BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT

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BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
BLOODBORNE PATHOGENS (BBP)
ANNUAL TRAINING

              FOR MEMBERS OF NCSU
               POLICE DEPARTMENT

IN ACCORDANCE WITH
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
(OSHA)
BLOODBORNE PATHOGEN STANDARD
29 CFR 1910.1030
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
Important!!!
For any injury or exposure to hazardous substances….

              Notify your supervisor immediately

        Questions regarding this training should be directed to
           the Environmental Health & Safety (EHS) Biosafety
           Officer at 515-6858.
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
Why is bloodborne pathogen training
required every year?

1. It is the law
2. It is North Carolina State University’s
   responsibility
3. Knowing this information can protect your
   health and the health of others
4. It works!
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
1. It is the law

 The Occupational Safety and
 Health Administration (OSHA) is a
 federal agency charged with
 enforcing health and safety
 legislation. OSHA makes sure
 that employers such as NC State
 University keep you, the worker,
 safe from workplace hazards.
 Some jobs at NC State are more
 likely to come into contact with
 hazards than others. The
 hazards we are concerned about
 in this program are germs called
 “bloodborne pathogens.”
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
2. It is the university’s responsibility
Departments, Supervisors, and/or Principal Investigators must
prove to OSHA that they are following the Bloodborne Pathogens
Standard by implementing an Exposure Control Plan. By law, the
Exposure Control Plan must detail certain steps that are taken to
keep workers safe, that is, the plan to control every worker’s
exposure to bloodborne pathogens.

This training module reviews the unique plan to control or avoid
exposures to bloodborne hazards for all members of NC State
University’s Police Department. Examples of job classifications in
the NC State Police Department that are expected to have job-
related (‘occupational’) exposures to bloodborne pathogens include
Administrative Sworn Personnel such as Police Officers,
Detectives, and Security Guards whether full or part time.

As a condition of employment, each officer must know the location
of--and comply with--the contents of their Exposure Control Plan.
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
3. Knowing this information can protect
your health and the health of others
 For some NC State police officers, the potential for exposure to bloodborne
 pathogens may exist when encountering spilled human blood or body fluids, or
 materials or waste contaminated with human blood or body fluids.

 The potential for exposure exists when officers are involved in assisting with
 automobile accident victims; working a crime scene; or processing suspects. In
 these situations they may encounter blood-contaminated hypodermic needles or
 weapons. Officers may also be required to search suspects, or subdue violent and
 combative people.

 There is an extremely diverse range of potential situations, which may occur in the
 control of persons with unpredictable, violent, or psychotic behavior. Therefore,
 informed judgment of the individual officer is paramount when unusual
 circumstances or events arise. The recommendations in this training should serve as
 an aid to rational decision making in those situations where specific guidelines do
 not exist, particularly where immediate action is required to preserve life or to
 prevent significant injury.
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
4. It works!
 Research shows that trainings such as this reduce the number of exposures in
 just about every group studied including emergency response personnel!

                           # of exposures reported nationally
                                                       (Source: CDC [2002a].)
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
Exposure Determination
The NC State Police Department, in cooperation
with EHS, uses the Exposure Control Plan to
document and track the status of occupational
exposure determinations to bloodborne
pathogens every 12 months. This is according
to the OSHA Standard (29 CFR 1910.130).

For officers, their exposure determination is
documented on their department’s Exposure
Control Plan.

Each determination must be made without
regard to use of personal protective equipment
and should be conducted upon orientation and
“no later than 10 days after the date of         This determination must made
employment” (OSHA).
                                                 without regard to use of PPE.
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
How do I determine
“Occupational Exposure”?
 The OSHA definition states that you have “Occupational
 Exposure” if your duties may result in a …

           …reasonably anticipated skin, eye, mucous membrane or parenteral
 contact* with human blood or other potentially infectious materials.

  *Parenteral contact is:                              …for definitions of
  piercing mucous membranes                            blood or OPIM
                                                       (other potentially
  or skin barrier through such
                                                       infectious
  events as needlesticks,                              materials), read on
  human bites, cuts and
  abrasions.
BLOODBORNE PATHOGENS (BBP) ANNUAL TRAINING - FOR MEMBERS OF NCSU POLICE DEPARTMENT
What are
Other Potentially Infectious Materials
(OPIM)?

  Bloodborne pathogens live and grow best in human blood. However, other
  human body fluids may also carry these germs. When making an Exposure
  Determination, we must also consider that OPIM are able to provide an
  environment for bloodborne pathogens to live and grow:

      •Semen
      •Vaginal secretions
      •Any fluid surrounding organs in the body
      •Visible blood in saliva, vomit, or feces
More OPIM
 Also considered Other Potentially Infectious Materials (OPIM) are:

 •Any body fluid visibly contaminated with blood;
 •All body fluids when it is difficult to differentiate between body fluids;
 •Any unfixed organ or tissue from a human, living or dead (clinics & morgues)
 and;
 •Other experimental human material (from laboratories) whether purposely
 infected or otherwise.

                                                              …so if I come into contact
                                                              with this material as part
                                                              of my job, I need to be
                                                              enrolled in the
                                                              Bloodborne Pathogens
                                                              program.
Law Enforcement Tasks with
Occupational Exposure
•   Arrests
•   Routine Interrogations
•   Domestic Disputes
•   Lock-up Operations
•   Assaults
•   Disruptive Behavior
•   Searches
•   Evidence Collection
•   Transportation of Prisoners
•   Crime Scene Processing
•   First Aid
•   Emergency Medical Response
Environmental Health & Safety can help

  As a University worker, if you have concerns about your exposure to
  bloodborne pathogens, you should discuss them with your
  supervisor and EHS.

  Your supervisor and EHS can help determine ways to make your
  job safer.
Now that we’ve discussed how your
exposure determination was made, let’s
look at what it means to be exposed.
Epidemiology

 Simply put, epidemiology is the science of tracking the spread of
 disease among a population.

 The population of concern in this
 training is NC State University law
 enforcement officers because of their
 potential exposure to bloodborne
 pathogens on the job.

 And the diseases of concern here are
 those caused by bloodborne pathogens.
What are Bloodborne Pathogens?
 Bloodborne Pathogens are germs that live and
 grow best in human material like blood. They
 enter your body through a puncture in your skin
 or through your eyes, nose or mouth.

 Many serious diseases are linked to
 bloodborne pathogens, but few bloodborne
 pathogens are frequently responsible for
 infections in the workplace.

          OSHA defines bloodborne pathogens as:

          “Pathogenic microorganisms that are present in
          human blood that can cause disease in humans.”
The “Big Three”
 As part of this training, officers should know some basic concepts about these
 diseases so that they can discuss them with their supervisor, co-workers, family
 members, their health care provider, and provide accurate information to the
 public.

   The risks and infections of the “Big Three”
   bloodborne pathogens will be discussed in
   this training:

   • Hepatitis B Virus (HBV)
   • Hepatitis C Virus (HCV)
   • Human Immunodeficiency Virus (HIV)
Disease Transmission
 Hepatitis B, Hepatitis C and HIV are passed by contact with the blood or other body
 fluids of someone who has the virus.

 The three main ways to get hepatitis B, C, or HIV are:
      – (1) having sex without latex condoms with someone who is
        infected;
      – (2) being born to a mother who is infected; and
      – (3) sharing needles and syringes with someone who is infected.

 We know that these viruses can be carried in infected human bodily fluids such as
 those defined under “Other Potentially Infectious Materials” (OPIM) in this training.
 And, if the Potentially Infectious Material contains enough of these pathogens, they
 can get into your bloodstream and may eventually cause disease.

 They can enter the bloodstream if the fluids come into contact with an unprotected
 break in your skin such as an open wound, acne, rash, etc. or if you experience a
 splash to your eyes, nose, or mouth.
Viral Hepatitis
“Hepatitis” means inflammation of the liver.
Viral hepatitis is inflammation of the liver
caused by a virus.

Your liver helps your body digest food, store
energy, and get rid of poisons. It acts as a
filtration system for your body.

As the filter begins to fail, impurities build up in
your body and symptoms can occur such as
jaundice (yellowing color of the skin and eyes),
dark urine, extreme fatigue, anorexia, nausea,
abdominal pain, and sometimes joint pain,
rash, and fever.
Types of Viral Hepatitis

  There are at least five types   Viral Hepatitis
  of viral hepatitis and each
  one is caused by a different
  virus. Hepatitis B is caused
  by hepatitis B virus (HBV),
                                  At least 5 types:
  and hepatitis C is caused       • Hep A
  by hepatitis C virus (HCV).
  In the United States, HBV
                                  • Hep B Virus (HBV)
  and HCV are the most            • Hep C Virus (HCV)
  common types related to
  occupational exposure to        • Hep D
  bloodborne pathogens.           • Hep E
Hepatitis B in the U.S.
 Annually, there are 10,000 new cases of Hepatitis B virus (HBV) reported in
    the U.S., with an estimated one to two million carriers of HBV.

 The hepatitis B virus takes about 2 months to show up in your blood. It may
    stay in your blood for months or years. Nine out of every 10 adults will get
    rid of the virus from their bodies after a few months. We say they have
    acute hepatitis B. One out of every 10 adults will never get rid of the virus
    from their bodies. We say they have chronic hepatitis B. They are called
    carriers.

 Most people with chronic hepatitis B will remain carriers of the virus if they do
   not get treated. The best things carriers can do is make sure their babies
   get all of their hepatitis B shots, make sure they do not spread it to their
   sex partners, and get good medical care.

 (Source: www.cdc.gov)
Hepatitis B Vaccination

 A safe and effective vaccine to prevent hepatitis B has
 been available since 1982. In short, a vaccine
 teaches your body how to defend against the virus
 and fight it off before it can make you sick. All NC
 State University officers must meet the requirements
 for Hepatitis B vaccination as a condition of
 employment.

 OSHA requires that vaccination be made
 available within 10 working days
 of initial assignment.

 This is a one-time requirement.

 Do you still need to schedule or decline the Hepatitis B
 vaccine at NC State University?
Getting Vaccinated – Exam Request Form
If you find you still need the Hep B vaccine, complete the Exam Request Form

As an employee, the vaccine is offered by NC State University at no cost to you:
     1. Notify your Supervisor.
     2. Notify Student Health of your request because you are employed by NC State University
         Police Department.
     3. Schedule your appointment with Student Health as indicated on the Exam Request Form.

                                      A series of 3 shots

                        Your               1                6
                       initial          month            months
                        visit            later            later
Hep B vaccine Declination Form
 If you’ve had the vaccine in the past at a location other than NCSU Student Health
      Services, you need to officially decline the Hepatitis B vaccination with NC State
      University by completing the Declination Form and returning it to Student Health.

 Other reasons people may decline the Hepatitis B vaccination include
            •current illnesses,
            •pregnancy, or
            •medications;
      They could lead to complications with the vaccination.

 As a member of the NC State University Police Department, if you are not getting a
 Hepatitis B vaccination at Student Health Services you must complete the Hepatitis B
 declination form.

 If you decline the vaccination, you may receive it at any time in the future by filling out the
      Exam Request Form and submitting it to Student Health Services.
Hepatitis B Vaccine information

For health concerns regarding this vaccination you may:

• Discuss your concerns with Student Health Services;

• Discuss your concerns with your personal health care provider; and

• Review CDC information about the vaccine at
  http://www.cdc.gov/vaccines/vpd-vac/hepb/default.htm
Hepatitis C Virus
 Hepatitis C virus is the most frequently
 occurring bloodborne pathogen infection.
 At least 85 out of 100 people infected with
 HCV become chronically infected, and
 chronic liver disease develops in an
 average of 67 out of 100. HCV is most
 often transmitted by large or repeated
 percutaneous (skin puncture) exposures to
 blood, such as through the transfusion of
 blood or blood products from infected
 donors and sharing of contaminated
 needles among injection drug users.
 There is no vaccine to prevent hepatitis C.
                                               A healthy and diseased
                                                    human liver
Hepatitis A?

Unlike Hepatitis B and C, Hepatitis A is not a bloodborne pathogen. Instead, it is
transmitted by the fecal oral route. It is mentioned here because many people in
the USA (33 out of 100 people) have had Hepatitis A virus with the most common
being school children and young adults. Infection with HAV is always acute; it is
therefore much less severe than HBV or HCV. A vaccine is available for HAV.
All prevention programs for NC State University employees should emphasize
proper handwashing after visiting or working in bathrooms or other fecal-
contaminated areas.

                                        Source: Viral Hepatitis and Liver Disease 1984;9-22
                                        J Infect Dis 1989;160:887-890
Wash Your Hands Often!

   Wash your hands with soap and water for 20 Seconds. The suds scrub
   dirt and germs away. Don't Leave Anything Out. Wash your hands front
   and back and between the fingers. Soap up your wrists too. And don't
   forget your fingernails.
         •Hands are to be washed immediately or as soon as feasible after
         removal of gloves or other personal protective equipment.
         •Use a utility or restroom sink for handwashing, do not use sinks in
         food preparation areas.
         •If handwashing facilities are not immediately available use
         antiseptic hand cleanser and/or disposable wipes for the short
         term...
         •…but wash your hands as soon as handwashing facilities are
         available.
HIV
 HIV stands for human immunodeficiency virus. It
 is different from most other viruses because it
 attacks the immune system. The immune
 system gives our bodies the ability to fight
 infections. HIV is the virus that causes AIDS
 (acquired immunodeficiency syndrome), the final
 stage of HIV infection. It can take years for a
 person infected with HIV, even without
 treatment, to reach this stage. Having AIDS
 means that the virus has weakened the immune
 system to the point at which the body has a
 difficult time fighting infections.
HIV Testing
 The only way to know whether you are infected is to be tested for HIV. You cannot
 rely on symptoms alone because many people who are infected with HIV do not have
 symptoms for many years. Someone can look and feel healthy but can still be
 infected. In fact, one quarter of the HIV-infected persons in the United States do not
 know that they are infected.

 Once HIV enters the body, the body starts to produce antibodies—substances the
 immune system creates after infection. Most HIV tests look for these antibodies rather
 than the virus itself. There are many different kinds of HIV tests, including rapid tests
 and home test kits. All HIV tests approved by the US government are very good at
 identifying HIV.
More about HIV
 HIV is a fragile virus. It cannot live for very long outside the body. As a
 result, the virus is not transmitted through day-to-day activities such as
 shaking hands, hugging, or a casual kiss. You cannot become infected
 from a toilet seat, drinking fountain, doorknob, dishes, drinking glasses,
 food, or pets. You also cannot get HIV from mosquitoes.

 HIV can enter the bloodstream
 similarly to HBV: if potentially
 infectious materials (like blood)
 come into contact with an
 unprotected break in your skin
 such as an open wound, acne,
 rash, etc. or if you experience a
 splash into your eyes and/or
 nose.
Exposure Incident
                                                Now that we’ve discussed
                                                what it means to be
                                                exposed, let’s look what
                                                to do in the event of a
                                                potential exposure.

 An important part of this training program is to make sure all officers know
 (1) if they have an exposure incident and (2) what to do after they have an
 exposure incident. An exposure incident could happen three ways:
 1. When human blood or other potentially infectious material (OPIM) get
     onto an unprotected break in your skin such as an open wound, acne,
     rash, etc.; or
 2. When blood or OPIM splashes or otherwise gets into your eyes, nose,
     or mouth; or
 3. If you are cut or stuck by an object (it must break the skin) that is
     contaminated with human blood or OPIM.
Fights and assaults
 Law enforcement officers are exposed to a
 range of assaultive and disruptive behavior
 through which they may potentially become
 exposed to blood or other body fluids
 containing blood. Behaviors of particular
 concern are biting, attacks resulting in blood
 exposure, and attacks with sharp objects.
 Such behaviors may occur in a range of law
 enforcement situations including arrests,
 routine interrogations, domestic disputes,
 and lockup operations. Hand-to-hand
 combat may result in bleeding and may thus
 incur a greater chance for blood-to-blood
 exposure, which increases the chances for
 bloodborne disease transmission.
What is a BBP Exposure?
 The OSHA Definition:
      “A specific eye, mouth, other mucous membrane, non-intact
      skin or parenteral contact with blood or OPIM that results from
      the performance of an employee’s duties.”
                                 BBP Exposure = Blood, OPIM
                                               contact with: Eye,
                                                            Nose,
      Also, remember:                                      Mouth,
           NC State University requires you           Shaving cut,
           to report ANY incident resulting              rash, etc.
           in injury from the performance of
           your duties.
Searches and Evidence Handling
 Criminal justice personnel have
 potential risks of acquiring HBV
 or HIV infection through
 exposures which occur during
 searches and evidence
 handling. Penetrating injuries
 are known to occur, and
 puncture wounds or needle
 sticks in particular pose a
 hazard during searches of
 persons, vehicles, or cells, and
 during evidence handling.
What to do for needlesticks, cuts from
contaminated objects, scratches or
splashes to an unprotected open wound:
 1. Remove contaminated gloves and if possible, allow the wound
    to bleed freely for a minute.
 2. Wash the wound with
    soap and water for 15
    minutes and apply sterile
    gauze or a bandage, if
    necessary.
 3. Decontaminate and
    remove protective
    clothing if necessary and
 4. Notify your Supervisor
    and seek medical
    attention immediately
What to do for splash to eyes, nose, or mouth:

  1. Rinse the area with
     continuous clean running
     water.
  2. Eyes should be irrigated
     for at least 15 minutes
     using an emergency
     eyewash station if
     available or a sink.
  3. Decontaminate and
     remove protective
     clothing and
  4. Notify your Supervisor
     and seek medical
     attention immediately
Report Exposures Immediately!
             Immediately report exposures to your
             supervisor and seek medical attention.

 After any exposure to human blood or OPIM,
 officers must be seen immediately at an
 Occupational Health Clinic or Emergency Room.
 Supervisors should notify dispatch to help
 determine the need for immediate treatment and
 direct the officer to the proper location for
 appropriate blood tests to be drawn and
 medications to be dispensed.

 Dispatch maintains “needlestick” packets with the Duke Occupational
 Health Hotline phone number and other required information. If the packet
 cannot be obtained or Fire Protection personnel is unavailable, call the
 Duke Occupational Health Hotline at 919-684-8115 for assistance .
Post Exposure Evaluation
Following the incident, you may be
    provided with a post exposure
    medical evaluation.

This evaluation could include:

    • Documenting routes of
      exposure
    • Documenting circumstances
      of the incident
    • Identifying sources of
      contamination
    • Blood tests with consent from
      employee
    • Post exposure prophylaxis
      and counseling
Employees are not billed for work-related injuries and medical records
are kept separate and confidential from performance reviews.
Reporting Injuries
The supervisor is responsible to follow-up all injuries with standard
reporting procedures.

The Accident Report Form Flowchart is a helpful guide. It is available
from the EHS website.
Bloodborne Pathogens Spills

Spills may occur during traffic accidents, when an injured person drips blood on
the floor, or when specimen containers of human blood or other potentially
infectious materials (OPIM) leak.

Employees designated to participate in emergency and decontamination
procedures are exposed to blood or OPIM; they are to be thoroughly familiar
with proper cleaning and decontamination procedures so that the
contamination is contained and exposure to other people is minimized.
Remember Your Sharps Precautions
During a Spill
 Contaminated broken glassware is cleaned up by mechanical
 means (e.g. tongs, forceps, pieces of cardboard).
Bloodborne Pathogens Spill Clean Up Kits Typically Include:

   –   1 pair disposable latex gloves,   – 2 disposable towelettes (w/
   –   1 disposable faceshield,            MSDS),
   –   1 disposable face mask,           – 2 scoops/scrapers,
   –   1 pair disposable shoe covers,    – 2 biohazard bags with ties,
   –   1 disposable apron, 1 absorbent   – 1 disposable towel,
       pack (w/ MSDS),                   – 1 instruction sheet,
                                         – 1 can 12 oz. Disinfectant spray (w/
                                           MSDS)
Spill Clean Up
 Inside university buildings
 Designated crews in Facilities Housekeeping
 are properly trained to handle spills of human
 blood and body fluids within University
 buildings.

 Outside university buildings
 Fire Protection and EHS should be consulted
 regarding spill clean up of human blood and
 body fluids exterior to university buildings.

 Officers may be requested for crowd control or
 other assistance to keep others out of the area
 until safe.
What to do with biohazard waste after
spill clean up

 Never throw untreated biohazard waste in the
  regular trash!

 The disposal of this waste generated on the NC State University campus is
 subject to federal, state, and local regulations. After spill clean-up is complete,
 waste must be removed from public access. If waste needs to be removed,
 contact your supervisor. The supervisor is responsible for contacting the
 Department of Environmental Health and Safety at 962-6858. After the location
 and other pertinent information is given, EHS will remove the waste for proper
 disposal.
Preventing Incidents at
NC State University     Now that we’ve
                                         discussed how to
                                         respond in the event of a
                                         potential exposure, let’s
                                         look at how to protect
                                         ourselves and others
                                         from exposure.

Make sure you know what’s expected to prevent exposures and protect
the campus community. It all starts with UNIVERSAL PRECAUTIONS.
Universal Precautions
 In the mid-1980s, health care facilities began adopting “universal precautions”
 against exposure to body fluids. These were followed in 1992 with the OSHA BBP
 Standard.

 These measures were included in annual training requirements which reduced
 incidents of work-related Hepatitis infections.
What Are Universal Precautions?

 “Universal Precautions” is the basis of every Bloodborne Pathogens
 training program. It is a simple approach to protecting yourself on the job.

 Because an Exposure Determination has already been made for your
 position, whenever you suspect the material is contaminated with
 bloodborne pathogens, you always respond AS IF bloodborne pathogens
 are present.

 Universal Precautions takes the guesswork out of responding to an
 incident. This means that if you anticipate human blood, body fluids
 (except sweat), or OPIM, you always wear appropriate Personal Protective
 Equipment and follow the specific requirements designated in this training
 and your Exposure Control Plan. This is also true for anything with a
 biohazard label on it.
Biohazard Symbol
 Communication of hazards is a key component to any OSHA and
 other safety program.

 The Biohazard symbol is used to alert
 others of the potential presence of
 biohazardous materials such as human
 blood, body fluids, and OPIM.

 This symbol is fluorescent orange or
 red/orange with contrasting letters and
 has the universal biohazard symbol.
Biohazard Labels
 In laboratories, biohazard labels are commonly used on:
       • Containers of biohazard waste
       • Refrigerators and freezers used to store human specimens
       • Containers used to store, transport and ship human specimens
       • Any equipment that could be potentially contaminated with human blood,
          OPIM, and other material that could allow bloodborne pathogens to live or to
          grow.

 We use the biohazard symbol at NC State University to provide a method for
 hazard communication between lab workers, visiting professors, Facilities
 Operations workers, Housekeeping personnel, vendors, and others who may
 come into contact with this material.
Biohazard Door Signs
 The Universal Biohazard
 Symbol may be posted on
 entryways to laboratories on
 campus. These laboratories
 are called Biosafety Level 2
 or BSL-2 labs. Posted BSL-
 2 areas are laboratories
 designated to work with
 bloodborne pathogens or
 with material that may allow
 germs that cause illness to
 humans,             including
 bloodborne pathogens, to
 live and grow.

 It is safe to enter areas that are labeled with a BIOHAZARD symbol. DO NOT
 handle anything labeled as biohazardous in these areas without special
 training. For example, it is very important that all open sores are covered and
 protected if work is required in these areas. Wear gloves and face protection
 when working in areas where contact with blood or OPIM is possible.
 Untreated waste in biohazard waste bins should never be handled by
 untrained workers in BSL-2 areas.
Sharps Disposal Containers

 Sharps containers are appropriate
 for any contaminated object that
 can penetrate the skin such as:
      •Needles
      •Scalpels
      •Razor blades
      •Syringes with/without
      needles
      •Specimen tubes and
      •Broken glass

   Overfilling the sharps container can result in exposures when the next
   person tries to use the container. Dispose of sharps in containers
   immediately and never allow a container to fill over 2/3 full.
Sharps Precautions
Needles/contaminated sharps:
   • Must never be bent, recapped or removed;
   • Must never be sheared or broken;
   • Must be placed in a plastic sharps container labeled with the
      biohazard symbol.

While processing the crime scene, personnel should be alert for the
presence of sharp objects such as hypodermic needles, knives, razors,
broken glass, nails, or other sharp objects.

Needles and other sharp objects recovered as evidence should be
manipulated as little as possible and should be stored and transported in a
puncture-proof container.

After use, disposable blades and other sharp items should be placed in
puncture-resistant containers for disposal. Contaminated disposable
needles are to be placed in red plastic sharps containers (available from
cabinet in squad room/supply room) after use.
Work Practice Controls: General
Work Practice Controls specifically reduce the likelihood of
exposure by altering the manner in which a task is performed.
Hand washing.          Hands are to be washed immediately or as soon as feasible after
  removal of gloves or other personal protective equipment. Use a utility or restroom
  sink for handwashing, do not use sinks in food preparation areas. If handwashing
  facilities are not immediately available use antiseptic hand cleanser and/or disposable
  wipes. Wash your hands as soon as handwashing facilities are available.

Prevent Ingestion.       Eating, drinking,
  smoking, applying cosmetics or lip balm,
  and handling contact lenses are
  prohibited during duties where there is
  reasonable likelihood of exposure to
  blood or other potentially infectious
  material.

Storage of food and drink is
  prohibited in refrigerators, freezers,
  shelves, cabinets or on countertops or
  bench tops where blood or other
  potentially infectious materials are
  present.
More General Work Practice Controls
 Sharps Precautions. Disposing of sharps in the proper container and disposing
    of the container when it is 2/3 full helps keep others safe. Remember, any
    contaminated object that can penetrate the skin, including needles, scalpels and
    glass objects requires extra attention.

 Contaminated needles. Contaminated needles
    are not to be bent, broken, recapped, or removed
    from the syringe. If you have no way to tell if the
    needle is contaminated or not, use Universal
    Precautions: assume the needle is contaminated.
    Contaminated needles are to be placed in the
    plastic sharps containers described previously
    and autoclaved before disposal.

 Broken glassware which may be contaminated with human blood or OPIM
     must not be collected directly with the hands. Wear gloves and use tongs or
     a brush and dust pan. While small shards of contaminated broken glass can
     be placed into sharps containers, large contaminated broken glass items must
     be autoclaved separately in a hard-walled container (such as a cardboard
     box) lined with a biohazard bag. The autoclaved glass waste is to be
     disposed of in a larger cardboard box lined with a plastic bag, clearly marked
     with the "GLASS AND SHARPS" label.
Work Practice Controls--Searches and
Evidence Handling
 The following work practice controls will help to reduce the risk of infection during searches
 and evidence handling:

 1. An officer should use great caution in searching the clothing of suspects. Individual
    discretion, based on the circumstances at hand, should determine if a suspect should
    empty his own pockets or if the officer should use his own skills in determining the
    contents of a suspect's clothing.
 2. A safe distance should always be maintained between the officer and the suspect.
 3. Wear protective gloves if exposure to blood is likely to be encountered.
 4. If cotton gloves are to be worn when working with evidence of potential latent fingerprint
    value at the crime scene, they can be worn over protective disposable gloves when
    exposure to blood may occur.
 5. Always carry a flashlight, even during daylight shifts, to search hidden areas. Whenever
    possible, use long-handled mirrors and flashlights to search areas (e.g., under car seats).
 6. If searching a purse, carefully empty contents directly from purse, by turning it upside
    down over a table.
 7. Use puncture-proof containers to store sharp instruments and clearly marked plastic bags
    to store other possibly contaminated items.
 8. To avoid tearing gloves, use evidence tape instead of metal staples to seal evidence.
Personal Protective Equipment
Personal protective equipment (PPE) is
specialized clothing or equipment worn by an
employee for protection against a hazard.

General work clothes
(including uniforms) are
not PPE.
PPE is worn when there is a need to provide
   protection for
               • clothing
               • skin
               • eyes
               • nose
               • mouth
PPE
Personal protective equipment should be present in each patrol
car for use in emergency and criminal response situations.
Replacement gloves and sharps disposal containers are kept in
the cabinet in the squad room/supply room. The cabinet is
restocked regularly by Fire Protection.

Nitrile gloves are issued on your duty belt. They do deteriorate
over time! Every couple of months replace the issued gloves on
your duty belt if unused.

Not all types of gloves are suitable for all situations. Vinyl or latex
rubber gloves provide little protection against sharp instruments,
and they are not puncture-proof. There is a direct trade-off
between level of protection and manipulability. In other words,
the thicker the gloves, the more protection they provide, but the
less effective they are in locating objects. Thus, there is no single
type or thickness of glove appropriate for protection in all
situations. Officers should select the type and thickness of glove
which provides the best balance of protection and search
efficiency.
Know the limitations of your PPE
Officers may confront unusual hazards, especially when the
crime scene involves violent behavior, such as a homicide
where large amounts of blood are present.

Protective gloves should be available and worn in this setting. In
addition, for very large spills, consideration should be given to
other protective clothing, such as overalls, aprons, boots, or
protective shoe covers.

Gloves should be changed if torn or soiled and always removed
prior to leaving the scene. While wearing gloves, avoid handling
personal items, such as combs and pens that could become
soiled or contaminated.

Face masks and eye protection or a face shield are required for
situations which could lead to potential exposures to blood via a
splash to the face, mouth, nose, or eyes.
PPE Removal

All PPE must be removed and disposed of prior to leaving the area.

Here is a sample removal technique
when gloves are contaminated:

1. Grasp outside of glove with opposite
   glove hand; peel off
2. Hold removed glove in gloved hand
3. Slide fingers of ungloved hand under
   remaining glove at wrist
4. Peel glove off over first glove
5. Discard glove in waste container           1.             2.      3.   4.
6. Wash hands immediately
PPE (continued)

PPE is NOT worn outside of the work area.

Gloves must be removed prior to washing
hands and leaving the area.

DO NOT wear gloves on elevators (even if
they are “clean”) or use them to open doors
or touch equipment (i.e. phones,
computers) that others will be handling
without gloves.
Laundry
 Although soiled clothing or uniforms may contain organisms that cause
 disease, the risk of actual disease transmission is negligible. Therefore,
 simple hygienic measures for handling and washing linens are
 recommended.

 1.   Handle uniforms soiled with blood as
      little as possible, using gloves and
      appropriate protective clothing.

 2.   Place uniforms soiled with blood in
      bags that prevent leakage.

 3.   Contaminated uniforms cannot be
      taken home for cleaning. Contact your
      supervisor so that arrangements can
      be made for laundering.
Safety Resources
    Below is a list of Safety Resources that can provide you
     with more safety information.

OSHA Topics Page
     http://www.osha.gov/SLTC/bloodbornepathogens/index.html
OSHA's Bloodborne Pathogens Standard
     http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051
Exposure to Blood: What Health Care Workers Need to Know (CDC)
     http://www.cdc.gov/ncidod/hip/Blood/Exp_to_Blood.pdf
As It Should Be Done: Workplace Precautions Against Bloodborne Pathogens (24 minute video, OSHA)
     http://www.osha.gov/SLTC/video/asitshouldbedone/video.html
Sharps Safety: Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention
     Program (CDC)
     http://www.cdc.gov/sharpssafety/
Questions???

If you have any questions, please contact the
Biosafety Officer in Environmental Health and
Safety at 515-6858 between 8 am and 5 pm.

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                 take the exam to
                 get credit for this
                 course!

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