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biosafety
the application of safety precautions taken to ensure the safe handling of biological
substances that pose a risk to health
what is hazard risk determined by
how infectious or transmissible a microbe or biological agent is, its means of
transmission, how serious the disease is that it could cause, and if there is an effective
treatment or vaccine
biohazard
anything harmful or potentially harmful to health and must be identified with a biohazard
symbol
parenteral routes
routes other than the digestive tract/ingestion
biohazard exposure routes
airborne, ingestion, nonintact skin, percutaneous, permucosal
ingestion (exposure route)
can be ingested if HCWs neglect to sanitize before handling food, drinks, cigarettes,
etc.; can occur when covering the mouth with hands instead of tissue when coughing or
sneezing; frequent hand washing, and avoid hand to mouth contact
nonintact skin (exposure route)
can enter the body through visible or invisible pre-existing breaks in the skin such as
abrasions, burns, cuts, scratches, sores, dermatitis, and chapped skin; defects in the
skin should be covered with waterproof bandages to prevent contamination
percutaneous (exposure route)
through the skin exposure to biohazardous microorganisms in blood or body fluid,
occurs through intact skin from accidental needlesticks and injuries from other sharps
and broken glass; using needlestick safety devices properly, waring heavy-duty utility
gloves when cleaning up broken glass and never handling broken glass with bare hands
permucosal (exposure route)
through mucous membranes exposure occurs when infectious microorganisms and
other biohazards enter the body through the mucous membranes of the mouth, nose,
and conjunctiva of the eyes, in droplets generated by sneezing/coughing, splashes, and
aerosols and by rubbing/touching the eyes, nose, or mouth with contaminated hands
bloodborne pathogen (BBP)
any infectious microorganism present in the blood and other body fluids and tissues;
most significant biohazard; HBV, HCV, HIV, cytomegalovirus (CMV),West Nile virus, etc
hepatitis B virus (HBV)
potentially life-threatening BBP that targets the liver; most frequently occurring BBP lab-
acquired infection (LAI) and major occupational hazard
hepatitis D (delta) virus (HDV)
HBV infected individuals are also at risk of acquiring, which can multiply only in the
presence of HBV
, HBV vaccination
best defence against HBV and HDV; 3 intramuscular injections; immunity can be
determined 1-2 months after last vaccination by test detecting presence of the hepatitits
B surface antibody (anti-HBs)
HBV exposure hazards
can be present in blood and other body fluids like urine, semen, cerebrospinal fluid
(CSF) and saliva; primarily transmitted through needlesticks and other sharps injuries,
and contaminated equipment, aerosols, spills/splashes; sexual contact anf sharing of
needles
symptoms of HBV
flu-like symptoms (last longer); fatigue, loss of appetite, muscle pain, abdominal pain,
nausea, vomiting; jaundice in 25% of cases; 50% asymptomatic; some become carriers
hepatitis C virus (HCV)
most widespread chronic bloodborne illness; discovered by molecular cloning, was
found to be the primary cause of what was formerly called non-A, non-B hepatitis; no
vaccine, but treatment
HCV exposure hazards
primarily in blood and serum, less frequently in saliva, seldom in urine and semen;
occurs after large or multiple exposures; sexual contact and needle sharing are primary
means of transmission
symptoms of HCV
similar to HBV; only 25-30% have symptoms; can lead to cirrhosis or liver cancer;
leading indication for liver transplantation; antibodies appear in serum from 4-10 weeks
after infection occurs
human immunodeficiency virus (HIV)
attacks the bodys immune system and can eventually cause acquired
immunodeficiency syndrome (AIDS); poor prognosis; ~50% of exposures in healthcare
have been related to phlebotomy procedures
acquired immunodeficiency syndrome (AIDS)
leaves body susceptible to opportunistic infections; pneumocystis pneumonia (PCP),
candidiasis (thrush), neurological disorders and certain cancers
opportunistic infections
caused by organisms that wouldn't ordinarily be pathogens to a normal healthy
individual
HIV exposure hazards
blood, semen, saliva, tears, urine, CSF, amniotic fluid, breastmilk, cervical secretions,
and tissue; can enter through the same routes as. hepatitis viruses
symptoms of HIV
initial symptoms are mild and flu-like; virus enters CD4 lymphocyte cells (t-cells) and
triggers them to produce copies of the virues and the virus hides in the cells; certain
conditions reactivate the virus, which slowly destroys CD4 cells (200 or less/mL [of CD4
cell count] patient has AIDS); immune system deteriorates
symptoms of AIDS
hairy leukoplakia, a white lesion on the tongue; Kaposi sarcoma, a cancer of the
capillaries that produces bluish-red nodules on the skin; deterioration of the nervous
system leading to neurological symptoms and dementia (end-stages)