BLOODBORNE PATHOGENS-Prevention Training

Know The Risks!

Introduction 

One of the risks that you face as a Border Patrol Agent is potential exposure to bloodborne pathogens such as the hepatitis B virus, the hepatitis C virus and the human immunodeficiency virus (HIV)  Several laws and regulations have been developed to help educate and protect you against bloodborne diseases. 

The Occupational Safety and Health Administration has issued a standard on bloodborne pathogens designed to protect employees who face exposure to blood or other potentially infectious materials on the job.  Under this law, sector management must address your protection in a written Exposure Control Plan which describes precautions you can take to prevent exposure as well as the steps you must take if an exposure occurs.  Your sector Safety Manager has complied this plan which also incorporates the Centers for Disease Control and Prevention (CDC) guidelines specific to law enforcement officers. 

You are also protected by the Ryan White Comprehensive AIDS Resources Emergency Act, updated in 1994, which mandate that medical facilities inform you when you have been exposed to a communicable disease while giving someone assistance.  It also requires that sector management have a Designated Officer who serves as your advocate in the event of an exposure.  Local 1613, of the National Border Patrol Council has appointed me as this person.  It is my responsibility to ensure that proper documentation and medical follow-up is conducted on your behalf. 

Bloodborne Diseases:  Know Their M.O. 

Although there are several diseases transmitted by blood, the ones you should be concerned about on the job are hepatitis B, hepatitis C and HIV. 

HIV Infection and AIDS

The human immunodeficiency virus attacks the body’s immune system  and destroys the ability to fight infection.  A person infected with HIV may simply carry the virus and remain in apparently normal health for many years.  Although many persons infected with HIV go on to develop AIDS, the rate is declining due to new drug treatments.  Persons with HIV infection can not live longer, healthier lives.  There still is no effective vaccine to prevent AIDS and no cure. 

Hepatitis B Viral Infection

Hepatitis B viral infection, a disease which affect the liver, poses a greater risk to than HIV infection.  Most persons infected with hepatitis B virus get over their infection, but for some, this disease progresses to chronic liver disease or liver cancer and death.  Fortunately, a vaccine IS available to protect you against getting hepatitis B virus.  Symptoms of the hepatitis B virus may include: jaundice, dark brown urine and clay colored feces—but sometimes the disease may go unnoticed.  Completely healthy people can carry the virus, so it is important to consider ALL BLOOD AS A POTENTIAL RISK. 

Hepatitis C Viral Infection
Hepatitis C virus also attacks the liver.  Since hepatitis C and hepatitis B have the same symptoms, a blood test is required to tell the difference.  Hepatitis C is more treacherous than hepatitis B: about 75 percent of people show no outward signs or symptoms of this disease when they become infected but up to 85 percent will go on to develop long term chronic liver disease.  Currently, there is no effective treatment or protective vaccine for this disease. 

Transmission of Bloodborne Diseases 

Hepatitis B, C and HIV are spread in the same ways.  They are not spread through the air like cold and flue germs, so you won’t get these viruses from working alongside someone who is infected or from touching, coughing, sneezing or a kiss on the cheek.  Nor will you become infected from sharing things such as telephones, bathrooms, eating utensils, gym equipment, swimming pools or water fountains with an infected person. 

These infections are spread through contact with blood, semen, vaginal secretions (sexual contact) and any other body fluid or tissue that contains visible blood.  You can also get infected by contact with the fluid that surrounds an unborn child and the fluid around the heart, lungs, or joints. 

Body fluids such as sweat, tears, saliva, urine, stool, vomitus, nasal secretions and sputum have not been shown to transmit bloodborne diseases, unless they contain visible blood. 

Exposure on the Job
You’re at risk when you’re exposed in the following ways:

ü      Being pricked by a contaminated needle

ü      Being cut with an object covered with blood or other potentially infectious materials

ü      Being splashed by blood or other potentially infectious materials into your eye, up your nose or in your mouth

ü      Having a broken area of your skin come in contact with blood or other potentially infectious materials.  Cuts, sores or even tiny breaks in the skin from dermatitis can be doorways for the viruses to enter your body. 

Risk for Infection After and Exposure

Fortunately, being exposed to blood or other potentially infectious material does not mean you are automatically infected with a bloodborne disease.  You need a  large enough dose of the live virus to enter your blood stream and overcome your body’s defense system to become infected.  For example, if the number of live organisms present in the exposure material is not high enough, infection cannot occur.  The ability of the virus to infect is also important.  For instance, the hepatitis B virus can survive on environmental surfaces in dried blood for at least a week, while HIV is fragile and dies when exposed to light and air. 

Remember: You can help those in need and protect the public safety without risking your own health by following simple safety precautions. 

How to Avoid Infection 

Sector’s Exposure Control Plan details the following precautions you can take to protect yourself against bloodborne pathogen exposure: 

Hepatitis B Vaccine

You can protect yourself from hepatitis B infection simply by receiving a hepatitis B vaccine, which is a series of three shots in the upper arm over a period of six months.  Today’s vaccines are safe and very effective at protecting you from hepatitis B in you complete the series. 

Body Substance Isolation

Many people can carry bloodborne pathogens for many years without showing any symptoms and yet be contagious.  That’s why it is so important to follow Body Substance Isolation, or BSI.  It means treating blood and body fluids as if they are infected with bloodborne or other pathogens.  BSI provides a simple rule: consider all body fluids to pose a potential risk. 

Personal Protective Equipment (PPE)

PPE provides a barier against contact with bloodborne diseases.  PPE includes gloves, protective eyewear, masks, gowns or coveralls and resuscitation devices.  Your department will provide you with these items and train you to use them properly, but here are some general rules. 

Ø      Make sure PPE fits properly and check it routinely for flaws or damage.

Ø      Remove PPE as soon as possible if it become penetrated by blood or other potentially infectious material.

Ø      Always remove PPE before leaving the work area.

Ø      Avoid eating, drinking, and using tobacco products while wearing PPE (gloves).

Ø      Immediately dispose of used PPE and have it laundered, decontaminated or disposed of according to Sector’s policy.

When removing gloves, be careful not to touch the outside.  While both hands are gloved, peel one glove off from top to bottom and hold it in the gloved hand.  With the exposed hand, peel the second glove from the top, tucking the first glove inside the second.  Dispose of the entire bundle promptly according to the waste regulations outlined in you Sector Health and Safety protocol.  Then wash your hands.

Protective eyewear blocks the splatter of blood and other potentially infectious materials from contacting the surface of the eye.  Protective eyewear should have side shields.  Prescription glasses with clip-on side shields can be used for eye protection.  Reusable glasses should be washed with soap and water after use and disinfected and then can be used again. 

Masks block the splatter of blood and other potentially infectious material from entering your mouth and nose. 

Resuscitation devices are designed to protect you from contact with blood and other potentially infectious materials during mouth-to-mouth resuscitation.  Your Sector Safety and Health Manager is responsible for ensuring that you are trained in the proper use and decontamination of these devices, whether reusable or disposal. 

PPE’s should be with you at all time.  Keep gloves on your person and other PPE in your “trique” bag.  Check your Exposure Control Plan to see what PPE is needed in each situation you may encounter. 

Generally, you should wear the amount of PPE needed to protect your skin or clothing against the type of exposure you reasonably anticipate.  For instance, you should wear gloves when transporting bleeding prisoners or contaminated materials such as clothing.  Your Sector Safety Manager is responsible for providing you with sharps puncture resistant containers at your processing locations or in other places you feel to be appropriate.   

Work Controls: Modify Daily Tasks 

Follow work practices that protect you against contact with blood or other potentially infectious material. 

Safe Search Practices

If possible, have arrestees empty their own pockets.  If you must search pockets, wear gloves and use your asp or flash light to rub the pockets and test for hidden objects.  Ask women to open their own purses by turning them upside down.  NEVER PUT YOUR HAND IN A PURSE! 

Safe Evidence Collection

Wear disposable single use gloves under your duty gloves.  In some situations where your clothing may become contaminated due to a large amount of  blood or other potentially infectious materials at a crime scene, wear a gown or coveralls.  Place evidence in clearly marked plastic bags and seal with evidence tape.  Bloody items should be air-dried on a rack, them bagged as evidence.  If you must collect syr8inges or other sharps, handle syringes by the barrel and do not cap, bend or break their needles.  Place needles and sharps in a collection container that is puncture-resistant, leakprooof, closeable and labeled or color-coded as a biohazard. 

Hand-washing

Hand-washing is your number one protection against infection, and it keeps you from infecting other people or objects.  Wash your hands with soap and water as soon as possible after every incident involving blood or another potentially infectious material, even if you wore gloves.  If soap and water are not available, use the waterless handwash solution furnished by your Sector Safety Manager as a temporary precaution only.  You still must wash your hands with soap and water as soon as you can. 

Here’s how:

• Wash hands thoroughly for at least 10 to 15 seconds (the time it takes to sing "Happy Birthday"), including under your rings, between your fingers and above your wrists.

• Rinse thoroughly under running water and dry hands with a paper towel.

• Use paper towel to turn off the faucet, then discard the towel into general trash.

Housekeeping: Making a Clean Sweep 

ü      T clean body armor, remove the vest while wearing gloves and spot-clean contaminated areas with soap and water.  If vest is soaked with blood, refer to tha manufacturer’s cleaning instructions.

ü      To clean leather gear, rinse contaminated areas and then wash with saddle soap.

ü      To clean metal gear, wash with soap and water and then spray disinfectant.

ü      To launder contaminated clothing, follow Sector’s policy.  At a minimum, rinse the articles well and then launder with soap.  Use the normal wash cycle of a standard washing machine.  Always wear gloves, mask and eye protection when laundering by hand.

ü      To clean contaminated surfaces, cover the spill with absorbent material such as paper towels.  Clean according to CDC recommendations by pouring a fresh solution of 1 part bleach to 100 parts water on the outer edge of the spill and allow to absorb inward.  Then, wearing utility gloves pick up the material and place into a biohazard bag and dispose of according to your state regulations.  Make sure to disinfect mops or any other cleaning equipment after use.

ü      To clean contaminated service vehicles, wear utility gloves and wash interior with bleach/water solution or Lysol concentrate, depending on the material.  Then bag cleaning materials and discard in biohazard bag following Sector’s policy. 

NOTE: When handling biohazardous waste, wear utility gloves and touch waste containers on the outside only.  Never reach inside or push trash down with your hands or feet.  Instead, shake down the waste by holding the top of the bag.  Carry bags away from your body.  Use a broom and dustpan or tongs to pick up broken glass, not your hands.  Dispose of biohazardous waste according to your state regulations.  Regulations differ from state to state depending on definition of medical waste. 

If You’re Exposed: Dealing with the Unexpected

Despite your best efforts you may sometimes get caught without personal protective equipment and become exposed to blood or other potentially infectious material.  If you are exposed, don’t panic.  Wash exposed skin areas with soap and water.  Flush eyes and mucous membranes with large amounts of water.  With large amounts of contamination, remove clothes and place in a plastic bag until they can be laundered, shower and don the clean change of clothing that you always carry with you.  Report the incident to your supervisor and your station’s designated Collateral Health and Safety Officer, giving as many details as possible regarding the type of and source of the exposure.  Your designated Collateral Health and Safety Officer will document the incident, ensure that the proper blood work is drawn on both you and the source individual, and inform you of the test results and the need for any additional medical treatment and consultation. 

Remember:  Exposure does not automatically mean infection.  To put risk exposure into perspective, let’s look at the greatest risk you face—your risk of acquiring bloodborne diseases after being injured by a contaminated sharp:

v     Your risk of acquiring hepatitis B is from 6 to 30 percent

v     Your risk of acquiring hepatitis C if from 3 to 10 percent

v     Your risk of acquiring HIV infection is 0.32 percent 

Summary 

As a Border Patrol Agent you will always face risks, and you will do whatever it takes to get the job done as safely and as effectively as possible.  You can deal effectively with the risk of exposure to bloodborne pathogens by following the simple safety precautions we just discussed.  Remember to use PPE when possible, report any potential exposure to your designated Collateral Health and Safety Officer and supervisor, and follow your treatment plan following any exposure.