Bloodborne Pathogen Prevention

by: Cassie Pfeifer, The Sandner Group - Claims Management

Occupational hazards exist everywhere in a school district. From auto shops to cafeterias to hallways, there is always the possibility for injuries to occur, creating a risk for bloodborne pathogen (BBP) exposure.

This exposure may be through needlesticks, sharps injuries, mucous membranes, and skin exposures. First aid team members, housekeeping personnel in some settings, and nurses are examples of workers who may be at risk of exposure. Workers and employers are urged to take advantage of available engineering controls and work practices to prevent exposure to blood and other body fluids.

In 1991, OSHA issued the Bloodborne Pathogens Standard to protect workers from this risk of exposure. In 2001, in response to the Needlestick Safety and Prevention Act, OSHA revised the Bloodborne Pathogens Standard, 29 CFR 1910.1030. The revised standard clarifies the need for employers to select safer needle devices and to involve employees in identifying and choosing these devices. The updated standard also requires employers to maintain a log of injuries from contaminated sharps.

For this reason, districts must take steps to prevent BBP exposures in all areas where they may occur. All districts are required by the Occupational Safety and Health Administration (OSHA) to identify the district jobs that have occupational exposure to “skin, eye, mucous membrane…blood or other potentially infectious materials.”  Personnel, such as the school nurse, shop and auto teachers, cafeteria workers, custodians, and maintenance staff, all work with occupational exposures in their daily job duties. Employees without regular occupational exposures also run the risk of being exposed to BBPs through emergency injuries that can occur at any time and for any reason. OSHA sets forth a number of requirements for districts to be fully prepared in preventing exposure to BBPs.
The first, and perhaps most important, requirement OSHA sets forth is the preparation of a written Exposure Control Plan. This plan provides districts with a starting point in assessing where risks of BBPs are present as well as what materials are needed to decrease the risks and give swift first aid and clean-up in the event of contamination. The plan must provide detailed information on first aid, clean-up, disposal, and active prevention procedures. Universal Precautions (treating all blood as if it carries a pathogen) must be taken in the Exposure Control Plan. No district member should come into contact with potential BBPs or any instrument that has been in contact with potential BBPs without proper protective equipment. Additionally, all employees who have jobs that fall under the list of occupational exposures as outlined in the Exposure Control Plan must be given the choice to receive an HBV Vaccination. This is an optional vaccination; however, the district needs to keep documentation of all vaccinations, both accepted and declined. In addition, the Exposure Control Plan should be made available to all employees regardless of whether or not they perform job duties with occupational exposure.

All jobs with occupational exposure require the use of personal protective equipment (PPE). PPEs are required for everything from clean-up to first aid kits in preventing BBP exposure and consist of such items as gloves, face masks, protective eyewear, and aprons. PPEs are deemed appropriate only if they do not permit bodily fluids to come into contact with clothing, skin, eyes, mouth, and other mucous membranes. Equipment needs to be kept in an organized, easily accessible area and in good condition. PPEs, particularly in first aid kits, should be inspected regularly for wear from disuse. Once personal protective equipment has been used, it should be placed in a biohazard container (if necessary), properly disposed of, and promptly replaced. Biohazard containers must be leak-proof, puncture-proof, and be fitted with large biohazard labels. Labels should be “fluorescent orange or orange-red or predominantly so, with lettering and symbols in a contrasting color.”  Biohazard containers are to be used for PPEs that have been contaminated as well as any needles or other materials that have been contaminated.

In case of exposure, the employee should wash the spot of contamination thoroughly with an appropriate disinfectant, seek medical attention, and receive the appropriate tests in cases where contamination is suspected. Additionally, work surfaces should be decontaminated immediately after it has come into contact with potentially infectious fluids. Under no circumstances should work be done on the surface area until it has been thoroughly cleaned with a disinfectant, such as diluted bleach. Only employees who have been trained in appropriate clean-up procedures should be allowed to decontaminate an area with BBP exposures. Employees cleaning the area must wear gloves while disinfecting the area and dispose of them after the area is clean. Work surfaces that pose a higher risk of being contaminated should be cleaned regularly, regardless of whether or not it was contaminated during the work shift. An example of such a surface would be in the cafeteria where employees may be handling raw meat, which can contain pathogens like salmonella, on work surfaces regularly.

The Exposure Control Plan should be reviewed and updated annually in order to keep track of advancements in BBP prevention, first aid, and equipment. Additionally, all employees should be trained on how to approach BBP risks on the date of hire and should receive annual refresher training after that. Training materials are available through the OSHA website. Our loss control specialists can also provide guidance in receiving OSHA accepted training materials for BBPs.

In order to ensure that your district is diligent in dealing with BBP risks, thorough records must be kept of all facets of the Exposure Control Plan. Detailed records of exposure incidents must be documented in order to improve prevention tactics. Training materials, including an ongoing log of employees who have received training, should also be kept on record in order to ensure that no district employee is unaware of how to proceed when dealing with BBPs. It is vital that all district personnel know how to deal with an incident involving a potential BBP.

Utilizing a complete Exposure Control Plan that fully adheres to all of the OSHA requirements benefits everyone in your district. For more information in how to prevent BBP exposure, please visit the following sites:
OSHA (search phrase: BBP exposure control plan).
CDC, NIOSH or contact your loss control specialist, who is always available to assist with all facets of the risk management process.

Youth football organization adopts new rules aimed at reducing player concussions

The Chicago Tribune reports that Pop Warner Little Scholars Inc., the nation’s largest youth football organization, is banning some common drills and telling coaches to spend two-thirds of their practice time on non-contact activities as part of a wider crusade to reduce the risk of head injuries that can reverberate for a lifetime. The organization hopes the changes lessen concussions and reassure parents and players that the game is safe.

Concern about concussions have risen to the fore in recent years as retired pro athletes recount their struggles with head injuries, and as new research shows the potentially devastating consequences of repeated brain-jarring collisions. Youth leagues in many sports, especially football, have scrambled to adjust. In 2010, Pop Warner started requiring players showing signs of a concussion to be cleared by a medical professional before returning to action. Before, a coach or parent could have made that decision.

The new national practice restrictions, take those precautions a step further. Now, coaches will only be allowed to have full-speed hitting – including one-on-one blocking and tackling, contact between linemen and scrimmages – for one-third of their weekly practice time. Previously, there were no restrictions on contact time. Also barred are any head-to-head, full-speed blocking or tackling drills in which players start more than 3 yards apart.

Most youth football concussions occur in practice, said Dr. Julian Bailes, chairman of Pop Warner’s Medical Advisory Board and chairman of the Department of Neurosurgery at North Shore University Health System. By eliminating high-risk drills and limiting contact time outside games, Bailes said, 60% of Pop Warner concussions could be eliminated.

But reducing concussions is not as easy as writing a new policy, said Pop Warner Executive Director Jon Butler. Drawing proper attention to head injuries requires differentiating the steps for treating a possible concussion and, say, a nasty bruise on the arm. “There is this tremendous he-man attitude,” Butler said. “There’s a lot of injuries you can play through — there’s others you don’t want to.”

Although the risk of concussions in football is no doubt high, the head injuries are not unique to America’s most popular sport. Pop Warner officials say their job is to eliminate unnecessary risks, and to make sure coaches and players are equipped to recognize the symptoms and secure proper care when an injury does occur.

Source:  Chicago Tribune, 6/13/12, By Mitch Smith