2. (THIS USED TO BE TWO SEPARATE
TRAININGS)
• This inservice will cover the basics of how to protect
yourself from body substance “encounters” in the school
setting.
• Most body substances can cause sickness.
• The OSHA Bloodborne Standard addresses only diseases
spread by contact with blood.
• This inservice will also address other body substances (such
as respiratory secretions, vomit, feces, etc.).
3. We’ll cover:
• Student and Staff Illnesses (The Top 8)
• Blood Borne Pathogens
– Hepatitis B, HIV/AIDS
• Prevention and Screening
– Tuberculosis, Vaccinations
• What to do if exposed or injured
• Confidentiality
4. The Top 8 Hit Parade of
Bad Bugs
• Upper Respiratory
Infections (Colds)
• Pink Eye
• Head Lice
• Influenza (flu)
• Ringworm
• Strep Throat
• Chickenpox
• Mononucleosis
5. Tuberculosis
• No annual screening
for ASD employees
• Airborne disease
• No vaccine
• Person can be
infected without any
signs or symptoms
• TB germ “hibernates”
in lungs for many
years
• A PPD skin test can
tell if infection is
present
6. • In a public setting, there is no way to
know who is infectious with what
disease or condition.
• Some infections have no signs or
symptoms.
• With some diseases a person is
infectious before she shows any
symptoms.
• Treat every body substance as if it
were infectious.
7. INFECTIOUS DISEASE PRECAUTIONS
APPLY TO:
• Blood
• All body substances with visible blood
• All body fluids, secretions and excretions -
except sweat - regardless of whether or
not they contain visible blood
• Non-intact skin (chapped, cut, etc.)
• Mucous membranes
(mouth, eyes, nose, genitals)
8. Infectious Disease
Precautions
• Treat ALL body substances (except sweat) as if they were
infectious
• Avoid cuts and other “sharps” injuries. Cover cuts that aren’t
healed with a bandaid.
• Put a barrier between yourself and others’ body substances
by using Personal Protective Equipment or “PPE”
• Keep environmental surfaces clean
– Bleach water is the best disinfectant (CDC) Use 1:100
and make fresh daily.
– Other commercial disinfectants available too
9. Getting Around
How do those nasty things do it?
• Saliva, nasal and throat discharges
Colds, flu, mono, chickenpox, cold sores, Hep B, TB
• Blood
– Hepatitis B and C, HIV, Cytomegalovirus
• Vomit
– Gastrointestinal germs
• Feces
– Hepatitis A, Salmonella, Shigella, Cytomegalovirus
11. The Chain of Infection
• For an infection to
occur, all must be present:
• A germ (pathogen)
• A source (a place for the
germ to live before it
infects)
• Transmission ( a way for
the germ to get from the
source to the person)
• Entry (where the germ
enters the body)
• A susceptible host
12. Breaking the Chain
• Pink Eye
– Wash your hands
– Separate towels, washcloths
– Throw out old makeup
– See doctor for antibiotics
• Respiratory Secretions
– Cover your mouth
– Cough into arm
– Wash your hands
– Throw out used tissues
13. Breaking the Chain, con’t.
• Headlice
– Don’t share
combs, hats
– Pick out all nits
• Ringworm
– Keep lesion covered
– Don’t share
towels, clothes
• Chickenpox &
Herpes
– Secretions are
contagious
• Blood and Body
Fluids
– Put a barrier
between you and
them
– Use PPE
14. 1910.1030(g)(2)(vii)(C)
How are BBPs Spread?
• DIRECTLY THROUGH SKIN - thru a cut or a break in the
skin
• THROUGH THE EYES OR MOUTH - by a direct
splash/splatter to these surfaces
• CONTAMINATED SURFACES - Hepatitis B virus can live up
to a week on surfaces
• SEXUAL CONTACT
• INFECTED MOTHERS -passed to newborn during delivery or
breastfeeding
• NOT inhaled, like cold germs
15. Just what is the Bloodborne
Pathogen Standard?
• Enacted in 1990 by OSHA in response to AIDS concerns
• Covers ALL employees (not just health care workers) who
could be exposed to blood on the job
• Requires every employer to have an “exposure control plan”
to protect its employees. Each plan must be tailored to its
individual setting.
• Copies of the OSHA Standard and the District’s Exposure
Control Plan are in the nurse’s office.
16. Prevention
• Stay healthy!
Healthy people have
stronger immune
systems.
– Recreate to reduce
stress
– Don’t smoke
– Stay current with
vaccines
– Eat well
– Move! Do something!
17. Prevention, con’t
• Avoid BAD BUGS
– Wash your hands. Don’t give germs a free ride into your
body.
– Put a barrier between you and body substances.
– Remember, EVERYTHING you touch has been touched by
someone else.
• Get Immunized
– Flu shots every year.
– Hepatitis B if you could be exposed to blood.
– Keep tetanus status current.
– Talk to your doctor if traveling to 3rd world countries.
(This includes parts of Mexico)
18. Vaccine Preventable
Diseases
• Influenza
• Measles, Mumps and Rubella (MMR)
• Polio
• Hepatitis A & B
• Chickenpox
• Tetanus, Diptheria & Pertussis
• There are more vaccines for travelers. Check with
your doctor.
20. Some of you will stay for
more detailed training about
bloodborne pathogens.
(The nurse will tell you who gets
to stay and who can leave)
21. In Conclusion:
• Remember, student health information is
confidential
• The single most important thing you can do to
prevent the spread of germs is HANDWASHING.
• If you have reason to think you have been exposed
to a disease at school, tell the nurse.
22. 1910.1030(g)(2)(vii)(D)
Just what is the “Bloodborne
Pathogen (BBP) Standard?”
• A federal law enacted in 1990 by the
Occupational Safety and Health Organization
(“OSHA”)in response to AIDS concerns
• Covers ALL employees (not just health care
workers) who could be exposed to blood on the
job
• Requires every employer to have an “exposure
control plan” to protect its employees. Each
plan must be tailored to its individual setting.
• Copies of the OSHA Standard and the ASD
Exposure Control Plan are in the nurse’s office.
23. 1910.1030(g)(2)(vii)(E)
Who does this apply to
in the ASD?
• Job classifications in
which ALL employees
have exposure:
– Nurses
– Noon Duties
– Safety/Security
– Coaches
– Designated
Responders
• Job classifications in
which SOME
employees may have
exposure:
– Teachers
– Teachers’
Assistants
– Admin Assistants
– Custodians
24. 1910.1030(g)(2)(vii)(A)
ASD Exposure Control Plan
• A copy of the school
plan, and of the actual
OSHA regulation, is in
the nurse’s office.
• The nurse can get you
a copy, and explain its
contents.
25. What are Bloodborne Pathogens?
(or “BBPs”)
• Viruses, bacteria, o
ther micro-
organisms present
in human blood
that can cause
disease:
– HIV/AIDS
– Hepatitis B
– Hepatitis C
– Malaria, syphilis
26. 1910.1030(g)(2)(vii)(C)
How are BBPs Spread?
• DIRECTLY THROUGH SKIN - thru a cut or a
break in the skin
• THROUGH THE EYES OR MOUTH - by a direct
splash/splatter to these surfaces
• CONTAMINATED SURFACES - Hepatitis B virus
can live up to a week on surfaces
• SEXUAL CONTACT
• INFECTED MOTHERS -passed to newborn during
delivery or breastfeeding
• They are NOT inhaled (like cold germs).
27. 1913.1030(g)(2)(vii)(F)
Universal Precautions
• Wash your hands before and after gloving.
• Treat ALL body substances (except sweat) as if they were
infectious
• Avoid cuts and other “sharps” injuries. Cover cuts that aren’t
healed with a bandaid.
• Put a barrier between yourself and others’ body substances by
using Personal Protective Equipment or “PPE”
• Keep environmental surfaces clean
– Bleach water is the best disinfectant (CDC) Use 1:100 and make
fresh daily.
– Other commercial disinfectants available too
28. 1910.1030(g)(2)(vii)(B)
Hepatitis B
• A liver disease, usually without symptoms
• Symptoms, when present, include:
– Loss of appetite
– Fever
– Tiredness
– Yellowing of skin and eyeballs
– Nausea, vomiting and diarrhea
– Dark urine
– Pain in muscles, joints, swollen stomach
29. 1910.1030(g)(2)(vii)(B)
Hepatitis B, con’t
• Highest incidence in 20-49 year olds
• Incubation period is 45-180 days
• Used to have 260,000 new infections annually
in 1980’s; now down to 78,000
• 1.25 million adults are chronic carriers
• Chronic carriers have 274 x greater chance of
developing liver cancer
• Have a 6-30% risk of infection if exposed to
virus
31. 1910.1030(g)(2)(vii)(I)
Hepatitis B Vaccination Election or
Declination Form
• All (potentially exposed) employees must
complete one
• Either accept or refuse the Hepatitis B
Vaccine
• If you want to start the vaccine, also fill out
the “Authorization for Hepatitis B Vaccine
Series” form and fax to Risk Management
• Risk Management must authorize
• School nurse can advise where to get the shots
32. 1910.1030(g)(2)(vii)(B)
HIV Infection Signs
and Symptoms
• Flu-like illness occurring 1-6 weeks after
exposure
• Rapid weight loss
• Diarrhea lasting over a week
• Pneumonia
• Dry cough
• Fever and/or night sweats
• Swollen lymph glands in armpits, groin or neck
• White spots on tongue
• Blotches on the skin
• Memory loss, depression
33. 1910.1030(g)(2)(vii)(B)
HIV/AIDS
• Spread through blood, breast milk and sexual
activities
• No vaccine
• 0.3% infection rate
• Does NOT survive on environmental surfaces
• 816,000 cases of AIDS in US (CDC, 12/01)
• HIV= Human Immunodeficiency Virus
34. 1910.1030(g)(2)(vii)(B)
Signs & Symptoms of
Hepatitis C
• 80% have no symptoms at all
• 5% infection rate
• Yellow skin & eyeballs
• Dark urine
• Tiredness
• Abdominal pain
• Loss of appetite
• nausea
35. 1910.1030(g)(2)(vii)(B)
Hepatitis C (HCV)
• No vaccine
• 3.9 million Americans infected; 200 million
worldwide
• 25,000 new infections a year in US
• Number 1 cause of liver disease in US
• Can have no symptoms for decades
• Vietnam vets have 4xgreater incidence
• Blood transfusion before July 1992 is biggest risk
• Most infections now due to injection drug use
• For every 1 person with HIV, there’s 4 with HCV
36. 1910.1030(g)(2)(vii)(K)
Exposure Incident Definition
• A contact with blood or bloody fluid, to any
mucous membrane (example =eyes, nose, mouth) or
to broken, chapped or cut skin
• A puncture wound from a used syringe, lancet or
other sharp
37. 1910.1030(g)(2)(vii)(J)
What to do if an exposure occurs?
• Immediately wash area/rinse eyes
• Change clothes if necessary
• Notify supervisor
• Get medical evaluation at once
• Document the incident
• Supervisor informs Risk Management
38. 1910.1030(g)(2)(vii)(L)
Post exposure evaluation
• Will be assessed for
need for HIV chemo-
therapy
• Hepatitis B status
will be checked out
• May have blood
drawn on yourself
and source
• Counseling
• No cost to employee
• Confidential
41. 1910.1030(g)(2)(vii)(H)
When to use PPE
• Before any possible contact with a body
substance
• If splashing or splattering is possible,
protect your face with a mask and eye
protection, or a shield. Protect your
clothes with an impervious gown or apron.
• Dispose of PPE after task is completed.
Don’t continue to wear soiled PPE.
42. 1910.1030(g)(2)(vii)(E)
Procedures that may involve exposure:
• Giving injections
(nurses)
• First Aid & CPR
• Personal care of
students with multiple
disabilities
• Clean up of blood spills
• Student fights &
altercations
45. 1910.1030(g)(2)(vii)(F)
Decontamination
• If area is heavily soiled, cover with thick paper
towels.
• Wearing gloves, wipe up the towels.
• Clean surface with bleach solution or ASD
approved disinfectant. Allow to air dry.
• If towels are dripping body fluids, dispose of in
biohazard container.
47. Regulated Waste
(as defined by OSHA) that
MUST go into biohazard containers:
• OPIM = “other potentially infectious materials”
• Liquid or semi-liquid blood or body fluids
contaminated with blood
• Contaminated items that would release blood
or OPIM in a liquid or semi-liquid state if
compressed
• Items that are caked with dried blood or
OPIM that would release when handled
• Contaminated sharps, syringes
48. Regulated Waste, con’t
• Regulated waste must be placed in
regulated waste containers
• Containers must be
closable, labeled or color-
coded, and marked with the
biohazard symbol
• Regulated waste will be incinerated
• Call Risk Management for pickup
