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) 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 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 for seven to ten days. 

BLOODBORNE PATHOGENS TRANSMISSION 
All human blood and certain human body fluids are to be treated as if known to be infected with HIV and HBV 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 and HBV 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.    

UNIVERSAL PRECAUTIONS 
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, 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.  
Disposable vinyl gloves: Used for first aide, 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.Other PPE also available are heavy-duty utility gloves, CPR microshields, antiseptic wipes, convenience bags, sharps containers, and mouth to mask resuscitator shield. 

Hand washing 
	1.	Use warm water only – not hot, not cold. 
	2.	Wet both hands and wrists well before applying soap. 
	3.	Apply liquid soap to palms first (about 1 tsp.). 
	4.	Lather well; spread lather to back of hands and wrists. 
	5.	Continue scrubbing, paying careful attention to fingernails and between fingers. The              scrubbing time should be a minimum of 20 seconds. 
	6.	Rinse hands and wrists well to remove all soap and detergent. 
	7.	Dry completely. 
	8.	Turn off 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    
1	Use disposable gloves. 

2	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. 

3	All Sharps will be disposed of in approved Sharps Containers located in the Health Office of each school building.

1	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. 

2	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.