OSHAcademy Course 755 Study Guide Copyright 2011 Geigle Communications LLC OSHAcademy Course 755 Study Guide OSHAcademy Course 755 Study Guide BLOODBORNE PATHOGENS Copyright (c) 2000-2011 Geigle Communications, LLC. No portion of this text may be reprinted for other than personal use. Any commercial use of this document is strictly forbidden. Contact the author to arrange for use as a training document. This study guide is designed to be reviewed off-line as a tool for preparation to successfully complete OSHAcademy Online Course 724. which will contain the correct answers to the questions. The final exam will contain questions taken from each module quiz. I hope you enjoy the course and if you have any questions, feel free to email or call: Read each module, answer the quiz questions, and return online to submit the quiz. Print the quiz response screen Steven Geigle, M. A. , CET, CSHM Geigle Safety Group Inc. 515 NW Saltzman Road #767 Portland, Oregon 97229 www. oshatrain. org www. cshmprep. com [emailÂ protected] net 503. 292. 0654 Copyright 2011 Geigle Communications LLC OSHAcademy Course 755 Study Guide Course Introduction Why do I need to learn about the risk of occupational exposure to bloodborne pathogens? OSHA estimates more than 5. 6 million workers are at risk of occupational exposure to bloodborne pathogens. All occupational exposure to blood or other potentially infectious materials (OPIM) place workers at risk for infection with bloodborne pathogens. Workers in many different occupations are at risk of exposure to bloodborne pathogens, including Hepatitis B, Hepatitis C, and HIV/AIDS. First aid team members, housekeeping personnel in some settings, nurses and other healthcare providers are examples of workers who may be at risk of exposure. Copyright 2011 Geigle Safety Group Inc. 1 OSHAcademy Course 755 Study Guide MODULE 1: WHAT ARE BLOODBORNE PATHOGENS? What are bloodborne pathogens? Bloodborne pathogens are infectious materials in blood that can cause disease when transmitted from an infected individual to another individual through blood and certain body fluids. Bloodborne pathogens are capable of causing serious illness and death. The most common illness caused by bloodborne pathogens are hepatitis B (HBV), hepatitis C (HCV, and acquired immunodeficiency syndrom (AIDS) from HIV, or human immunodeficiency virus. Who is covered by OSHA's Bloodborne Pathogens standard? The standard applies to all employees who have occupational exposure to blood or other potentially infectious materials (OPIM). ? Occupational exposure is defined as â€œreasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM that may result from the performance of the employee's duties. â€ ? Blood is defined as human blood, human blood components, and products made from human blood. ? Other potentially infectious materials (OPIM) means: a. The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids; b. Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and Copyright 2011 Geigle Safety Group Inc. 2 OSHAcademy Course 755 Study Guide c. HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV. The following references aid in recognizing workplace hazards associated with bloodborne pathogens. What is the purpose of OSHA's Bloodborne Pathogens standard? The purpose of the standard is to minimize or eliminate occupational exposure to disease-carrying microorganisms or â€œpathogensâ€ that can be found in human blood and body fluids. Who must be trained under OSHA's Bloodborne Pathogens standard? OSHA has mandated annual training is required for all employees with potential occupational exposure. This means if there is a reasonable possibility an employee might be exposed to blood or other potentially infectious bodily fluids, they must receive training to minimize or eliminate their risk to potential exposure. What are the primary bloodborne pathogens? The primary bloodborne pathogens are: ? ? ? Hepatitis B Virus (HBV) Hepatitis C Virus (HCV) Human Immunodeficiency Virus (HIV) Other commonly recognized pathogens transmitted by body fluids include: ? ? ? West Nile Virus Malaria Syphilis OSHA has determined employers can minimize or even eliminate occupational bloodborne hazards by developing and enforcing a combination of exposure control strategies which work for all bloodborne diseases. It is not enough for an employer to provide bloodborne pathogens training; they must also have a formal exposure control plan documented and implemented. Training Is Not Enough; An Employer Must Implement A Formal Exposure Control Plan Copyright 2011 Geigle Safety Group Inc. 3 OSHAcademy Course 755 Study Guide Scenario Stanley is an employee for a small manufacturing company. One of Stanley's job responsibilities is to respond to medical emergencies that might happen in the warehouse. Stanley has worked for his employer for five years and has never had to respond to an emergency. Does Stanley still need to receive annual bloodborne pathogens training? Yes! The frequency in which an employee is exposed to potential bloodborne pathogens is not the standard used to determine the need for training. Because there is a reasonable possibility that Stanley might be exposed to bloodborne pathogens as an employee, he must receive annual training. Neither Stanley nor his employer can predict when he might need to provide emergency medical care. Copyright 2011 Geigle Safety Group Inc. 4 OSHAcademy Course 755 Study Guide MODULE 1 QUIZ 1. As part of Kevin's job he is required to provide emergency first aid to employees that become injured or ill while at work. What are the three primary bloodborne pathogens Kevin must be aware of due to occupational exposure? a. West Nile Virus, Influenza, and MalariaUrgent and immediate lifesaving and other measures, which can be performed for injured or ill persons by nonmedical personnel when medical personnel are not immediately available. . Hepatitis B, Syphilis, and Malaria c. Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus d. Human Immunodeficiency Virus, Influenza, and Small Pox 2. Samantha is an employee covered by the OSHA Bloodborne Pathogens Standard 29 CFR 1910. 1030. How often must she complete bloodborne pathogen training? a. once b. annually c. every 2 years d. every 4 years 3. What is the purpose of OSHA's Bloodborne Pathogens standard? a. To ensure that companies don't unnecessarily train employees about bloodborne pathogens. b. To minimize or eliminate occupational exposure to pathogens that can be found in inorganic matter. c. To minimize or eliminate occupational exposure to disease-carrying microorganisms or â€œpathogensâ€ that can be found in human blood and body fluids. d. To increase the likelihood that employees are exposed to bloodborne pathogens. Copyright 2011 Geigle Safety Group Inc. 5 OSHAcademy Course 755 Study Guide 4. Who is covered by OSHA's Bloodborne Pathogens standard? a. Only public employees b. Only EMT's, Nurses, and Doctors. c. Employees who DO NOT have occupational exposure to blood or other potentially infectious materials (OPIM). d. All employees who have occupational exposure to blood or other potentially infectious materials (OPIM). . In regards to OSHA's Bloodborne Pathogens Standard, occupational exposure is defined as: _______. a. reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM that may result from the performance of the employee's duties b. reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM while at home c. exposing your employer to legal liability d. skin contact with chemical solutions while in the performance of the employee's duties Copyright 2011 Geigle Safety Group Inc. 6 OSHAcademy Course 755 Study Guide MODULE 2: SPECIFIC BLOODBORNE PATHOGENS Hepatitis B Virus (HBV) The Hepatitis B virus (HBV) is one of the primary causes of Hepatitis, an infection which causes inflammation of the liver. Complications of Hepatitis include cirrhosis of the liver, liver cancer, and liver failure. There is no known cure for the Hepatitis B virus. In the United States, approximately 15 to 25 percent of people infected with HBV will die because of the illness. Hepatitis B can be either acute or chronic. ? Acute Hepatitis B virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis B virus. Acute infection can, but does not always, lead to chronic infection. Chronic Hepatitis B virus infection is a long-term illness that occurs when the Hepatitis B virus remains in a person's body. Chronic Hepatitis B is a serious disease that can result in longterm health problems, and even death. Symptoms of HBV Symptoms of HBV infection include, but are not limited to: ? ? ? ? ? ? Loss of appetite Fatigue Fever Nausea, vomiting and/or abdominal pain Joint pain Jaundice seen in the eyes Jaundice, a symptom of hepatitis B, often first appears in the eyes Jaundice, also called icterusis, is a yellowing of the skin or eyes and occurs in the more serious phase of Hepatitis B virus. Hepatitis B can damage the liver, resulting in decreased liver function. As the Copyright 2011 Geigle Safety Group Inc. 7 OSHAcademy Course 755 Study Guide liver's ability to filter waste from the blood decreases, the concentration of waste in the blood increases. Only about 50 to 60 percent of individuals infected with Hepatitis B virus show symptoms. It is important to understand even without symptoms, HBV-infected individuals are still infectious to others. Exposure An exposure that might place a worker at risk for HBV, HCV, or HIV infection is defined as: 1. a percutaneous injury (e. . , a needlestick or cut with a sharp object); or 2. contact of mucous membrane or nonintact skin (e. g. , exposed skin that is chapped, abraded, or afflicted with dermatitis) with blood, tissue, or other body fluids that are potentially infectious. Indirect exposure from contaminated objects is a risk, because Hepatitis B virus can remain infectious on environmental surfaces for up to a week (7 days) in the form of dried blood. This means you must always treat blood, wet or dry, as infectious! Vaccination A vaccination to prevent Hepatitis B virus infection is available. The Hepatitis B vaccine series is a sequence of three shots, typically given one month apart, that stimulate a person's natural immune system to protect against the virus. After the vaccine is given, the body makes antibodies to protect a person against the virus. Antibodies are specialized proteins found in the blood that produce an immune response to a virus invading the body. These antibodies are stored in the body to guard against future infections. They will fight off an infection if a person is exposed to the Hepatitis B virus in the future. Copyright 2011 Geigle Safety Group Inc. OSHAcademy Course 755 Study Guide Scenario Michelle is a custodian in a public elementary school. At the end of each school day, she cleans and vacuums the building, including the schools health room. While cleaning the health room she notices some dried blood on the floor. Should Michelle be concerned about exposure to Hepatitis B virus? Yes. Any blood, wet or dry, has the potential to carry infectious Hepatitis B virus. As a result, Michelle must take precautions to prevent potential exposure to bloodborne pathogens, including Hepatitis B virus. Hepatitis C Virus (HCV) The Hepatitis C virus (HCV) is also a significant cause of severe liver damage and death. Although only 849 cases of confirmed acute Hepatitis C were reported in the United States in 2007, Center for Disease Control (CDC) estimates approximately 17,000 new Hepatitis C virus infections occurred that year, after adjusting for asymptomatic infection and underreporting. Persons newly infected with Hepatitis C virus are usually asymptomatic, so acute Hepatitis C is rarely identified or reported. Approximately 3. 2 million persons in the United States have chronic Hepatitis C virus infection. Chronic Hepatitis C virus infection accounts for an estimated 8,000-10,000 deaths each year in the United States. Approximately 5% of people infected with Hepatitis C virus die as a result of the long term damage caused to the liver and body. Approximately 70%-80% of people with acute Hepatitis C do not have any symptoms. Some people, however, can have mild to severe symptoms soon after being infected, including: ? ? ? ? Fever Fatigue Loss of appetite Nausea Copyright 2011 Geigle Safety Group Inc. 9 OSHAcademy Course 755 Study Guide ? ? ? ? ? ? Vomiting Abdominal pain Dark urine Clay-colored bowel movements Joint pain Jaundice (yellow color in the skin or eyes) If symptoms occur, the average time is 6-7 weeks after exposure, but this can range from 2 weeks to 6 months. However, many people infected with the Hepatitis C virus do not develop symptoms. Hepatitis C virus-infected individuals are infectious to other people, whether they show symptoms or not. Interestingly, Hepatitis C virus is strictly a human disease. It is not known to cause disease in any animals. Blood testing for Hepatitis C virus was not available until 1992. As a result, blood donation agencies did not screen for Hepatitis C virus. Many Hepatitis C virus infections occurred as a result of receiving blood products from infected individuals. Today, testing for Hepatitis C is common place and should occur after any exposure to potential bloodborne pathogens has occurred. There is no vaccine for Hepatitis C. Scenario Manuel is a nurse working nights in the local hospital. During a shift in the emergency department he is stuck with a used needle that punctures his skin and draws blood. Is Manuel at risk for contracting Hepatitis C? Yes. After a needlestick or sharps exposure to Hepatitis C-positive blood, the risk of infection is approximately 1. 8%. Manuel should immediately report the potential exposure and follow his employer's exposure control plan to ensure he receives proper medical treatment and testing. Copyright 2011 Geigle Safety Group Inc. 10 OSHAcademy Course 755 Study Guide There are approximately 200 million people worldwide infected with the Hepatitis C virus. Hepatitis C infections are treated with antiviral drugs, such as interferon. As of 2004, approximately 63% of Hepatitis C virus patients could expect to be cured of the virus. Any blood spills â€“ including dried blood, which can still be infectious â€“ should be cleaned using a dilution of one part household bleach to 10 parts water. Gloves should be worn when cleaning up blood spills. Human Immunodeficiency Virus (HIV) The Human Immunodeficiency Virus (HIV) is the virus responsible for causing Acquired Immunodeficiency Syndrome (AIDS). The HIV virus was originally identified on December 1st, 1981. At the end of 2006, an estimated 1. 1 million persons in the United States were living with diagnosed or undiagnosed HIV/AIDS. In 2007, 42,655 new cases of HIV/AIDS in adults, adolescents, and children were diagnosed. Almost 5,500 people die every day due to AIDS. AIDS caused 2 million deaths in 2008. An estimated 25 million people have died from HIV-related causes since the beginning of the pandemic. The Human Immunodeficiency Virus attacks and suppresses the immune system, reducing a person's ability to fight infection. The virus specifically targets the cells crucial for fighting infection from pathogens. This allows diseases and infections to progress without resistance. Within a few weeks of being infected with HIV, some people develop flu-like symptoms that last for a week or two, but others have no symptoms at all. People living with HIV may appear and feel healthy for several years. However, even if they feel healthy, HIV is still affecting their bodies. Untreated early HIV infection is also associated with many diseases including cardiovascular disease, kidney disease, liver disease, and cancer. Copyright 2011 Geigle Safety Group Inc. 11 OSHAcademy Course 755 Study Guide Scenario Stacy is a police officer employed by the city of Denver, Colorado. She is regularly required to respond to emergency medical situations, often arriving before the local ambulance company. As a result, Stacy is frequently exposed to human blood. Is Stacy likely to contract HIV from exposure to infected blood? No. As long as Stacy follows universal precautions she is not likely to contract HIV. Universal precautions involve the use of protective barriers such as gloves, gowns, aprons, masks, or protective eyewear, which can reduce the risk of exposure of the first aid provider's skin or mucous membranes to potentially infective materials. It can take many years before an HIV-infected person displays symptoms of the disease. Symptoms include: ? ? ? ? ? ? ? Enlarged lymph nodes Fatigue Frequent fevers Persistent or frequent yeast infections of the mouth or vagina Persistent or frequent skin rashes Short-term memory loss Weight loss Enlarged liver and spleen As with Hepatitis B virus and Hepatitis C virus, it is important to understand that individuals with HIV are potentially infectious to others, even though they may have no observable symptoms. Presently, there is no known cure for HIV. Although the life expectancy for HIV-infected individuals has increased due to recent advances in treatment, the end result of HIV/AIDS is premature death. Copyright 2011 Geigle Safety Group Inc. 12 OSHAcademy Course 755 Study Guide HIV cannot reproduce outside the human body. It is not spread by: ? ? ? ? ? Air or water. Insects, including mosquitoes. Studies conducted by CDC researchers and others have shown no evidence of HIV transmission from insects. Saliva, tears, or sweat. There is no documented case of HIV being transmitted by spitting. Casual contact like shaking hands or sharing dishes. Closed-mouth or â€œsocialâ€ kissing. All reported cases suggesting new or potentially unknown routes of transmission are thoroughly investigated by state and local health departments with assistance, guidance, and laboratory support from CDC. Disease Comparison Of the three major bloodborne pathogens, Hepatitis B virus is the most contagious. Approximately 33% of individuals exposed to Hepatitis B virus will become infected. Of those individuals exposed to Hepatitis C virus, only about 2% will become infected. Comparatively, Human Immunodeficiency Virus is much less contagious than either form of hepatitis. About 0. 33%, or 1 in 300, people exposed to HIV will become infected with the virus. Despite these statistics, every exposure has the potential to transmit bloodborne pathogens and must be considered significant. Copyright 2011 Geigle Safety Group Inc. 3 OSHAcademy Course 755 Study Guide MODULE 2 QUIZ 1. The Hepatitis B virus (HBV) may remain infectious on contaminated objects or surfaces for up to: _______. a. b. c. d. 3 hours 24 hours 3 days 7 days 2. What percentage of individuals infected with Hepatitis B virus display symptoms? a. b. c. d. 10-15% 25-35% 50-60% 80-90% 3. There are approximately __________ people worldwide infected with the Hepatitis C virus. a. b. c. d. 5 million 75 million 200 million 1 billion 4. Which of the three major bloodborne pathogens is the most contagious, with 33% of those exposed becoming infected? a. b. c. d. Hepatitis B virus (HBV) Hepatitis C virus (HCV) Human Immunodeficiency Virus (HIV) H1N1 Influenza (Swine Flu) 5. HIV is not spread by: _______. a. b. c. d. saliva, tears, or sweat casual contact like shaking hands or sharing dishes closed-mouth or â€œsocialâ€ kissing all of the above Copyright 2011 Geigle Safety Group Inc. 14 OSHAcademy Course 755 Study Guide MODULE 3: Transmitting Bloodborne Pathogens Fluids that Spread Bloodborne Pathogens The transmission of bloodborne pathogens from one person to another occurs through the transfer of infected body fluids. Common body fluids which can transmit pathogens includeâ€ ? ? ? blood cerebral spinal fluid semen vaginal secretions Semen and vaginal secretions can transmit bloodborne pathogens, but only during sexual contact. Wearing disposable gloves can help protect you from accidental exposure to bloodborne pathogens. Fluids that Do Not Spread Bloodborne Pathogens Some body fluids have no documented risk of transmitting pathogens, including: ? ? ? ? sweat saliva urine feces Although the risk of contracting a pathogen from these bodily fluids might be low, you may not always be able to tell which fluids you are handling, or whether injury has mixed them with blood. For example, a severe abdominal injury could cause blood to be present in urine or feces. Therefore, it is best to protect yourself from ALL bodily fluids. Copyright 2011 Geigle Safety Group Inc. 15 OSHAcademy Course 755 Study Guide How Bloodborne Pathogens are Transmitted Non-occupational bloodborne pathogens are most commonly transmitted through: ? ? sexual contact; or sharing hypodermic needles. Occupational bloodborne pathogens are most commonly transmitted through: ? ? puncture wounds from a sharp or contaminated object, such as broken glass; or from a splash of blood to the mucous membranes of the eyes, nose, or mouth. Protect Yourself from All Bodily Fluids It's important to remember the Hepatitis B virus can remain infectious outside of the body for up to 7 days. For this reason, it is essential that cleanup and decontamination of contaminated objects and surfaces be performed as soon as possible. This will reduce the risk of indirect contact resulting in a bloodborne exposure incident. Understanding how bloodborne pathogens are transmitted will help reduce your risk of exposure and infection. Casual social contact, such as shaking hands, hugging, or sharing a telephone or tool, does not transmit bloodborne pathogens. Direct contact with blood or other potentially infectious bodily fluid can cause an exposure incident. Indirect contact with a contaminated object, such as a countertop, bedding, or clothing, can also cause an exposure incident. Copyright 2011 Geigle Safety Group Inc. 16 OSHAcademy Course 755 Study Guide Scenario Jasmine is a daycare worker taking care of children between the ages of 6 months and 12 years. Kevin is a 3 year old child at the daycare center and has been complaining of a stomachache. Suddenly Kevin begins to vomit unexpectedly. After Kevin's parents have been called to pick him up, Jasmine is asked to clean up the mess. Should Jasmine be concerned about bloodborne pathogens? Yes! Although vomit is not documented as a risk for transmitting bloodborne pathogens, it is often impossible to determine if there is blood mixed in with the vomit. Even a very small amount of blood has the potential to transmit disease. You should always prevent contact with bodily fluids, regardless of whether blood is visible in the fluids. Copyright 2011 Geigle Safety Group Inc. 17 OSHAcademy Course 755 Study Guide MODULE 3: REVIEW QUIZ 1. Trent is an employee for a local ambulance company. As part of his job he is routinely exposed to blood and other bodily fluids. Which of the following could potentially transmit a bloodborne pathogen to Trent? a. b. c. d. Having blood splashed into his eyes Shaking a patient's hand Using the telephone at the hospital Pushing a wheelchair 2. Common body fluids which can transmit pathogens include: _______. a. b. c. d. blood and cerebral spinal fluid sweat and saliva semen and vaginal secretions both a and c 3. Some body fluids have NO documented risk of transmitting pathogens, including: _______. a. b. c. d. lood and cerebral fluid sweat, saliva, urine, and feces semen and vaginal secretions all of the above 4. Bloodborne pathogens are commonly transmitted through: _______. a. b. c. d. puncture wounds from sharp, contaminated objects. shaking hands hugging sharing a telephone 5. It is essential that cleanup and decontamination of contaminated objects and surfaces be performed as soon as possible. a. true b. false Copyright 2011 Geigle Safety Group Inc. 18 OSHAcademy Course 755 Study Guide MODULE 4: The Exposure Control Plan The Exposure Control Plan An employer exposure control plan (ECP) is a requirement of 29 CFR 1910. 030(c) of the Bloodborne Pathogens Standard established by the Occupational Safety and Health Administration (OSHA). The purpose of the ECP is to establish procedures to eliminate or minimize employee exposure to bloodborne pathogens. Does your employer have an ECP? A written ECP outlines the strategies necessary to eliminate or minimize employee occupational exposure to bloodborne pathogens. This site-specific plan identifies all employee classifications which have occupational exposure to bloodborne pathogens and other potentially infectious materials (OPIM). Additional components of an ECP are: ? ? ? ? Engineering and work practice controls Personal protective equipment (PPE) Housekeeping Containment and labeling of potentially infectious materials Site-Specific Methods Another key component of the ECP includes listing the site-specific methods by which the facility will reduce the employee risk. These methods include appropriate training, the communication of hazards, hepatitis B vaccinations for any employee who has occupational risk of exposure, methods for postexposure evaluation and follow-up, proper recordkeeping, and a sharps injury log. The final part of the plan describes the procedure for the investigation and evaluation of circumstances surrounding exposure incidents in order to quickly provide effective follow-up care to exposed employees. This investigation will also help each site team learn from accidents and establish new measures to prevent them from happening again. Copyright 2011 Geigle Safety Group Inc. 19 OSHAcademy Course 755 Study Guide Employees Must Have Access To Their Employer's Exposure Control Plan (ECP) The written exposure control plan must be accessible to all employees. It must be reviewed and updated annually or when alterations in procedures create the possibility of new occupational exposures. Additionally, non-managerial employees who provide direct patient care must be asked to provide input in the identification, evaluation, and selection of effective controls to isolate or remove bloodborne pathogens from the workplace. Scenario Steven is a new employee for AAA Manufacturing. He has been hired as a supervisor to oversee line production on the swing-shift. As a supervisor, he is expected to provide emergency medical care if an employee becomes injured or sick. Should Steven's position be classified as having occupational exposure to bloodborne pathogens? Yes. Although providing emergency medical care is not Steven's primary responsibility, it is part of his job classification. As a result, Steven does have the potential for occupational exposure to bloodborne pathogens. Steven's employer must ensure he has the proper training and equipment to provide medical care safely and with minimal risk of occupational exposure. Copyright 2011 Geigle Safety Group Inc. 20 OSHAcademy Course 755 Study Guide MODULE 4: REVIEW QUIZ 1. An exposure control plan must: _______. a. . c. d. be unique to each location or job site define the employees covered by the Bloodborne Pathogens Standard provide procedures for investigating and evaluating an exposure all of the above 2. The purpose of the Exposure Control Plan (ECP) is: _______. a. b. c. to establish procedures to create or increase employee exposure to bloodborne pathogens to help employees after they've been exposed to blood borne pathogens to establish procedures to eliminate or minimize employee exposure to bloodborne pathogens to reduce the employers legal liability after an employee is exposed to blood borne pathogens . 3. The following is a component of an Exposure Control Plan (ECP): _______. a. b. c. d. the release of potentially infectious materials personal protective equipment (PPE) monetary controls purchasing controls 4. Employees must have access To their employer's exposure control plan (ECP). a. b. true false 5. When must an Exposure Control Plan (ECP) be reviewed and updated? a. Semi-annually and when alterations in procedures create the possibility of fewer occupational exposures. Annually or when alterations in procedures create the possibility of new occupational exposures. Every two years Every four years b. c. d. Copyright 2011 Geigle Safety Group Inc. 21 OSHAcademy Course 755 Study Guide MODULE 5: Recognize the Potential for Exposure Employer Responsibilities to Identify Jobs at Risk Employers must identify job classifications in which employees have occupational exposure, as well as the associated tasks and procedures in which there is a potential of exposure to blood or other infectious materials. Employers must review job classifications annually to ensure proper procedures and training is established. What jobs are most at risk of exposure? Occupations with a likely chance of occupational exposure include: ? ? ? ? ? ? ? ? ? first aid providers teachers daycare workers housekeepers lab workers firefighters Emergency Medical Technicians (EMTs) and paramedics law enforcement agents medical and dental personnel An employer must review every job classification and make a determination of the potential occupational exposure for that position. Failure to properly identify potential occupational exposure can result in warnings or fines issued by OSHA. If an occupational exposure does occur, it is important for you to follow the employer's written procedures for handling medical self-care and evaluation, as well as documenting the circumstances of the exposure. Copyright 2011 Geigle Safety Group Inc. 22 OSHAcademy Course 755 Study Guide Scenario Maria is an employee for a local hospital and works in their housekeeping department. Is it Maria's responsibility to know what her occupational exposure is? No. It is the employer's responsibility to ensure each employee is properly trained and understands their potential occupational exposure. Further, the employer is responsible for documenting the training and maintaining all associated records. Maria has the responsibility to follow the established procedures identified in her employer's exposure control plan and ask questions if needed. It is important to know if your job classification puts you at risk for occupational exposure. If your job classification does put you at risk, be aware that specific tasks or procedures in your job may still have the potential for exposure. Copyright 2011 Geigle Safety Group Inc. 23 OSHAcademy Course 755 Study Guide MODULE 5: REVIEW QUIZ 1. Sarah has just been assigned new job responsibilities after receiving a promotion at work. Where should Sarah look to determine if her new responsibilities create an occupational exposure to bloodborne pathogens? a. b. c. d. an employer provided list of job classifications job applications standard operating procedure employee handbook 2. How often must employers review job classifications to ensure proper procedures and training are established? a. b. c. d. every two years whenever the employer feels like it semi-annually annually 3. Occupations with a likely chance of occupational exposure include: _______. . b. c. d. first aid providers, teachers, and daycare workers housekeepers, lab workers, and fire fighters EMT's/paramedics, law enforcement agents, and medical/dental personnel all of the above 4. An employer must review every job classification and make a determination of the potential occupational exposure for that position. a. b. true false 5. Failure of an employer to properly identify potential occupational exposure can result in warnings or fines issued by OSHA. a. b. true false Copyright 2011 Geigle Safety Group Inc. 24 OSHAcademy Course 755 Study Guide MODULE 6: Exposure Control Methods Methods To Control The Risk Of Exposure The recommended infection-control concept called â€œUniversal Precautionsâ€ advocates everyone's blood and body fluids be considered potentially infectious. This eliminates the difficulty in determining risk individually. Remember, although some bodily fluids have not been documented to transmit pathogens, it is sometimes impossible to tell if blood or another potentially infectious fluid is present. The two essential control strategies employees use to eliminate or minimize the transmission of bloodborne diseases in the workplace are: ? engineering controls, and work practice controls. Engineering Controls Engineering controls minimize exposure in the workplace either by removing or isolating the hazard, such as providing a sharps container for needles, splash guards, and mechanical pipetting devices. Engineering controls is all about the equipment used to minimize exposure. The Sharps container for needles is a good example of an engineering control. Employers will examine and maintain or replace engineering controls on a regularly scheduled basis. Work Practice Controls Work practice controls focus on the manner in which tasks are performed. For example, using disposable gloves when performing emergency care is considered a work practice control. Another example of work practice controls is to perform all actions involving potentially infectious material in such a way as to minimize splattering, splashing, and spraying. Proper handling and disposal of needles or sharps, contaminated bandages, gauze, or linens is also essential. Work practice controls is all about how tasks are performed to minimize exposure. Safe work practices include eliminating eating, drinking, smoking, applying make-up or lip balm, or handling contact lenses in locations with potentially infectious material. In healthcare facilities, Copyright 2011 Geigle Safety Group Inc. 25 OSHAcademy Course 755 Study Guide employees are prohibited from wearing artificial nails. Food and drink must not be kept in a refrigerator, freezer, shelf, or in the general area of where blood or other potentially infectious material are kept. Wash your hands! Hand washing after an exposure can reduce your risk of infection Your employer must provide readily accessible hand-washing facilities or antiseptic hand cleanser or wipes if hand-washing facilities are not available. Perform hand washing immediately after any exposure, even if you were wearing gloves. Vigorous scrubbing with soap or alcohol-based foam or gel and warm water is considered the most effective technique. This will further reduce your risk of infection resulting from an exposure. Practices that are completely prohibited in the workplace include: bending, recapping, and removing contaminated needles, shearing or breaking needles, and mouth pipetting or suctioning of potentially infectious material. Antiseptic hand cleaner in conjunction with clean cloth/paper towels or antiseptic towelettes are examples of acceptable alternatives to running water. However, when these types of alternatives are used, employees must wash their hands (or other affected areas) with soap and running water as soon as feasible. This alternative would only be acceptable at worksites where soap and running water are not feasible. Copyright 2011 Geigle Safety Group Inc. 26 OSHAcademy Course 755 Study Guide Scenario Dr. Kramer owns and operates a small dental clinic in San Francisco, CA. As part of her exposure control plan, she requires her employees to wash their hands before and after working with any patients. She also requires new gloves be used with every patient. Is this an example of engineering controls or work practice controls? Work practice controls Dr. Kramer is requiring her employees to do something to reduce the risk of occupational exposure. Work practice controls focus on the actions taken to minimize exposure. Copyright 2011 Geigle Safety Group Inc. 27 OSHAcademy Course 755 Study Guide MODULE 6: REVIEW QUIZ 1. The recommended infection-control concept called â€œUniversal Precautionsâ€ advocates everyone's blood and body fluids be considered: _______. a. b. c. d. potentially non-infectious not harmful not infectious potentially infectious 2. The two essential control strategies employees use to eliminate or minimize the transmission of bloodborne diseases in the workplace are: _______. a. b. c. d. elimination and administrative controls substitution and elimination controls administrative and substitution controls engineering and work practice controls 3. Which of the following are work practice controls? a. b. c. d. Adding a sharps container to the bathroom. Using disposable gloves when performing emergency care. Adding a splash gaurd into an operating room. Both a and c. 4. Perform _______ immediately after any exposure, even if you were wearing gloves. . b. c. d. hand washing work practice controls engineering controls eye flushing 5. When exposed to bloodborne pathogens, antiseptic hand cleaner in conjunction with clean cloth/paper towels is only an acceptable alternative to washing your hands when soap and running water are not feasible. a. b. true false Copyright 2011 Geigle Safety Group Inc. 28 OSHAcademy Course 755 Study Guide MODULE 7: Personal Protective Equipment Using Personal Protective Equipment (PPE) Personal Protective Equipment (PPE) is specialized clothing or equipment that protects you from exposure to blood or other potentially infectious material. Personal protective equipment is designed to keep blood and other potentially infectious material away from your skin, eyes, and mouth Examples of PPE include: disposable gloves, gowns, laboratory coats, protective face shields, resuscitation masks or shields, and mouth pieces. Any equipment necessary to prevent exposure to blood or other potentially infectious material is considered PPE. Effective personal protective equipment must not allow potentially infectious materials to pass through or reach your skin, eyes, mouth, or clothes under normal conditions of use. General work clothes, such as uniforms, pants, shirts, or blouses, which are not intended to function as a protective barrier against hazards, are not considered to be PPE. Employer responsibilities An employer must ensure employees use appropriate personal protective equipment. Your employer must make PPE available to you in the appropriate size and at no cost. Nonlatex alternatives will also be made available to employees who have allergic sensitivity to latex. Employers must also properly clean, launder, repair, replace, or dispose of contaminated PPE as needed at no cost to the employee. Disposable Gloves Disposable gloves should be a standard component of emergency response and first aid equipment and should be worn by anyone initiating emergency care. It is best to always wear disposable gloves when providing first aid care. Copyright 2011 Geigle Safety Group Inc. 29 OSHAcademy Course 755 Study Guide Replace your gloves as soon as possible if they are torn, punctured, contaminated, or if their ability to function as a barrier is compromised. Remove contaminated gloves by turning them inside out. Be careful to prevent any splashing or spraying of potentially infectious material. You should always wash your hands after removing your gloves, even if you don't think they were contaminated. Pocket CPR Mask and Gloves Wear face shields when splashes, sprays, spatters, or droplets of infectious material pose a hazard to your eyes, nose, or mouth. It is always better to be prepared and wear a face shield if there is any chance of potential exposure to your eyes, nose, or mouth. Use a disposable ventilation mask or shield with a one-way valve to prevent an exposure when performing rescue ventilations during CPR. It is common for patients to vomit during CPR due to excess air in the stomach. Place contaminated protective equipment in appropriately designed areas or containers for cleaning or disposal. These areas or containers should be properly labeled and identified in your employer's exposure control plan. Scenario Sarah is a medical laboratory technician. As part of her job duties she analyzes blood and body fluid samples. Sarah was recently reprimanded for not wearing disposable gloves to perform her work duties. She tells her supervisor the gloves make it hard for her to handle the collection containers and that she would like to not be required to wear gloves. What should Sarah's supervisor tell her? Sarah's supervisor must tell her the use of personal protective equipment is not optional. She must wear the gloves. The supervisor should also ask Sarah if the gloves are the correct size and fit for her hands. If the gloves are not the correct size, then this issue must be resolved as well. Only under very rare circumstances can an employee decline the use of personal protective equipment. Copyright 2011 Geigle Safety Group Inc. 30 OSHAcademy Course 755 Study Guide MODULE 7: REVIEW QUIZ 1. Is it acceptable for an employee to take contaminated clothing home to be washed? a. b. c. yes no maybe . All of these are examples of personal protective equipment, EXCEPT: _______. a. b. c. d. disposable gloves laboratory coat thermometer safety glasses 3. When performing CPR, it is always best to: _______. a. b. c. d. wear disposable gloves use a ventilation mask or shield with a one-way valve be prepared for the patient to vomit all of the above 4. Remove contaminated gloves by: _______. a. b. c. d. cutting them off ripping them off turning them inside out pulling them off and spraying infectious material across the room 5. Place contaminated protective equipment in: _______. a. b. c. d. garbage bag laying on the floor a stainless steel garbage can with no garbage bag appropriately designed areas or containers for cleaning or disposal a plastic basket labeled â€œreuseâ€ Copyright 2011 Geigle Safety Group Inc. 31 OSHAcademy Course 755 Study Guide MODULE 8: Hepatitis B (HBV) Immunization Getting vaccinated The best way to prevent Hepatitis B is by getting vaccinated. The Hepatitis B vaccine is considered one of the safest and most effective vaccines ever made. Numerous studies looking at the vaccine's safety have been conducted by the Centers for Disease Control and World Health Organization. Your employer must offer you a Hepatitis B vaccination series if you have a risk of occupational exposure to blood or other potentially infectious materials. Your employer must pay for the cost of the vaccination series. You must be offered the vaccination before you undertake tasks that expose you to potentially infectious materials, and at a reasonable time and location. Three shots! The Hepatitis B immunization series requires three separate injections The Hepatitis B vaccine is very effective in protecting against the Hepatitis B virus. Approximately 97 percent of people who receive the vaccine will become fully immune to the virus. It is given in a series of three shots. The entire series of shots is required to provide full immunity. The vaccine is safe with very few adverse reactions. Typical Vaccination Schedule: The first injection can be administered at any given time. The second injection must be given at least one month after the first, and the third injection must be given six months after the first. A licensed physician or other healthcare professional will perform or supervise the vaccinations. Your employer does not have to offer you the vaccination series if you have previously received the complete series or have tested as immune to HBV. Copyright 2011 Geigle Safety Group Inc. 32 OSHAcademy Course 755 Study Guide You can decline the vaccination for Hepatitis B after being informed of the risks and benefits. To do this, you must sign a declination form. If you initially decline the vaccination for Hepatitis B, you can later request it from your employer at no charge. There are currently two vaccines used to prevent Hepatitis B infection in the United States. Neither vaccine contains blood products. You cannot get Hepatitis B from these vaccines. Scenario Tony has just been accepted to a local paramedic training program. Before beginning the program, the school requires students to receive the Hepatitis B vaccination and pay for it themselves. Is the school required to pay for the vaccination? No. Typically only employers are required to pay for the Hepatitis B vaccination series. Postsecondary schools can require the vaccination series as an admissions requirement, and require the applicant to pay for the cost. There have been instances where public school districts (K-12) have been required to pay for the vaccination series if there is a potential for the student to be exposed to bloodborne pathogens as part of their coursework. Copyright 2011 Geigle Safety Group Inc. 33 OSHAcademy Course 755 Study Guide MODULE 8: REVIEW QUIZ 1. Kristina has just been hired for a position which is classified as having occupational exposure. Kristina's employer offers to pay for the Hepatitis B vaccination series. Can Kristina decline the vaccination series? a. yes b. c. no maybe 2. What percentage of people receiving the Hepatitis B vaccine will become fully immune? a. b. c. d. 17% 35% 75% 97% 3. The Hepatitis B vaccine is considered one of the safest and most effective vaccines ever made. a. b. true false 4. Your employer does not have to offer you the vaccination series if: _______. a. b. c. d. you have previously received the complete series or have tested as immune to HBV you have tested immune to HCV you have tested immune to HIV you have previously received one shot of the vaccination series 5. You cannot get Hepatitis B from either of the Hepatitis B vaccines that are available. . true b. false Copyright 2011 Geigle Safety Group Inc. 34 OSHAcademy Course 755 Study Guide MODULE 9: When an Exposure Occurs What to do When You are Exposed When an exposure occurs, immediate self-care is the highest priority. Flush potentially contaminated materials from the mucous membranes of the eyes, nose, and mouth with large amounts of running water. Allow a puncture wound from a potentially contaminated sharp object to bleed. Wash the wound with soap and water. Wash potentially contaminated material off your skin with soap and water as quickly as possible after an exposure. Washing is especially important when you have cuts, rashes, or scrapes on your skin. When available, use a face and eye wash station to flush the eyes, nose, or mouth if they are exposed to blood or bodily fluids. What do you do next? After self-care, report the exposure incident without delay. This allows for timely testing of the source individual and, if necessary, the employee. You will be directed to a healthcare professional for medical evaluation as soon as possible after receiving the source individual's test results. The evaluation will document the route of exposure and how the exposure occurred. There is no cost to you for this evaluation. Post-Exposure Therapy If you are exposed to HIV-infected blood, most medical facilities offer short-term therapy called Post-Exposure Prophylaxis (PEP). This therapy must begin as soon as possible after the exposure. PEP can reduce the risk of getting HIV by as much as 80 percent. Copyright 2011 Geigle Safety Group Inc. 35 OSHAcademy Course 755 Study Guide The evaluation will also include counseling and education regarding the testing process and the ramifications of the exposure. This includes sexual practices information for the six month post-exposure evaluation period. The result of testing is confidential and will be reported only to you and your company's exposure control plan. No other person will be notified of the results. Scenario Patrick is a nurse working in the emergency department of the local hospital. During one of his shifts he is accidentally jabbed by a used needle. The needle punctures his skin and draws blood. What should Patrick do? Immediate self care is Patrick's first priority. He needs to allow the puncture wound to bleed, hopefully flushing any contaminates out of his body. Next, he should wash the affected area thoroughly with soap and water. Next, Patrick needs to report the incident to his direct supervisor so a injury report can be completed. Patrick will then be seen by a health care professional to determine the best course of treatment for him. Sometimes it is possible to test for various diseases if the exposure source can be identified. This is not always possible. Copyright 2011 Geigle Safety Group Inc. 36 OSHAcademy Course 755 Study Guide MODULE 9: REVIEW QUIZ 1. While providing first aid treatment to a fellow employee, Maria had blood sprayed into her eyes. What should Maria do first? a. Provide immediate self care. . Report the incident to her supervisor. c. Go to a hospital. d. Continue working. 2. If your eyes, nose, or mouth are exposed to blood or bodily fluids you should: _______. a. use a washcloth to wipe your face off b. flush the eyes, nose, and mouth with large amounts of running water c. take a shower within 24 hours of exposure d. apply baking soda to the eyes, nose, and mouth to absorb any contaminated materials from the mucus membranes 3. If you have potentially contaminated material on your skin the first thing you should do is: _______. a. lay down and elevate the contaminated area b. eek medical attention c. apply ice d. wash with soap and water as quickly as possible 4. You are exposed to contaminated material and finish immediate self-care. What do you do next? a. Go home and try to forget about the exposure. b. Catch a movie to take your mind off of the exposure. c. Report the exposure incident without delay. d. you Write about the exposure incident in your personal journal. 5. If you are exposed to HIV-infected blood, most medical facilities offer short-term therapy called Post- Exposure Prophylaxis (PEP). a. true b. false Copyright 2011 Geigle Safety Group Inc. 7 OSHAcademy Course 755 Study Guide MODULE 10: Housekeeping What is housekeeping? â€œHousekeepingâ€ refers to ensuring a worksite is maintained in a clean and sanitary condition. An employer must implement an appropriate written schedule for cleaning, and determine the best method to decontaminate each location within a facility. There are four types of regulated waste that require special handling: 1. Liquid or semi-liquid blood or potentially infectious materials 2. Contaminated items that could release potentially infectious material in a liquid or semi-liquid state 3. Items caked (solid or dry) with potentially infectious materials that are capable of releasing these materials during handling 4. Contaminated sharp objects It is of the utmost importance that infectious waste be safely contained. ? Infectious waste should be placed in specially designed containers constructed to contain the contents. ? The containers need to be leak-proof, labeled or color coded, and closed prior to removal to prevent spills. ? If a container is leaking, place it in a secondary leak-proof container. Copyright 2011 Geigle Safety Group Inc. 38 OSHAcademy Course 755 Study Guide Contaminated Laundry Contaminated laundryâ€ refers to laundry that is soiled with potential infectious material or that may contain sharp objects, such as needles. ? ? Contaminated laundry should be handled as little as possible. Wear gloves when handling contaminated laundry, and place it in labeled, leak-proof bags or containers before transporting it. ? Never take contaminated protective clothing home for laundering, even if it is personal clothing. ? Pick up potentially contaminated broken glassware using mechanical means only, such as tongs, forceps, or brush and dustpan. ? Never use your hands, even if you are wearing gloves. Contaminated items should not be stored or processed in a way that requires you to reach into containers. Work practice controls should be established to prevent you from reaching into a container to remove potentially contaminated items, such as glassware or needles. All equipment and work surfaces that could become contaminated should be cleaned and decontaminated routinely using an appropriate disinfectant while wearing PPE. All pails, bins, and similar reusable receptacles should be decontaminated on a regular basis and as soon as possible after visible contamination is noticed. Copyright 2011 Geigle Safety Group Inc. 39 OSHAcademy Course 755 Study Guide Scenario Kevin is a custodial engineer for a local middle school. As part of his job duties, he is required to clean the health room daily. It is common for students to have minor injuries or ailments, such as nose bleeds or a skinned knee, during the school day. What housekeeping issues does Kevin face? It is important all contaminated materials, such as bloody gauze, is contained, labeled, and disposed of properly. Kevin should wear PPE, such as gloves, when performing this task. Kevin should decontaminate the health room surfaces daily using an approved method and appropriate disinfectant. If visible blood or body fluids are present on a surface, the fluid should be cleaned and the surface decontaminated immediately. Copyright 2011 Geigle Safety Group Inc. 40 OSHAcademy Course 755 Study Guide MODULE 10: REVIEW QUIZ 1. Is it acceptable for an employee to take contaminated clothing home to be washed? a. yes b. no c. maybe 2. One of the four types of regulated waste that requires special handling is: _______. a. b. c. d. ater with a concentration of bleach that is 5% or greater liquid or semi-liquid blood or potentially infectious materials cigarette butts food wrappers or cups that have been used by persons with HIV 3. In regards to bloodborne pathogens and contaminated materials, what is â€œhousekeepingâ€? a. An employer managing their financial books appropriately. b. When an employer lays off employees that cause trouble, especially employees that expose themselves to bloodborne pathogens. c. Employees cleaning and maintaining their own homes. d. An employer ensuring a worksite is maintained in a clean and sanitary condition. . Infectious waste should be: _______. a. b. c. d. placed in specially designed containers constructed to contain the contents placed in any available garbage can thrown out with all of the other garbage both b and c 5. Pick up potentially contaminated broken glassware using: _______. a. your bare hands b. mechanical means only, such as tongs, forceps, or brush and dustpan c. your hands while wearing gloves d. both a and c Copyright 2011 Geigle Safety Group Inc. 41 OSHAcademy Course 755 Study Guide 6. Contaminated items should not be stored or processed in a way that requires you to reach into containers. . true b. false Copyright 2011 Geigle Safety Group Inc. 42 OSHAcademy Course 755 Study Guide MODULE 11: Communicating a Hazard in the Workplace Primary methods of communicating: Signs and Labels Signs and labels that alert you to the presence of potentially infectious material and the risk of exposure are vital to a workplace with occupational exposure to potentially infectious materials. Be sure you are aware of and abide by all signs and labels signaling hazards and hazardous material. Signs should have a fluorescent orange or orange-red background with a black â€œbiohazardâ€ symbol in the foreground. Labels must contain the biohazard symbol and must have the word â€œBiohazardâ€ written on them. A biohazard label or sign should be attached to each object or container of contaminated material by string, wire, adhesive, or another method that prevents loss or unintentional removal of the label or sign. When red bags or containers with the biohazard symbol on them are used, a sign or label is not necessary. Also, when medical laboratory personnel are drawing and testing blood samples, the individual containers housing potentially infectious materials do not need to be labeled. Properly indicating contaminated material using labels and signs will greatly reduce the risk of accidental exposure to the contaminated material. It is important to maintain appropriate container labeling at all times. Annual training must be conducted for all employees with occupational exposure. Copyright 2011 Geigle Safety Group Inc. 43 OSHAcademy Course 755 Study Guide Information and Training All employees (including part-time and temporary employees) with occupational exposure in the organization should participate in a training program that is provided at no cost during working hours. The training materials used should be appropriate in content and vocabulary to the educational and literacy levels and are conveyed in the language of the employees. The training materials should clearly state the objectives of the training. Trainers should be knowledgeable in the subject matter covered by the training program as it relates to the workplace. All employees should have an opportunity for interactive questions and answers with the person(s) conducting the training. If computer or online training is used, it should provide an opportunity for a person knowledgeable about the training material to be available to answer questions. Training Program Elements The Bloodborne Pathogens training program should include information and explanations of at least the following: ? ? ? ? Epidemiology, symptoms, and modes of transmission of bloodborne diseases the Exposure control plan that has been implemented and how to obtain a copy of the written plan Appropriate methods for recognizing tasks and activities that may involve exposure to blood or OPIM Use and limitations of methods that will prevent or reduce exposures, including appropriate engineering, administrative or work practice controls, and personal protective equipment (PPE) Information and Training ? ? The basis for selection of PPE Types, proper use, location, removal, handling, decontamination, and disposal of PPE Hepatitis B vaccination series, including its efficacy, safety, method of administration, benefits, and the fact that the vaccination will be offered to employees free of charge ? ? Appropriate actions to take and persons to contact in an emergency involving blood or OPIM Procedure to follow if an exposure incident occurs, including the: 44 Copyright 2011 Geigle Safety Group Inc. OSHAcademy Course 755 Study Guide o o o ? Method of reporting the incident Medical follow-up that will be made available Procedure for recording the incident in the sharps injury log Post-exposure evaluation and follow-up that will be made available to employees Signs, labels, and/or color codings that are used Frequency of Training Training should be provided at the time of employees' initial assignment (to tasks in which occupational exposure may occur) and at least annually thereafter (i. e. , within one year of their previous training). Additional training, limited to addressing the new exposures created, is provided to the employee whose occupational exposure is affected by: ? ? ? Introduction of new engineering, administrative, or work practice controls Changes or modifications in existing tasks or procedures Institution of new tasks or procedures Copyright 2011 Geigle Safety Group Inc. 45 OSHAcademy Course 755 Study Guide Scenario Jennifer works for a computer parts manufacturer. One of her job duties is to perform housekeeping tasks for her section of the warehouse. During her last shift an employee was injured and required first aid treatment, producing contaminated clothing and personal protective equipment. This contaminated material needs to be labeled and disposed of. How should Jennifer dispose of this contaminated material? Jennifer needs to use appropriate personal protective equipment while working with the contaminated materials. She must also place the contaminated material in a leakproof bag that is labeled with the symbol and word â€œBiohazardâ€. Jennifer should then dispose of the bag based on her employer's exposure control plan. What's missing on the bag of contaminated clothing to the right? Copyright 2011 Geigle Safety Group Inc. 46 OSHAcademy Course 755 Study Guide MODULE 11: REVIEW QUIZ 1. Signs should have a: _______. a. fluorescent yellow background with a black â€œlightning boltâ€ symbol in the foreground b. fluorescent red background with a black â€œradioactivityâ€ symbol in the foreground c. fluorescent orange or orange-red background with a black â€œbiohazardâ€ symbol in the foreground d. red background with a black â€œskullâ€ symbol in the foreground 2. A biohazard label or sign should: _______. a. be attached to each object or container of contaminated material b. be posted, at eye level, at the entrance of any room that contains biohazard material c. not be necessary if the biohazard container is made of a clear material and has no indicators that contaminated material is inside d. contain the contaminated materials symbol and the words â€œcontaminated materialsâ€ written on it 3. All employees (including part-time and temporary employees) with occupational exposure in the rganization should participate in a training program that is provided at no cost during working hours. a. true b. false 4. The Bloodborne Pathogens training program should include: _______. a. The Exposure control plan that has been implemented and how to obtain a copy of the written plan. b. Appropriate methods for recognizing tasks and activities that may involve exposure to blood or OPIM. c. Types, proper use, location, removal, handling, decontamination, and disposal of PPE. d. All of the above. Copyright 2011 Geigle Safety Group Inc. 47 OSHAcademy Course 755 Study Guide 5. Training should be provided at the time of employees' initial assignment (to tasks in which occupational exposure may occur) and at least: _______. a. semi-annually thereafter (i. e. , within six months of their previous training) b. annually thereafter (i. e. , within one year of their previous training) c. every 2 years thereafter (i. e. , within two years of their previous training) d. every 3 years thereafter (i. e. , within three years of their previous training) Copyright 2011 Geigle Safety Group Inc. 48
Niche marketing is a very important marketing tool that is defined as â€œfocusing on sub-segments or niches with distinctive traits that may seek a special combination of benefits (Kotler & Armstrong, 1997)
Niche strategy or sometimes-called focus strategy is a marketing segmentation strategy that concentrates or focuses on a few target markets. Users of this strategy hope that by focusing on a few (one or two) markets segments that are narrow, they would be in a better position to meet the needs of that market. Therefore the company strives to tailor make its marketing mix to suit these specialized markets that it has identified. By using the niche strategy the company easily stands to gain or have a competitive advantage by being effective rather than efficient. (Kotler & Armstrong, 1997)
Niche strategy in most cases is suitable for small firms although it is open to any company which would want to utilize it in selecting targets with lesser substitute vulnerability or where there is weak competition. (Kotler & Armstrong, 1997)
There are several factors that greatly enhance a successful niche strategy and include: â€“
1) Market â€“research Before developing any niche market it is very important to conduct a comprehensive market research of the desired market before embarking on any marketing program. Towards this end, a SWOT analysis that highlights the strength and weaknesses of the company vis-Ã -vis the market it desires to segment is very necessary. (Chisnall, P.M.1997)
The market research will enable the company determine the market characteristics that will enable it serve this particular segment in a better way. Such characteristics would include, customer preferences, desirable price ranges level of competition, product differentiation, distribution channels, the marketing mix and various other important marketing variables.Â (Chisnall, P.M.1997)
When these characteristics have been established and defined the company on its part designs a marketing model that should suit the target market and be a profitable venture for the company. The market research in itself will enable the company not only identify a market but will give it more information on the demographic history of the market as well. (Chisnall, P.M.1997)
2) Create customer loyalty.
One major threat to establishing and growing any niche is competition. Competition may eat up a share of the companyâ€™s market, reducing the profitability or worse still drive out the company from the market. Towards this end it is very important for the company to make it its priority to listen to the customers. When the company makes it its goal to carefully listen to the customers, it will have the ability to create products or services that will not only meet customer expectations but will meet their needs as well.
Listening to the customer will enable the company differentiate its product range to suit the needs of the niche. This will in turn create loyalty that will enable the company weather any form of competition, in fact when customers are loyal it will be very difficult for them to seek other alternatives or switch to the competitors. (Peter, J.P. and Olson, J.J., 1996)
3) Develop two or more niches
By developing two or more niches it will prove quite advantageous to the company in several ways. The experiences and lessons gained in other niches will give the company the ability to tackle the challenges that would likely to occur in a different niche. (Baker, M. 2000)
Two or more niches on the other hand may work towards supporting each other especially in the advent of any form of competition; for example when one niche is faced with competition other niches can be of great support especially if price competition would be necessary.
Two or more niches supporting each other gives the company a leverage that would enable it sustain any form of marketing campaign to maintain high market penetration. By maintaining two or more niches, the company lowers the risk of closing shop just in case one of the niches collapses or is faced with competition and thereâ€™s a reduction in profitability levels.Â By developing more than two niches the chances of success are increased tremendously as well. (Baker, M. 2000)
4) Focus on a particular region
To achieve successful specialization, it is important for the company to address those geographic markets that other competitors ignore. By focusing on a particular region, it is easier for the organization to design a distribution channel that will not only be effective in terms of logistics but will ensure timeliness in the distribution of goods or services. By focusing on a particular area, it enables the company to create or design an effective marketing strategy to promote and create awareness of its goods and services.
The company also stands a better chance of interacting with the customers more deeply and freely to which case it would be easier to predict the buying trends and the customer preferences. (Linneman, R.E. and Stanton, J.L. 1991)
Gamma Plc Gamma PLC produces very high quality motors for garden mowers and this fact gives it an edge over its competitors in this particular niche. However the company can not sit back and sit on its laurels, It is imperative for company to work extra hard to ensure it commands these niche especially with the competition of such established organizations like Yamaha and Honda.Â To guard itself from this onslaught there are certain challenges that the company will face which might force it out.
As it is, already the company is facing competition from such world acclaimed names like Yamaha and Honda. For such names to be attracted to such a market, then it follows that the market is very lucrative.
Gamma PLC is not quite renown, apart maybe for this particular market segment, unlike the competitors who are well established and with renowned brands. The big players if they would decide to flex their muscle, this might drive out Gamma from this niche. (Linneman, R.E. and Stanton, J.L. 1991)
They can do this in various ways including powerfully utilizing the 4ps (Price, promotion, product and place) of marketing. The kind of marketing or promotion blitz they would likely conduct, would obviously be superior compared to Gammaâ€™s with a lesser budget. Besides, these companiesâ€™ would likely introduce price wars that would have adverse effect on Gamma Plc, whose budget would likely be comparatively small. The latterâ€™s prices cannot compete with those ones of the more established firms.
This kind of competition would prove to be a nightmare for Gamma whose niche is under threat. After all, the bigger companiesâ€™ bottom line would not be affected in any way because their presence is worldwide and are more experienced and advanced especially with the marketing capabilities. (Linneman, R.E. and Stanton, J.L. 1991)
The competitors may also decide to adopt or even copy how Gamma Plc is producing its high quality motors, thereby claiming some of the market share.
Competition may also come in terms of remuneration and staff training where the other organizations may be attractive to employees in Gamma.
The niche strategy may be limiting By adopting and relying on this particular niche the company would be faced with another challenge of future growth. Because it might expend all its energies trying to defend this niche from Yamaha and Honda it might lack the resources to venture in other markets thereby limiting its own growth. This is always foreseen especially if the market is relatively small. As time goes by Gammaâ€™s market share might shrink which might eventually affect its continued production of highly quality motors. (Linneman, R.E. and Stanton, J.L. 1991)
Is the market defensible?
This should be the question that should be ringing in the minds of Gamma Plcâ€™s management. It would not be worthwhile to cling to one niche especially if it is not defensible. Most small companies like Gamma will find it challenging to judge this especially bearing in mind that this is the market that supports the organization. The company may lack the resources to get out if the competition becomes unbearable and establish another niche elsewhere. (Linneman, R.E. and Stanton, J.L. 1991).
The market would be defensible if the customers within the niche have shown the willingness to support the company regardless of who comes to compete, which is to mean they are strictly loyal to Gamma. It would also mean that the market would be big enough to warrant any fight over it. However if the market is small and shrinking thereâ€™s not need to waste the resources to defend it.
Substitute Products Gamma Plc manufactures quality products and as stated before this might be the edge it might be having over the competition. However, it is worth noting that quality in most cases comes at a higher price. Thus consumers would likely to be charged more compared to similar products from other companies. Yamaha and Honda may take advantage of this by providing cheaper alternatives that the customers can select from. This means that not all consumers use quality as the driving purchasing factor. Most consumers will go for cheaper products provided the offer similar functions. This would force Gamma either to lower quality so that the product becomes cheaper or seek for more efficient ways of production. (Linneman, R.E. and Stanton, J.L. 1991).
Gamma Plc most probably specializes in the production of motors for garden mowers, which in essence means that they lack any other product line, unlike Yamaha and Honda who have a very wide product range, that ranges from generators to motorbikes. The range could be a very crucial marketing entry point for consumers who might not necessarily want motors for garden mowers yet they possess them. (Linneman, R.E. and Stanton, J.L. 1991).
Baker, M. (2000) Marketing Management and Strategy, 3rd edition, Macmillan Business.
Chisnall, P.M. (1997) Marketing Research, Fifth Edition, London: McGraw-Hill
Kotler, P. and Armstrong, G. (1997) Marketing An Introduction. Fourth Edition. NewÂ Â Jersey. Prentince Hall International
Linneman, R.E. and Stanton, J.L. (1991) Making Niche Marketing Work, New York:Â Â Â Â McGraw Hill
Peter, J.P. and Olson, J.J. (1996) Consumer Behaviour and Marketing Strategy, USA:Â Â Â Irwin
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