OSHA Training - Bloodborne Pathogens I

Hepatitis B

If you have hepatitis B (formerly called "serum hepatitis"), a virus attacks and reproduces in your liver cells. Despite the more extensive publicity surrounding AIDS, OSHA names hepatitis B as "the major infectious bloodborne occupational hazard to healthcare workers."

Effects of HBV Exposure on Healthcare Workers

Approximately 1,000 infections in 1994 (a 90% decrease from the estimated number in 1985) Over 400 hospitalizations annually 100 to 200 deaths annually during past decade 5% to 10% of HBV-infected healthcare workers become chronically infected 30% risk of infection after percutaneous exposure to blood positive for hepatitis B surface antigen

If you are infected with HBV, you may experience a self-limited acute hepatitis B infection.

• 1/3 Mild Flu-Like Illness - May not be diagnosed as hepatitis.

• 1/3 Severe Illness - Jaundice (yellowing of the eyes & skin), dark urine, extreme fatigue, loss of appetite, nausea, abdominal pain + possible joint pain, fever, rash.

• 1/3 No Symptoms

One in 1,000 - Will develop fulminant hepatitis, which is fatal about 85% of the time.

Chronic HBV Infection

A chronic infection develops in 5% to 10% of infected individuals when they cannot clear the virus from their liver cells. Chronic HBV carriers are at high risk of developing chronic hepatitis, cirrhosis, or liver cancer.

Death can result from either acute or chronic hepatitis. Infected individuals may spread the disease to others. An effective vaccine is available and recommended for all people as a public health measure.

Hepatitis C

Hepatitis C is an RNA virus with an slow onset, often leading to chronic liver disease and possibly failure. Chronic liver failure is the 10th leading cause of death among adults in the US. More than 10 years ago transfusion transmission accounted for a large portion of HCV infections; however, that is no longer the case. Most cases of HCV are associated with injection-drug abuse. Because HCV is a bloodborne pathogen, healthcare providers exposed to blood products are at risk for HCV transmission.

Incidence of Hepatitis C

In 1995, there were 28,000 non-A/non-B hepatitis infections. Fortunately, this is significantly lower than the estimated 170,000 in 1988. However, 2% to 4% of these infections continue to occur in healthcare workers. Much of the non-A/non-B hepatitis reported in the United States appears to be caused by the hepatitis C virus (HCV), also a bloodborne pathogen. According to the CDC, hepatitis C is the most common chronic bloodborne infection in the US. This is supported by a study performed in 1995 whereby seroprevalence of the hepatitis C antibody among patients was almost 8 times higher than hepatitis B (5% vs 39%, respectively).

The CDC estimated that during the 1980s an average of 230,000 new infections occurred each year. Fortunately though, since 1989 the annual new number of infections has declined by 80% to 36,000 in 1996. Data collected from the 3rd National Health and Nutrition Examination Survey (NHANES III) conducted between 1988 and 1994, estimated that 3.9 million (1.8%) Americans have been infected with HCV. Chances are that most of these persons are chronically infected, but not clinically ill, making them a source of transmission and at risk for chronic liver disease or other HCV-related illnesses during the first two decades or more following their initial infection.