Blood-borne pathogens

The OSHA Blood-Borne Pathogen Standard mandates that each facility must establish its own blood-borne exposure control plan to avoid placing employees in contact with blood, body fluids, or other potentially infectious materials. Each facility develops its own program and trains employees to the requirements of that program. 

A typical petrochemical plant or a refinery has hundreds of chemical hazards. Lack of care in handling or storage of the chemicals can cause bodily harm that can vary in intensity from minor to severe or even death. However, due to effective standard operating procedures, engineering controls, and personal protective equipment these risks have been controlled relatively effectively. Training, procedures, engineering controls, and administrative procedures are collectively responsible for this success. 

The health hazards of blood-borne pathogens—AIDS, hepatitis B, syphilis, etc.—are an important concern of medical and emergency response personnel. When workers receive a serious trauma that results in a bleeding wound of some type, responders are at risk to 

It can take as long as 30 years before the adverse effects of exposure to a particular 

(T/F) Like process operators, analyzer technicians, and instmmentation technicians are all at risk to toxic chemicals. 

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Monocytes A leukocyte that protects against blood-borne pathogens which rapidly moves to sites of infection in tissues. Monocytes consist of 3% to 8% of the leukocytes in the blood. In tissues, monocytes mature into different types of macrophages at different anatomic locations. Their main function is phagocytosis of foreign material, cellular debris, and pathogens that are not effectively controlled by neutrophils. 

It overcomes problems of product safety. Direct extraction of product from some native biological sources has, in the past, led to the unwitting transmission of disease. Examples include the transmission of blood-borne pathogens such as hepatitis B and C and human immunodeficiency virus (HIV) via infected blood products and the transmission of Creutzfeldt-Jakob disease to persons receiving human growth hormone (GH) preparations derived from human pituitaries. 

However, the use of HSA in now discouraged due to the possibility of accidental transmission of blood-borne pathogens. The use of recombinant HSA would overcome such fears. 

The identity of each blood donor should be recorded, and all donor blood bags must be labelled carefully. Traceability of individual blood donors/donations is essential, in case the donor or product is subsequently found to harbour blood-borne pathogens. The risk of contamination of blood during collection/processing is minimized by using closed systems and strict aseptic technique. 

HCV is the most common blood-borne pathogen. Screening for HCV infection is recommended in selected groups who are at high risk for infection (Table 25-7). 

Advisory Committee on Dangerous Pathogens (1984), Hazards and Precaution for Handling of Blood Borne Pathogens, HHG, Washington, D.C. 

Figure 9.17. Overview of the manufacture of Ceprotin. As the active ingredient is derived directly from pooled human plasma, particular emphasis is placed upon ensuring that the finished product is pathogen-free. Precautions entail the incorporation of two independent viral inactivation steps and high-resolution chromatographic purification. Additionally, extensive screening of plasma pool source material for blood-borne pathogens is undertaken. Viral screening is undertaken using a combination of immunoassay and PCR analysis for the presence of viral nucleic acid...

As is the case with all other pharmaceutical substances, all aspects of antisera production must be undertaken by means conducive to the principles of GMP. Most regulatory authorities publish guidelines which outline acceptable standards/procedures for the production of such blood-derived products. Donor animals must be healthy and screened for the presence of (particularly blood-borne) pathogens. They must be housed in appropriate animal facilities, and withdrawal of blood must be undertaken by aseptic technique. Subsequent downstream processing must be undertaken according to the principles of GMP, as laid down in Chapter 3. 

Unfortunately, the potential danger of transmitting blood-borne pathogens (human immunodeficiency virus, hepatitis viruses) associated with the injection... 

Health Act (OSHA), which regulates workplace safety. In particular, pharmacists who perform laboratory tests that require finger sticks are at risk from exposure to blood-borne pathogens. Pharmacies who perform these tests should have a blood-borne pathogen exposure control plan (BPEPC) that describes who should be trained about the hazards of blood-borne exposure, precautions that need to be taken to prevent exposure, and what to do when an exposure incident occurs (Rosenthal, 2000). More information regarding OSHA and an example BPEPC can be found at the OSHA Web site (www.osha.gov). 

Another series of thio- and selenopyrylium photosensitizers were prepared and evaluated for their ability to purge blood-borne pathogens <2007BMC4406>. The preparative route is illustrated for selenopyrylium iodide 193 (Scheme 23) (see Section 7.11.8.1). 

The prevention and control of the spread of disease is a significant part of public health practice. A yearly review of the agency s blood-borne pathogen policy is advisable. PHN infection control specialists conduct at least yearly in-services for community organizations, many of whom are part of the first responder team. 

With the proliferation of concern regarding blood-borne pathogens and the expanding need for medical devices and packages which enable defects in... 

More expensive and costly to produce Potential for infection at site of injection Potential for sepsis Potential for thrombophlebitis Potential for fluid overload Potential for air embolism Potential for extravasation Psychological distress by the patient Require specialized equipment, devices, and techniques to prepare and administer drugs Potential for pain upon injection Potential for tissue damage upon injection Risk of needlestick injuries and exposure to blood-borne pathogens by health care worker Increased morbidity associated with long-term vascular access devices Disposal of needles, syringes, and other infusion devices requires special consideration... 

Documented policies and effective use of mandated plans and/or programs in the areas of chemical hygiene, control of exposure to blood-borne pathogens, tuberculosis control, and ergonomics... 

As discussed earlier in this section, OSHA has mandated that all U.S. laboratories have an exposure control plan. In addition, the National Institute for Occupational Safety and Health (NIOSH), a functional unit of the GDC, has prepared and widely distributed a document entitled Universal Pre-cautions that specifies how U.S. clinical laboratories handle infectious agents. In general it mandates that clinical laboratories treat aU human blood and other potentially infectious materials as if they were known to contain infectious agents, such as HBV, HIV, and other blood-borne pathogens. These requirements apply to all specimens of blood, serum, plasma, blood products, vaginal secretions, semen, cerebrospinal fluid, synovial fluid, and concentrated HBV or HIV viruses. In addition, any specimen of any type that contains visible traces of blood should be bandied using tliese Universal Precautions. 

Blood-borne Pathogens. In 29 Code of Federal Regulations Section 1910.1030, Revised as of July I, 1999 261-274. 

Although the focus of this discussion emphasizes HIV infection, healthcare workers must be aware that other 10. blood-borne pathogens such as HBV and HCV may also be of significant concern. The healthcare worker is encouraged to refer to alternative references for more detailed discussions pertaining to these infections. 

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