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Environmental Health and Safety

Bloodborne Pathogens

Oklahoma State University

MATT GALLMANHALEY BATES

OKLAHOMA STATE UNIVERSITYENVIRONMENTAL HEALTH AND SAFETY

(405) 744-7241

CURRENT AS OF: October 2017

Presenter

Presentation Notes

I’m Haley and this is Matt—we’re laboratory safety inspectors for OSU. We survey over 900 labs on campus to ensure the safety of students and faculty, and are here to give your annual BBP training.

Environmental Health and SafetyObjectives

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• What is a Bloodborne Pathogen? • Types, modes of transmission and causes.• Who is at risk? Could you be exposed at work?• Why do we have OSHA standards regarding Bloodborne pathogens and what are your

employer’s responsibilities?• What is an exposure control plan, and how do I get one? • How do I know when I could be exposed to a Bloodborne pathogen? • How do I prevent or reduce exposure or the spread of Bloodborne Pathogens?• Types of PPE, proper use, location, removal, handling, decontamination and disposal. • Emergency actions and contact following the exposure or presence of BBP

Presenter

Presentation Notes

Things we’re going to talk about: -the definition of a BBP, some examples of these pathogens, and how you can be exposed -the OSHA BBP standard and how employee’s are protected -the purpose of having an exposure control plan -work practice controls to limit your exposure -your response if someone were to be exposed and needed treatment

Environmental Health and SafetyBBP in the News

Recently, OSHA announced that it has fined the U.S. Postal Service $342,059 in willful violations, after workers were exposed to

bloodborne pathogens. These violations were a result of the lack of an implemented bloodborne pathogens exposure control plan. Exposure to bloodborne pathogens can result in serious or life-

threatening illnesses. To reduce these hazards, an effective exposure control plan must be implemented.

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Presenter

Presentation Notes

What happened here? Box was leaking blood, employee’s and managers were aware of this, did not have exposure control plan, hep B vaccinations on record, AND did not provide gloves. OSHA fined them. Another example, the lab accident at UCLA—woman was not provided with flame-resistant lab coat, working with pyrophorics and caught on fire, died from burns—went to court, EHS proved that the PI of this lab was aware of the PPE he needed to supply his research personnel with, but did not do so; not only fined, but found criminally negligent. If we relate this to us and OSU’s financial situation right now, that amount of fines could be catastrophic. And, if lab PI’s don’t have their ducks in a row on training documentation and safety precautions, they could be hung out to dry and end up paying for it all themselves. On our end: if we don’t do our “due diligence” in keeping up with surveys and reporting our findings, we could become liable since we represent the University

Environmental Health and SafetyWhat is a BBP, and why are they important?

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• Microorganisms that are carried in blood that can cause disease in humans.

• These pathogens include, but are not limited to, HBV, HCV, and HIV.

• OSHA estimates 5.6 million workers in health care and other facilities are at risk of exposure to bloodborne pathogens, such as HIV and HBV.

• Bloodborne pathogens can be transmitted through blood or ‘other potentially infectious material’ (OPIM), such as?

Presenter

Presentation Notes

Bloodborne pathogens are pathogenic organisms carried in blood or other body fluids that cause illness/injury to the body. Could be virus, bacteria, fungi, prion, etc. Most common are Hepatitis B, C, and HIV, and you’ll see that there many exposures worldwide to these pathogens. Can be transmitted through other means—saliva, semen, vaginal secretions, cerebrospinal fluid, feces, urine, just to name a few

Environmental Health and SafetyCould you contract a bloodborne pathogen doing these things?

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• Administering First-Aid?• Cleaning the restroom?• Using a tool covered with dried blood?• A co-worker sneezing on you?• Working in a sewer manhole?• Cleaning up after an accident?• Shaking a sick coworkers hand?• Cutting yourself with glass that is

contaminated with blood?

Presenter

Presentation Notes

Kind of a given—you could be exposed in all of these situations It’s intuitive to know that emergency and first aid treatment and needle sticks could expose you, but you might not think about contact with fluid from a sick person

Environmental Health and SafetyModes of Transmission

Direct Indirect

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Indirect contact transmission refers to situations where a susceptible person is infected from contact with a contaminated surface. Some organisms are capable of surviving on surfaces for an extended period of time. To reduce transmission by indirect contact, frequent touch surfaces should be properly disinfected.

Direct contact transmission requires physical contact between an infected person and a susceptible person, and the physical transfer of microorganisms. Direct contact includes touching an infected individual, kissing, sexual contact, contact with oral secretions, or contact with body lesions.

Presenter

Presentation Notes

Again, very basic here on modes of transmission. You can be exposed by directly handling these infectious materials, or indirectly through a contaminated surface. Most labs we see are very careful when working with samples, but you could forget to wipe down your lab bench at the end of the day, resulting in potentially indirect contact with BBP. Fun fact, spraying 70% ethanol to decontaminate a lab bench is not effective under this OSHA standard—cleaning products have to be listed by the EPA as effective against mycobacterium tuberculosis.

Environmental Health and SafetyHepatitis B (HBV)

• 1-1.25 million Americans are chronicallyinfected, however, there has been a HBV vaccination available since 1982!

• Hepatitis B can lead to chronic liver disease.

• HBV can survive for at least one week in dried blood.

• Symptoms, such as jaundice, fatigue, abdominal pain, nausea and vomiting can occur 1-9 months post-exposure.

• HBV is transmitted when blood or OPIM enters the body of a non-infected person.

• Employees are at risk of exposure when drug-injection materials are shared, direct contact is made with blood, or there is exposure to other sharp materials.

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Presenter

Presentation Notes

We all know about hepatitis B—there’s a vaccine for it that is effective in 95% of people It’s the most infectious of the three we’re going to talk about This affects the liver as I’m sure you infer from its name We have the general symptoms of liver dysfunction listed but most infected persons are actually asymptomatic which makes it difficult to catch/treat Under this BBP standard, employer’s are required to offer this vaccination free of charge within 10 working days of hire

Environmental Health and SafetyHepatitis C (HCV)• HCV is the most common chronic

bloodborne infection in the United States– it affects about 3.5 million people in the United States.

• Hepatitis C can also lead to chronic liver disease and is a leading cause of liver cancer.

• Symptoms are similar to Hepatitis B, including jaundice, fatigue, abdominal pain, nausea and vomiting.

• HCV spreads through direct contact with infected blood.

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Presenter

Presentation Notes

Hepatitis C is the most common chronic bloodborne infection and also damages the liver -around 30% of infected persons do not show symptoms, compared to 75% of those with Hep B, but up to 85% of those infected develop long-term infection and chronic liver disease -there is no vaccination

Environmental Health and SafetyHuman Immunodeficiency Virus (HIV)• HIV is the virus that leads to _______? • HIV depletes the immune system by

destroying blood cells that help the body fight diseases.

• HIV does not survive well outside the body. • HIV can be transmitted through unprotected

sex with someone who has HIV, sharing needles, and even during childbirth.

• Less common transmission methods include: being stuck with an HIV-contaminated needle or sharp, and contact with broken skin, wounds, or contaminated body fluids.

• The CDC reports that HIV cannot be spread by air, water, insects, saliva, tears, sweat, casual contact; or closed mouth contact.

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Presenter

Presentation Notes

HIV leads to AIDS It weakens the immune system by destroying the cells responsible for fighting infection No effective cure, but it can be controlled Does not survive well outside the body, so unless you’re directly exposed HIV infectious material, you’re probably safe from encountering this

Environmental Health and SafetyFrequently Asked QuestionsDoes 29 CFR 1910.1030 only apply to HBV, HCV, and HIV?

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Plasmodium species Spirillum minusTreponema species Colorado Tick Fever VirusesBabesia species Borrelia speciesBrucella species Creutzfeldt-Jakob agentLeptospira species Human T-lymphotropic Virus Type IFrancisella species Hemorrhagic Fever VirusesStreptobacillus moniliformis Mycobacterium tuberculosis Rabies Virus Cutaneous AnthraxVaccinia Epstein-Barr VirusHuman Papillomavirus Simian Vacuolating Virus 40

Presenter

Presentation Notes

One of the most frequently asked questions we get is whether the hepatitis viruses and HIV are the only disease covered under this standard? Here are some other infectious agents that fall under this standard—some of these, like Brucella, anthrax, and rabies are seen frequently in vet med

Environmental Health and SafetyCutaneous Anthrax

Occupational exposure could occur when:• Non-intact skin or mucous

membranes are exposed to drainage from cutaneous anthrax lesion.

• There is entry through skin with sharp instruments that are contaminated with lesion drainage.

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Presenter

Presentation Notes

Anthrax most commonly infects warm-blooded animals—sheep, cows, horses, and goats--but can also infect humans through the spores of infected animals. Approximately 20% of untreated cases will die from the infection. Real threat as far as biological warfare goes.

Environmental Health and SafetyRabiesOccupational exposure could occur when:• Non-intact skin or mucous membrane is

exposed to saliva, nerve tissue, or cerebral spinal fluid from an infected person or animal.

• There is entry through skin with sharp instruments that are contaminated with infected nerve tissue.

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Presenter

Presentation Notes

Rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal. The rabies virus infects the central nervous system, ultimately causing disease in the brain and death. Death usually occurs within days of the onset of these symptoms. While there aren’t many positive cases, the animal laboratories on campus have a higher chance of exposure here.

Environmental Health and SafetyVaccinia

Occupational exposure could occur when:• Mucous membranes or non-intact skin

contact with drainage from a vaccinia infection.

• Susceptible skin comes into direct contact with object contaminated with lesion material.

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Presenter

Presentation Notes

Related to smallpox, origin is unknown as to whether it was derived from cowpox There is a vaccine—in fact, because of the possibility of using vaccinia for bioterrorism, many military personnel and first aid responders were requiring members getting vaccinated The poxviruses are the largest known DNA viruses and are distinguished from other viruses by their ability to replicate entirely in the cytoplasm of infected cells. They don’t require nuclear factors for replication, at all Vaccinia is also of interest as mechanism for delivering the immunogenic proteins of other viruses—like Hep B, herpes simplex, and HIV— Pretty neat that this is a possible vector for active immunization against other viruses, and research is ongoing here

Environmental Health and SafetyWho is at risk? Could you be exposed at work? • Workers in many occupations are at risk of

exposure, including first responders, housekeeping personnel in some industries, lab personnel, Facilities Management, nurses and other healthcare personnel, although, all may be at risk for exposure to bloodborne pathogens.

• What other occupations could be at risk for Bloodborne pathogen exposure?

• Remember, exposures can occur when working in animal laboratories.

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DON’T BE LIKE BAD LUCK BRIAN

Presenter

Presentation Notes

You may be thinking of how this relates to you… -We at EHS are exposed through conducting lab surveys and inspections -As a PI or researcher, you can be exposed through working with blood or OPIM samples in your lab -Custodial staff is exposed through handling blood or other biological material -If you work in an animal laboratory, although you aren’t dealing with human samples, you are working with agents that ARE considered to be pathogens in humans -And, any person, can be exposed through accidents required first aid

Environmental Health and SafetyFrequently Asked QuestionsWhy does 29 CFR 1910.1030 apply to finite and continuous human cell lines?

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While an OSHA standard interpretation from 1994 does exempt established human cell lines that are characterized to be free of contamination from human hepatitis viruses, HIV, and other bloodborne pathogens, our OSU Bloodborne Pathogens Program does not. This is for a few reasons: • The CDC’s Biosafety in Microbiological and Biomedical Laboratories recommends that all work

with NHP and human cells follows the Bloodborne Pathogen Standard. • There is extensive testing required to ensure that cell lines are free of all bloodborne pathogens

– not just Viral Hepatitis and HIV (EBV, HTLV, HPV, CMV . . . ).• Establishment of an ECP is much easier than maintaining documentation of testing for OSHA.• Safety is our number one priority.

Presenter

Presentation Notes

This just states that OSHA’s standard applies to human cell lines due to the CDC’s recommendation, and also because extensive testing is required to ensure that cell lines are free of BBP, and it’s much simpler to just incorporate cells in with blood and OPIMs

Environmental Health and SafetyOSHA 29CFR 1910.1030

In March 1992, OSHA's Bloodborne Pathogen Standard, 29 CFR 1910.1030 took effect. This standard was designed to prevent more than 200 deaths and 9,000 Bloodborne infections every year. While the standard was primarily aimed at hospitals, funeral homes, nursing homes, clinics, law enforcement agencies, emergency responders, and HIV/HBV research laboratories, anyone who can "reasonably expect to come in contact with blood or potentially infectious materials" as part of their job is covered by the standard.

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Presenter

Presentation Notes

This is the BBP standard, which states that anyone who can “reasonably come into contact with blood or OPIMs as part of their job is covered Do animal laboratories fall under this standard? No. Because you’re not working with human samples, HOWEVER, you are working with agents that ARE considered to be pathogens in humans, and it’s better to be safe rather than sorry in this regard, and also because the AVMA recommends it

Environmental Health and SafetyEmployer Responsibilities OSHA’s Bloodborne Pathogen Standard states that anyone whose job requires exposure to BBP is required to complete BBP training.

– Initial training is conducted face to face; not online– Training is required annually

Anyone whose job requires exposure to BBP shall be offered vaccines and post exposure evaluation following any possible exposure incidents at no cost to the employee. The Standard also requires employers to offer PPE and a written exposure plan.

– EHS has an example exposure plan

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Presenter

Presentation Notes

Employer responsibilities are to provide training annually, in person, to ensure that everyone is knowledgeable about the risks of exposure, and how to prevent these risks -Hep B vaccinations are to be offered at no cost to the employee -Required PPE supplied by employer and development of an exposure control plan

Environmental Health and SafetyExposure Control Plan: Elements of the plan• Your exposure control plan should be updated annually to implement any

changes and should be available within your department– EHS can provide current template

• Address the implementation of Universal Precautions and the identification and use of engineering controls

• Provisions for PPE and training• Hep B vaccinations available for all employees with occupational exposure• Post exposure evaluation and follow-up for any occupational exposure• Use of signs and labels to communicate hazards• Record keeping

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Presenter

Presentation Notes

When drafting your Exposure Control Plan, or making annual changes. Make sure you implement Universal Precautions (we’ll address this later) and identify your engineering controls List your PPE requirements and training requirements Make Hep B vaccinations available to all employees with risk of occupation exposure Have procedures for Post Exposure Evaluation and follow-up Use of biohazard signage Maintain all records

Environmental Health and SafetyBloodborne Pathogen BinderSuggested binder set up:

– OSHA Bloodborne Pathogen standard 1910.1030– ECP with all appendixes– List of all employees under plan– Copies of completed/signed Hep B vaccination forms– Training documentation– Self inspection documentation– Completed parameter sheet

EHS can assist with program set up and may do periodic checks.

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Presenter

Presentation Notes

We recommend that you keep all of this in a binder, starting with the standard (available on the OSHA website) Then your ECP List of all employees that fall under the plan Copies of completed Hep B vaccination forms or declination forms Your training documentation (if you don’t have this, it never happened) Your self-inspection documentation And a completed parameter sheet—this just states what specific hazards are applicable to your group

Environmental Health and SafetyExposure Prevention

• Elimination and Substitution: Eliminate the hazard completely or substitute with something less hazardous.

• Engineering Controls: Isolate workers from the hazard.

• Administrative Controls: Controls employees’ exposure by scheduling tasks to minimize exposure levels. Provides guidance to employees through SOPs and training.

• PPE: Clothing and other work accessories designed to create a barrier against work place hazards.

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Presenter

Presentation Notes

When trying to reduce risk of BBP exposure in your laboratory, or other areas really, there is a hierarchy of controls that we want to follow to mitigate the risks. First we want to see if we can eliminate the hazard completely or substitute the hazard – could we not use human blood or OPIM, or could we use animal blood instead. This is often not feasible. So we move on to the next control Engineering controls are controls that isolate workers from the hazard. An example could be a biological safety cabinet or a sharps container. However, this does not completely remove the hazard so we move on to administrative controls. Administrative controls reduce exposure by providing guidance, training and SOPs. And the last control (line of defense) we use is PPE, which are garments used to create a barrier against hazards.

Environmental Health and SafetyEngineering Controls

• Reduce exposure by either removing or isolating the hazard, or isolating the worker from exposure

• Are limited in effectiveness due to proper selection, examination, and maintenance

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Presenter

Presentation Notes

Engineering controls reduce the risk by removing or isolating the hazard, or isolating the work from the exposure. The are limited in effectiveness due to proper selection, examination, and maintenance. For example, in you BSC, you would have to choose the one that is correct for you pathogen, check the airflow daily, and get it decon’d and calibrated annually.

Environmental Health and SafetyAdministrative/Workplace Controls• Restrict eating, drinking, smoking, applying cosmetics, and handling contact

lenses • Prevent the storage of food or drink in refrigerators or other locations where

blood or OPIMs are kept• Provide and require the use of handwashing facilities • Require the use gloves when cleaning up OPIM spills • Prohibit recapping, bending, removing, shearing, or breaking contaminated

needles• Routinely check equipment and decontaminate it prior to servicing and shipping

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Presenter

Presentation Notes

Administrative controls could include good laboratory practices such as no eating in the labs, smoking, applying cosmetics, or handling contact lenses. Prevent storage of food in lab fridges Prove handwashing stations Washing hand (with soap) when gloves are removed or ASAP after contact with blood or OPIM Using gloves when cleaning up OPIM spills And preventing recapping, bending, shearing, or breaking contaminated needles.

Environmental Health and SafetyUniversal PrecautionsPrecautionary measures based on the principle that all blood, body fluids, secretions, excretions except sweat, non-intact skin, and mucous membranes may contain transmissible infectious agents.

These include:• Hand hygiene• Use of gloves, gowns, masks, eye protection, or face shield, depending on

the anticipated exposure; and • Safe injection practices

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Presenter

Presentation Notes

The universal precaution rule is to treat all human blood, bodily fluids and other potentially infectious materials as if they are infectious. Following universal precautions, you should use PPE when handling OPIM/blood, wash hands frequently, and follow safe injection practices.

Environmental Health and SafetyPersonal Protective Equipment Hand, eye, face, extremities, protective clothing, respiratory devices and protective

shields and barriers.

• PPE must be used if engineering controls and work practice control do not eliminate exposure

• PPE is only appropriate if it prevents blood or OPIM from passing through or reaching clothes or body

• PPE can consist of gloves, gowns, laboratory coats, face shields, masks, and eye and respiratory protection

• PPE selection is based on anticipated contact with blood or OPIM

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Presenter

Presentation Notes

Personal protective equipment (or PPE) is your last line of defense against the biological hazard. It must be used if the exposure hazard is not eliminated by engineering controls. PPE is only appropriate if it prevents blood or OPIM from reaching clothes or the body PPE most commonly consists of gloves and a laboratory coat, but as the biohazard risk increases or if there is potential of aerosolization, it could include face shields, masks, or even respiratory protection. PPE selection should be based on the anticipated contact with blood or OPIM

Environmental Health and SafetyProper Use and Handling of PPEFor PPE to be effective, observe the following precautions:• Wear appropriate gloves when there is a reasonable hazard of contact

with infectious materials• Replace gloves if torn, punctured, contaminated or if they no longer

function as a barrier • Never reuse disposable gloves• Only reuse utility gloves if they are uncompromised • Wear face and eye protection if risk of splashes, sprays, splatters or

droplets of blood or OPIM are present • Wear protective body coverings when necessary • Remove PPE when contaminated and before leaving the work area

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Presenter

Presentation Notes

# 1, remove PPE when contaminated and before leaving the work area. You should never leave a biosafety level 2 laboratory with your lab coat and gloves on . . . I see this too often. Wear gloves when there is potential contact with OPIM or blood. Replace gloves immediately if they are compromised. Never reuse gloves – or spray them with bleach/hand sanitizer and continue using them. Wear face protection and eye protection if risk of splashes, sprays, splatters or droplets are present – pay attention to ANSI. The eye protection standard is in the process of requiring eye protection in biological laboratories. Wear body coverings if necessary. And remove garments if contaminated.

Environmental Health and SafetyPPE, Contaminates and Sharps Disposal

• Gloves and other PPE should be disposed of in an appropriate area

• Sharps should be disposed of in sharps containers

• Sharps containers must be puncture-resistant, leak-proof and labeled or color-coded red

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Presenter

Presentation Notes

PPE and gloves that are contaminated should be disposed of in biohazardous trash. Sharps should always be disposed of in approved sharps containers which must be puncture resistant, leak proof, and labeled or color coded red.

Environmental Health and SafetyDisposal of Biological Waste

• Blood and OPIM should be disposed of in a closable, leak-proof and labeled/color-coded container

• In the event of a spill, each building should have a janitor trained in body fluids cleanup-- this is the person in charge of the cleanup

• Disinfectants used in laboratories must be effective against Mycobacterium tuberculosis and listed by the EPA

• EHS does not accept any biological waste that has not been autoclaved

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Presenter

Presentation Notes

Blood and OPIM should be disposed of in a closable leakproof, and labeled or color coded container. If a spill happens, there should be a janitor training in body fluids cleanup. If not, and you are comfortable cleaning up the spill, make sure to use appropriate PPE and an EPA listed disinfectant effective against Mycobacterium tuberculosis.

Environmental Health and SafetySigns, Labels and Color-Coding

Warning labels will be affixed to items such as:• Containers of regulated waste• Containers of contaminated reusable sharps• Refrigerators and freezers containing blood or

OPIMs• Containers used to store, transport, or ship

blood or OPIMs• Contaminated equipment being

shipped or serviced• Bags or containers of contaminated

laundry

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Presenter

Presentation Notes

To communicate biohazardous material in the workplace, it is important to us biohazard warning labels. OSHA requires that the following be labeled as biohazardous: Containers of regulated waste Containers of contaminated reusable sharps Refrigerators and freezers containing blood or OPIMs Containers used to store, transport, or ship blood or OPIMs Contaminated equipment being shipped or serviced Bags or containers of contaminated laundry

Environmental Health and SafetySigns, Labels and Color-Coding Cont.

Labels will:• Include appropriate legend in fluorescent orange or orange-red• Be affixed as close as feasible to the container

Items that do not need labels:• Labeled containers of blood released for clinical use• Regulated waste that is decontaminated

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Presenter

Presentation Notes

OSHA also requires that label will include the biohazardous legend and that it be fluorescent orange or orange-red in color and that it be affixed as close as feasible to the container, if not on the container itself. OSHA also has a few exemptions to the labeling requirements: Blood released for clinical use, and regulated waste that is decontaminated.

Environmental Health and SafetyWhat happens after an accidental exposure?• Post exposure evaluation and follow-up procedures:

• Evaluation will involve documenting exposure root cause and circumstances• Identifying and documenting the source individual• Collecting exposed employee’s blood• Testing individual’s blood• Sharing results with exposed employee• Post exposure measures and counseling• Evaluating reported illness

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Presenter

Presentation Notes

What happens after an accidental exposure? Timing is key. First, rinse the exposure site with copious amounts of water and notify your supervisor. The supervisor will determine if you need to proceed with a medical evaluation. The exposed employee can choose not to proceed with a medical evaluation, but it must be offered per OSHA. If possible, identify the source of the exposure, whether it’s an individual or biohazardous material. This exposure source will be tested for HBV, HCV, and HIV. The exposed individual will also be tested for pre-exposure status. The exposed individual will be offered post-exposure prophylaxis for HBV and HIV per CDC guidelines – MUST HAPPEN WITHIN 72 HOURS. If the exposure source is unknown or positive for a BBP, the employee will be offered follow-up testing will be made available to the individual at 3 and 6 months following the exposure. If the exposed employee becomes ill or seroconverts (develops antibodies to the virus), the medical provider will file a report with HR, who handles workers comp.

Environmental Health and SafetyWhat is the risk of infection following an occupational exposure?

• HBV Personnel who have received hepatitis B vaccine and developed immunity to

the virus are at virtually no risk for infection. For a susceptible person, the risk from a needlestick or cut exposure to HBV-infected blood ranges from 6 – 30%.

• HCV The average risk for infection after a needlestick or cut exposure to HCV-

infected blood is approximately 1.8%.• HIV

The average risk of HIV infection after a needlestick or cut exposure to HIV-infected blood is 0.3%

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Presenter

Presentation Notes

What is the risk of infection following an occupational exposure? This data is from the CDC . . . .

Environmental Health and SafetyPrecautions for Providing First-Aid to a Co-WorkerProtect yourself before offering assistance by:• Wearing clean, leak-proof gloves • Being aware of personal cuts or broken skin• Attempt to have the co-worker self administer first-aid• Protect your nose and mouth in the event of splatters or sprays• Immediately wash skin if contaminated with blood, or flush eyes with water if

contaminated• Report the incident to your supervisor

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Environmental Health and SafetyBBP and the US Department of Transportation• The shipping of infectious substances is highly regulated by the US

Department of Transportation (49 CFR 173.134)• The US DOT classifies infectious substances into two categories:

• Category A Infectious Substances – an infectious substance in a form capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals when exposure to it occurs.

• Category B Infectious Substances – an infectious substance that is not in a form generally capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals when exposure to it occurs.

• Infectious substances must be packaged in accordance to 49 CFR 173.196 or 49 CFR 173.199.

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Presenter

Presentation Notes


Environmental Health and SafetyBBP and the US Department of Transportation

Examples of Category A Infectious Substances Examples of Category B Infectious SubstancesBacillus anthracis Borrelia burgdorferiBrucella abortus Campylobacter jejuniCoxiella burnetti Chlamydia trachomatisHuman Immunodeficiency Virus Human B-Lymphotropic VirusHighly Pathogenic Avian Influenza Virus Hepatitis E VirusWest Nile Virus Hepatitis C VirusEbola Virus Herpes Simplex Virus 2

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The determination of the appropriate category for an infectious substance must be done by an individual trained in infectious substance shipping (49 CFR 171.1 (b))

Presenter

Presentation Notes


Environmental Health and SafetyBBP and the US Department of Transportation

• The following are exempted from the US DOT requirements:• Non-infectious biological materials from humans, animals, or plants. Examples include non-

infectious cells, tissue cultures, blood or plasma from individuals not suspected of having an infectious disease, DNA, RNA, or other non-infectious genetic elements.

• Material containing microorganisms that are non-pathogenic to humans or animals.• Material containing pathogens that have been neutralized or inactivated such that they no longer

pose a health risk.• Material with a low probability of containing an infectious substance, or where the concentration

of the infectious substance is at a level naturally occurring in the environment so it cannot cause disease when exposure to it occurs.

• Blood collected for the purpose of blood transfusion.• Human or animals samples being transported for routine testing not related to the diagnosis of an

infectious disease.

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Presenter

Presentation Notes


Environmental Health and SafetyBBP and the US Department of TransportationScenarios

• Dr. Jane Smith needs to ship a blood sample that she believes could contain Hepatitis B Virus. • Hepatitis B Virus is a Category A Infectious Substance. It must be shipped following provisions in 49

CFR 173.196. All of those involved in shipping the sample must be trained in infectious substance shipping.

• Dr. John Brown needs to send a medical instrument to be calibrated. He disinfected the instrument before shipping. • Dr. John Brown is exempt from the US DOT 6.2 shipping requirements. He disinfected the instrument

prior to shipping and removed biological hazards. However, medical equipment must be labeled in accordance with 29 CFR 1910.1030.

• Ms. Karen Clark needs to send a bacterial culture for identification. She has reason to believe it could be Campylobacter.• Campylobacter spp. is a Category B Infectious Substance. It must be shipped following provisions in

49 CFR 173.199. All of those involved in shipping the sample must be trained in infectious substance shipping.

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Presenter

Presentation Notes


Environmental Health and SafetyBBP and the US Department of Transportation• Do you perform any of the following tasks:

• Determine the hazard class of an infectious substance to be shipped?• Select packaging for an infectious substance to be shipped?• Package an infectious substance?• Secure a closure on an infectious substance package?• Mark a package to indicate it contains an infectious substance?• Label a package to indicate it contains an infectious substance?• Prepare or review a shipping paper?• Provide emergency response information for a package containing infectious substance?• Certify that an infectious substance is in proper condition for transportation?• Load an infectious substance package into a transport vehicle?

If yes, you must complete training in infectious material shipping.

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Presenter

Presentation Notes



Remember, for industries that do not work with blood in an occupational manner; any exposure to these

potentially hazardous substances by anyone other than the cleaning staff is almost always the result of an

accident. We make continual efforts to create safe work conditions and avoid these accidents.

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Environmental Health and SafetyWhat should you take away?

Bloodborne pathogen rules are in place for your health and safety

Failure to follow these rules is an unnecessary risk that shouldn’t be taken

“Better safe than sorry"

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Environmental Health and SafetyEnvironmental Health and SafetyPrograms and services: • Fire Protection Engineering• Life Safety and Emergency

Preparedness• Laboratory Safety• Occupational Safety• Occupational Health and Medical

Surveillance• Materials Management• Industrial Hygiene• Chemical Hygiene• Safety Training

Location: University Health Services Building, Room 002 (Basement)

Phone Number: 744-7241

Email: [email protected]

Website: http://ehs.okstate.edu

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Oklahoma State UniversityEnvironmental Health and Safety

744-7241

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Jeopardy

Jeopardy

$100

Controls BBP Misc

$200

$300

$400

$500 $500

$400

$300

$200

$100

$500

$400

$300

$200

$100

Final Jeopardy

1 - $100

• The act of treating any potentially infectious material as if it is contaminated.

• Universal Precautions

1 - $200

A transmission route that requires physical contact between an infected person and a susceptible person.

Direct Contact Transmission

1 - $300

The most effective type of exposure prevention.

Engineering Controls

1 - $400

This organization designed the Bloodborne pathogen standard 29CFR 1910.1030.

OSHA

1 - $500

This Bloodborne disease can survive for at least one week in dried blood.

Hepatitis B

2 - $100

How often must employees receive BBP training?

Annually

2 - $200

Which employees are required to participate in BBP training?

Any employee whose job requires exposure to BBP.

2 - $300

This Bloodborne pathogen cannot be spread by: air or water, insects, saliva, tears or sweat, or casual contact.

Human Immunodeficiency Virus (HIV)

2 - $400

Work accessories designed to create a barrier against work place hazards.

Personal Protective Equipment

2 - $500

Employers are required to provide employees with this vaccination if they have the chance of occupational exposure.

Hepatitis B Vaccine

3 - $100

This Bloodborne pathogen has infected 1-1.25 million Americans.

Hepatitis B

3 - $200

This rigid container is designed to prevent unwanted BBP exposures by containing dirty needles and other sharp waste.

Sharps Container

3 - $300

These microorganisms are carried in blood and can cause disease in humans.

Bloodborne Pathogens

3 - $400

This standard prevents more than 200 employee deaths and 9,000 Bloodborne infections per year.

OSHA’s Bloodborne pathogen standard- 29CFR 1910.1030

3 - $500

Employees should never do what while wearing contaminated gloves or working with OPIM?

Smoke, eat, drink, apply cosmetics, or handle contact lenses.

Final Jeopardy

True or false: The EHS department is the GREATEST department on campus?

TRUE

Documents

Bloodborne Pathogens · Things we’re going to talk about: \爀屲-the definition of a BBP, some examples of these pathogens, and how you can be exposed\爀ⴀ瑜ഀ栀攀 伀匀䠀䄀

Bloodborne Pathogens · Things we’re going to talk about: \爀屲-the definition of a BBP, some examples of these pathogens, and how you can be exposed\爀ⴀ瑜ഀ栀攀伀匀䠀䄀