause anemia and jaundice.



Written Exposure Control Plan
Required by OSHA.
Must be available to employees.
Posted on the QACC/Services and the Real Estate EH&S
websites and/or posted at your site.
Copies can be obtained from a Field Supervisor, MERT
Team Captain or NAR Regional EH&S Manager.
Identifies job classifications and tasks where exposures
to BBP can occur.
Describes post-exposure evaluations and follow-ups.



Written Exposure Control Plan
(Continuation)
Plan includes:
Procedures

Biohazard Labeling

Policies

Employee Information /
Training

Universal Precautions
Engineering Controls
Workpractice Controls
PPE

Recordkeeping
Exposure Incidents, PostExposure Evaluations and
Follow-Ups

Methods of
Decontamination



What is an exposure incident?
An exposure incident is a specific eye, mouth, other
mucous membrane, non-intact skin, or parenteral
contact with blood or other potentially infectious
materials that results from the performance of an
employee's duties.
Notes:
Non-intact skin includes skin with dermatitis,
hangnails, cuts, abrasions, chafing, acne, etc.
Parenteral contact means the piercing of mucous
membranes or the skin barrier through events such as
needle sticks, human bites, cuts & abrasions.



Potential Routes of Exposure
Ingestion
Inhalation
Absorption through mucous membranes (i.e., nose,
mouth, stomach, intestines, bronchial tubes, urinary
tract) or eyes.
Contact with blood or “Potentially Infectious
Materials” (PIM) resulting from a break in the skin
caused by human bites, sharp objects and needles.
Note: People should not be touching their mouth,
nose or eyes if their hands haven’t been washed.



Preventing Exposure
Universal precautions
Treat all body fluids as if contaminated with a BBP.
Engineering and work practices controls
Personal protective equipment
Prevent PIM from reaching eyes, mouth, or mucous
membranes.
Good housekeeping
Clean spills immediately with 1:10 to 1:100 dilution of
bleach/water solution.



Engineering Controls
These controls reduce employees exposure by either
removing the hazard or isolating the worker.
Example:
Sharps Disposal Container
Note: hollow-borne needles considered more severe
than solid materials (i.e., scalpels)



Work Practice Controls
These controls reduce the likelihood of exposure by
altering how a task is performed.
Examples:
Wearing two pairs of impermeable gloves (latex or
nitrile gloves) and face protection.
Adequate hand washing (antiseptic towelettes or
alcohol based hand cleanser if water and soap are not
available).
Remove contaminated garments.
No eating, drinking, smoking, applying cosmetics/lip
balm or handling contact lenses in areas where blood
or PIM are present.



Personal Protective Equipment
Examples of personal protective equipment
Gloves (Latex or Nitrile Gloves)
Safety Glasses
Face Shields
One-way air valve resuscitation
mouthpieces



Good Housekeeping
BBP Decontamination
A bleach solution diluted between 1:10 (1/4 cup bleach
to 1 gallon water) to 1:100.
Must be freshly mixed!
Tools for cleanup
Brooms
Brushes
Dust pans
Disposable clothes
Use proper PPE and Universal Precautions.
Wash hands and exposed body parts immediately.


Surface Decontamination
Clean gross contamination with soap and water first to
ensure the disinfectant is completely effective.
Ensure 15 minutes contact time with contaminated
Surface.



Sharps Handling and Disposal
Use tongs or other means to pick up contaminated sharps
and broken glass.
Do not pick up contaminated sharps
and broken glass directly with hands
even if gloves are worn.
Use sharps containers for syringes,
needles, and broken glass.



Sharps Containers
Sharps containers must be:
closable,
puncture resistant,
leak proof on sides and
bottom,
and labeled or color-coded
Upon closure, duct tape may be
used to secure the lid of a sharps
container as long as the tape
does not serve as the lid itself.
Containers must be closed prior
to removal.


Biohazard Waste
Regulated Waste (Don’t put in regular garbage)
Place waste material in red
biohazard container / bag 3rd party disposal not normal trash
Small Biohazard Bag provided
with 514A First Aid Kit



Biohazard Labels
Biohazard Labels must be used:
When equipment cannot be properly decontaminated
On waste containers
Red bags or containers may be
substituted for labels.



Post-Exposure Follow-Up
Wash hands and exposed body parts immediately with
soap and water.
When in remote locations with no
potable water, use antiseptic towelettes
or alcohol based cleansers until
able to wash hands.
Mucous membranes should be
flushed with water for at least
15 minutes.



Incident Reporting
Report incident to your supervisor and the EH&S
Manager immediately
The employee must:
- complete the Biological Exposure Incident Report Form (414) and
the Hepatitis B Vaccine Immunization Form (413),
- submit to the main ALU EH&S Office at fax number 1-908-5825907 within the work shift the incident occurred and

- The supervisor must ensure immediate medical
attention.



Incident Reporting (cont.)
If the exposure incident occurred outside of normal
hours of operation, the affected employee must:
- complete forms 413 and 414 and
- proceed to his or hers private physician or local emergency care
facility for initial evaluation and treatment within 24 hours
- notify ALU EH&S on the next day of operation

The supervisor contacts their NAR Regional EH&S
Manager for assistance in completing the electronic On
Job Injury/Illness Incident and Investigation form (E083)
and submits following the instructions on the form.
Affected employees names are omitted from the final
record of injury reports to protect employee’s
confidentiality.


In the event of an exposure incident, the source
individual’s blood is screened for HBV, HCV and HIV
unless prohibited by law or consent not given by the
source individual. Blood testing will occur at specific
intervals.
Regardless of the test results, treatment protocols are
individualized.
The Healthcare Provider shall complete the necessary
information on the 413 and 414 forms. Once all three
vaccination series and follow-up visits are completed,
employee submits or asks the Healthcare Provider to
submit the 413 and 414 forms to the main ALU EH&S
Office.



You will be offered a Hepatitis B vaccine if not
previously vaccinated.
During follow-up of an exposure incident you will be
asked to be tested for HIV and HBV.
Testing will not be done unless consent is given
If vaccine is declined, declination form must be signed.
Physician follow-up to discuss test results and further
evaluation.



Hepatitis B Vaccination
Available to affected employees at no cost
A series of 3 shots
A yeast derivative that cannot transmit HBV



Hepatitis B Vaccination
Affected employees:
Employees certified in First Aid-CPR and current in
Bloodborne Pathogens training
Members of Medical Emergency Response Teams (MERT)
Employees having experienced an exposure incident
Pre-exposure vaccinations available to employees
provided with First Aid-CPR training in accordance with
the Installation First Aid-CPR Training Policy and
members of a MERT Team upon request.
Post-exposure vaccinations will be available to all
affected employees no later than 24 hours after an
exposure incident has occurred.



Forms 413 and 414
Completed 413 and 414 forms are classified as a medical
record.
Distribution of completed forms must be limited to
EH&S, the Healthcare Provider and ALU employees
designated to administer medical records and process
worker’s compensation claims.
Completed forms must not be copied or included in
local employees files.



Training
Provided at no cost to employees during working hours.
Annual refresher
Training records maintained for 3 years



Alcatel-Lucent - Installation First Aid-CPR Training Policy
Installation management shall ensure that all Installation installers
and maintenance technicians on each job site have a valid*
certificate in Standard First Aid-CPR.
Local management is responsible for selecting and scheduling the
subject training in order to maintain current certification status.

* Meeting current requirements as set forth by either the American
Red Cross, the American Heart Association, the American Safety &
Health Institute, the Emergency Care and Safety Institute or the
National Safety Council.



Employee Medical Records
Employee medical records:
- must be kept confidential
- not disclosed or reported without the employee’s
written consent (unless required by law)
- must be maintained for duration of employment plus
30 years



Summary
The Alcatel-Lucent Exposure Control Plan plays an
important role in the implementation of safeguards
intended to protect workers against the health hazards
from exposure to blood and other potentially infectious
materials.
Your assistance in the implementation of this plan is
essential. Your input into the plan is encouraged.
Additional information regarding Bloodborne Pathogens
and other infectious diseases can be found at the
following websites:
www.osha.gov
www.cdc.gov
www.usphs.gov


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