occupational risks (bloodborne pathogens) Flashcards
these organisms such as bacteria, viruses, and even parasites that are carried in blood and cause diseases in people.
pathogenic
examples of primary concerns bloodborne pathogens
HIV, HCV, HBV
it is a dna virus that belongs to the hepadnaviridae family
HBV
what are the modes of transmission for HBV
parenteral, sexual, or perinatal
it is a mode of transmission where HBV is transmitted by intimate contact with HBV contaminated blood or other body fluids such as seminal fluid, vaginal secretions, and saliva
Parenteral
mode of transmission where their is a possibility that this bloodborne pathogen to be passed on or transmitter to the baby from the mother, most likely during delivery.
perinatal
incubation for HBV
45-90 days
HBV has a high chance of progression to
chronic state
chronic development of hepatitis will increase the risk of ___________ and also ________
liver cirrhosis and cancer of the liver or hepatocellular carcinoma
complications of hepatitis b virus, how many percent of cases may develop chronic hepatitis with increased risk of liver cirrhosis and cancer of the liver or hepatocellular carcinoma
10%-90%
HBV can survive at least ____ week in dried blood on environmental surfaces or contaminated needles and instruments
1 week
signs and symptoms of HBV
fever, fatigue, loss of appetite, nausea, dark urine, vomiting, abdominal pains, joint pains, and jaundice
the main risk for health workers being exposed to HBV is being?
being stuck with a HBV contaminated needle or other sharp objects
Measures to prevent HBV infections:
- screening blood donors
- treating plasma-derived products to inactivate HBV
- implementing infection control measures
- immunization of hepatitis b vaccine
examples of implementing infection control measures
no recapping of needles, wearing proper ppe, and prioritizing one’s welfare
an enveloped, single stranded RNA virus belonging to the Flaviviridae family
hepatitis c virus
modes of transmission for HCV
parenteral, sexual, and perinatal
HCV has a high chance of progression to _____
chronic state
HCV patient will really progress to chronic infections because HCV attacks the ____and may lead to inflammation.
HCV attacks the liver
what percent of develop chronic infection with increased risk of liver cirrhosis, hepatocellular carcinoma, and autoimmune manifestations in HCV.
85%
symptoms of HCV include
Jaundice, fatigue, abdominal pain, loss of appetite,, intermittent nausea, dark urine, and joint pains.
some HCV situations don’t show any symptoms at all and don’t know they are infected until decades later when liver damage shows up in ____ tests.
routine tests
the etiologic agent of the acquired immunodeficiency syndrome
human immunodeficiency virus
what are the former names of human immunodeficiency virus the 4 types
HIV 1 (discovered 1983-1984)
Human T-cell lymphotropic virus-type III (HTLV III)
Lymphadenopathy-associated virus (LAV)
AIDS-associated retrovirus (ASR)
HIV that causes AIDS attacks the __________ leaving the body at higher risk of developing more serious conditions.
human immune system cells
Signs and Symptoms of HIV
Flu like symptoms. (Fever, chills, appearance of rash, night sweats, muscle sore, sore throat, fatigue, swollen lymph nodes, or the presence of mouth ulcers.)
the signs and symptoms usually appear _ -_ weeks after infection while other people who are already infected with the virus may not feel sick.
2-4 weeks
HIV does not survive long and cannot reproduce outside a human host; so once transmitted, in order for the virus to replicate inside the body it will use the ____?
immune system
a related but genetically distinct virus from HIV -1 which discovered in 1986
HIV 2
Majority of infection of HIV 1 occurred in
West Africa
how is the transmission of HIV 2?
it has the same transmission process as HIV 1 and may also cause AIDS
what is the difference between HIV 1 and HIV 2?
HIV 2 is less pathogenic and has a lower rate of transmission
What are the 3 major routes of transmission of HIV?
- intimate sexual contact
- contact with blood or any other body fluids (parenteral route)
- Perinatal route (infected mother to infant)
transmission of virus may happen through vaginal or anal intercourse (which the major of the cases of HIV infection.)
intimate sexual contact
most cases worldwide of HIV can attributed to ____ contact
heterosexual contact
in the USA, the largest number of cases has resulted from anal intercourse in _______ males.
homosexual males
in order to prevent the transmission of parenteral route, prevention may include__________ and _________________ for HIV
screening of the blood and organ donors for HIV
what are the body fluids that are not considered to be infectious unless they contain visible blood.
saliva, sputum, nasal secretions, tears, sweat, urine, vomit, and feces.
transmission is through pregnancy, by transfer of blood during delivery or through breast feeding.
perinatal route
steps to reduce transmission of HIV through perinatal:
(HAT)
- HIV screening
- Administration of antiretroviral drug for HIV+ pregnant women
- The use of infant formula by infected mothers
Disease caused by bloodborne pathogens:
- syphilis
- malaria
- zika
- babesiosis
- brucellosis
- Creutzfeldt-Jakob disease
- human t-lymphotropic virus type 1
- ebola virus disease
an infection caused by treponema pallidum (spirochete)
syphilis
mode of transmission for syphilis
sexual contact (primary mode of dissemination) and perinatal route
syphilis sore is usually in what area of the body?
genital area
the causative agent of syphilis characteristic has:
coils and periplasmic flagella
syphilis has how many stages
4 stages
once contact has been made with a susceptible skin site, there will be thickening of ____
endothelial cells
thickening of endothelial cells that usually occurs with
aggregation of lymphocytes, plasma cells, and macrophages
sore appears on the spot where
the bacteria entered the body
chancre or the sore usually develops within ___ days after infection, within 21 days being the averaged
10-90 days
in men, chancre usually occurs
outside the penis
in women chancre usually occurs ___ and may go undetected
in the vagina or on the cervix
the primary stag usually lasts from ____ weeks during in which the lession may heal
1-6 weeks
it is a stage in syphilis infection where systematic dissemination or the spread of organism usually happens
secondary stage
symptoms for secondary stage of syphilis:
generalized lymphadenopathy, malaise fever, pharyngitis, and rashes on skin or mucous membrane
these rashes of syphilis may not be itchy and may also be accompanied by ___
wart-like sores in the mouth and in genital area
in secondary level, patient may exhibit neurological signs such as
visual disturbances, hearing loss, tinnitus, and facial weakness
in secondary level syphilis, lesions persist from a few days to ___ weeks
few days to 8 weeks
spontaneous healing may occur, as the __ stage
primary stage
the third stage of the syphilis infection level is the
latent stage
without treatment, syphilis will ____ in the body even if there are no signs and symptoms
remain in the body
it follows the disappearance of the secondary stage
the latent stage
in this stage of syphilis, it is characterized by a lack of clinical symptoms.
latent stage
the patient of syphilis this time are non-infectious, except for pregnant women
latent stage
what are the 2 types of latent stage syphilis
early latent syphilis
late latent syphilis
the infection (SYPHILIS) occurred less than 1 year’s duration
early latent syphilis
the infection occurred more than 1 year previously
late latent syphilis
the last and final stage of syphilis infection
tertiary stage
appears anywhere from months to years after secondary infection remains untreated
tertiary stage
the tertiary stage of syphilis occurs most often between __ and __ yeaars following secondary stage
10 and 30 years
what are the three manifestations of the tertiary stage
Gummas or Gummatous lesions, cardiovascular disease, and neurosyphilis
the gummas or gummatous lesions is localized areas of ____ inflammation
Granulomatous inflammation
complications involve the ascending aorta, and symptoms due to the destruction of elastic tissue
cardiovascular disease
the cardiovascular disease of syphilis may result to
aeutic aneurysm, thickening of the valve, aortic regugatation, and angina pectoris
the complication that most associated with the tertiary stage
neurosyphilis
can actually occur anytime after the primary stage and can span all stagees of the disease process
tertiary stage
a life threatening parasitic disease caused by infection with plasmodium protozoa
malaria
the mode of transmission of this disease is through an female anopheles mosquito
malaria
the two plasmodium poses the greatest threat
plasmodium falciparum and plasmodium vivax
symptoms for malaria are
fever, chills, and headaches
how many days would the symptoms appear after the ineffective mosquito five
10-15 days
what is the life cycle plasmodium
development in blood feeding insect host
injects parasite into vertebrae host
parasite grow in liver
parasite enters bloodstream to affect rbcs
caused by a virus transmitted primarily by the bite of an infected aedes species mosquito
zika
the two types of Aedes
Aedes egypti and Aedes albopictus
symptoms of infection include rash, fever, conjunctivitis, muscle and joint pain, malaise headaches, usually lasting 2-7 days
zika
zika can be transmitted by
mother to infant (perinatal)
sexual contact
transfusion of blood
organ transportation
the sever manifestation of zika are usually seen in babiies of infected mothers that can result problems in baby like
mircocephaly
an abnormally small head bexause of the brain that does not developed normally that causes seizure and delay of intellectual develoment
microcephaly
Caused by Babesia microti
babesiosis
transmitted by the bite
of infected Ixodes scapularis ticks - typically, by the
nymph stage of the tick, which is about the size of a
poppy seed.
babesiosis
Babesia parasites infect and destroy red blood cells
which results in hemolytic anemia leading to
jaundice and dark urine
Babesiosis can be a severe, life threatening
disease especially for people who?
people who do not have a spleen
have a weak immune system
have other serious health conditions
very old people
Zoonotic infection caused by the bacterial genus
Brucella
brucellosis
Transmitted from animals to humans by ingestion
through infected food products (milk from cow),
direct contact with an infected animal, or inhalation
of aerosols.
brucellosis
other names for brucellosis
mediterranean fever
malta fever
gastric remittent fever
undulant fever
species of brucella
b. abortus
b. meltiness
B. suis
when the Brucella infects an animal, this usually results in
spontaneous abortion
if the Brucella infects
humans, this usually leads to
fever like undulant fever or
malta fever.
A rare brain disorder that leads to dementia believed
to be caused by a protein known as prions.
Creutzfeldt-Jakob Disease (CJD)
is marked by changes in mental abilities
including personality changes, memory loss,
impaired thinking, blurry vision or blindness,
insomnia, problems with coordination, trouble
speaking or swallowing, and sudden jerky
movements.
CJD
3 TYPES OF CJD
`sporadic cjd
hereditary CD
acquired cjd
the disease appears even
though the person has no known risk factors for
the disease. This is by far the most common type
of CJD and accounts for at least 85 percent of
cases.
sporadic cjd
— the person may have a family
history of the disease and test positive for a
genetic mutation associated with CJD.
Hereditary CJD
the disease is transmitted by
exposure to brain or nervous system tissue,
usually through certain medical procedures
Acquired CJD
: A type of CJD called variant CJD (or vCJD) can
be acquired by eating meat from cattle affected by a
disease similar to CJD
bovine spongiform
encephalopathy (BSE) or, commonly “mad cow”
disease.
Occurs when a person is infected by the human
T-lymphotropic virus type 1 causing
T-cell
leukemia/lymphoma.
human t-lymphotropic virus type 1
blood transfusions, sexual
contact and sharing needles; mother to child during
birth or breastfeeding (Perinatal Transmission)
If a person has HTLV-1, the nucleus of the
lymphocytes looks like
flower
ebola virus was formally known as _______, a rare but severe, often fatal illness in humans
Ebola hemorrhagic fever
Symptoms of EVD can be sudden and include:
Fever, fatigue, muscle pain, headache, sore
throat
○ Vomiting, diarrhea, rash, impaired kidney and
liver function, internal and external bleeding
modes of transmission for ebola virus
fruit bat and zoonotic
the risk of exposure on the healthcare setting is high because
most of the time we are always dealing with specimens coming from patients
the main source for contamination source is the
blood (the human blood, human blood components, and products made from human blood)
other potential infectious materials
human body fluids
any unfixed tissue or organ from human
culture, culture mediums, or other solutions
experimental animal blood, tissues, or organs infected with HIV and HBV
Since we are constantly exposed to these sources when
working in healthcare, it is also important to remember
that we need to protect ourselves by
- practicing standard guidelines of processing specimen
- wearing PPE
spread of blood borne pathogens occurs through:
direct contact
indirect contact
respiratory transmission
vector-borne transmission
Wherein infected blood or body fluids from one
person is transferred directly to another
direct contact
Wherein a person touches an object that may
contain the blood or body fluid of an infected
person.
indirect contact
The person inhales respiratory droplets from an
infected person through coughing or sneezing.
respiratory transmission
Wherein a person’s skin is penetrated by a bite
from an organism that carries the disease (e.g.
mosquitos and ticks).
vector-borne transmission
how does an exposure occurs
needlestick injuries
cuts from other contaminated sharps
contacts of mucous membrane with contaminated blood or opim
Unbroken skin forms an impervious barrier against
bloodborne pathogens. However, infected blood can
enter your system through:
open sores
abrasions
cuts
acne
any sort of damaged or broken akin such as sun burn or blisters
Occupations at Risk
● First aid responders
● Housekeeping personnel in some industries
● Nurses and other healthcare personnel
CDC estimates ___ million workers in healthcare
and related occupations are at risk.
5.6
All occupational exposure to blood or OPIM
places ___ at risk.
workers
Percent of occupational groups of
healthcare workers which are exposed to blood or
body fluids. With ____, ___, ___
accounting for most of the incident.
nurses, physicians, and technicians
Healthcare work locations where
exposures usually occur. With____
(medical or surgical wards, and intensive care units,
as well as operating rooms) account for the majority
of the exposure sites.
inpatient facilities
Data from the National Surveillance System for
Healthcare Workers show that _________sustain the
highest number of percutaneous injuries.
nurses
They are the predominant occupational group
injured by needles and other sharps, because they
are the largest segment of the workforce at most
hospitals.
nurses
Although sharp injuries happen everywhere, data
also shows that the majority of injuries happen at
____ units particularly in medical floors, ICUs,
operating rooms; after use and before disposal of
sharp devices; during use; during or after disposal of
sharp devices.
in-patient
written plan to eliminate or minimize
occupational exposures.
exposure control plan
ECP is a mandated written document that:
- Identifies sources of exposure
- Communicates information to employees
- Provides methods of compliance
- Records training/vaccinations/incidents
When an ECP is established, there is also a need to
______ and _____ the plan _____
review and update; annually
When an ECP is established, there is also a need to
review and update the plan annually or:
1. Whenever _____ or ____ task or procedures
affect occupational exposures.
new or modified tasks or procedures
When an ECP is established, there is also a need to
review and update the plan annually or:
- When there is a new or revised ___________ position with occupational exposure.
employee position with occupational exposure.
Required elements of ECP
(ESP)
- Exposure determination
- Schedule and method of implementation
- Procedure for evaluation of exposure incidents
ECP must include:
● Potential exposure determination
● Safe work practices
● Changes in technology that reduce/eliminate
exposure
● Decontaminating equipment
● Selecting and using PPE
ECP must include:
● Handling biohazard waste
● Labels and signs
● Training requirements for healthcare workers
● Recordkeeping requirements
● Annual review and update
This is important because it
helps you protect your workers from exposure to blood and other potentially infectious materials. By protecting the workers, you also control exposure incident costs.
exposure control plan
ECP must meet OSHA’s criteria.:
It must be written ___ for the facility
It must be reviewed and updated at least____.
It must be ___________ to all workers.
● It must be written specifically for the facility.
● It must be reviewed and updated at least yearly.
○ To reflect changes such as new worker positions
or technology-use to reduce exposure to blood or
other bodily fluids.
● It must be readily available to all workers.
The key to not being able to acquire infections from
bloodborne pathogens lies in ______ the exposures.
controlling
this is the observe _______ such as:
● Treating all blood and bodily fluids as if they are
contaminated
● Proper cleanup and decontamination
Observe Universal Precautions
Engineering and Work Practice Controls
- Safer medical devices
- Sharps disposal containers
- Hand hygiene
One of the risk mitigation controls. According to the
hierarchy of controls, this is the least effective but the most commonly implemented risk mitigation control.
PPE
This is the responisibilty of ?
● Perform hazard assessment
○ He/She must pinpoint areas where there is risk of
being exposed to bloodborne pathogens or risk of
acquiring infections caused by bloodborne
pathogens.
● Identify and provide appropriate PPE to employee at
no cost
● Train employees on use and care
● Maintain/replace PPE
● Review, update, evaluate PPE program
Employer’s Responsibilities
PPE Selection
● Safe design and construction
● Fit comfortably
Required PPE Training
Employers are required to train the workers on how to use the PPE to know:
● When it is necessary
● What kind is necessary
● Proper donning, adjusting, wearing, doffing
● Limitations
● Proper care, maintenance, useful life, disposal
Written schedule for cleaning and
decontamination
Housekeeping
Picking up broken glass is prohibited it should be:
● Not picked up by hands
● Mechanical means only
proper Clean-up and Decontamination
● Wear protective gloves or PPE
● Use appropriate disinfectant
● Clean and disinfect contaminated equipment and
work surfaces
● Thoroughly wash up immediately after exposure
● Properly dispose of contaminated PPE, towels, rags,
etc.
OSHA mandates that the disposal of the infectious
waste is in accordance with ____ state and ___
regulations,
federal and local
OSHA mandates that the disposal of the infectious
waste. that the surface is left wet with the
disinfectant for ___ seconds for HIV-1 and ___ minutes
for HBV.
30 seconds for HIV-1 and 10 minutes
for HBV.
refer to the following categories of
waste which requires special handling.
Regulated waste
The bloodborne pathogen standard, uses the term
Regulated Waste to refer to the following categories of waste which requires special handling:
(5)
- Liquid or semi-liquid blood or other potentially
infectious materials (OPIM). - Items contaminated with blood or OPIM, and which
would release these substances in a liquid or
semi-liquid state if compressed. - Items that have dried blood, and are capable of
releasing these materials during handling. - Contaminated sharps.
- Pathological and microbiological wastes containing
blood or OPIM.
Dispose of contaminated sharps in
closable,
puncture-resistant, leakproof (red)
Dispose of regulated waste in
closable, leak-proof
red or biohazard labeled bags or containers
who are needed to attain the training
● All employees with occupational exposure to blood
or other potentially infectious material (OPIM)
● Employees who are trained in first aid and CPR
No cost; during working hours
When is training needed or happen
● Initial assignment
● Annually; or with new/modified tasks
this is Offered to all potentially exposed employees
Provided at no cost to employees (within 10 days to
employees with occupational exposure)
Hepatitis B vaccination:
If the employee declines, the employer must
ensure that the employee signs a HBV
_____ form
Declination form
No vaccinations available for:
● Hepatitis C
● HIV
this is result of an employee’s duties. Specific eye, mouth, or other mucous membrane,
non-intact skin, parenteral contact with blood or OPIM that results from the performance of an employee’s
duties.
exposure incident
Immediate Actions to do when exposed to BBP and OPIM
● Wash exposed area with soap and water
● Flush splashes to nose, mouth, or skin with water
● Irrigate eyes with water and saline
Confidential Medical Evaluation and Follow-up.
These steps are important to ensure and to reassure
that the healthcare worker is really undergoing the
process of knowing if he or she is affected or
infected with the bloodborne pathogen.
● Route(s) of exposure and circumstances
● Source individual
● Collect/test blood for HBV and HIV serological status
● Post exposure prophylaxis (when medically
indicated)
● Counseling
● Evaluation
