Bloodborne Pathogen Training

for
BIOL 232 Anatomy & Physiology 2

Reasons for training

1. Your health and safety
2. The health and safety of your instructor
and classmates
3. OSHA regulations
4. Your career

What are bloodborne pathogens?

Bloodborne carried in the
blood (and frequently semen,
vaginal secretions, breast milk,
saliva, tears, urine, feces, vomit,
peritoneal fluid and amniotic fluid)

Pathogens disease-causing
microorganisms: viruses,
bacteria, protists, and fungi
Examples: HIV, HBV, HCV,
syphilis, malaria, trypanosomiasis

NOT Bloodborne Pathogens:

Seasonal or pandemic flu
Common Cold and other URIs
Chickenpox
Strep and staph infections

Of greatest concern:
Bloodborne viruses
Human immunodeficiency virus (HIV)
Hepatitis B virus (HBV)
Hepatitis C virus (HCV)
non-B, non-C Hepatitis

Human Immunodeficiency Virus

About 0.3% of the US population is infected
(about 1 million people)
Approximately 25% of infected persons dont know it
Women are the fastest-growing group to be infected

42 million worldwide with 3 million deaths per

year.
25 million children will be orphaned by 2010.
Highest number of infections in sub-Saharan Africa,
where most (60%) of infected persons are women.
Fastest infection rates in China, India, Indonesia,
Central Asia, Russia, Western Europe

HIV continued
Infects multiple types of cells and especially Tlymphocytes (important immune cells)
Depletes the immune system of critical cells leading
to secondary infection and failure of tumor
suppression (due to loss of T-cells)
Multiple strains that vary in virulence, individuals also
vary in susceptibility
Weak and short-lived outside of human body fluids
(minutes-hours)

HIV continued
Within a month of exposure the infected person may
experience:
Fevers and chills
Sore muscles and joints
Night sweats
Swollen lymph nodes and rashes

Years later, symptoms reappear, occur more frequently

and last longer
Treated with antiviral drugs which delays the progression
of the disease and improve quality of life

HIV / AIDS
Acquired Immune Deficiency Syndrome
AIDS: secondary infections following HIV
infection, often including normally rare diseases
Pneumocystis carinii pneumonia
Kaposis sarcoma (cancer)
Candida (thrush, vaginal yeast infection)
Cytomegalovirus (usually eye infection)

Hepatitis B Virus
About 0.3% of the US population is infected (about 1
million people) annually.
Worldwide, approximately 2 billion people have been
infected at some point in their life.
Approximately 350 million are chronic carriers.
Endemic in China.
Spread primarily either among children or via maternal-fetal
transmission in regions with many chronic carriers.
Spread mainly via IV-drug needle sharing and unprotected
sex in developed nations with low infection rates and routine
childhood HBV vaccination.

HBV continued

Infects the hepatocytes of the liver leading to inflammation and cell death
mediated by cytotoxic T-lymphocytes .

Acute (self-limiting) infection

Initial symptoms (within 1 week to 1 month after infection) are flu-like: fever and
chills, body aches.
Later symptoms include: abdominal pain, fatigue, loss of appetite, nausea,
vomiting, jaundice, and dark urine.
Individuals often recover on their own over a period of a few weeks.
In severe cases, fulminant hepatic failure and death may occur

Chronic infection
May cause chronic liver damage due to cirrhosis leading to death, but 90% of
cases are cured with treatment.
In some infection leads to chemotherapy-resistant liver cancer

HBV continued

The virus can persist in the environment (e.g., in dried blood for up
to a week).

Vaccination recommended for infants and anyone at risk for

exposure (e.g., healthcare workers) mandatory in most cases.

If infected, most patients do not require treatment because they will

clear the infection on their own.

Antiviral treatment is only recommended for about 1% of patients.

The virus also persists in the body and may be reactivated in cases
of immunosuppression (e.g., transplant recipients)

Hepatitis C Virus
Infects 200-350 million people worldwide
Approximately 3-4 million new infections annually

Between 3 million and 7.5 million people in the US are

infected
35,000 to 180,000 new cases per year
10,000-20,000 deaths annually
Much higher rates of infection in prisons (34%)
In the US, 60% of infections are transmitted by IV-drug use, 15% by
sexual contact, 10% from pre-screening transfusions, 10% unknown,
5% healthcare work
In the US, about 35% of HIV-infected individuals are co-infected with
HCV

HCV continued

Infects the hepatocytes of the liver leading to cell death mediated by

cytotoxic T-lymphocytes.

60-70% of infected persons are asymptomatic during the acute

phase (first 6 months post-infection)

Few patients (10-60%) will clear the infection on their own.

Chronic infection leads to: abdominal pain, fatigue, loss of appetite,

nausea, vomiting, jaundice, and dark urine due to fibrosis of the
liver

Untreated chronic infection leads to cirrhosis of the liver and

extrahepatic complications (such as glomerular nephritis)

HCV continued
May be persistent in the environment (e.g., in dried blood
for up to a week).
Standard treatment:
PEGylated Interferon--2a (or 2b) and ribavirin for 24-48 weeks
New drugs being developed include viramidine, and protease
inhibitors

There is no vaccine yet.

How Exposure Occurs

Body fluid
containing

Mode of
transmission

Virus

Needle stick

Bacteria

Sexual contact

Protist

Bite or scratch

Fungus

Ectoparasites
(some)

New
infection

Modes of transmission in the

workplace
Sharps
piercing intact skin (e.g. needle-stick)

Spills, splatters and sprays

entry through mucous epithelia, open cuts and
abrasions are vulnerable to:

Modes of transmission outside

of the workplace
Unprotected sex (HIV, HBV)
Maternal-fetal, maternal-infant (HIV, HBV)
Transfusion prior to 1992 (HCV), prior to 1985 (HIV),
prior to 1971 (HBV)
Needle-sharing (HIV, HBV, HCV)
Body piercing and tattooing with contaminated
equipment (HIV, HBV, HCV)
Iatrogenic transmission (contaminated equipment)

Why you need to be careful

In the US, about 8 million people have
occupational exposure annually
About 8700 health professionals are infected by
HBV annually
About 65 professionals are infected by HIV
annually
1ml of blood can contain up to 100,000,000
infectious doses of HBV

Who is at risk?
Who is at risk at ONU
Biology and allied health students, staff and faculty
Athletes, coaches and trainers
Custodial and maintenance staff

Certain occupations carry greater risks than others

Healthcare professionals
Emergency personnel and first responders
Medical researchers
Law enforcement

RULE #1
Treat all human tissues and anything that
contacts human tissues as if they are
contaminated!

Biohazardous Material

Universal Precautions
In the lab when we are working with human body fluids do
not put anything in your mouth. In other words, no:
Eating
Drinking
Chewing gum

Do not apply cosmetics or lip balm.

Do not handle contact lenses.
Do wear personal protective equipment.
Do wash your hands after removing personal protective
equipment.
Do use alcohol-based hand sanitizers if available.

Personal Protective Equipment

Gloves
Lab coat
Eyewear
Check all equipment for defects or
damage before usage!
Replace damaged equipment
Remove equipment before leaving a
contaminated area
Do not reuse disposable equipment
(lab coats may present an exception)

Engineering Controls
Self-sheathing needles
Biohazard disposal bags and boxes
gloves
wipes and paper towels
soft plastic items

Sharps disposal boxes

needles and lances
glass slides and cover slips
glass capillary tubes

Must have the biohazard symbol AND the word

Biohazard or Biohazardous on the label.

Work practice controls

Use personal protective equipment
Always clean your lab station when you are done for the
day
Do not leave the lab without cleaning your station!
Dont rely on your classmates or instructor to clean it for you
better to clean it twice than not at all!

Use 10% bleach solution prepared fresh daily

Wash your hands thoroughly with soap and water
finish up with a hand sanitizer such as an alcohol gel
(e.g., Purell, Germ-X)

Hand-washing
If hands free towel-dispensers are not available, prepare
towels in advance.
Remove rings and watches before washing.
Position the hands lower than your arms.
Use soap and copious quantities of running water.
Rub your hands vigorously under the running water for
10-15 seconds (10 sec minimum).
Wash all surfaces and rinse well.
Dry hands with disposable towels.

Hand-washing continued
When to wash hands:
After removing gloves and other PPE
After using the restroom
Before and after eating

Alcohol-based hand-sanitizer is not an

acceptable substitute for hand-washing unless:
The skin is unsoiled AND
Hand-washing is not possible.

Exposure
Report any exposure immediately to your
instructor
You may need to go to the Health Center or
your family physician for evaluation
Health center:
315 West College Avenue
(419) 772-2086