Understanding the Different Methods of Bloodborne Pathogens TransmissionGreg Garner
If you’re looking to join the medical field, it’s very important to understand the various methods of pathogens transmissions. But that’s only the beginning.
Knowing where potential infections come from is great, but knowing how to prevent them from infecting yourself and others is even better. While we will cover where they come from, we will also cover how to stop them from coming.
So whenever you’re ready to take your understanding of the medical world to the next level, keep reading and get your notes handy.
What Are Bloodborne Pathogens?
BBPs, also known as bloodborne pathogens are microorganisms, such as bacteria or viruses that are transmitted via human blood (and other fluids) that can cause disease.
There are a variety of bloodborne pathogens, such as syphilis, malaria, brucellosis. But HIV, HBV, and HCV are most common, and they are the only ones that are specifically addressed by a standard.
The training towards these diseases are limited for transmission via human blood, animal blood is excluded.
Bloodborne Pathogens Transmission
Pathogens such as HIV, Hepatitis C, or Hepatitis B can be transmitted by contact with infectious materials or infected human blood.
In definition, the term for blood is comprised of human blood, products made with human blood, and human blood components. It also includes medications that are made with human blood, such as albumin, immune globulin, and factors 9 and 8.
Other potential infected materials are human body fluids, unfixed organs or tissue, infected mediums or tissues, tissues, and blood of experimental animals.
To be more specific, human body fluids cover vaginal secretions, semen, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, cerebrospinal fluid, amniotic fluid, body fluids contained with blood, saliva, and impossible to differentiate fluids.
All unfixed organs and tissues (not including intact skin) from a dead or living human. Cell lines are considered part of this as well. Fixed human tissues are not potentially infectious, they are not considered OPIM.
HIV or HBV/HCV containing cultures, organ tissues, solutions, and experimental animal tissues are part of the cell category.
It’s essential to know-how transmission, and exposure is likely to occur in most circumstances. Especially if you are providing first aid, handling human cells, or cleaning blood away. For more accurate information, contact your supervisor or review the Bloodborne Pathogens Exposure Control Plan.
Pathogens are most likely to transmit via contact between damaged skin and infected fluids, accidental puncture from broken glass, contaminated needles, or other sharps. But it’s also transmitted by sexual contact, from mother to baby, and hypodermic needle sharing.
In most circumstances of work nature, the transmission is likely to happen because of accidental exposure to sharps or contact between mucous membranes and infected fluids.
If there’s the possibility of blood-to-blood contact, the transmission is very possible.
Examples of Pathogen Entrances
Intact skin has an impenetrable barrier against pathogens. Blood getting on the skin is not an exposure risk. But, infected blood can easily enter your system through cuts, abrasions, open sores, acne, or other damaged skin (chapped, sunburnt, blistered).
They can also be transmitted via mucous membranes like the nose, mouth, and eyes. A splash of contaminated blood to the face is an exposure risk because the fluids might have entered either of the three orifices.
Hepatitis C Virus
This virus causes substantial damage to the liver. It can be fatal. Infection is possible with very mild symptoms. People born between 1945 and 1965 have the highest presence of this virus.
The virus kills more in that generation than over 60 other diseases in combination. Because a vaccine does not exist, it’s a very important pathogen from a risk view.
There have been over 2000 cases of acute HCV in over 40 states in one of the past years. The chronic form of this disease develops in over 80% of individuals, with over half of them developing an active liver illness.
Of those with active liver illness, a quarter will develop cirrhosis and a bit less liver cancer. Among those with cirrhosis, there is a greater risk of hepatocellular carcinoma and hepatic decompensation. The risk of death with these issues increases significantly.
Nonetheless, the total infections with HCV that have occurred have decreased over the past 60 years. A slim percentage of infected people were exposed to health care workers.
Hepatitis B Virus
This virus can also cause liver damage, as well as fatal death. Symptoms that are covered are nausea, fever, jaundice, and abdominal pain. A smaller percentage of people with HBV developed a chronic illness.
Nonetheless, this chronic illness does carry the same risks of cirrhosis and a greater likelihood of liver cancer. Individuals infected with Hepatitis B during birth are more likely to get infected chronically.
Almost 100% of infants, and 50% of children up to 5 years old remaining infected with chronic HBV after infection. New cases of HBV have not been steadily increasing or decreasing for the past 10 years.
There are about 3000 cases each year. Nonetheless, after adjustments made for under-reporting and lack of ascertainment, the number was predicted to be at 20000 in recent years.
The chance of getting HBV from sharps is a quarter of all possible infections. National HBV surveillance shows that health care workers get infected with it regularly. But not as much as 20 years ago, when the new infections for workers were at about 16000.
This decline is due to the immunization protocols of workers with a vaccine, as well as universal precautions required by OSHA. The CDC does not collect post-exposure seroconversion information anymore.
Human Immunodeficiency Virus
HIV removes the body’s immune abilities, making the person unable to fight against infections. Once somebody is immunocompromised, they can exhibit low-grade fevers, weight loss, flu symptoms, and night sweats.
They will be more vulnerable to the intestinal disorder, pneumonia, fungal infection. About 1 in 6 people don’t know they have HIV, simply because they have not been tested for it. This means that both the patient and doctor will not be aware of the exposure risk.
The potential risk for HIV from sharps is quite small, about 1 in 300. The CDC reported about 50+ documented cases of HIV for the past 30 years. Of those cases, 40+ were from punctures or cuts.
Most cases involved lab technicians or nurses. Other researchers estimate that the actual case number is much higher. Once again, the CDC does not collect any more data on occupation HIV. Thus, the number is under-estimated.
The Importance Of PPE
Personal protective equipment is an efficient barrier between infected material and people. A hazard assessment must also be performed to determine task risk and the precautions with PPE that will help avoid exposure.
PPE must be appropriate for tasks and readily available. All PPE should be supplied to workers at no charge.
Some of the general rules for PPE are:
- Wear assigned PPE in exposure circumstances
- Do not wear punctured or torn PPE
- Do not wear PPE that is unable to function as a barrier
- Remove PPE before exiting work environment
PPE gloves should be water-impervious. Latex gloves can cause allergies, so that should be considered in advance. If glove material is flimsy or thin, double gloving is essential.
If you know you have sores or cuts on teh hands, cover them with bandages or other protection before wearing gloves. Always inspect gloves for punctures and tears. If gloves are damaged, don’t use them.
When taking used PPE, make sure to not touch the external parts of it with bare skin. If there is the risk of misting or splashing infected fluids, eye protection must be used.
Face shields can be worn in addition to goggles. Face shields will prevent splashes to the mouth and nose. Splashing is common and it can happen when cleaning spills, providing first aid, performing laboratory protocols.
Lab coats, protective suits, and aprons should be work to keep contaminated fluids from soaking clothes and skin. Shoe covers might also be required.
Contaminated PPE should never be moved from the worksite. IT should be handled minimally and placed in appropriately labeled containers until decontaminated, laundry, or disposal.
It’s important to find out where disposal locations are at work before performing any tasks. Normal clothing that’s contained should be removed ASAP. Fluids can easily seep into cloth, coming into contact with potentially damaged skin.
In the Event Of Exposure
Even when blood is not visible or infected material not present, any needlestick or puncture of skin at work or elsewhere can be an exposure risk for bloodborne pathogens transmission.
Not to mention, exposure as mentioned earlier, covers blood spraying, splashing. Another exposure extends to splashing of material to cracks, cuts, and open sores. Human assault and bites from patients is another exposure risk.
The CDC has outlined some steps to be taken after coming into contact with body fluids or blood. First, in the incident of a cut or needlestick, you should wash the skin throughout with water and soap.
If fluids or blood have splashed on your face, flush the nose and mouth with water. Eye exposure required continual and immediate flushing with saline or clean water.
Next, one should report all exposure incidences to medical specialists or employers. Most incidents of such injuries and exposure are not mentioned or reported.
Immediate reporting of exposure is an essential component of safe practice and a direct streamline towards ensuring you receive the appropriate care.
Handwashing Protocols for Improved Safety
Another thing worth mentioning alongside modes of transmission and disease prevention is handwashing protocols. Following these at work or at home, before or after exposure will enhance your level of safety against BBPs.
You must start to use warm water, scalding hot water will not work. If you have a towel dispenser at work and it’s not automatic, don’t contaminate the towels with dirty hands.
Wet your hands thoroughly, apply soap to all parts of the hand up to the elbow. Scrub until it lathers greatly. Scrub the entire skin surface, two inches up your wrists.
Use a side-to-side motion of scratching with the palm of your opposing hands. After this scrub under the fingernails. Rinse the soap off the skin, from the wrists to the tips of the fingers.
Don’t touch the sink or other surfaces. Dry your hands and arms with a towel. Dry entirely to avoid chapping of skin. The towel should be disposed of in an appropriate bin.
Use another towel to turn off the sink, because the old towel can transport pathogens back to surfaces and hands. Throw it away.
After disposing of the towel, use another new towel to open the door as you leave. If you’re not using towels, replace the towel steps with thick napkins or toilet-duty napkins.
Bloodborne Pathogens Training Extended
Now that you know about bloodborne pathogens transmission, you are one step ahead of the virus itself. It might know how to infect you, but it does not know that you know how to avoid it. As long as you put it in the effort and take safety protocols seriously, you will diminish the risk of exposure hundred-fold.
Even a single approach to safety will improve your ability to remain healthy. And with each new approach that you add or make use of, you will continue to stack your health barrier higher and higher.
If you’re interested in taking your knowledge of bloodborne pathogens to the next level, get in touch with us and we will set you up with some specialized training.