The OSHA Bloodborne Pathogens Standard became effective in 1992 to protect any employee who has a reasonable anticipated risk of an occupational blood or body fluid exposure based on his or her job. This law provides for the protection of employees dealing with blood and body fluids in order to protect and prevent the transmission of bloodborne diseases. These standards are extended to staff working in the clinical setting in order to ensure the safety of both Employees and the consumer population (patients, students, volunteers, supply staff). Employees covered by this standard include those who:
All employees covered by this standard are required to follow their employer's Exposure Control Plan, which includes procedures for:
Hepatitis is an inflammation of the liver usually from a viral infection, but may also be caused by parasites, bacteria, chemicals, alcohol, or toxic agents. Endemic throughout much of the developing world, viral hepatitis now ranks as a major public health problem in industrialized nations. The three most common types of viral hepatitis A, B, and C affect thousands of people in the U.S. each year and millions worldwide. Signs and symptoms of Hepatitis include enlargement of the liver, lymph nodes and often the spleen; headache, continuous fatigue, nausea, anorexia, abdominal pains and sometimes mild fever. Specific testing must be done to determine the specific cause of Hepatitis (viral Hepatitis A, B, C or toxin, etc.).
Hepatitis A is spread by contact with fecal matter or blood, most often through ingestion of contaminated food (fecal-oral route). Jaundice is a common symptom. There is a vaccination available to prevent this disease, however the CDC has not recognized the risk of hepatitis A as a significant risk for healthcare workers and does not require employers to offer routine vaccinations.
Hepatitis B ranks as the ninth leading killer in the world. The Hepatitis B virus is found in blood, semen, vaginal secretions, and saliva for several weeks before and after symptoms develop. It is usually transmitted sexually, perinatally, by injection of infected blood or blood derivatives, or by use of contaminated needles, lancets or other instruments. The virus may take up to 6 months to incubate, and people may also become asymptomatic carriers.
The greatest bloodborne risk to the health care worker is infection by the Hepatitis B virus. Occupational needlesticks and other sharps injuries and exposure to blood and other potentially infectious material (OPIM) are the leading sources of transmission to the healthcare provider.
The Hepatitis B vaccine is the best protection against Hepatitis B. The vaccine is given in a series of three injections over a 6-month period and all three injections must be received. Post-vaccination antibody screening, is suggested by the CDC four to eight weeks after the third injection. If the employee is found to be an anti-body "non-responder" after completing the initial series, a second series of vaccination and antibody screening is recommended. OSHA regulations require that employers must offer the hepatitis B vaccination series and antibody screening to employees having occupational exposure to bloodborne pathogens.
There are post exposure treatments available for exposure to Hepatitis B. A medical professional decides these treatments. At this time the CDC has no recommendation for routine booster vaccinations.
Employees who do not wish to be vaccinated must sign a declination form.
Hepatitis C infects about 36,000 Americans annually. About 85% of those infected become carriers and 70% develop chronic hepatitis leading to cirrhosis, liver failure, and liver cancer.
Persons infected with this disease may have no symptoms for 20 to 30 years and are contagious. The main mode of transmission is through blood transfusion and it is the principal cause of post-transfusion hepatitis. Of those exposed to Hepatitis C, 85 - 90 % become chronically infected. Currently no post-exposure prophylaxis exists for Hepatitis C, although treatment exists for severe disease. Occupationally acquired Hepatitis C is primarily from contaminated sharps injuries.
In all cases, blood testing is required for a definitive diagnosis.
HIV or the Human Immunodeficiency Virus (the causative agent of AIDS) can be transmitted parenterally (needle-sharing, needlestick, blood exposure) sexually and perinatally.
Most people who are infected with HIV will experience a flu-like illness 2 to 6 weeks post infection with symptoms of fever, lymphadenopathy, fatigue, and aches. The development of antibodies usually occurs shortly afterwards (2 weeks to up to 6 months after infection).
If HIV is undetected and untreated, most persons will develop symptoms of AIDS (weight loss, diarrhea, fevers, infections, cancers) in about 7-10 years.
While there is no cure for HIV or AIDS, there is very effective treatment which, when taken as directed, can slow down the disease process and improve immune function.
Post exposure treatments are being used and are most effective if administered soon after the possible exposure. The evaluating physician makes determination of the appropriate treatment.
Services to assist members with their Exposure Control Plan and annual training are available by request. For more information on this and other Loss Control Programs, please contact us by e-mail at losscontrol@wctrust.com or by telephoning (203) 678-0123, or faxing a Service Request form to (203) 678-0323