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Exposure Control Plan For Bloodborne Pathogens

From Appalachian State University Policy Manual

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Policy 303.8

1 Introduction

1.1 This Fact Sheet is intended to inform Appalachian employees about bloodborne pathogens issues confronting us here in the workplace. For more information about non-workplace bloodborne pathogens exposures, contact the University Exposure Control Officer, a medical provider, your county health department, or one of the many resources now available on the internet.

2 Scope

3 Definitions

4 Policy and Procedure Statements

4.1 What are Bloodborne Pathogens?

4.1.1 Bloodborne Pathogens, or BBP, are disease-causing organisms that are present in human blood. The BBP we are most commonly concerned about in the U.S. are Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV).

4.1.2 BBP can be present in many human body fluids as well as in products derived from human blood (such as plasma). From a practical standpoint, you may find it easier to remember the human body fluids that do not contain BBP: these are nasal secretions, sputum, saliva (unless from a dental procedure), vomit, urine, feces and cerumen.

4.1.3 These body fluids are not assumed to be potentially infective unless they contain visible blood or it is difficult or impossible to distinguish these from other body fluids. Of course, some of these body fluids can cause other, non-bloodborne diseases, so it is best to treat them in much the same way as you would body fluids that do contain BBP.

4.1.4 Hepatitis A (which is the cause of "outbreaks" of hepatitis at schools, restaurants, etc) is not a BBP, as it is transmitted by the fecal-oral route rather than via blood.

4.2 How Can BBP Affect My Health?

4.2.1 Hepatitis B and C can cause chronic liver inflammation and liver cancer. In fact, Hepatitis C is now the leading cause of liver transplants. HIV causes AIDS, which weakens the immune system. All of these diseases can result in death.

4.3 How Does a Person Become Infected?

4.3.1 If blood or certain other body fluids infected with BBP enters your blood there is a possibility you could get infected too. In the work setting, there are several ways this could happen. A contaminated needle sticks you; infected blood or other body fluids enter through an opening in your skin such as a cut, scrape, irritated insect bite, etc; infected blood or body fluids enter your eyes, nose, or mouth.

4.3.2 There are of course other ways to get infected, such as sharing needles (including tattoo needles) or having unprotected sex with an infected person. These are not situations you should encounter as part of your job at Appalachian, though, so they are not addressed further in this fact sheet.

4.4 How Do I Know if Someone is Infected?

4.4.1 You can't tell. Many people carry Hepatitis B, C, or HIV for years without even knowing it. The symptoms are often very vague and sometimes they have no symptoms at all.

4.5 How Do I Protect Myself?

4.5.1 The two most important things to do are to always wear liquid-proof gloves and to wash your hands well afterwards when you contact blood or other potentially infectious body fluids. This is a good idea any time you contact human body fluids, since even fluids that don't contain BBP (such as nasal secretions) can infect you with unpleasant diseases like colds and the flu.

4.5.2 Except in the case of occasionally acting as a "good Samaritan" if someone is hurt, you must not contact human blood or other potentially infective body fluids at work unless you have received special OSHA-required training. The University trains all Housekeepers on how to clean up blood or other body fluids safely. Others who receive training include all people who are expected to render first aid or other medical attention, such as Student Health Services employees, designated daycare providers, wilderness outing leaders, University police, and certain Communication Disorders Clinic personnel. Town firefighters and emergency medical staff who respond on campus also receive training.

4.5.3 One thing you can do to protect yourself against Hepatitis B is to get vaccinated. The Hepatitis B vaccine consists of 3 shots taken over a several-month period. This vaccine has been shown to be so safe and effective that all children in public school now receive it.

4.5.4 If you are part of the University's BBP Pathogens Program, your department will pay for you to receive the vaccine. If you would like to get it on your own, it is readily available at doctors' offices, the health department, and is even offered occasionally on campus through the faculty/staff wellness program. The state health plan usually pays for the vaccine.

4.5.5 Another thing you can do to protect yourself and your family is to get a Hepatitis C test at your doctor's office if you received any blood or blood products prior to July 1992. Before July 1992 there was no test in place to detect Hepatitis C in donated blood, so people who received blood or human organs before that time may have gotten the infection without knowing it.

4.6 What is the ASU BBP Program?

4.6.1 The BBP Program is an OSHA-required program. It requires the university to have a written Exposure Control Plan (PDF), to provide affected people with yearly training, to offer them Hepatitis B vaccines at no cost, and to appoint an Exposure Control Officer.

4.7 How Do I Know if I'm Part of the ASU BBP Program?

4.7.1 If your job duties have a reasonable possibility of putting you at risk for contacting human blood or other potentially infective body fluids, you must participate in the ASU BBP Program. We believe that all such positions have been identified; to see if your job is one of them, look at the Exposure Determinations List (Appendix 3) in the Exposure Control Plan (PDF). If your job title does not appear there but you think it should, ask your supervisor to contact the University Exposure Control Officer. Instructions for adding an employee or job category to the Program can be found at the end of the Exposure Determinations List (Appendix 3).

4.8 How Much Does It Cost to be Part of the University's BBP Program?

4.8.1 There is no cost to any employee that is covered under the BBP Program. There is no charge for training. Departments with covered employees are charged for each vaccine administered and for any post-exposure care an employee requires. Post-exposure care is covered by Workers' Compensation. Employees or students who are not part of the University's BBP Program can attend training for free but must pay for their own Hepatitis B vaccine.

4.9 What About Students - Are They Covered by the University's BBP Program?

4.9.1 It depends. Only people who receive a paycheck from the University are considered "employees" and are covered by the BBP Program. These are the people who can receive the Hepatitis B vaccine at no charge. This includes graduate assistantships if the assistantship includes work that could put the graduate student at risk for exposure to BBP.

4.9.2 Students who might be exposed to BBP as part of unpaid work (for example, required coursework, volunteer work, or unpaid internships) are not covered by the BBP Program. That means that they must pay for their own Hepatitis B vaccines. However, departments or instructors that require or encourage work that will expose students to BBP are strongly encouraged to require proof of Hepatitis B vaccination before allowing the student to enter the academic program (as is commonly required when entering nursing schools, for example).

4.9.3 See Appendix 10 of the Exposure Control Plan (PDF) for the Appalachian form for departments/instructors whose students may be exposed to BBP. The purpose of the form is to inform students of their rights and responsibilities. The form will also help limit instructors' and the university's liability should a student be exposed to BBP as part of required coursework or internship.

4.10 Whom Do I Contact if I Need More Information?

4.10.1 Contact the University Exposure Control Officer.

5 Additional References

6 Authority

Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (42 U.S.C. 262a)

42 CFR Part 73

7 Contact Information

8 Original Effective Date

9 Revision Dates