Bloodborne Pathogens: Introduction and Class Outline

One of the classes that I teach in my spare time is a Bloodborne Pathogens class. It is a class that is recommended for dentists, healthcare providers and other professionals who may deal with blood and other bodily fluids on a frequent basis. I created a basic outline to cover the information in class and I thought I would take some time over the next week to share some of the information that I give to students on a regular basis. I am hopeful that a few people can enjoy and possible use this information in your own lives. Over the next few days I will post my home written pretest along with answers.... Enjoy :)

What are Bloodborne Pathogens?

• Microorganisms present in the blood of persons who are infected with them (germs that make people sick)
What are examples of diseases that are caused by bloodborne pathogens?
• Hepatitis B infection -HBV-
Symptoms of Hepatitis – yellowing of skin or whites of the eyes, tired, abdominal pain, gastrointestinal problems including nausea and diarrhea, loss of appetite, damage to liver (can lead to death)
• Hepatitis C infection – HCV- can live in dried blood at least six hours and up to four days. (Hepatitis A is NOT transmitted by blood - it is transmitted by eating)
• Human Immunodeficiency Virus - HIV-, which causes AIDS – extreme tiredness, poor appetite with (rapid) weight loss, fever, swollen glands, etc. (affected person will get other illnesses easier (immunosupression) and can lead to death)

The Goal of this class is to discuss and reduce exposures as well as how to stay safe in environments and situations where exposures are more likely to happen!

How are bloodborne pathogens transmitted?
• By blood-to-blood contact only!
• Not by casual contact such as hugging, shaking hands, sneezing
Which body fluids may contain BBP?
• Human blood, semen
• Not urine, feces, vomit - unless visibly contaminated with blood
What are 'Universal Precautions'?
• You must treat all human blood as though it may contain any bloodborne pathogen... treat all bodily fliuds as if they are none to be infectious.
• You cannot tell if someone is infected by looking at them because many of these diseases do not show symptoms
What are the routes of infection of BBP in the general population or Most Common Forms/Paths of Exposure?
• Sexual contact
• Sharing needles among injecting drug users
• Mother to unborn child
What are the routes of infection of BBP in the workplace?
• Puncture or cut from a contaminated sharp object (needle, broken glass). This is the highest risk!
• Contact with broken skin (cut, hangnail, dermatitis including slight damage from shaving)
• Contact with mucous membranes of eyes, nose, mouth
Make a PACT, Know How to Act!
P - Protect : Protect yourself from blood or blood-containing materials
A - Act : Act quickly and safety
C - Clean : Clean the area that has blood or blood – containing materials
T - Tell : Tell your supervisor about the incident
How can I protect myself at work?
• Wear gloves if you need to touch human blood, used condoms or any item that can be or is suspected to be contaminated.
• Do not pick up needles or syringes with your hands. Use tongs or broom and dustpan.
• Do not use your hands to compress trash (to make more room in the bag). (A good rule is to not put your hands anywhere that you can not see everything they might touch)
• Use disinfectant to wipe up blood.
• Always wash your hands after you remove your gloves.
• Always wash your hands before you eat lunch and before you leave at the end of the day.

What should I do if I am stuck or cut with a contaminated sharp object (such as a needle stick or cut from broken glass, or if I get blood on an open cut, or in my mouth or eyes)?
• Wash the exposed area well
• Follow your companies procedures for notifying your Infection Control manager as set up in your company's Blood Borne Pathogens control guidelines
• Exposure control plan should include
• all job classifications that have chance of exposure to blood
• list of all tasks and procedures through which exposure may occur and are performed by employees
• methods of compliance to protect employees
• procedure for how to review problems

Are there vaccines available to prevent any of these diseases?
• There is a vaccine to prevent Hepatitis B that is given in three shots over a six month period
• You may get them through your physician or local health center or immunization clinic.
• Cost varies- some employers and health insurances will pay for these shots... never hurts to ask. :)

Feedback and comments are welcome! :)

pictures from: http://www.ehow.com/list_6822351_list-bloodborne-pathogens.html, http://www.emsworld.com/article/10320719/borne-free,

Counting Blessings...

One of the truly blessed things about the trials that Heavenly Father gives us and others is that not only are we able to learn, but I have found that sometimes a blessing in disguise comes to the foreground in my own life. We all have discovered this a few times in our lives I am sure. We discover the blessing of a nose when we get sick and it is constantly runny- very rarely do we thank the Father for our wonderful nose nor do we really remember it is there unless there is something wrong with it. And there are so many of those blessings in all of our lives. The blessings of kidney and liver function, of laughter...of breathing.

Last night, I was given some great news as I found that a relative is out of prison and back home. His problems have weighed heavily on my mind over the last few years. As I thanked my Father in prayer, I recognized that while my relative is no longer in prison, he is now on 'house arrest'. While I find that much better, being trapped in the house can also be seen as a large burden. While I sometimes wake up in the morning and feel tired and 'growly' that I 'have' to go out, the blessing is found in the realization that I can go out... I really can! So while I am out volunteering today, passing out food and trying to give advice and cheer... I am thankful that no matter how tired or grumpy or sad... Or even happy and hyper... I have the ability to do what I feel I need to do without the limitations that some others have to deal with in their lives.

It's a blessed day!

Vitamins- Differences, Needs and Supplements

Here are a few ideas and answers on some of the most well known vitamins.....

As consumers, we need to be careful about over consumption of fat soluble vitamins. Fat soluble vitamins are not as easily excreted in the urine or removed from the body as easily as water soluble vitamins. Almost anything we drink can be broken down into H2O… and many foods have water as a by-product from the digestive process. Fat, or lipids, is a very different story. Most individuals tend to try and limit their fat intake in our diet and so if we get fat soluble vitamins through food consumption, but we do not eat enough fat to ‘process’ or consume them then we could not only have the problems of poor absorption – which can cause symptoms of deficiency- but also problems with toxicity as well. Some can be stored in the body in small amounts (mostly in the liver and other fatty tissues.) These vitamins are able to be stored for longer periods of time increasing the chance of toxicity when these vitamins are consumed in excessive amounts. Water soluble vitamins leave the body more quickly and are very little are stored for future use.

A carotenoid is a pigment and the pigment materials that are found in fruits and vegetables- usually the colors range from yellow to orange to red (they can only be found in plant products and some fungus and bacteria- not in animal products with the exception of egg yolks and butter). I think one of the easiest ways to tell if a fruit or vegetable has plenty of carotenoids is to simply look at its color…. Although some green vegetables are high in carotenoids as well. Some examples of high carotenoid foods are asparagus, broccoli, carrots, lettuce, spinach, squash, sweet potatoes, apples, oranges, bananas, peaches, tomatoes and corn.

Vitamin D functions primarily as a hormone- not simply as a vitamin. As a hormone, vitamin D is used to regulate calcium in the blood and the cells of the body as well as bone metabolism. It helps to regulate the absorption of consumed calcium and phosphorus from the intestines and how much calcium is deposited into the bones. My first answer to the question of who needs vitamin D is everyone! My physician told me that anyone she tests tends to be low and needs to take a supplement (we do live in Maine however, which can be a risk factor due to location.) A few risk factors that help a human being to be low in this vitamin/hormone are: skin color (dark skin can block sun exposure), season (northern climates in winter get less direct sun exposure and fewer hours of it), time of day (less direct sun exposure) and age (the ability to get/process vitamin D through the skin becomes more difficult with age.) If you wear sunscreen over 8 SPF than you are also at risk and individuals who spent little time in the sun are very much at risk as most of the vitamin D that our body uses is absorbed through the skin and not from diet.

Vitamin E has a few benefits that are fairly important. As an antioxidant, vitamin E helps form barriers between target molecules and other compounds wishing to ‘steal’ the electrons of the target molecule. The antioxidant will stand between the two compounds and willingly give up some of its electrons or hydrogens to the compound attempting to commit theft and protect the target molecule. Free radicals is the name for some of these compounds that steal electrons. Free radicals have ‘free reign’ when the body doesn’t have enough resources like vitamin E to protect cells. When a free radical steals electrons from other cells, the cell’s DNA is altered and the cell is unable to work the way that it is intended to do so. The cell could be injured or it could simply die. While exposure to free radicals is an essential part of life, exposure to huge amounts is not and doesn’t tend to be healthy.

Individuals who are more likely to have higher physical activity than the general population need a few higher amounts of some vitamins. One of them is vitamin B-6 as this vitamin is needed to process glycogen and protein for full metabolism… and people who engage in more physical activity are more likely to need more protein for energy. Thiamin is also needed in higher quantities for people with higher physical expediency because it helps to break carbohydrates down into energy and also certain amino acids. Folate is especially important for pregnant woman as their body needs the folate, but not enough folate can cause birth defects such as neural tube deficits (and for just general knowledge to women in this class who do not know… when you get your blood work done for your pregnancy and you are told that it is off and you might have a neural tube problem with your fetus…. Take a deep breath and smile- more than 90% of these results are wrong and having a due date that is one or two days off can give you a false positive… as well as a few other things. Yes make sure you are getting what you need especially if you are trying to get pregnant, but don’t stress for days over your blood test until it is confirmed by ultrasound. There is no reason to suffer that way. : )

There are a few reasons that individuals need to take supplements or multi-vitamin pills... but for the most part, the average person gets everything that they need from their diet. That of course depends on whether they are eating a good diet. In the end, I think that one thing I have learned is that the phrase ‘everything in moderation’ is really true. You can have too much of a good thing… and a virtue can become a vice if focused on too intensely. Vitamins and minerals appear to be the same way. One line that really stuck out to me during my readings was that dietary supplements might be necessary if you "don't eat well or consume less than 1,600 calories a day". Supplements can help with not eating well by adding missing nutrients, but I don’t think that supplements can give us good amounts of some things like fiber nor can supplements usually taste good. I would rather enjoy broccoli with a little bit of Ranch than whole foods in a pill. I think that would be so much more enjoyable. : )

What do you think? How do you eat?

Alcohol, it's Digestion, and 'Potentials'

I will admit that alcohol is something I do not really understand or have much experience with. So except for classes, I don't really have any personal experience. Last semester, I found myself quite shocked to see the high statistics on college drinking and I think that studying these subjects really help me to see that I am not actually missing anything. :)

Alcohol is an easily metabolized 'food' which can go straight from the digestive system to the bloodstream. Most of the metabolism of alcohol takes place in the liver-- unlike most consumed foods which are broken down in the digestive track. The liver produces an enzyme called alcohol dehydrogenase which helps the body to absorb and metabolize the alcohol to get it 'out of the system' so to speak. When the liver is trying to metabolize the alcohol, it uses the enzyme mentioned above to turn the alcohol into acetaldehyde... and then eventually into carbon dioxide and water.

While alcohol is able to easily enter the bloodstream, there are many factors that affect the body's ability to break it down quickly and deal with the onslaught of too much alcohol. In an average, healthy person with normal liver function, the body/liver is able to break down 5-7 grams of alcohol per hour – to put that figure into perspective, that is approximately half of one beer. So if you drink faster than your liver can metabolize the drink, then you will become 'drunk' as the alcohol affects your brain function. Gender and race can also affect how the body is able to deal with alcohol- for instance, Asians and Native Americans have much less ability to metabolize alcohol in comparison to Caucasians. Women also have less ability to digest alcohol due to less 'body water' and low activity of the enzyme to digest it... and the woman's stomach is not able to digest as much of it as the average man's. Because of these differences, women are more likely to suffer from alcohol related complaints... such as cirrhosis, ulcers, etc.... Both genders will suffer complications due to frequent over-consumption however, which can include muscle damage, decreased memory and brain damage, reduced immune and nerve function and increased blood pressure... and only temporary relief from anxiety, grief, peace and other emotion/mental health concerns.

There are also two nutrient deficiencies that are common in individuals who overuse alcohol. A general depletion of the 'B' vitamins such as foliate (helps produce and maintain new cells), vitamin B12 (helps maintain healthy nerves and red blood cells), niacin, thiamin, and vitamin B-6. The drinker is also at risk for being short of the fat soluble vitamins as well... such as vitamin A, D, E, and K. As alcohol is able to have a negative effect on virtually every organ system in the body, the potential negatives of alcohol use far outweigh the few potential positives.

So, for individuals who do still wish to have the occasional drink, what exactly is the definition of 'one drink'? That appears to depend on what the contents of the 'drink are... as each type of alcoholic beverage can vary in how much alcohol it contains. A general rule of thumb is is to consume 15 grams of alcohol you must consume:

5 oz wine
1 ½ oz hard liquor
12 oz beer or wine cooler

It is considered moderate usage for a man to drink no more than 2 drinks a day and a women should not consume more than one. It should also be remembered that for some individuals, even a moderate amount is too much- such as pregnant females, children, specific medical conditions, etc... And while there is scientific evidence that there are some health benefits to moderate drinking, it is fully recognized that the potential negative effects of drinking are so much more potent... and so it is recommended that those who do not drink should not start for their health! And for those individuals that do drink, they should do so very moderately... or even a little less!

So maybe I am not missing out on too much... :)