1	Bloodborne Pathogens Training: Preventing Disease Transmission Indiana State University Athletic Training Department
2	What is the purpose of the Bloodborne Pathogen (BBP) Training Program? To prepare Athletic Training Students for the potential dangers related to bloodborne diseases Because as Athletic Training Students, you are at an increased risk of exposure to BBP To promote safety and compliance with regulations set forth by Occupational Safety and Health Administration (OSHA) To comply with our CAATE accreditation standards
3	How often do you complete BBP Training? BBP Training is completed each year Documentation of completion is kept on file for CAATE and sent to the University of Florida’s Environmental Health and Safety Office To successfully complete the BBP Training Program, you must complete the assessment/quiz at the conclusion of the training module
4	What can you expect from this training program (i.e. information presented)… Discussion of Bloodborne Pathogen and the regulations issued by OSHA Modes of disease transmission for Bloodborne Pathogens and other Infectious Diseases Prevention and Management Strategies for Bloodborne Pathogen Infection General Guidelines for Exposure/Incident Procedures
5	WHAT IS OSHA? “OSHA” stands for the Occupational Safety and Health Administration; this is a United States Federal Agency that is part of the Department of Labor
6	Policy Regulation: Occupational Safety and Heath Administration In 1991 OSHA established a Bloodborne Pathogen “performance” standard Designed to protect the employee, employers, and patients/athletes Colleges not held accountable at this time (not under federal guidelines Professional organizations have developed policies and procedures to help prevent transmission of pathogens Our national organization (National Athletic Trainers’s Association has a position statement www.nata.org
7	What are Bloodborne Pathogens? Bacteria and viruses present in blood and body fluids (i.e., Semen, Vaginal secretions, CSF, Synovial fluid) that can cause disease in humans
8	How are Bloodborne Pathogens Spread? Four conditions that must be met for transmission (i.e., infection): A pathogen must be present in the fluid (blood, semen, etc) Enough of the pathogen needs to be present to cause disease A person must be susceptible to the pathogen The pathogen must pass through the correct entry site (i.e, open wound, venous blood supply, etc)
9	How do you become infected? There are four modes of transmission for BBP infection Direct contact Indirect contact Airborne Transmission Vector-borne Transmission
10	Modes of Disease Transmission Direct Contact refers to “physical” contact with an infected person or bodily fluid containing the pathogen; all four criteria for infection must be present (see previous slides) Example: You care for a laceration on an athletes arm (without using “universal precautions” (gloves in this case) and you have a cut on your hand which comes into “direct contact” with the blood from the athlete
11	Modes of Disease Transmission Indirect Contact refers to exposure to “droplets”, air, dust, or fomites (i.e., contaminated bed linens, clothing, utensils) containing the disease; all four criteria for infection must be present (see previous slides) Example: If you pick up soiled/contaminated towels without using “universal precautions”
12	Modes of Disease Transmission Airborne Transmission is a form of Indirect Contact in which a person is exposed to “droplets” in the air (i.e., when an infected host coughs or sneezes and the disease is suspended in the droplets in the air; all four criteria for infection must be present
13	Modes of Disease Transmission Vectorborne Transmission is a form of Direct and Indirect Contact. The person is “bit” by the arthropod (i.e., flea, tick, mosquito, etc) which is carrying the infected blood of another person or animal (Direct) The arthropod leaves disease germs on a surface or object, which is then contacted by the person (Indirect); all four criteria for infection must be present (see previous slides)
14	How does a Pathogen enter the body? Portals of entry include vulnerable areas such as the Eyes, Nose, Mouth Breaks in skin Puncture from a needle stick Sexual Contact (i.e., oral, anal, vaginal)
15	What are the diseases of concern? Meningitis Tuberculosis Syphilis and other STDs Lyme Disease West Nile Virus SECONDARY CONCERN Hepatitis B (HBV) Hepatitis C (HCV) Human Immunodeficiency Virus (HIV) PRIMARY CONCERN
16	What is Hepatitis? (HBV, HCV) Viral Infection that attacks the Liver 85% who are infected recover in 6-8 weeks Infected person’s blood may test (+) within 2 to 6 weeks after symptoms develop Signs/Symptoms Flu-like (fatigue, weakness, nausea, abdominal pain, headache, fever, jaundice) Mode of transmission (direct and indirect)
17	HBV Prevention and Management Prevention Good personal hygiene (i.e., washing your hands and practicing universal precautions) Avoid high-risk activities (i.e., unsafe sex) Avoid contact with bodily fluids Management Vaccination at no cost to employee and must be provided within 10 days of employment Given in three doses over six-month period
18	What is Human Immunodeficiency Virus (HIV)? HIV is a retrovirus that attacks immune system (Stages I-III) Person dies from opportunistic diseases (i.e., pneumonia, cancer, etc) during Stage III (i.e., “full-blown” AIDS) AIDS = Acquired Immune Deficiency Syndrome
19	What are the Signs & Symptoms of HIV/AIDS? Fatigue, weight loss, muscle/joint pain, painful or swollen glands, night sweats, fever Once a person is infected with the virus they can transmit the disease There is a small window before a person becomes “HIV+”, but they are still infected HIV+ people who do not appear sick are considered “silent carrier” People do not appear sick until Stage II
20	How do you prevent and/or treat HIV/AIDS? Prevention Avoid unprotected sexual contact Avoid contact with bodily fluids (use universal precautions) Avoid sharing needles Management/Treatment No vaccine available, but Anti-viral drug therapy can extend life Proper diet, exercise, reduce risk of exposure to opportunistic diseases will extend life
21	Additional Disease Concerns Meningitis (Bacterial and Viral) Attacks the Brain and Spinal Cord Mode of Transmission is dependent on the type Tuberculosis Infection of the Lungs and Respiratory System Airborne transmission
22	Additional Disease Concerns Syphilis and other STDs Sexual contact and direct contact with blood Lyme Disease Vector-borne from tick West Nile Virus Mosquito (direct and/or indirect modes) ex: bites or blood/mucous from infected person
23	Prevention is the key! ALWAYS Practice “Universal Precautions” and observe standard precautions per OSHA Guidelines Wear personal protective equipment Practice proper hand hygiene Safe environment to practice athletic training (i.e., engineering and work practice controls) Daily and per use equipment cleaning and disinfecting Disposal of Infectious Materials Properly (i.e., in “Biohazard Container”; biohazardous waste is incinerated)
24	Exposure Control Plan Have an Exposure Control Plan Please review the ISU Exposure Control Plan Speak to your supervisor for specific site guidelines
25	What is Personal Protective Equipment? Disposable gloves, gowns, eye shields, masks, breathing barriers If an eye exposure, wash immediately and see medical attention
26	Practice Good Hand Hygiene!
27	What to use for equipment cleaning and disinfecting… Solution of 1 part Bleach per 10 parts Water to clean treatment surfaces and other hard surfaces (must be made daily)
28	How do you clean up a spill on the floor or counter? Use of OSHA Approved “Spill Kits” for fluid removal (vomit with blood present, blood, etc)
29	How do you dispose of SHARPS and Biohazard Materials Properly? Soiled linens placed in a separate red bag for laundering Wound care Items (gloves, gauze, etc) should be placed in a red biohazard bag/container Sharp objects (i.e., needles, razors, etc) must be disposed of in Sharps containers
30	What happens if you are exposed to a BBP? Exposure incidents involve contact with blood or other potentially infectious material If there is an exposure: Clean the area of contact with soap and water IMMEDIATELY seek medical attention Write down what happened to prevent from forgetting any details Notify your supervisor and give them the written account of the incident and follow the directions from your supervisor (Needle-stick Hotline 1-866-477-6824)
31	BBP Considerations in Athletics HIV transmission risk is low; No validated reports of transmission in sports Risk levels of Bloodborne Pathogen infections (examples) HIGH: Boxing, martial arts, wrestling, rugby MODERATE: Basketball, football, ice hockey, soccer, handball LOW: Golf, fencing, gymnastics, track/field, swimming, volleyball, weight lifting, badminton, bowling, cycling
32	High Risk Transmission
33	Take Home Points Take precautions to prevent bloodborne pathogen transmission when providing care Always wear protective equipment when providing care Use good hand hygiene Maintain good work control practices Clean and disinfect equipment after each use with disinfecting solution