ESD 101



-68580-543560NorthEast WashingtonEducational Service District 10100NorthEast WashingtonEducational Service District 101 BLOODBORNE PATHOGENS REFRESHER/UPDATE 2020-21The bloodborne pathogen standard was put into effect by OSHA in Washington State in May 1992 (WAC 296-823, Occupational Health Standards). The purpose of this requirement is to reduce the occurrence of illness spread by blood/body fluids by protecting employees against exposure.Bloodborne pathogens are infectious organisms which are carried in the blood or other body fluids; i.e., HIV, Hepatitis B and Hepatitis C.Universal/Standard Precautions are guidelines that use a two-tiered approach, offering infection control precautions that are standard for all individuals and include bloodborne, airborne, and epidemiologically important pathogens. Universal/Standard Precautions refers to the use of barriers or protective measures when dealing with the following:Blood (lacerations, nose bleeds, abrasions, menstrual flow, etc.)All body fluids, secretions, and excretions except sweat, regardless of whether they contain visible blood (urine, emesis, feces, etc.)Non-intact skin (cuts, scrapes, dermatitis, etc.)Mucous membranes (oral/nasal secretions, etc.)Universal/Standard Precautions mandate wearing gloves when handling blood or body fluids, disposing of materials used to clean up blood or body fluids in plastic bags, disposing of used sharps in designated sharps containers, and THOROUGHLY WASHING HANDS as soon as possible after any encounter with blood or body fluids.An exposure incident means a specific eye, mouth, other mucous membrane, non-intact skin, parenteral (through the skin or mucous membrane) contact with blood or other potentially infectious body fluids that result from the performance of an employee’s duties.If direct skin contact with blood/body fluids occurs, wash hands and/or other affected skin areas thoroughly with soap, friction and running water as soon as feasible. If direct mucous membrane contact with blood/body fluids occurs, flush affected mucous membranes thoroughly with copious amounts of running water as soon as possible. Then wash the area thoroughly with soap and running water.If direct contact with contaminated blood/body fluids occurs, contact the site manager and NEWESD 101 Human Services Executive Director to report the contact as a possible exposure incident (no later than 24 hours). You will be provided with the necessary forms to be completed by yourself and your licensed health care professional (see NEWESD 101 Exposure Control Plan).Hepatitis B vaccinations are offered to all Category One and some Category Two NEWESD 101 employees. The Hepatitis B vaccine is safe. Soreness at the injection site is the most common side effect reported. As with any medicine, there are very small risks that a serious problem could occur after getting the vaccine. There is a series of two or three vaccinations required over a (usual) period of 6 months. Completing the series of shots is needed for full protection. Efficacy is 95% (range 80-100%). Available data show that vaccine-induced antibody levels decline with time. However, immune memory remains intact for more than 20 years following immunization, and both adults and children with declining antibody levels are still protected against significant HBV infection. See the Human Services Executive Director to obtain the appropriate paperwork prior to getting your vaccination.Requirements for confidentiality regarding HIV/AIDS and Hepatitis B & C: No person may disclose or be compelled to disclose the identity of any person who has been investigated, considered or requested a test or treatment for any sexually transmitted disease. Sharing of ANY information about a person’s HIV/HBV status may occur only following written permission. The fine for a breach in confidentiality is $10,000.00!HIV AND ITS TRANSMISSION, TESTS & TREATMENTThe Human Immunodeficiency Virus (HIV) targets the immune system and weakens people’s defense systems against infections and some types of cancer. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. Immune function is typically measured by CD4 cell count. Immunodeficiency results in increased susceptibility to a wide range of infections and diseases that people with healthy immune systems can fight off.The most advanced stage of HIV infection is Acquired Immunodeficiency Syndrome (AIDS), which can take from 2 to 15 years to develop depending on the individual. AIDS is defined by the development of certain cancers, infections, or other severe clinical manifestations.HIV can be transmitted via the exchange of a variety of body fluids from infected individuals, such as blood, breast milk, semen and vaginal secretionsThere is no known risk of HIV transmission to co-workers, clients or consumers from contact in industries when routine universal/standard precautions are followed. Contact with saliva, tears, sweat, urine, and feces (that do not contain blood) have never been shown to result in the transmission of HIV.HIV TESTING: Antibody tests detect the presence of antibodies, proteins that a person’s body makes against HIV, not HIV itself. Most HIV tests, including most rapid tests and home tests, are antibody tests. It can take 3 to 12 weeks for a person’s body to make enough antibodies for an antibody test to detect HIV infection. In general, antibody tests that use blood can detect HIV slightly sooner after infection than tests done with oral bination tests look for both HIV antibodies and antigens. Antigens are a part of the virus itself and are present during acute HIV infection. It can take 18-45 days for a person’s body to make enough antigens and antibodies for a combination test to detect HIV. Combination tests are now recommended for testing done in labs and are becoming more common in the United States.Nucleic acid testing (NAT) detects HIV in the blood. It can take 10-33 days for NATs to detect HIV. This test is very expensive and is not routinely used for HIV screening unless the person recently had a high-risk exposure or a possible exposure with early symptoms of HIV infection.An initial HIV test will either be an antibody test or combination test. It may involve obtaining blood or oral fluid for a rapid test or sending blood or oral fluid to a laboratory. If the initial HIV test is a rapid test and is positive, the individual will be directed to get follow-up testing. If the initial HIV test is a laboratory test and is positive, the laboratory will usually conduct follow-up testing on the same blood specimen as the initial test. Although home HIV tests are generally very accurate, follow-up testing allows the health care provider to be sure the diagnosis is correct. Results from home testing can be ready in 20-30 minutes depending on the test used.Ongoing HIV replication leads to immune system damage and progression to AIDS. HIV infection is always harmful and true long-term survival free of clinically significant immune dysfunction is unusual.TREATMENT: Anti-HIV medications are used to control the reproduction of the virus and to slow the progression of the disease. Anti-HIV medications are called antiretroviral (ART) medications. There are six classes of FDA approved antiretroviral medications: NRTIs, NtRTIs, NNRTIs, PIs, fusion and attachment inhibitors. The recommended treatment for HIV is a combination of three or more medications in a regimen called Highly Active Antiretroviral Therapy (HAART). Each drug has its own dosing requirements (frequency, with/without food, etc.). Many drug regiments are very complicated and have negative side effects such as liver problems, diabetes, abnormal fat distribution, high cholesterol, pancreatitis, decreased bone density, nerve problems, skin rashes, and increased bleeding in hemophiliacs. Anti-retroviral therapy has been proven to slow disease progression and extend life.HIV medications when used properly can reduce a person’s viral load to a level which is undetectable by laboratory testing. A person with an undetectable HIV viral load may be considered infectious for HIV transmission via needle stick, however new research indicates that at this point there is no chance of transmission sexually. All persons with HIV/AIDS should be counseled on lowering their risk for transmission to others.PEP stands for post-exposure prophylaxis. It involves taking antiretroviral medicines as soon as possible, but no more than 72 hours (three days) after you may have been exposed to HIV, to try to reduce the chance of becoming HIV-positive. These medicines keep HIV from making copies of itself and spreading through your body. Two to three drugs are usually prescribed, and they must be taken for 28 days. PEP is not always effective; it does not guarantee that someone exposed to HIV will not become infected with HIV.PREVENTION“PrEP” stands for Pre-Exposure Prophylaxis. The word “prophylaxis” means to prevent or control the spread of an infection or disease. The goal of PrEP is to prevent HIV infection from taking hold if you are exposed to the virus. Currently, this is done by taking a medication which is called Truvada. Truvada contains two HIV medications ( HYPERLINK "" tenofovir disoproxil fumarate and emtricitabine) combined in one pill. These are some of the same medications used to keep the virus under control in people who are already living with HIV.HIV/AIDS STATISTICSAccording to the Center for Disease Control (CDC), globally, there were approximately 37.9 million people living with HIV at the end of 2018.Per the CDC, there were 37,968 new cases of HIV diagnosed in the U.S and approximately 1.2 million have been diagnosed with HIV as of the end of 2018. Young people aged 13 to 24 are being especially affected by HIV. As of 2018, they accounted for 21% of all new HIV diagnoses.According to the Washington State Department of Health, the estimated number of people living with HIV in Washington as of December 31, 2018 was over 14,000. There have been 402 new HIV diagnosis in Washington in 2018 and 193 new AIDS diagnoses.There were 17 new cases of HIV reported in Spokane County in 2018. HEPATITIS UPDATEHepatitis A is a liver disease caused by the hepatitis A virus (HAV). HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease. HAV infection is primarily transmitted by the fecal-oral route, by either person-to-person contact or through consumption of contaminated food or water. There were 12,474 reported cases in 2018 in the U.S. and 35 acute cases reported in Washington State in 2018. There was one new case reported in Spokane County in 2018. There is a vaccine available that is recommended for those living in or traveling to areas of high prevalence of HAV.Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). HBV infection can cause acute illness and lead to chronic or lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. HBV is transmitted through percutaneous (puncture through the skin) or mucosal contact with infectious blood or body fluids. About 30% of persons infected with HBV have no signs or symptoms while others may exhibit jaundice, fatigue, abdominal pain, among others. The number of reported cases of acute HBV in the United States decreased from 8,036 in 2000 to 3,322 in 2018, with a reported 51 acute cases diagnosed in Washington State in 2018. There were 13 acute cases reported in Spokane County in 2018. There is a vaccine available to prevent HBV.*Twinrix is a combination Hepatitis A/B vaccination given in a series of three injections.Hepatitis C is a liver disease caused by the hepatitis C virus (HCV) that sometimes results in an acute illness, but most often becomes a silent, chronic infection that can lead to cirrhosis (scarring), liver failure, liver cancer, and death. Chronic HCV infection develops in a majority of HCV infected persons, most of who do not know they are infected since they may have no symptoms. HCV is spread by contact with the blood of an infected person. HCV can be spread sexually but this is rare. There is no vaccine for hepatitis C. Following Universal/Standard Precautions is the best way to prevent contracting the disease. The number of new acute cases of hepatitis C reported in the United States increased from 849 in 2007 to 3,621 new cases in 2018, and 118 acute cases reported in Washington State in 2018. There were 15 acute cases reported in Spokane County in 2018. Most infections are due to sharing drug-injection equipment with a HCV infected person. Hepatitis D, also known as “delta hepatitis,” is a defective virus that needs the hepatitis B virus to exist. Hepatitis D virus (HDV) is found in the blood of persons infected with the virus. Because HDV cannot exist without HBV, a person will be protected against HDV if they have had the HBV vaccine. Hepatitis E is a liver infection caused by the hepatitis E virus (HEV) that usually results in a self-limited disease. HEV infection is primarily transmitted by the fecal-oral route, mostly through consumption of contaminated water. While rare in the United States, hepatitis E is common in many parts of the world. There is currently no approved vaccine for HEV. Risk of infection with HIV, HBV, HCV following a single needle stick or sharp instrument injury with contaminated blood: HIV 0.3 ~ 0.4% HBV 6.0 ~ 30% HCV 0.5 ~ 2%REMINDERSHand washingWhat is the right way to wash your hands?Wet your hands with clean running water (warm or cold) and apply soap.Rub your hands together to make lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails. Wash up to your elbows if possible. Be sure to either remove your jewelry (watches) before work, or wash them as you wash your hands.Continue rubbing your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.Rinse your hands, and jewelry if worn, well under running water. Dry your hands using a clean paper towel or air dry.Use a dry paper towel (if available) to turn off the faucet.Washing hands with soap and water is the best way to reduce the number of germs on them. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.Hand sanitizers are not effective when hands are visibly dirty.Removing Gloves Taking off disposable gloves is a simple task but should be done carefully in the proper way to prevent contact with the bare hands and the outside of the contaminated glove. With one hand, grasp the cuff of the opposite glove and carefully pull the glove completely off the hand. This should turn the glove inside out. With the removed glove now in the gloved hand, wad the used glove up into a ball in the palm of the gloved hand, being careful not to touch anything with the unprotected hand. Use the index finger of the unprotected bare hand to slip underneath the cuff of the other glove and remove it by peeling it back off the hand carefully, not touching the outside. When you get this glove off it will act as a bag, holding the other glove. Discard these gloves in the proper receptacle and immediately wash hands thoroughly.Signs and labeling or color-coding of containers used for contaminated materials:9226558890At NEWESD 101, potentially contaminated materials should be placed in red, plastic bags or containers that have a biohazard label applied on them.00At NEWESD 101, potentially contaminated materials should be placed in red, plastic bags or containers that have a biohazard label applied on them. For sharps that have been contaminated with potentially infectious body fluids, you must place them immediately, or as soon as possible after use, in appropriate containers. Containers must be all of the following: (a) puncture resistant; (b) labeled or color-coded; (c) leak-proof on the sides and bottom; (d) closable; (e) store or process contaminated sharps so employees are not required to reach into the container or sink by hand; (f) sharps containers are not to be opened, emptied, or cleaned manually or in any other manner that would expose employees to contaminated sharps; (g) easily accessible to personnel; (h) maintained upright throughout use; and (h) replaced routinely and not allowed to overfill. NEWESD 101 staff who work off-site, whether in a NEWESD 101 facility or in a different school district, should check with each site to be aware of their procedures regarding potentially contaminated materials.2020 Recommended Adult Immunization ScheduleVACCINE AGE 19-49 YEARSAGE 50-64 YEARSAGE 65 YEARS & OLDERTetanus, Diphtheria, Pertussis (Tdap/Td)1 dose Tdap then Td booster every 10 yearsPneumococcal 13 (PCV 13 & PPSV23) 1 dose PCV13 1 dosePPSV23Hepatitis B2-3 doses depending on vaccineHepatitis A2-3 doses depending on vaccineMeasles, Mumps, Rubella (MMR)1 or 2 doses depending on indication (if born in 1957 or later)***Varicella2 doses (if born in 1980 or later)Meningococcal (polysaccharide)1 or more doses depending on indicationHuman papillomavirus (HPV)Age 19-26: 2-3 doses depending on age at initial vaccinationInfluenza1 dose annuallyZoster Recombinant 2 doses 1 doseZoster60 years and up: 1 doseHIB (Haemophilus Influenzoe Type B)1 or 3 doses depending on indicationBased on recommendations from the Center for Disease Control (CDC). Individual patient assessment is required. *** MMR Vaccine Exemption Law Change 2019The law?took effect July 28, 2019 and applies to public and private schools and childcares. The law removes the option for a personal/philosophical exemption to the MMR vaccine requirement for schools and child cares. It also requires employees and volunteers at childcare centers to provide immunization records indicating they have received the MMR vaccine or proof of immunity. This would include any staff who provide services within a childcare center such as our ECEAP program. ?*Note: In the case of an outbreak of the vaccine preventable diseases that are in bold, both students and staff without proven immunity may be excluded.OSPI suggests that immunization or proof of immunity documentation for all school staff be kept on file. There is an Immunization History for Personnel form available from the Human Services Executive Director.**A detailed description of Universal/Standard Precautions can be found in the NEWESD 101 Bloodborne Pathogens Exposure Control Plan. It is available on the NEWESD 101 website or you may request a copy from the Human Services Executive Director.CORONAVIRUS DISEASE--COVID 19What is it?COVID-19 is a respiratory illness caused by a new or “novel” coronavirus that was not identified in humans before December 2019. Coronaviruses are a large family of viruses that usually cause mild respiratory illnesses such as the common cold. Some coronaviruses have caused more severe illness, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).Most people will recover on their own, but some people can develop more serious complications, such as pneumonia, and require medical care or hospitalization.?For example, if you are older than 60, have a chronic medical condition or immunosuppression, or are pregnant, you?are more likely to get very sick from COVID-19.The novel coronavirus that causes COVID-19 is spreading from person to person.How is it spread?It is most commonly spread from an infected person to others through:The air by coughing and sneezingClose personal contact, such as touching or shaking handsTouching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your handsRarely, fecal contamination with coronavirus presentPeople are thought to be?most contagious?when they are the sickest, though some spread is possible before people show symptoms.What are the symptoms?Symptoms??may appear?2-14 days after exposure?to the virus.?People with these symptoms or combinations of symptoms may have COVID-19:CoughShortness of breath or difficulty breathingFeverChillsMuscle painSore throatNew loss of taste or smellOther less common symptoms include nausea, vomiting, or diarrheaHow to protect yourself and others?There are steps you can take to reduce your risk of getting and spreading coronavirus:Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60 percent alcohol if soap and water aren't available.Avoid touching your eyes, nose, or mouth with unwashed hands.Avoid close contact with people who are sick.Cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash and wash your hands.Clean and disinfect objects and surfaces.Stay home if you are sick.Wear a face coveringStay six feet away from others.Follow recommendations from your?local health department.What is face covering guidance?Unless you have an exemption, you are?required to wear a face covering:In indoor public settings, including:Inside any building, including any business open to the public, this includes schools.While in line to enter one of the above, or while waiting for or riding on public transportation or paratransit or while in a taxi, private car service, or ride-sharing vehicle, including school district vehicles.In outdoor public settings, including public parks, trails, streets, and recreation areas, when six feet of physical distancing cannot be maintained between individuals who do not share a household.Face coverings are not required when you are exercising; however, a six-foot distance from others should still be maintained.How can I take care of myself and others during this outbreak?Getting plenty of rest, drinking fluids, eating healthy foods, and managing your stress may help you prevent getting COVID-19 and recover from it if you do.If you smoke or vape, consider trying to quit. People who smoke may be more likely to develop serious health complications from COVID-19. Smoking weakens the immune system, making it harder for your body to fight off viral infections. Initial findings suggest that vaping may increase lung inflammation and exacerbate lung infections. Need help quitting? Call 1-800-QUIT-NOW. Watch your children for symptoms of COVID-19. If your child shows symptoms of COVID-19, separate them from others immediately. If they have been at a childcare center or school recently, notify the center or school.Set up a separate room for sick household members. Clean the room regularly and make sure they have clean disposable facemasks to use. Check in with family and friends who live alone—especially those with chronic diseases. If you live alone, ask your friends and family to check in with you if you become sick.Stay connected to your loved ones over the phone, via text messages, email, or using video chat programs.Should I be tested?The Department of Health recommends testing anyone with:Symptoms consistent with COVID-19.Likely exposures, such as close contacts of cases, or those exposed in outbreak situations.If you have symptoms consistent with COVID-19, contact your health care provider. If you do not have a health care provider, contact an urgent care center near you. If you do not have health insurance, contact your local health jurisdiction.What are the types of COVID tests?When it comes to COVID-19, there are two kinds of tests: The PCR test, which diagnoses a person as "COVID-19 positive." An antibody test, which shows if a person has been previously exposed to COVID-19, but does not diagnose them as being currently COVID-19 positive.What if I test positive for COVID-19?If you have confirmed or suspected COVID-19 and?have symptoms, you can end home isolation when:It has been at least 24 hours with no fever without using fever-reducing medication?ANDYour?symptoms?have improved,?ANDAt least 10 days since symptoms first appeared.If you test positive for COVID-19, but?have not had any symptoms, you can end home isolation when:At least 10 days have passed since the date of your first positive COVID-19 test,?ANDYou have had no subsequent illness.What does it mean to quarantine?Quarantine is what you do if you were exposed to COVID-19.? Quarantine means you stay home and away from others for the recommended period of time in case you are infected and are contagious. Quarantine becomes isolation if you later test positive for COVID-19 or develop symptoms.You can leave quarantine 14 days after your last contact with a person who has COVID-19, as long as you do not develop symptoms.Employee Statement of Acknowledgement 681355243205Universal/Standard Precautions Procedures for Protection against Bloodborne Diseases00Universal/Standard Precautions Procedures for Protection against Bloodborne DiseasesUniversal/Standard Precautions refers to a system of infectious disease control that assumes every contact with body fluids is infectious and requires every employee exposed to be protected as though such body fluids were infected with infectious diseases.The following are specific steps that must be taken for protection against contamination from infected blood or body fluids of another person or from injury by a contaminated sharp object:Wash hands frequently to reduce the risk of exposure to infectious diseases.Wear gloves if there is even a possibility you might have contact with another person’s body fluids.After the removal of gloves or after exposure to blood or other potentially infectious materials, wash hands (or other affected areas) thoroughly with soap, friction and running water as soon as feasible. If direct mucous membrane contact occurs, flush affected mucous membranes with copious amounts of water. Wear disposable gloves once and discard; do not attempt to wash and reuse.Clothing or supplies contaminated with body fluids should be placed in red bags or bags marked with a biohazard label and tied.Used needles or sharp instruments that have been contaminated with potentially infectious materials must be discarded in a biohazard infectious waste sharps container or an impenetrable container with a biohazard label. See individual building site managers for specific procedures.If a possible exposure incident has occurred, contact the site manager and NEWESD 101 Human Services Executive Director as soon as possible (within 24 hours).Assume all blood or body fluids are contaminated and potentially harmful to your health.I have read and agree to abide by the Universal/Standard Precautions Procedures as outlined above and included in the 2020-21 Bloodborne Pathogens training update sheets I received. I understand that if I have any questions or concerns, I may contact the NEWESD 101 Human Services Executive Director._______________________________ _________________________________ ___________________Printed Name of Employee Signature of Employee DateEmployee must keep pages 1-7 of the Bloodborne Pathogens Training Update for reference and return this signed document (page 8) to the NEWESD 101 Human Services Executive Director. ................
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