The annual bloodborne pathogen refresher is required for every employee that is covered under the bloodborne pathogen standard

1. Bloodborne Pathogen Control
Annual Refresher Training
Instructor: Holly Niehoff, R.S.
Environmental Health & Safety
Office: 606-783-2584
Cell: 606-207-9425

2. What is the Purpose of OSHA?
• OSHA requires all employers, even those with
only one employee, to provide a safe and
healthy workplace for employees.
• OSHA exists only for the protection of
employees in the workplace.

3. What Are The Responsibilities
Under OSHA?
Employers:
Are required to comply with the OSHA standards.
This means provide a safe and healthy workplace for employees.
Provide training to all employees on hazards in the workplace (e.g.
bloodborne pathogens)
Employees:
You must comply with OSHA rules and regulations; these are not an
option! You have the responsibility for participating in your
employer’s safety program and notifying the employer of
overlooked hazards or controls).
You have the responsibility for reporting any occupational illnesses
or injuries, including sharps injuries or exposures to bloodborne
pathogens. (CFR 29 OSHA 1910.1030)

4. MSU Bloodborne Pathogen Exposure
Control Plan
Included in the Infection Control Plan are the following:
• Universal / standard precautions
• Engineering and work practice controls
• Personal protective equipment
• Effective housekeeping
• Hepatitis B vaccination
• Post-exposure evaluation and follow-up
A Copy of the Exposure Control Plan is on MSU EHS website.

5. What Are Bloodborne Pathogens?
They are microorganisms capable of producing disease.
They are found in the blood of infected individuals and can be
spread to others by blood or body fluids.
There are more than 25 bloodborne pathogens known
today, and that number is increasing. Hepatitis B, hepatitis
C, and human immunodeficiency virus are 3 of the most
significant bloodborne pathogens.

6. How Could You Come in Contact With Bloodborne
Pathogens?
Bloodborne pathogens are spread through several
routes:
In the workplace:
Splash, splatters or spills; sharp injuries.
Injections, IV’s, surgical and dental procedures, invasive
procedures, handling/cleaning contaminated items.
Human bites.
In the general community:
Sexual contact, sharing dirty needles, tattoos, body
piercing, acupuncture. Mother to fetus at birth;
through breast milk.

7. Hepatitis B Virus
• Strong concentrations of Hepatitis B Virus in body
fluids make it highly contagious and easily spread.
• HBV can be contracted by touching contaminated
surfaces where the virus has been shown to live as long
as four weeks.
• Not just through needle sticks!
• Vaccine is available to prevent HBV infection!

8. What Is Your Chance Of Becoming Infected With
Hepatitis B Virus (HBV) at the Workplace?
• Hepatitis B Virus: There are currently over
one million people in the U.S. infected.
• If an employee, not vaccinated against HBV, is
exposed to an infected patient: The chance
the employee will become infected with HBV
is 1 in 6. (This exposure rate is based upon
needle stick injuries in health care, a common
mode of transmission.)

9. Which bloodborne pathogen is the leading
cause of liver transplants in the U.S.?
• The liver is the largest internal organ!
• In children, it is about the size of a grapefruit.
• In adults, it is about the size of a football.

10. Hepatitis C Virus
• Hepatitis C Virus (HCV) is more common in the U.S. than HBV. CDC
estimates 3.2 million Americans have it.
HCV is different from other types of hepatitis in that it is more likely
to cause a chronic carrier state and more likely to lead to
cirrhosis, liver cancer, and death. It kills more people in the US than
HIV. Most of them are in the 45-64 year old range.
There is no vaccine or cure for HCV but they have treatments
similar to HIV that.
Individuals may have HCV for up to twenty years before showing
any symptoms of disease. Up to ¾ do not know they have it until
the liver is severely damaged.

11. What Is Your Chance Of Becoming Infected With
Hepatitis C Virus (HCV) at the Workplace?
Hepatitis C Virus: There are currently four million
people in the U.S. infected.
If an employee is exposed to an infected patient:
The chance the employee will become infected
with HCV is 1 in 100 (This exposure rate is based
upon needle stick injuries and cut exposures in
health care, a common mode of transmission.)
Recent studies suggest that HCV may survive on environmental surfaces at
room temperature at least 16 hours, but no longer than 4 days

12. Symptoms of Viral Hepatitis
If symptoms occur, the individual may
experience any or all of the following:
Loss of appetite, extreme tiredness,
nausea/vomiting/diarrhea, abdominal pain,
dark tea or cola colored urine, jaundice,
arthritis/joint pain, or rash.

13. Which bloodborne pathogen has infected
between 10 to 12 million people worldwide?

14. What Do You Need To Know About Human
Immunodeficiency Virus (HIV)?
• Infection with HIV in the workplace represents a
small but real hazard.
With almost a million AIDS cases reported in the
general population, there is ever-increasing
potential for exposure.
• Although there is currently no vaccine that is
effective against HIV, the barrier techniques used
to prevent HBV and HCV will also be effective
against HIV.

15. HIV (Cont.)
• Individuals may have HIV infection for up to 10 years
before showing any symptoms of disease.
These individuals can transmit the virus to others
through direct contact with blood or other body fluids
and through sexual intercourse.
This can happen regardless of whether or not they
have developed the symptoms of AIDS.
• Only blood and blood products, semen, vaginal
secretions and human milk have been directly linked to
transmission of HIV.

16. What Are The Symptoms of HIV?
• Approximately 50% of HIV-infected individuals will
have one or more of the following symptoms within 2-
4 weeks after becoming infected:
Fever illness (similar to mono or influenza and
resolves on its own)
Fatigue
Body aches
Rash (similar in appearance to measles)
Swollen lymph nodes
Headache
Loss of appetite
Weight loss

17. What Is Your Chance of Becoming Infected With HIV at
the Workplace?
• HIV: Almost 900,000 people in the U.S. have been
infected.
If an employee is exposed to an infected patient:
The chance that the employee will become
infected with HIV is 1 in 300 (This exposure rate is
based upon needle stick injuries and cut
exposures in health care, a common mode of
transmission).

18. When Could You Have an Exposure To a Bloodborne
Pathogen at the Workplace?
• Anytime you come in contact with blood or potentially
infectious body fluids.
This includes:
Infected blood or body fluids coming in contact with
mucous membranes of the eyes, nose or mouth.
Needle sticks, puncture wounds or cuts from contaminated
objects.
Non-intact skin such as abrasions, cuts, rashes or burns.
Touching blood, or other potentially infectious materials, or
a contaminated surface, with bare hands - because people
may be unaware of skin abrasions.

19. How Could You Become Infected With A Bloodborne
Pathogen at the Workplace?
• Simply put, if an infected person’s blood enters
your bloodstream you may become infected with
whatever viruses that person is carrying.
Unfortunately, a person may be infected with a
bloodborne pathogen and not know it.
• Therefore, we have to assume that everyone we
come into contact with is infected and protect
ourselves accordingly!

20. What Tasks or Procedures May Result in an Exposure
at the Workplace?
• Drawing blood
• Administering injections
• Assisting and Handling instruments during patient
procedures
• Collecting and handling lab specimens
• Cleaning treatment area/exam
rooms/Instruments
• Handling biohazardous waste
• Handling contaminated items
• All invasive procedures

21. How Can You Protect Yourself Against Bloodborne
Pathogens ?
• By using:
• Universal / Standard Precautions
• Engineering Controls
• Work Practice Controls

22. What Are Universal/Standard
Precautions?
• Universal Precautions:
• This is the practice of treating all blood and
certain body fluids as potentially infectious.
• Standard Precautions
• CDC expanded Universal Precautions to
include ALL body fluids as potentially
infectious.

23. When Do You Use Universal/Standard Precautions?
• ALL Workers will use Standard Precautions
any time there is a risk of being exposed to
human blood and other potentially infectious
body fluids.
• All patients’ blood and body fluids will be
treated as though known to be infectious for
HBV, HCV, HIV, and other bloodborne
pathogens.

24. What are Engineering Controls?
• Engineering controls:
These are the physical or mechanical systems in place
to eliminate bloodborne pathogens at their source and
prevent them from reaching employees
• Examples:
• Sharps with safety devices.
• Disposable sharps containers.
• Hand washing facilities.
• Labeled, leak proof biohazardous bags and containers.

25. What Are Work Practice Controls?
• These are the specific on the job procedures you must
follow to reduce exposure to blood or other
potentially infectious materials.
• Examples:
• Hand hygiene.
• Proper disposal of sharps, needles, contaminated
objects.
• Effective housekeeping procedures.
• Safe handling of lab specimens.
• Precautions to take in possibly contaminated areas

26. What is Hand Hygiene?
Wash Hands:
Before gloving or applying any personal protective equipment.
Immediately after removing gloves.
Before leaving the work area.
After touching a possibly contaminated surface.
Before and after eating.
After using the restroom.
Wash hands thoroughly with warm water and soap.
***Where no sink is available, an alcohol based hand cleaner
(gel or foam) will be used as a temporary measure, followed
by hand washing with soap and water as soon as possible.

27. What Are Disposable/Contaminated Sharps?
• Disposable/Contaminated Sharps are any
contaminated object that can puncture the skin.
Examples:
Needles, scalpels, broken glass, slides, extracted
teeth with roots, exposed ends or dental wires,
and any other objects capable of penetrating the
skin.
Place all of these items immediately into a sharps
container after use.

28. What you should know about sharps
containers:
• Sharps containers are an engineering control.
• These containers should be;
• Labeled and color-coded red.
• Rigid and puncture-resistant.
Leak proof.

29. What Should You Know About Sharps
Containers?
• Sharps Containers:
•
• Keep sharps containers upright at all times
• NEVER overfill a sharps container
• Seal the lid tightly prior to transporting the container
• If the outside of the container becomes contaminated,
it should be placed in another leak proof container
prior to disposal

30. Barriers
• What items can be worn as a protective
barrier between your body and potentially
dangerous body fluids of others?

31. What Is Personal Protective Equipment?
Specialized clothing or equipment worn by an
employee for protection against a hazard
EXAMPLES:
• Gloves
• Fluid Resistant Gowns
• Face Shield with Mask
• Resuscitation Equipment
• Masks

32. Why Should You Use Personal Protective
Equipment?
Use Personal Protective Equipment (PPE) to
prevent blood or other potentially infectious
material from passing through or contacting the
following:
Your work clothes, street clothes, or
undergarments.
Your skin, eyes, nose or other mucous
membranes.

33. When Should You Wear Personal
Protective Equipment?
Wear personal protective equipment whenever
there is a risk of occupational exposure.
Personal protective equipment is selected based
upon the type of exposure that is anticipated.
Prior to use, inspect all personal protective
equipment.
Replace if damaged

34. In What Order Do You Apply Personal
Protective Equipment?
• Gown
• Respirator or mask
• Face shield with mask or goggles
• Gloves

35. How Should You Remove Personal
Protective Equipment?
In general, start from the most contaminated item and
work your way to the least contaminated item.
This usually means removing your gloves first.
Turn items wrong-side-out as you are removing them.
Wash your hands immediately.
Dispose of equipment before leaving the work area.

36. What Are Some General Rules You Should
Follow?
Do not eat, drink, apply cosmetics or lip balm, handle contact lenses or
smoke in areas where there is risk for contamination.
Blood or other potentially infectious materials should always be in a
closed, biohazard label container/bag that prevents leakage during
collection, handling, processing, storage, transportation, or shipping.
This sign tells you when blood or other potentially infectious materials
may be present and designates lab areas, refrigerators or contaminated
equipment.

37. What Is Regulated Waste?
• Blood or other potentially infectious materials
• Items coated with dried blood or other
potentially infectious materials and are capable
of releasing these materials during handling
• Contaminated sharps (e.g. needles, blades,
broken tubes, glass)
• Pathological and microbiological waste containing
blood or other potentially infectious material

38. What Should You Know About Disposal of
Regulated Waste?
• Regulated waste requires disposal in a biohazard
container appropriate for the specific type of
waste:
Sharps containers (e.g.
needles, scalpels, lancets, broken glass)
Biohazard labeled bags (e.g. saturated
dressings/gauze; grossly contaminated gloves)
Regulated waste is required to be pick-up by a
medical waste disposal contractor.

39. What Items Can Go Into The Regular
Trash?
• Gloves
• Exam table paper
• Alcohol swabs
• Band-aids/dressings
• Cotton balls/Gauze pad
• Towels/drapes
• Urine specimen cups
• Tampons/sanitary pads
• Tongue depressor blades
• Face masks
• Lab utensils

40. How Do You Handle an Accident/Spill Involving
Blood or Body Fluids ?
Spill kits are available for spills involving blood or body
fluids.
Isolate the area where the spill occurred by placing up a
hazard sign or having another employee stay at the site to
warn others
Put on gloves, mask, eyewear, and fluid-proof gown
(contained in the PPE kit)
Apply the absorbent material in the spill kit to absorb the
blood or body fluid
Allow absorbent material to solidify and gel for several
minutes before cleaning up.

41. How Do You Handle an Accident/Spill Involving
Blood or Body Fluids ? (Cont)
• Place the absorbed material and all disposable clean-up items in
the biohazard bag using the scoop/brush provided.
Clean area where the spill occurred with:
(1) germicidal wipe/cleaner provided, then with
(2) a disinfectant per label directions.
Place remaining items in the biohazardous bag provided.
Remove and dispose the personal protective equipment. (Remove
gloves first).
Place the biohazard bag into the central biohazard container.
Wash hands with soap and running water.

42. What Programs Are In Place To
Protect You ?
• Hepatitis B Vaccine Program
Hepatitis B vaccine may be utilized, in case of
an exposure.
The vaccine is given in a series of three shots
over a six-month period.
YOU MUST GET ALL SHOTS IN THE SERIES!

43. What Plan Is In Place If You Have An
Exposure?
MSU has a post-exposure follow-up program providing
immediate counseling and medical evaluation.
The importance of participating in the post-exposure
follow-up program cannot be overemphasized.
Decisions involved in management of an exposure are
complex.
Employees who have suffered an exposure often need
emotional support as well as medical advice.
You have the right to accept/decline a medical evaluation

44. What Do You Do If You Have An Exposure?
• FIRST: Immediately wash the affected skin with soap and water;
flush nose, eyes, or mouth quickly and thoroughly with saline or
water.
SECOND: Immediately report the incident to your supervisor.
THIRD: Have source wait with you if possible until MSU Clinic staff
have arrived and both person’s blood can be tested. At the very
least, get their name, contact information and information on
where they will be until EHS or clinical staff can assist you.
FOURTH: Refer to the MSU Bloodborne Pathogens Exposure
Control Plan

45. Your Not Finished!
You must complete the quiz at the end of this presentation and submit.
Thank You!