Bloodborne Pathogens

OSHA's Liberal Fix and Final Rule on Bloodborne Pathogens - It mandates government intervention into many of our work places. Employees who may be exposed to bloodborne pathogens must receive bloodborne pathogen training every year.

I call this a "liberal fix" because a "conservative fix" could not exist. In fact, in today's usage of the term "conservative," "conservative" and a government "fix" sounds like an oxymoron. "Liberals" do fine-tuning in government. That's what liberals are about. "Conservatives" object to government intervention, period. Without "liberal fixes" to our government, no protection for United States' labor would or could exist. So next time you do work at crime scene cleanup's blood messes, thank your local liberals for both your government protection from blood and wage depreciation.

It's important to place some sense of proportion into our thinking about bloodborne pathogen contamination. So keep this in mind: Mucous membranes found in our orifaces become bloodborne pathogen sites of entry. Direct injection by sharps also accounts for contamination. These threats to human health became OSHA's mission to eradicate.

OSHA used its powers in a final exposure control program. It required two types of controls from employers in work places. One, engineering controls seek to create safer working conditions by restricting contact with contaminated objects. Two, it seeks to reduce exposure by directly protecting workers. Protective clothing and equipment now reduces employees' exposure to human blood in work places. But more, education in the form of training and medical environment observation came into play as protective measures for employees and their work places.\

"Hepatitis B vaccination, signs and labels, and other provisions" became standards in work places associated with human blood contact. This mouthful continues below in shorter sentences.

We now have a standard applied to all employers. Any employees with a possible exposure to blood needs certain protections. Suppose an employee's skin, eyes, mucous membranes have a potential for contacting blood. Then imagine an injection, or scrape, or wound allowing blood or other potentially infectious materials" (containing the pathogens Hepatitis B Virus, the Human Immunodeficiency Virus (HIV), syphilis, malaria and other diseases resulting from one's work.

The early OSHA standard applied to the skin trades. Skin trades include anyone in the medical field, doctors, dentists, medical technicians, and others. Many types of institutional workers came under this standard's compliance mandate.

Now the standard applies to many more employers. Because of its federal backing, OSHA's standard causes employers to plan for employee safety. A "schedule and method" to prevent employee contact with blood became mandated. A post-exposure plan must also explain how employees respond to contamination. Employers must ask how, who, what, when, and where exposures take place.

Our Center for Disease Control (CDC) responded first. it issued guidelines for Universal Precautions. These guidelines helped to protect workers from patients' blood or body fluids. The guidelines were meant to apply to all bloodborne pathogens. Among CDC's recommendations, we find recommendations for increased use of personal protective equipment (PPE). Gloves, fluid-resistant gowns, protective eyewear, masks and other barrier garment protection from blood and OPIM soon became standard operating procedure. To these improvements followed mechanically designed devices for safer handling and disposal of sharp objects. CDC's efforts led to Hepatitis B vaccine offered at no cost to employees within the entire United States Effective use of puncture-resistant sharps containers now placed close to their point-of-use inhabit work sites.

Training Objectives:

Crime Scene Cleanup
Founded in 2001, this Crime Scene Cleanup web site is both a for profit web site and crime scene cleanup activity related to individual, corporate, and government corruption.

This web page's mission is to educate and influence people to prevent accidental injury and death from injuries and acts causing bloodborne contamination and airborne contamination. Crime scene cleanup seeks to enhance workplace safety worldwide.

Chapter 1
A Bloodborne Pathogens Standard

Nationwide standards for public health become available as science and legislative bodies identify health risks and legislatures codify activities.

Our U.S. Occupational Safety and Health Administration (OSHA) created workplace safety standards for a great number of medical personnel as well as others routinely in contact with or at risk from blood contact. (the Standard) arose as a consequence of congressional legislation and then our Occu¬pational Exposure to Bloodborne Pathogens Standard's design sought to eliminate or minimize employees' exposure to human blood and other potentially infectious materials (OPIM). This Standard went into effect in 1992 and applies to all employees who, as part of their job, may reasonably expect to be exposed to blood and OPIM that may contain pathogens.

CHAPTER PREVIEW
Because of many needle-stick injuries in medical work places, and because bloodborne pathogens (germs) were spreading by unprotected sexual activities between men and women, and men and men, and women and women, congress created legislation to slow if not stop spreading bloodborne pathogens. Well within its power and scope of duties, congress zeroed in on employers and employees somehow associated with human blood. Protecting employees, especially in hospitals, became a major concern. Delegating responsibilities for overseeing this legislation's powers, our Occupational and Safety Health Administration (OSHA) took on this task. Its goal, protect United States workers from bloodborne pathogens.

Introductary Comments
We call germs "Pathogens" because they cause pain and suffering. They also cause death from HIV, Hepatitis C, and other monsterous killers. Carried by blood, these pathogens migrate through our human population by blood and OPIM. We see our Standard seeks to help protect employees working near blood. Our U.S. Centers for Disease Control and Prevention (CDC) created bloodborne pathogen guidelines. Preventing needless exposure to bloodborne pathogens clearly identified in CDC's manual aids those in need of clarification.

Practices in the National Fire Protection Association (NFPA) also seek to control the spread of bloodborne pathogen infections. See NFPA 1581 (http://www.nfpa.org).

Who Does the Standard Protect?
Our Standard identifies those jobs exposing workeers to blood or OPIM.

Bloodborne Pathogens

Workplace contamination by infected blood or OPIM occurs too often and needlessly. When it does, others become at risk from newly infected carriers. Thereafter, disease-causing microorganisms such as Hepatitis B, Hepatitis C or HIV viruses find new hosts elsewhere.

Infectious bloodborne pathogens reside in some, not all human blood, but we pretend that these germs infect all human blood. This is part of what we call "Universal Precautsions." We should remember many people with weak immune systems have a high-risk of death from these pathogens.

We need to understand that simple, daily activities like a visit to our dentist poses a risk for dental staff from blood in our saliva. We need to remember that unprotected sex leads to deadly transmission of infected semen and vaginal ("pussy") secretions. We must remain aware that once infected, even mothers' breast milk becomes a biohazard for nursing babies.

Other fluids contain bloodborne pathogens. Vomit infected by blood, feces infected by blood, and as above, saliva contaminated by blood become deadly biohazards. Once transmitted, there is no biohazard cleanup known to return our bodies to their once healthy condition.

Blood and semen cause the most disease from HIV and Hepatitis C. Women are 15 time more at risk from seman contamination than men are from vaginal secretions.

Hepatitis B causes liver damage, cirrhosis, and liver cancer.
Because of routine hepatitis B vacci¬nations, the number of new infections per year has declined significantly, edpecially in younger people. Yet, according to the Centers for Disease Control and Prevention (CDC), Hepatitis B l infects about 60,000 every year. As a consequence we have around 1.25 million chronic carriers in these United States. About 3000 to 5000 people die of liver problems ressulting from Hepatitis B infection every year.

We find after about 12 weeks, with a range of 4
weeks to 6 months, full-blown incumbation of HVB. Infection by Hepatitis B sometimes leads to acute hepatitis. At other times, long-term Hepatitis B infection arises in milder forms. Everyone's body has a different immune system and each responds a bit differently to viruses. In most cases the body produces an antibody that helps destroy liver cells containing viruses. Viruses then find their way out through normal excretion routes. An infected person will then have lifelong immunity to hepatitis B.

Infected HBV adults grow antibodies to hbv. After about 6 months their infection's physical symtoms subside. In these cases carriers no longer pose a threat to other, uninfected people. Then there's chronic Hepatitis B infections, leaving carriers without a growth of antibodies. These carriers remain infectious to others for decades.

Hapatitis B Vaccination

Hapatitis B Vaccinations occur twice. About two months following a first injection, a second injection takes place. Anyone involved in an occupation where blood may expose people to blood must have these vacsinations. From surgeons to physical education teachers, hbv vaccinations save lives and slow the spread of hbv. Following innoculation with hbv, contamination, any or all of these symptoms may occur, but first understand this:

Testing for this virus shortly after infection may not reveal its presence. It symptoms tend tend to occur differently depending on its progression and its carrier's immune system.

Muses and joints may begin to ache like they do during a flu illness. Likewise, a mild fever may arise along with, or without stomach pains.

Jailers in county jails have long known how to recognize hbv amonge inmates because the whites of their eyes become yellow. This finding alone tells us that during crime scene cleanup, our clients may have become ill from hbv. I'm generalizing here from jail populations to those involved in future violent crimes; this logic should keep us alert to crime scene cleanup's probability of turning up "hot" blood, contaminated blood from bloodborne pathogens like hbv.
How Do I Know If I Have Hepatitis B?

The best a crime scene cleanup practitioner can do for their health and the health of others, relatived to hbv, is to receive their two vaccinations for hbv infections. Yeast cultures probide the source material for creating antibodies to hbv. As many as three, and even more injection may be received for protections. Oftentimes soreness on and near the injection sites accompanies innoculation with anti-bodies.

Along with environmental, engineering, and
work practice controls, medical preparedness reduces the spread of hbv and other bloodborne pathogens.

Our CDC further recommends staying away from high-risk behaviors. "Just say no" has a life-saving meaning in the context of unprotected sex, sex with more than one partner, anal sex, and intravenous recreational drugs,

Hemophila patients must protect themselves with hbv vaccinations. hbv partners must ensure protection for their sex partners. People visiting countries with high hbv populations should have hbv vaccinations.

The Standard requires ensures employers offer hepatitis B vaccine to employees. Employees receive these at no cost and at their convenience. Employers must pay employees' travel costs. It took an act of congress, we should remember, for OSHA to have a hand in these matters. Just the same, an employee ha every right to refuse vaccination, and may later change their mind.

Some employees may refuse vaccination because they previously received their vaccinations; testing shows they are immune; they have an allergic reaction to this vaccination; their are no risks in an employees work related to hbv.

In addition, employers must offer training and the hepatitis B vaccine before employees start a work assignment; explain that vaccination is voluntary, and ensure employees have proper medical treatment following any exposure. Medical treatment follows an exposure incident whether or not an employees previously received their hbv innoculation regimine. When employers and employees follow these guidelines and practices, we have a reliable means for slow the growth of hbv within our ranks.
Prevention of Hepatitis B Infection

Bloodborne Pathogen Cautions
• Use of barriers for preventing contact with human blood and OPIM
• Careful handling of sharps
• Hygenic tattooing and body piercing; Avoiding recreational IV drugs
• Foregoing use of items possibly contaminated with blood

Spreading hcv

Without question, intravenous drug use spreds HCV through drug injections with contaminated needles. Now the hcv goes "underground" with the underground-like life-styles of its hosts. Infections related to tattooing and body piercing tools, sharing toothbrushes, and any other items contaminated with blood increase risk of contracting hcv. Preg¬nant woman may infect their fetus.

Healthcare facilities employ those most at risk for hcv infection. I nfectious blood through an acci¬dental needlestick or injury with other sharps remains the greatest risk of medical personnel deaths from their place of employment.
Symptoms of HCV may not occur in some infected people. Others experience fatigue, loss of appetite, anxiety, depression, and nausea.

A yellowish color of the whites of eyes, as in hbc, indicates jaundice. Usually weight loss occurs. At times an intolerance to aclohol may follow. Abdominal pain, and loss of concentration may follow.

Blood tests for hcv may become tricky when they occur too soon after infections. At other times false-positives may occur. Healthcare workers exposed to hcv must have blood tests and follow-up testing. Those using recreational IV drugs, blood transfusions, signs of liver disease damage need testing.

Preventing of HCV Infection
No vaccine exists for HCV and no cure. All we have preventive methods. Careful handling of needles and other sharps remains mandatory at all times and places.

Spreading HIV

Personal items become habitat for Hepatitis contaminated by blood. AIDS patients' then have a greater risk from opportunistic infections. Invading microorganisms find a weakened immune system. Fatalities occur.

Body fluids serve as habitat so long as blood remains embedded and free from external environments. Blood, semen, vaginal fluid, breast milk, and other OPIM carrying blood spread HIV.

HIV's presence in saliva, tears, urine, cerebrospinal
fluid, and amniotic fluid have not proven infectious. For health care workers, needle-stick remains the primary means of contracting HIV. Protected by a syringe's internal environmental conditions, HIV's life span continues for various periods of time. Injections under these conditions leads to over 200 deaths per year among health care workers. Over one-quarter of HIV carriers remain ignorant of their medical condition. Over all, about one-million United States residents remains HIV infected. These carriers create riskes for our total population.

Although when President Reagan denied HIV's existence among our general population, some of our nation's top religious leaders called for pyhsical detention of homosexual carriers of HIV. Before long medical science demonstrated HIV's presence among heteral sexuals. Liberals voiced concern for civil liberties, too.

OSHA's plan for increasing safety requires employers to reduce occupational exposure to bloodborne pathogens:

1. Engineering controls include needleless injection systems, eye wash stations, and biohazard labels. Isolating and controlling bloodborne pathogens in work places remains the goal of engineering controls. Engineers and entreprenuers found common cause. As a result, self-sheathing needles or syringes, eye wash stations, handwashing facilities, sharps containers, and biohazard labels became commonplace. We now expect these innovations to our risk of exposure to bloodborne pathogens.

Sharps
Sharps remain medical workers greatest nightmare. They easily penetrate skin. Sharps include needles, scissors,
scalpels, and broken glass. Sharps containers designed for disposal and safe handling are standard. Sharps containers remain an important tool in our fight against HIV. The containers for reusable sharps such as scissors are not required to be closable, as these containers likely will be reused.

Each year employers must consider adding newer, more effective protective devices to their inventory of engineering controls. They have no duty to replace existing controls so long as they work to protect workers.

Employers must ensure that warning labels conspicuously placed on all biohazard containers must reflect a biohazard symbol against a contrasting background. Contaminated fabrics, tools, and other objects go inside these containers for transporting. Before transport, Freezers and refrigerators used for blood or other potentially infectious materials (OPIM)
should be used when feasible.

Following contamination of skin, Immediagte use of antiseptic towelettes or antibacterial handwashing liquid on contaminated areas helps; water used while thoroughly scrubbing with soap and water must follow as soon as possible.

Well lit, easily reach eye wash stations used to flush eye contaminants help clean infected or injured eyes.

A 10% bleach to water solution of decontaminating cleaning solution helps to properly clean equipment and tools.

A universal biohazard symbol must clearly mark rooms, vehicles, barrels, sharps containers, and laundry bags used to hold and transport contaminated clothing, linen, and other fabrics.

Work practice controls reduce exposure to bloodborne pathogens by altering task practices. Standardizing protective personnel equipment (PPE), handwashing, decontaminating and steriliizing equipment and areas, safely handling sharps, correctly disposing of wastes, safely handling
laundry, and good personal habits reduce exposures.

Handwashing prevents transmission of bloodborne pathogens. Although handwashing may not destroy all pathogens immediately, it reduces their numbers to a fraction of their previous population, rendering their infectious nature less viable. Washing exposed skin with anti-bacterial soap qucikly after exposure occurs with a gentle application of cleaner near scabs or sores; all areas of hands from back to front, wrists, fingers, and under fingernails helps protect all. Running water helps to remove debris from hands during washing.

Effective handwashing practices should following using the toilet in any case. Contact with bathroom surfaces, especially door handles, increases infectious contamination of others by cross-contamination of infectious material from feces. Use a paper towel to reduce water on hands, turn water off, and cover door handle with paper towel to open door. Dispose of towel.

Regulated waste and disinfecting equipment require special handling and disinfectiing. Like hospitals, crime scene cleaners often come into possession of fabrics. For hospitals and crime scene cleanup practitioners, uniform laundering, clothing, and cloth supplies are kept free of contamination
when possible. Special laundry bags identify blood and OPIM soiled fabrics for special handling. Hospitals use laundry facilities for their cleaning needs. Yellow bags bags a biohazard symbol affixed to them separates their contents from red bag contents.

Employees handling contaminated laundry receives traineing to handle bloodborne pathogens. Wearing appropriate PPE helps reduce inadvertent exposure..

Working near blood means keeping hands away from your mouth or eyes. Of course, one does not smoke or eat in such environments. Do not put pencils, pens, or other objects in your mouth where potentially infectious materials may be present. Likewise, eating in a laboratory used for human tissue sampling makes no sense whatsoever. We never store food or beverages in refrigerators, freezers, shelves, or cabinets or on countertops or benches near blood or OPIM.

Gloves
Gloves create a barrier between hands and contaminating objects. We're talking about spreading spreading bloodborne pathogens here, an important subject for future generations. Know that nitrile, vinyl, latex, or other waterproof gloves like those sold at Home Depot serve fairly well as barriers. Since we wear gloves to avoid needless exposures, we never touch a glove's contaminated outer surface with our bare hands. Grasp one glove at the wrist or palm it down and off your opposing hand. Then, your first glove is balled up inside the second. Then pull the glove the rest of the way off. Intuitively, we find ourselves with our next step before us. Peel gloves off, one peeled into the other; both waded so their interiors are now exterior for disposal.

Resperators, Hats, Caps, and Booties
Crime scene cleanup practitioners create greater barriers to blood by wearing resperators at times. A full-face resperator eliminates exposure to eyes, nose, and mouth while filtering air. Charcoal filters do a nice job eliminating death odors from blood's decomposition.

Disposable hats, caps, and
shoes or boots with waterproof materials serve blood cleanup activities well.

Bloodborne Pathogens

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Training Objectives: