Blood Borne Pathogen: Study Guide for Blood Borne Pathogen Class

A bloodborne pathogen is an infectious microorganism present in blood that can cause diseases. Common Bloodborne Pathogens that cause human disease include human HIV (Immunodeficiency Virus), Hepatitis B, and Hepatitis C. These viruses are usually transmitted through exposure to blood, cuts, abrasions, burns, and punctures, needle sticks, bites, rashes, and mucous membranes. They can also be transmitted through Body Fluids like semen, vaginal fluids, pleural fluid, synovial fluid, and cerebrospinal fluid. Bloodborne Pathogens cannot be transmitted through vomit, nasal, sweat, tears, saliva, sputum, or urine.

Individuals vaccinated against a pathogen can still become infected as vaccinations are not always 100% effective, and effectiveness may decrease over time. 

Bloodborne Pathogens can be transmitted if infected blood or OPIM enters your body through these ways of transmission:

• Parenteral exposure from sharp objects like needles, cuts from broken glass, illegal drug use, abrasions, and human bites.
• A mucous membrane in the mouth, eye, and nose.
• Sexual Contact

CDC estimates that workers in the health care industry and anyone whose job involves contact with blood are at the highest risk of occupational exposure. For infection to occur, the following conditions must be met:

• A pathogen must be present.
• A sufficient quantity of pathogens must be present to cause an infection.
• A person must be susceptible to the pathogen in question.
• The pathogen must access the body via an entry site, such as abrasions, punctures, and the respiratory system.

Bloodborne pathogens cannot be spread by casual contacts such as shaking hands or hugging. However, droplet transmission may occur when another person inhales an infected person's coughs or sneezes and pathogens.

Universal precautions are guidelines followed by medical personnel to protect themselves from patients' infections and vice versa. For example, washing your hands before touching a patient is a simple way to prevent the spread of diseases, especially when no other protective materials are available. The use of gloves is another practical step in stopping the spread of germs between the first aider and the patient.
Rescuers can prevent cross infection in many ways, such as:

• Wear protective gloves.
• Cover cuts, sores, and wounds with a waterproof bandage.
• If large amounts of the injured person's body fluids are exposed, wear a plastic apron and plastic eyeglasses.
• Use care around needles to prevent pricks.
• Watch out for broken glass.
• If the rescuer does come in direct contact with the injured person's body fluids, the area should be washed as soon as possible with soap and water. Particularly in the case of the eyes, nose, mouth, and open wounds. The rescuer should seek medical attention.
• Use a mask or face shield when administering CPR.
• Clean up the scene of the emergency safely when the rescue is complete.
• Rescuers should consult their doctor to see if a hepatitis B immunization is advisable before encountering possible infection sources.

Personal protective equipment are used to minimize the exposure to bloodborne pathogens, especially for Healthcare Providers. They need to think of the possible exposure sources and protect themselves from these before the exposure occurs. Also, more robust protection is required if the exposure extends over a longer period. For this reason, a variety of personal protective equipment (PPE) is available, including:

• Goggles: It should fit around and over the eyes.
• Gloves: To protect the hands
• Face shields: To protect the eyes, mouth, nose, and face. It should cover the forehead and wrap around the sides of the face. It should also extend below the chin
• Gowns/aprons: To protect clothing and skin. It should be resistant to fluid penetration
• Masks: To protect the mouth and nose. Mask should cover the nose and mouth fully and should be resistant to fluid penetration
• Respirators: To protect the respiratory tract from airborne agents, such as influenza.

The Human Immunodeficiency Virus is one of the common bloodborne pathogens. Also called HIV, this is the virus that causes acquired immune deficiency syndrome (AIDS). It's persistent in blood, semen, vaginal fluids, pre-ejaculation, and breast milk. Symptoms include fever, headache, sore throat, swollen lymph glands, and rash.
Treatment: No vaccine, hormones for women, Hepatitis C drugs, antiviral medicines.

Acquired Immunodeficiency Syndrome (AIDS)
AIDS or Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). Symptoms include sweating, fatigue, shortness of breath, dry coughing, chronic diarrhea, white lesions on the tongue and mouth, headache, and weight loss.
Treatment: No vaccine, hormones for women, Hepatitis C drugs, antiviral medicines.

Hepatitis B is a bloodborne disease that results from infection with the Hepatitis B virus or HBV. Although it is usually transmitted through blood, other body fluids from an infected person with the virus can also cause the disease. Symptoms include fatigue, nausea, vomiting, abdominal pain/discomfort, loss of appetite, fever, dark urine, muscle pain, jaundice, and joint pain.

Hepatitis B infection is called "acute" when it occurs within six months after a person is exposed to HBV. This infection can lead to a long-term, chronic Hepatitis B infection if left untreated, and the virus will remain in the victim's body. Hepatitis B can also lead to death, but there is a vaccination to prevent the disease.

Treatment: Vaccine, transplant

Hepatitis C is the most common bloodborne pathogen infection in the United States. Among all the bloodborne diseases, Hepatitis C is the least likely to be transmitted through sexual contact; however, it can be transmitted sexually.

Hepatitis C is persistent in blood, transmitted through blood contact, sexual contact, drug use, and contaminated needle stick, about 1.8%. Symptoms include fatigue, nausea, vomiting, abdominal pain/discomfort, loss of appetite, fever, dark urine, muscle pain, jaundice, and joint pain.

Treatment: No vaccine availabale

Work practice controls are measures used to change how work practices are carried out to ensure safety, whereas engineering controls are those measures used to isolate or remove hazards from the work environment. Examples of work practice controls are removing and disposing of PPE as soon as possible after use and isolating areas of contamination to prevent others from being exposed. Examples of engineering controls are labeling infectious materials, cleaning, disposing of, documenting, and containment.

Sharp with Engineered Sharps Injury Protections (SESIP)

• Retractable needles, retractable finger-prick, needleless systems.

Proper recapping of needles

• One-handed motion
• Mechanical device

When a Health Care Provider has an exposure incident, such as a needle stick, employers must provide immediate confidential medical evaluation and follow-up. These incidents need to be reported immediately. The source of the possibly infectious materials can also be tested for bloodborne pathogens, giving vital information to the HCP and developing a treatment plan. Infection following exposure to a bloodborne pathogen depends on a few variables, including

• Pathogen present during the exposure
• Type of exposure
• Amount of blood or OPIM involved in the exposure
• The concentration of the virus in the blood during the exposure

Even after taking precautionary measures, you can still be exposed to blood or body fluids. Reporting an exposure incident to your employer or manager will help you get the treatment you need and help your employer identify and reduce exposure causes.

• The employer must follow OSHA standards and document the exposure incident/sharps injuries.
• The employer must keep these reports confidential.
• Seek treatment from a healthcare professional.
• Required OSHA forms should not delay any medical attention or counseling that you may need.
• The employer will continue with forms according to their policies.

What Training Does OSHA Require for BBP?

Under OSHA's bloodborne pathogens standard, OSHA requires employees with occupational exposure to blood or other potentially infectious materials (OPIM) to complete a BBP training annually regardless of the employees' prior training or education.

What is an Employer Control Plan?

An Employer Exposure Control Plan or ECP requires 29 CFR 1910.1030(c) of the Bloodborne Pathogens Standard established by OSHA. The purpose of the Employer Control Plan is to establish procedures to eliminate or minimize employee exposure to bloodborne pathogens.

What is the main focus of the OSHA bloodborne pathogens Standard?

The standard discusses a framework to minimize exposure to bloodborne pathogens such as HIV, HBV, and HCV viruses that could be present in human blood, tissues, and body fluids.

What are the four methods of Compliance with Bloodborne Pathogens Standards?

To effectively minimize or eliminate exposure to bloodborne pathogens, Standard Precautions must be followed. These include Universal Precautions, Engineering Controls, Work Practice Controls, and PPE.