Which Osha Bloodborne Pathogens Affect The Liver

- hepatitis B - hepatits A - HIV/AIDS

- infection that causes inflammation of the liver - can live on surfaces in dried blood for several days

- usually not lethal - spread fecal-oral route

- caused by a virus that attacks the liver - deadly: can cause acute or lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death - spread when blood from an infected person enters the body of a person who is not infected * killed hundreds of health care workers each year before vaccine available - healthcare personnel who have received vaccine + developed immunity are at virtually no risk

- in 2013: ~700,000-1.4 million people were infected with chronic HBV - people of all ages get virus and ~ 1,800 die/year of sickness caused by virus - june 1982: AICP recommends vaccination to high risk groups - 1991: AICP recommends national HBV childhood vaccination program - for a susceptible person, the risk from a single needlestick or cut exposure to HBV infected blood ranges from 6-30% - the annual number of occupational infections have decreased 95% since vaccine became available

- no vaccine yet - poses same risk as B - caused by a virus that attacks the liver - can cause acute or lifelong infection, cirrhosis of the liver, liver failure, and death - spread by contact with the blood of an infected person - spread from one person to another in healthcare setting is rare, but possible - can live in dried blood for several days

- the average risk for infection after a needlestick or cut exposure to HCV infected blood is ~1.8% - there are no exact estimates on the number of healthcare personnel occupationally infected with HCV

- less common

- HIV: attacks immune system, leaving patient unable to fight off infection - AIDS: set of conditions that results when the immune system has been attacked by HIV - lower risk for health care workers than hepatitis or TB - contact with blood usual route of infection

- 1.1 million with HIV in U.S. (14% unaware of infection) - 39,513 new infections in 2015 (18,303 new AIDS diagnoses) - 6,721 deaths directly due to HIV in 2014

- destroys CD4 + T cells - results in lower cell mediated immunity - AIDS patents more susceptible to infections - exposure occur through: needlesticks, cuts from other sharp instruments, infected blood contact with eye/nose/mouth/skin - important factors: number of infected individuals in the patient population, type of exposures, number of exposures - 58 confirmed occupational cases in U.S. history (1 since 1999) - accidental needlestick risk is 0.23% w/o treatment

- heath care workers who handle hazardous drugs are at risk of skin rashes, cancer, and reproductive disorders - ~8 million health care workers are potentially exposed

- pharmacy - nursing - physicians - operating room personnel - veterinary personnel - shipping and receiving personnel - laundry workers - waste handlers - maintenance workers

- aerosols - inhalation - ingestion (from hand to mouth) - injection with a sharp - transconjuctival - skin absorption

- handle drug vials - compound hazardous drugs - administer hazardous drugs - dispose of hazardous drugs - clean spills - touch contaminated surfaces

- select specific respirators and protective clothing based on an assessment of potential exposure to hazardous drugs - understand the proper use and limitations of any selected PPE to ensure that it functions properly - use care in donning and removing all items to prevent damage to PPE and to reduce the spread of contamination - ensure that all PPE fits correctly and is constructed of materials that are appropriate for hazardous drug exposure - donning and doffing of PPE should follow local hospital procedures and the manufacturer's instructions

- gloves - gowns - respiratory protections - face and eye protections - radiologic protections

- needlesticks and other sharps related injuries which expose workers to bloodborne pathogens continue to be a significant hazard for hospital employees - OSHA estimates that 5.6 million workers in the healthcare industry and related occupations are at risk of occupational exposure to bloodborne pathogens

- avoid the use of needles where safe and effective alternatives are available - help your employer select and evaluate devices with safety features that reduce the risk of needlestick injury - use devices with safety features - avoid recapping needles - plan for safe handling and disposal of needles before using them - promptly dispose of used needles in appropriate sharps disposal containers - report all needlestick and sharps related injuries promptly to ensure that you receive appropriate followup care - report needlestick hazards observed - participate in training related to infection prevention - get a hep B vaccination

- safer needle devices have built in safety control devices, such as those that use a self sheathing needle to help prevent injuries before, during, and after use through safer design features - CDC estimated 62-88% of sharps injuries in the hospital could be prevented by using safer devices - safety syringes and needles for hypodermic devices - prefilled medication syringes - safety IV catheters and needless IV systems - safety and closed system blood collection devices - safety blades, scalpels, suture needles, and surgical sharps protections devices - hemodialysis safety needle sets - safety procedure trays - sharps protection and disposal devices

for IV delivery systems (ex. blunt cannula for use with prepierced ports and valved connectors that accept tapered or luer ends of IV tubing)

- initially, the sleeve is located over the barrel of the syringe with the needle exposed for use - after the device is used, the user slides the sleeve forwards over the needle where it locks in place and provides a guard around the used needle

after the needle is used, and extra push on the plunger retracts the needle into the syringe, removing the hazard of needle exposure

- recapping - transferring a body fluid between containers - improper disposal

- closable, puncture resistant, and leak-proof on side and bottom - accessible, maintained upright and not allowed to overfill - colored red or labeled with the biohazard symbol - labeled in fluorescent orange or orange/red, with lettering and symbols in a contrasting color

- under the occupational safety and health act of 1970, employers are responsible for providing a safe and healthy workplace for their employees - role: promote the safety and health of america's working men and women by setting and enforcing standards, providing training, outreach and education, establishing partnerships, and encouraging continual process improvement in workplace safety and health