Blood Borne Pathogens
Bloodborne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include, but are not limited to, hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV)
Causative agent
– The microorganism
that causes an infection
Reservoir
– The place where an
infectious agent (microorganism) can
survive;
Portal of exit
– The path by which an
infectious agent leaves the reservoir
Mode of transmission
The method
of transfer of an infectious agent from
the reservoir to a susceptible host
Portal of entry
The path used by an
infectious agent to enter a susceptible
host
Susceptible host
A person that
lacks the ability to resist infection by an
infectious agent.
Small Spills
- Don the appropriate Personal Protective Equipment (PPE). Look on the label or Safety Data Sheet
(SDS) for this information. - Locate your Chemical Spill Kit.
- Use the materials provided in the spill kit to absorb liquid spills (i.e., spill pillows, vermiculite).
Dispose of the absorbent materials as chemical waste. - Sweep powder form chemicals carefully into a dustpan. Avoid vigorous sweeping or other actions
which generate respirable dust. Dispose contaminated materials as chemical waste. - Contact EH&S
Large Spills (500ml or more)
- Don appropriate PPE. Look on the label or
the SDS for this information. - Contain the spill if safe to do so
- If possible, warn others in the immediate
area. - Restrict access to the area.
- Evacuate the area.
- Contact UAB Emergency at (205-934-3535). State your name, extension, location of the spill, and
quantity and name of the spilled chemical. - Decontaminate personnel who may have been splashed with the chemical in deluge showers and
flush eyes with eyewashes. - Get prompt medical attention for anyone injured.
Mercury Spills
- Don appropriate PPE.
- Gather all the droplets using a suction tube,
syringe, or piece of paper. - Get up as much mercury as possible.
- Store the spilled mercury in a labeled container.
- Put the sponge on the spilled mercury and/or the contaminated area – zinc side down.
- Move the sponge in clockwise circles from the outside working in toward the center.
- Follow the manufacturer’s instructions for re-use and/or disposal of the zinc sponge
- Contact EH&S at 205-934-2487 if you encounter a mercury spill
- Broken thermometers that contain small amount of mercury may be safety collected in a container
that can be sealed. - Always wear PPE (disposable gloves, lab coats and safety goggles) when cleaning up mercury.
- Dispose of mercury and mercury contaminated waste through the chemical waste program.
- Anyone handling mercury or cleaning up mercury should wash their hands thoroughly with soap and
water when finished
Standards for temperature
72 to 78 F
Minimum total air exchange 4 per hour. Maximum relative humidity 60% Temperature range
Quaternary Ammonium Compounds [QUATS]
The quaternary ammonium compounds are widely used as disinfectants. Health-care–
associated infections have been reported from contaminated quaternary ammonium compounds used to
disinfect patient-care supplies or equipment, such as cystoscopes or cardiac catheters. The quaternaries are good cleaning agents, but high water hardness and materials such as cotton and
gauze pads can make them less microbicidal because of insoluble precipitates or cotton and gauze pads
absorb the active ingredients, respectively
Phenolics
In high concentrations, phenol acts as a gross protoplasmic poison, penetrating and
disrupting the cell wall and precipitating the cell proteins. Low concentrations of phenol and higher
molecular-weight phenol derivatives cause bacterial death by inactivation of essential enzyme systems
and leakage of essential metabolites from the cell wall
Peracetic Acid
Peracetic acid will inactivate gram-positive and gram-negative bacteria, fungi,
and yeasts in ≤5 minutes at <100 ppm
Peracetic, or peroxyacetic, acid is characterized by rapid action against all microorganisms. Special advantages of peracetic acid are that it lacks harmful decomposition products
(i.e., acetic acid, water, oxygen, hydrogen peroxide), enhances removal of organic material 711, and
leaves no residue
Ortho-phthalaldehyde (OPA)
Ortho-phthalaldehyde is a high-level disinfectant.
Preliminary studies on the mode of action of OPA suggest that both OPA and glutaraldehyde interact with amino acids, proteins, and microorganisms. However, OPA is a less potent
cross-linking agent. This is compensated for by the lipophilic aromatic nature of OPA that is likely to assist
its uptake through the outer layers of mycobacteria and gram-negative bacteria. OPA appears to kill spores by blocking the spore germination process.
Three levels of Spaulding Classification
critical, semicritical, and noncritical
according to the degree of risk for infection involved in use of the items.
Flat wrappers
Flat wrappers come in different sizes so that items can be completely covered without leaving an excess of material that makes packaging cumbersome or causes steam to pool. Improper packaging can result in ineffective sterilant penetration into the package, wet packs, and inability to open the package aseptically. Reduce the amount of instruments in a set. Heavy instrument sets are a common cause of packaging tears.
- Use the correct packaging weight. Heavy instrument sets require thicker packaging.
- Place corner protectors or tray liners between the instrument set and packaging to reduce holes that occur when instrument sets with sharp corners cut the wrapper.
- Place transport trays under the instrument set to facilitate handling after sterilization and avoid tears.
- Store heavy instrument sets on the easy to reach middle shelves rather than on very low or very high shelves. This provides for easy handling by the staff and prevents dragging the instrument set, which could cause tears.
- Store each instrument set on its own shelf, and do not stack instrument sets. Stacking can damage the wrapper material.
Paper-plastic peel pouches
Paper-plastic peel pouches are designed for packaging small, lightweight instruments. Not all paper-plastic peel pouches are validated for double pouching, so it is important to check with the manufacturer before double pouching.
If double pouching is permitted, pouches must be placed plastic to plastic for complete visibility, without any folds. If the internal chemical indicator is visible through the package, an external chemical indicator is not required.
Because the plastic side of the package is the stronger side, labeling is done there. Paper-plastic peel pouches should not be placed into an instrument set regardless of whether the set is wrapped or in a sterilization container. Placing paper-plastic peel pouches inside can obstruct air removal, steam contact, and drying. Steam cannot penetrate the plastic side of the pouch and thus prevents the sterilant from reaching all surfaces inside the package.
The sterilant enters and exits the package from the paper side. When the package is loaded onto the sterilizer cart, it must be loaded on its side to permit the sterilant to both enter and exit. As with all types of packages, these too must be loaded loosely so that the sterilant can circulate. Paper-plastic peel pouches can be loaded into baskets to hold them up. There are also holders designed specifically to sterilize these packages on their side.
Instrument set weight, and preparation
Sterilization is based on density. The total instrument set weight, including the weight of the instrument container, should not exceed 25 pounds. Chemical indictors are placed in the area of the instrument set that is least accessible to the sterilant
Alcohol
The most feasible explanation for the antimicrobial action of alcohol is denaturation of proteins. This mechanism is supported by the observation that absolute ethyl alcohol, a dehydrating
agent, is less bactericidal than mixtures of alcohol and water because proteins are denatured more quickly in the presence of water
