Bloodborne pathogens (BBP) can be insidious invaders if not dealt with properly. In public health (PH), one has to be aware of BBP and PH has to plan and prepare for dealing with it.
First; What are bloodborne pathogens? Bloodborne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include, but are not limited to, hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). There are a variety more, but for this article let’s consider just them and figure that exposure to someone else’s blood may be bad for you.
Second; Is blood the only exposure medium? Besides blood the Other Potentially Infectious Materials (OPIM) are: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any bodily fluid that is visibly contaminated with blood, and all bodily fluids that are impossible to distinguish the source and cell cultures that are normally found in a lab.
Meigs County Health Department (MCHD) wants to limit the ability for BBP to spread. MCHD has relationships with many people; from the babies and youngsters in WIC to people who want flu vaccinations to students wanting school vaccinations to seniors wanting their latest blood pressure reading. Certainly, MCHD doesn’t want to spread BBP to our clients or to our staff.
Safeguards have to be established and maintained for effectiveness. The Big 3 BBP, Hep B, Hep C, and HIV can live outside of the body from several hours (HIV) to 7 days in dried blood samples (HEP B). So, the following steps need to be followed for protection:
• Have a plan for exposure control.
• Engineering Controls-from needleless sharps to rigid, puncture-proof containers for sharps disposal.
• Work Practice Controls- Universal precautions must be followed by all employees to prevent contact with blood, body fluids, or other potentially infectious material. All blood and body fluids must be treated as potentially infectious. All procedures involving blood or other potentially infectious material must be performed in a manner to minimize splashing, spraying, or splattering.
• Handwashing-Proper handwashing after removal of latex or nitrile gloves used during procedures. Dry skin with no breaks, such as, cuts, scrapes or hangnails is a good deterrent for bloodborne pathogens but if exposed, unwashed hands can transfer BBP to the eyes, nose, mouth for easy transferal to the hand’s owner. Handwashing is key to disease prevention.
• Sharps disposal-Proper sharps containers, fully loaded, must be sealed and properly disposed. MCHD has a protocol.
• Housekeeping and cleaning procedures-MCHD follows proper EPA protocols for cleanup of any potential BBP spills.
• Personal Protective Equipment (PPE)-MCHD staff uses latex or nitrile gloves for most vaccinations. MCHD also has available face shields, N-95 Respirators (for employees’ comfort and patient protection), gowns, and other PPE if we have outbreaks of diseases that require them. AND the PPE is provided at no cost (thanks preparedness grants!).
• Worker training-in September of each year the MCHD staff receives BBP training and during the course of the year, if any BBP protocols change, there is an additional training given at monthly staff meetings.
• Hepatitis B Vaccination-All MCHD nursing staff are vaccinated for Hep B.
• Recordkeeping- BBP exposure record keeping is essential in PH. Employees who are exposed by syringe double-sticks, or by any other means of contact of blood or OPIM, must report the exposure to the Director of Nursing or the Administrator to begin post- exposure evaluation and follow-up by a medical practice.
After all of this, then we can review periodically the protocols and safely perform vaccinations and other procedures for our public.
In the 21st Century, planning and preparedness are the resources for great public health performance.
Frank Gorscak is employed by the Meigs County Health Department.