Health Services-Policies & Procedures
Volunteer State Community College | Student Services Division
Policies & Procedures
Bloodborne Pathogens
Hiv / Aids / Hepatitis / Tuberculosis
All Blood And Body Fluids Should Be Treated As Infectious Material
Bloodborne Pathogen Overview
- At the time of the employment, all new employees will receive information pertaining to infectious diseases.
- Certain job classifications have been identified as having greater risk for exposure to bloodborne pathogens. Those job classifications include:
- Campus Police
- Health Services
- Custodial Services
- Athletics
- Plant Operations
- Health, Physical Education, and Wellness Faculty
- Allied Health Faculty
- Telecommunications Staff
These employees will complete annual bloodborne pathogen training prior to their yearly evaluation.
- At the time of employment, all high-risk employees must sign the Hepatitis B Acceptance/Waiver Form and return to Human Resources.
Purpose
It is the purpose and goal of Volunteer State Community College to adequately protect all employees from the risk of transmission of communicable diseases in the workplace.
To eliminate or minimize occupational exposure to bloodborne pathogens, VSCC plan is in accordance with OSHA Standard 29 CRFR 1910.1030, “Occupational Exposure to Bloodborne Pathogens”.
All employees who are directly exposed or whose jobs have the likelihood of exposure to blood or other potentially infectious materials incur risk of infection and subsequent illness are referred to as “high-risk”. The purpose of this overview is to inform and reduce workers exposure incidents to bloodborne pathogens, such as HBV and HIV.
The information received from the Centers Disease Control (CDC) indicates that instructors, clerical workers, administrators, who have virtually no risk of contact with blood, body fluids or other infectious materials as a result of their employment; are at no greater risk of contracting bloodborne diseases than other members of the general population, and would not necessarily need to receive the Hepatitis B vaccine. Universal or standard precautions should always be practiced in all areas of our life. These include but are not limited to good hygiene techniques specifically: handwashing before and after eating, after removing gloves, smoking and after using the restroom and treating all body fluids as nfectious material.
The Plan For High-Risk Employees
- VSCC has identified all employees who are exposed to blood and body fluids as a regular part of their jobs.
- All high-risk employees will be provided protective equipment, such as gloves, at no cost and will be taught how and when to use them.
- All high-risk employees will be trained, at least annually, in use of equipment, methods of avoiding coming into contact with blood, methods for clean-up and disposal of waste, and rules for reporting any situations where employees do contact someone else's blood or body fluids. In addition they will be provided information about the risks involved with contact with blood as well as about the diseases themselves.
- VSCC Health Services will provide all high-risk employees the Hepatitis B vaccine at no cost to the employee.
- Any employee who has a direct exposure will receive free medical evaluation and treatment, if needed.
- VSCC will mark anything that contains blood or body fluids with labels and/or color-coding and will provide bags and boxes for proper disposal of items containing blood.
- VSCC must keep records of all training offered as well as medical records associated with the Plan.
Training and Education
Volunteer State Community Collge shall ensure that all employeesemployees will receive bloodborne pathogen training during the orientation period and annually for those employees deemed at higher risk for bloodborne pathogen exposure.
Common Bloodborne Pathogens
Bloodborne pathogens are microscopic bacteria in the bloodstream that can cause disease. Although they are very small, they can carry many diseases, including the biggest health concern today - the HIV virus that causes AIDS, and the HBV virus or the Hepatitis B virus.
Where Are Bloodborne Pathogens Found?
Bloodborne pathogens are found in blood and blood products, including:
- blood
- urine
- semen
- tears
- vaginal secretions
- other body fluids
- breast milk
- tissue cultures
- saliva
- organ cultures
Although small traces of HIV can be found in tears, saliva, urine and perspiration, extensive studies have shown that there is not enough of the virus or the virus is not strong enough to be transmitted. Only blood, semen, vaginal secretions, and breast milk have been proven to transmit the HIV virus and Hepatitis B. HIV cannot be passed on by casual contact.
You Cannot Get HIV From the Following
- By sharing food, drinking glasses or towels
- From sinks or toilets in the bathroom
- By sharing personal protective equipment such as goggles, respirators or clothing
- By sharing tools
- Insects such as mosquitoes have not been proven to carry the HIV virus
There is no documented evidence that dried blood on a surface is strong enough to transmit HIV, but Hepatitis B can be transmitted from dried blood.
HIV and Hepatitis B can only be transmitted if both of the following are true:
- Exposed blood is infectious.
- Blood is allowed to enter directly into the body through any of the following ways:
- Unprotected openings in the skin such as cuts, scrapes and dermatitis
- Unprotected mucus membrane openings such as the eyes, nose and mouth
- Penetration into the skin by a sharp object such as broken glass, a needle, or knife blade.
HIV / AIDS
The Acquired Immunodeficiency Syndrome (AIDS) was first reported in the United States in 1981. The Human Immunodeficiency Virus (HIV) is apparently the cause of this disease. In its most severe form, this virus destroys the body's ability to resist a wide variety of infections. Most of these secondary infections pose little or no risk to persons with normal immune systems. HIV is transmitted through body fluids, mainly blood and semen. You can develop AIDS from 2 to 10 years or more after being infected with HIV. In some cases, the virus can be present in the body for 10 or more years before any symptoms occur. You do not have to have AIDS, show any symptoms, or even be ill to infect another person with HIV. Presently, there is no vaccine or cure for AIDS.
What Are the Symptoms of HIV / AIDS?
Early symptoms include:
- swollen glands
- chronic fatigue
- diarrhea
- fever
- yeast infections
- loss of appetite and weight
- night sweats
The AIDS patient may suffer from one of many different diseases due to the immune system's inability to fight off infections. These diseases include forms of cancer and pneumonia. Casual contact with persons in high-risk groups for AIDS (e.g., homosexuals, IV drug abusers) does not place you at risk for acquiring AIDS. No cases of AIDS have been identified among non-sexual household contacts of patients with AIDS. Although HIV is mainly transmitted through sexual contact and sharing needles, any situation in which blood is present in the work environment is an area of concern. If the infectious blood enters directly into the other person's body, there is the possibility of transference. This may occur due to:
- Unprotected opening in the skin such as cuts, scrapes and dermatitis
- Unprotected mucus membrane openings such as the eyes, nose and mouth or penetration into the skin by a sharp object such as broken glass or a needle or knife blade
Hepatitis-B (HBV)
Hepatitis B is a disease/inflammation of the liver. It can be caused by a number of agents, including bacteria, drugs, toxins, and excess alcohol. Hepatitis that results when any of the several hepatitis viruses infect the liver brings serious concern. You can get the virus and not show any symptoms. In this situation, you are still contagious and could pass the disease on to someone else. You also have a greater risk of liver diseases such as cirrhosis or liver cancer.
Symptoms appear gradually if at all. Many people who are infected have no symptoms and you cannot tell a person is infected by the way he/she looks or feels. Only having a blood test can identify often-infected persons. While most patients recover, HBV can be a very serious and sometimes-fatal disease for which there are no specific treatments and no known cure. At the time of exposure to blood or body fluid of a known Hepatitis B carcinoma, Hepatitis B Immune Globulin may be administered which may reduce the likelihood of infection.
What Are the Symptoms of Hepatitis B?
Symptoms include:
- flu-like symptoms in the early stages
- jaundice, an abnormal yellowing of the skin, eyes, and urine
- weakness or fatigue
- lack of appetite
- vomiting
- abdominal pain
- diarrhea
Those who have the disease build up antibodies, or a natural protection against further occurrences. Ten percent of Hepatitis B cases are chronic, meaning repeated illnesses. About 2 to 3 percent of Hepatitis B cases are fatal.
Other Types Of Hepatitis
- Hepatitis A
- Formerly called “infectious hepatitis”
- Hepatitis A virus is excreted in the feces. Infected people can spread the virus by neglecting to wash their hands after eliminating solid body waste. The virus may be passed along when these individuals handle food or other items that are placed in the mouth. Hepatitis A virus also can be spread through direct contact with infected people. In addition, hepatitis epidemics occur when Hepatitis A virus has contaminated drinking water or food (including raw or steamed clams, oysters, or mussels). Hepatitis A outbreaks also occur quite commonly in day-care centers or nurseries where an infected child may transmit the disease to others quite rapidly. Hepatitis A often produces fever, however, the disease is generally resolved without any long-term effects.
- Hepatitis B
- Formerly called “serum hepatitis”
- Hepatitis B virus is found in all body fluids of infected people, including blood, semen, saliva, and urine. The principle ways of spreading the Hepatitis B virus includes intimate contact with infected people or exposure to body fluids from these individuals. Piercing of the skin by contaminated instruments such as those used for tattooing, ear piercing, acupuncture and dental or medical procedures poses a serious risk of passing Hepatitis B virus to others. This disease also can be spread when illicit drug users share equipment. In addition, hepatitis B virus may be transmitted sexually, when contaminated body fluids come into contact with mucous membranes or tiny breaks in the skin. Hepatitis B may also be transmitted to infants born to women who are highly infectious at the time of delivery. Hepatitis B may have a broad range of clinical symptoms including complete recovery for most people, death due to fulminant (severe) hepatitis (less than 1 percent of the cases) or chronic liver disease which may progress to liver cancer (5-10 percent).
- Hepatitis C
- Formerly called “non-A, non-B hepatitis”
- Hepatitis C virus, until recently, was known as non-A, non-B hepatitis because it could not be traced to A,B, or D viruses. In the late 1980's genetic sequences of the virus were isolated and cloned and a test for identifying an antibody to the virus was developed. The virus was designated Hepatitis C. Transfused blood is one source of the transmission of this disease. Most hepatitis cases that occur as a result of blood transfusions are hepatitis C. Hepatitis C also may be spread through intimate contact with an infected person. People who acquire Hepatitis C stand a 50-60 percent chance of developing lifelong liver disease.
- Hepatitis D
- Also known as “delta hepatitis,” an infection that exists only in combination with Hepatitis B virus.
- Hepatitis D virus cannot initiate an infection by itself. A person must have acquired Hepatitis B before becoming infected with Hepatitis D. These viruses together usually produce a disease more severe than that caused by the Hepatitis B virus alone. Hepatitis D virus is spread in the same ways as the Hepatitis B virus In the United States, infections with Hepatitis D occur primarily among those who must receive blood products frequently, such as dialysis patients, hemophiliacs, or among those who inject illicit drugs. Hepatitis D, in conjunction with Hepatitis B, is the most severe known form of viral hepatitis and generally progressed into chronic active disease or death due to severe hepatitis.
- Hepatitis E
- Formerly known as “epidemic” or “waterborne non-A, non-B hepatitis”
- Hepatitis E virus is acquired when water or food contaminated with human feces is ingested. It is among the leading causes of acute viral hepatitis in young to middle-aged adults in developing countries. It has a high mortality rate - nearly 20 percent - in infected pregnant women.
Complete recovery from any form of hepatitis may take four months or longer. Many people say that they are not themselves for years after infection. In certain cases, individuals do not regain their former levels of energy and stamina; sometimes they are forced to take less demanding jobs and discontinue many aspects of their previous lifestyle.
Hospitals and blood banks are required to test all blood drawn for transfusion with very sensitive tests for Hepatitis B and Hepatitis C viruses. Many hospitals are testing staff members, patients being prepared for surgery, kidney patients, and pregnant women for evidence of Hepatitis B infection, as well. In some areas, testing of all patients admitted to the hospital for signs of Hepatitis is done on a routine basis.
A major advance in the control of Hepatitis B occurred in 1981 with the introduction of a hepatitis vaccine. For people at high risk of acquiring hepatitis, vaccination is recommended.
Hepatitis B Vaccination
Hepatitis B vaccines currently being used are produced by recombinant DNA technology using common bakers yeast. The recommended series of three intramuscular doses administered only in the deltoid muscle of adults induces a protective antibody response in above 90% of healthy adults. Hepatitis B vaccines have been shown to be safe when administered to adults. It confers protection against chronic Hepatitis B infection and carrier state.Booster doses of vaccine are not recommended. Any presumed risk of adverse events possibly associated with Hepatitis B vaccination must be balanced against the expected risk of acute and chronic liver disease due to Hepatitis B virus. It has also been classified as an anti-cancer agent because it prevents liver cancer associated with Hepatitis B.
If you desire the immunization, please complete the Hepatitis Waiver/Acceptance Form (PDF) and return the signed document to Health Services. The vaccine will be ordered and you will be notified when vaccine is available.
The Hepatitis B vaccine is highly recommended but is not mandatory.
If you do not wish to receive the Hepatitis B vaccine, please complete the Hepatitis Waiver/Acceptance Form (PDF) and return the signed document to Health Services.
If you have previously received the Hepatitis B vaccine, please complete the Hepatitis Waiver/Acceptance Form (PDF) at the portion that states you have completed the Hepatitis B vaccine or are in the process of receiving the vaccine and return to Health Services.
If you sign a waiver and for any reason decide to receive the vaccine, simply contact Health Service, sign the Hepatitis Waiver/Acceptance Form (PDF), and receive the vaccine. Employee designated at higher-risk for bloodborne exposure will receive the vaccine at no cost to the employee. Employees designated at low-risk for bloodborne exposure may receive the vaccine for a nominal fee
Tuberculosis (TB)
Tuberculosis is a chronic, recurrent infection most common in the lungs, but any organ may be affected. Once infection is established (a positive TB skin test), clinical TB may develop within months, or it may be delayed for years or even decades.
TB refers to the disease caused by Mycobacterium tuberculosis, M. Boris, or M. Africanum. Although other mycobacterium cause diseases that mimic TB, the infections are not communicable and most respond poorly to drugs that are very effective for TB.
Infection is virtually always airborne. It occurs almost exclusively by inhalation of organisms dispersed as air droplets from a person with positive pulmonary TB. The organisms may float in room air for several hours, increasing the chance of infecting an unsuspecting contact. According to the Centers for Disease Control and Prevention, in 2007, a total of 13,293 tuberculosis cases were reported in the United States; the TB rate declined 4.2% from 2006. The TB incidence rate in 2007 was the lowest recorded since national reporting began in 1953. Despite this overall improvement, progress has slowed in recent years; the average annual percentage decline in the TB rate slowed from 7.3% per year to 3.8% during 2000--2007. TB is a reportable disease. It must be reported to the state health department.
Signs and symptoms of active TB are:
- Prolonged cough (over 2 weeks)
- Cough with sputum or blood
- Fatigue
- Loss of appetite
- Weight loss
- Fever
Treatment
- Multiple antibiotics for 6-9 months.
- Treatment must be completed to be effective.
- Drug resistant TB results from active TB being repeatedly not treated with the full cycle of antibiotic therapy.
Transmission
Inhalation of droplets of mycobacterium TB.
Increasing Factors
- Poor ventilation
- Prolonged shared air
VSCC Plan/Protocol for Turberculosis
Gallatin Health Department has determined SumnerCounty to be in the Minimal-Risk Category. This is based on the number of TB cases in our county area. Therefore, VSCC will abide by the Minimal-Risk Requirements.
- Any employee requesting a TB (PPD) skin test will be given one without charge.
- Any employee whose symptoms warrant testing will be offered the TB skin test or referred to their private physician
- Any employee with a reading of positive TB skin test 48-72 hours after being given the PPD skin test will:
- Be sent to the Sumner County Health Department for evaluation and treatment.
- If an employee is diagnosed with active TB, any employee that has had close contact with an employee with active TB, will be screened for TB by administration of a TB skin test.
- If 48-72 hours, the TB skin test is negative, the procedure will be repeated in 3 months.
- If the two TB skin tests are negative, no further action is required.
- If an exposed employee presents with a positive TB skin test, the results will be reported to the health department and the employee will be sent to their personal physician or the health department for treatment. All employees that have had close contact with an employee with active TB will repeat the TB skin test initially and at a 3 month interval.
Employees or students will not be admitted to campus until they have been released by their personal physician and/or the health department.
