This training module is designed to provide a basic understanding of the following:
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Bloodborne pathogens
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Common modes of transmission
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Prevention of transmission, and
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Emergency procedures and other pertinent information
ISD 622 is responsible for determining employees who are reasonably anticipated, as a result of performing their job duties, to be in contact with bloodborne pathogens. Employees in positions that have contact with students are required to be trained within the first 30 days of employment and each year thereafter, throughout the duration of their employment with ISD 622. This program is designed to meet the requirements of the Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogen Standard, 29 CFR 1910.1030.
This module is intended to be used by ISD 622 staff for training purposes.
To receive credit for completing this required training, please complete the online test after you have read through this module (also found on the district website).
Bloodborne Pathogens Diseases
Bloodborne Pathogens are pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV).
HIV Facts
HIV is a virus that attacks the immune system, and it can cause Acquired Immune Deficiency Syndrome (AIDS). AIDS is characterized by a defect in natural immunity against disease. People who have AIDS are vulnerable to serious illness that would not be a threat to anyone whose immune system was functioning normally. These illnesses are referred to as “opportunistic” infections or diseases.
AIDS is considered one of the most devastating public health problems in recent history. In 1996, the Centers for Disease Control and Prevention (CDC) estimated that one million persons in the United States are HIV-positive, and 223,000 are living with AIDS.
Most individuals infected with HIV have no symptoms and feel well. Some develop symptoms that may include tiredness, fever, loss of appetite and weight, diarrhea, night sweats, and swollen glands (lymph nodes) usually in the neck, armpits, or groin.
HBV Facts
Hepatitis B is an infection of the liver caused by HBV. HBV is one of several types of viruses (infections) that can cause hepatitis. There is a vaccine that will prevent HBV infection (the vaccine will be discussed in a section later in this module).
Hepatitis B infection may occur in two phases. The acute phase occurs just after a person becomes infected, and can last from a few weeks to several months. Some people recover after the acute phase, but others remain infected for the rest of their lives. They go into the chronic phase and become “chronic carriers”, meaning the virus remains in their liver and blood.
Acute Hepatitis B usually begins with symptoms such as loss of appetite, extreme tiredness, nausea, vomiting, and stomach pain. Dark urine and jaundice (yellow eyes and skin) are also common, and skin rashes and joint pain can occur. Over half the people who become infected with HBV never become sick, but some may later have long-term liver disease from their HBV infection. About one in 250 Americans is a chronic carrier, and many have no health problems themselves.
The Hepatitis B virus is very durable, and it can survive in dried blood/bodily fluid for seven to ten days.
HCV Facts
Hepatitis C is an infection of the liver caused by HCV. HCV is one of several types of viruses (infections) that can cause hepatitis. There is no vaccine that will prevent HCV infection.
Hepatitis C infection may occur in two phases. The acute phase, though somewhat rare in HCV cases, occurs just after a person becomes infected, and can last from a few weeks to several months.
Some people recover after the acute phase, but most remain infected for the rest of their lives. They go into the chronic phase and become “chronic carriers”, meaning the virus remains in their liver and blood.
Acute hepatitis C symptoms are very similar to those associated with Hepatitis B. Well over half of the people infected with HCV do not experience symptoms. However, about 55-85% of those infected become chronic carriers.
Like hepatitis B, hepatitis C is a very durable virus, and can survive in dried blood/bodily fluid for up to four days.
Bloodborne Pathogens Transmission
All human blood and certain human body fluids are to be treated as if known to be infected with HIV, HBV, HCV and other bloodborne pathogens. Although exposure to body fluids other than blood is unlikely in a school, the following body fluids are also to be treated as being infectious:
- semen and vaginal secretions
- amniotic fluid
- cerebrospinal fluid
- all body fluids where it is difficult or impossible to differentiate
Body fluids “not” carrying HIV:
- sweat
- tears
- saliva
- vomit
- urine
- feces
- if visible blood, treat as infectious
HIV, HBV and HCV are most commonly transmitted through:
- sexual contact
- needle sharing
- blood transfusions
- direct skin or mucous membrane contact with infected blood
- from mother to baby at birth
Unbroken skin forms a barrier against bloodborne pathogens. However, infected blood can enter your system through:
- open sores
- cuts
- abrasions
- acne
- any sort of damaged or broken skin such as sunburn or blisters
DID YOU KNOW…the number one type of exposure in schools is a bite?
Bloodborne pathogens may also be transmitted through the mucous membranes of the eyes, nose and mouth. If you are in doubt as to whether or not you have had an exposure, be sure to ask a school nurse or your own physician.
Preventing transmission of bloodborne pathogens
Universal precautions are practices and procedures that assist in the prevention of contact with blood and other body fluids. They are the best protection against HIV, HBV, HCV and other infectious agents. Universal Precautions provide the first line of defense against the risks of exposure to bloodborne pathogens.
Personal Protective Equipment (PPE)
When an exposure potentially exists, even with engineering controls in place, PPE should be used. There is a large range of PPE in the use of infectious control, but the main consideration in choosing and using such equipment is to restrict blood or other potentially infectious materials from contact with skin or other mucous membranes. ISD 622 provides PPE to employees at no cost of their own.
The following PPE can be ordered through the ISD 622 Training Supervisor at no cost to you.
Disposable vinyl gloves
Used for first aid, clean up, handling of sharps, and when in contact with any blood or other potentially infectious materials. Before putting on gloves, first wash your hands. After you have put on the gloves, check for proper fit and punctures. Gloves should fit snugly. Be sure to use the proper size for your hands (small, medium, large, or extra large).
To remove gloves, place the fingers of one gloved hand on the wrist of the other gloved hand. Peel the glove from the wrist to the fingers so that the glove is inside out. Place the inside-out glove in the palm of the gloved hand. Peel the remaining glove in the same manner (from wrist to fingers) while enfolding the first glove into this one. Following these practices minimizes contamination. Gloves should be disposed of immediately and never re-used. Wash your hands again after disposing of the gloves.
Goggles
Anytime there is a risk of splashing or vaporization of contaminated fluids, goggles and/or other eye protection should be used to protect your eyes. Bloodborne pathogens can be transmitted through the thin membranes of the eyes so it is important to protect them. Splashing could occur while cleaning up a spill, during laboratory procedures, or while providing first aid or medical assistance.
Aprons
Aprons may be worn to protect your clothing and to keep blood or other contaminated fluids from soaking through to your skin.
Other PPE also available are heavy-duty utility gloves, CPR microshields, antiseptic wipes, convenience bags, sharps containers, and mouth to mask resuscitator shield.
Handwashing
- Use warm water only – not hot, not cold.
- Wet both hands and wrists well before applying soap.
- Apply liquid soap to palms first (about 1 tsp.).
- Lather well; spread lather to the back of hands and wrists.
- Continue scrubbing, paying careful attention to fingernails and between fingers. The scrubbing time should be a minimum of 20 seconds.
- Rinse hands and wrists well to remove all soap and detergent.
- Dry completely.
- Turn off the faucet using disposable towels when there is no knee control. This avoids recontamination of clean hands.
Personal Hygiene
Eating, drinking, applying cosmetics or lip balm and contact lens handling are prohibited in work areas where there is a reasonable likelihood of occupational exposure. Also, food and drink should not be stored in close proximity to where blood or other potentially infectious materials are present.
Employees are asked to physically cover all exposed skin lesions, abrasions or cuts so as to protect themselves and others from potential bloodborne pathogens exposure.
Needles
Contaminated needles and other contaminated sharps shall not be bent, recapped or moved unless accomplished through the use of a mechanical device such as forceps, pliers, or broom or dust pan.
Never break or shear needles.
Needles shall be disposed of in labeled sharps containers only. Immediately, or as soon as possible after use, contaminated reusable sharps (scissors, knives, etc.) shall be placed in appropriate containers until properly reprocessed. These containers shall be: puncture resistant, labeled, and leak proof on both sides and bottom.
Sharps Handling
- Use disposable gloves.
- Mechanical devices such as tongs, dustpan or broom will be available to pick up contaminated sharps such as blood covered broken glass. This will avoid direct contact with the sharps. Contaminated glass may not be picked up by hand.
- All sharps will be disposed of in approved sharps containers located in the Health Office of each school building.
- Sharps containers will be appropriately disposed of according to Infectious Waste Procedures. When moving containers of contaminated sharps from the area of use, the containers shall be closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.
- Sharps containers are labeled with the biohazard symbol that is readily visible and are picked up from health offices once per year, or on an as-needed basis.
Exposure Control Plan
Most of the information contained in this training module can also be found in the School District’s Exposure Control Plan (ECP). The School District has developed this ECP to comply with the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard. This Standard has been specifically enacted to reduce exposure to HBV, HCV, HIV and other Bloodborne Pathogens.
The ECP and accompanying records are public documents and available for public review (except for information protected by the Data Practices Act). Copies of the ECP are kept in the following locations:
- Human Resources/Wellness Office (Education Center)
- Operations Office (Education Center)
- Main Office (All Schools)
- Health Offices (All Schools)
- Office – Bus Garage
- Main Office – Beaver Lake, Gladstone Community Center, Harmony ALC, Next Step
- Central Maintenance
- All Pools
- Polar Arena
- Tartan Arena
- Warehouse
Bloodborne Pathogens Emergency Procedures
In an emergency situation involving blood or potentially infectious materials, you should always use Universal Precautions and try to minimize your exposure by wearing gloves, splash goggles, pocket mouth-to-mouth resuscitation masks, and other barrier devices.
Spill Clean Up
- Always use gloves. Do not reuse disposable gloves. If utility gloves are used, decontaminate after use with soap and water and appropriate disinfectant.
- Use absorbent over spill or paper towels to absorb spill.
- Clean spill with soap and water.
- Utilize proper disinfectant (usually 1:10 bleach and water that is mixed fresh daily) and follow procedures.
How to Mix Bleach Solutions
Use for Hard Surfaces (800 ppm)
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Water
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Regular Bleach 5.25%
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Ultra Bleach 6-6.25%
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1 Gallon (16 cups)
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¼ cup
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3 1/3 tablespoons
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1 Quart (4 cups)
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1 tablespoon
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2 1/2 teaspoons
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1 Pint (2 cups)
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1 ½ teaspoons
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1 ¼ teaspoons
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Use for Mouthed Toys & Food Contact Surfaces (200 ppm)
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Water
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Regular Bleach 5.25%
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Ultra Bleach 6-6.25%
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1 Gallon (16 cups)
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1 tablespoon
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2 teaspoons
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1 Quart (4 cups)
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¾ teaspoon
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½ teaspoon
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1 Pint (2 cups)
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3/8 teaspoon
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¼ teaspoon
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5. Dispose of waste in a proper container (bloody rags and towels can be disposed of in regular, lined waste containers UNLESS you are dealing with very large amounts of blood and no matter how many rags you use, the rags or towels are saturated or dripping. If this is the case, then they are considered Biohazardous Waste and must be disposed of as infectious waste).
6. As a general rule, items that may be contaminated with blood or other body fluids, such as feminine hygiene product containers, diaper pails, etc. should be plastic/paper lined to eliminate any potential for exposure.
7. Wash hands thoroughly with warm water and soap.
8. Contact direct supervisor and the Exposure Control Officer (651-748-7524) for spill evaluation.
Post Exposure Information
If you are exposed, School District 622 is responsible for evaluating an exposure incident (i.e., blood contact with the skin or mucous membrane by needle stick, cut, bite, etc.).
In the event of an exposure incident, it is imperative that the employee and district follow the appropriate protocol. Time is important in providing the most comprehensive and protective treatment. The Exposure Control Officer may refer the exposed individual to their personal health care professional immediately following the exposure.
Any school district employee who has an exposure incident should follow the post-exposure protocol. The school district will be responsible for providing a confidential medical evaluation and follow-up after an exposure incident has been reported. The following protocol will be followed:
Exposed employee should:
- Immediately wash the exposed area or flush mucous membrane with running water.
- Contact Supervisor and Exposure Control Officer (748-7424) immediately.
- Obtain a Post Exposure Incident Packet from the front office, health office or Human Resources office and complete the “Accident Report” form (included in the Post Exposure Incident Packet) and submit it to the Human Resources Department at the
District Education Center
2520 East 12th Avenue
North St. Paul, MN 55109
This packet will provide employees with step-by-step instructions on what needs to be done in the event of an exposure.
4. Obtain post medical follow-up through the exposed employee’s own physician as soon as possible or at least within 24 hours of the exposure.
Bloodborne Pathogens HBV Vaccination Policy
School District 622 offers the hepatitis B vaccination to all employees who have occupational exposure to blood or other potentially infectious material.
The HBV vaccination series is provided at no cost to the employee. The school district will not institute a reimbursement program, or require the employee to use healthcare insurance to pay for the vaccination if there is any copay for insurance or procedure. In addition, the school district will not require the employee to enter into an “amortization contract” which requires employees to reimburse the school district for cost of the vaccine if the employee leaves prior to a specified time. The employee will incur no “out-of-pocket” costs.
The HBV vaccine is:
- Made available to high-risk employees at a choice of three reasonable locations and at reasonable times.
- Performed by a licensed physician or licensed healthcare professional following appropriate healthcare procedures.
- Made available after the employee receives the required training and within 10 days of initial assignment to all employees who have occupational exposure.
Exceptions include:
- An employee who has received vaccine series previously
- Antibody testing which reveals that employee is immune
- Medical reasons
The school district shall not require a pre-screening program as a prerequisite for receiving the HBV vaccination. If health services employees are vaccinated through ISD 622, then a titer shall be administered within a month after completing the vaccination series. This titer test is not given to any other employee groups unless the healthcare professional conducting the vaccination requires the test prior to provision of the vaccination. In these circumstances, the employer shall pay for the titer test.
An employee may decline the HBV vaccination, in which case the employee needs to sign a declination statement. The employee may, at a later date, request the vaccine. The school district shall then grant the request with no out of pocket expense to the employee.
School District 622’s occupational exposure hepatitis B vaccination procedure is as follows:
Vaccination for employees will be given the opportunity to receive the hepatitis B vaccination through the Washington County Public Health Department at a place and time to be determined after initial training takes place.
Infectious Agents
These are hazardous biological materials that present a risk or potential risk to the health of humans or animals. Examples include Influenza, head lice, strep-throat, pink eye, etc.
Reservoir
This is where the disease lives inside your body. For example, the reservoir for pertussis is inside the mouth and throat.
Modes of Escape
This is how the disease is spread from the infected person. For example, pertussis is spread through the air in droplets produced during sneezing or coughing.
Modes of Transmission
This is how the disease moves from one person to another. For example, a person can get pertussis by being directly sneezed or coughed on by someone with pertussis.
Modes of Entry
This is how a person becomes infected with a disease. For example, pertussis can be inhaled or ingested.
Host Susceptibility
This depends on the individual’s bodily reaction to the disease in question. For example, if someone was infected with pertussis, they may be immune to the disease for up to 10 years from their last infection.
One break in the chain can prevent infectious diseases from spreading. The easiest way to break the infection chain is via HANDWASHING. Properly washing your hands before and after eating, after using the restroom, and after working with students can decrease your chances of infection by more than 95%!
Confirmation Page
You're halfway there! Please go back to Bloodborne Pathogens and click on the Bloodborne Pathogens Test. Once the online test is completed and you receive the confirmation of submission, you can assume that you are compliant for this school year unless you hear otherwise from the Human Resources department.
Thank you!