Occupational Safety in Healthcare
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Questions and Answers

What is the recommended timeline for follow-up testing after an HIV exposure?

  • 6 weeks, 3 months, and 6 months (correct)
  • 2 weeks, 1 month, and 3 months
  • Immediately, 6 months, and 12 months
  • 1 month, 3 months, and 6 months

    • Which statement regarding hepatitis C post-exposure prophylaxis is true?

  • Immune globulin is recommended after exposure
  • There is no vaccine available for hepatitis C (correct)
  • Vaccination against hepatitis C is highly effective
  • Antiviral therapy is the primary treatment option

    • What should be done to prevent HIV transmission after exposure?

  • Perform a thorough medical evaluation before treatment
  • Start post-exposure prophylaxis within 72 hours (correct)
  • Immediate insertion of a needle
  • Wait for symptoms to develop before treatment

    • How many antiretroviral drugs should be included in a PEP regimen for occupational exposure to HIV?

    <p>3 or more antiretroviral drugs (B)</p> Signup and view all the answers

    What is the purpose of determining the HIV status of the source patient after an exposure?

    <p>To guide the need for HIV post-exposure prophylaxis (A)</p> Signup and view all the answers

    What does the presence of Hepatitis B surface antigen (HBsAg) indicate?

    <p>The person is infectious. (C)</p> Signup and view all the answers

    Which marker indicates a recent hepatitis B infection (less than 6 months)?

    <p>IgM anti-HBc (C)</p> Signup and view all the answers

    What does the presence of total hepatitis B core antibody (anti-HBc) indicate?

    <p>Ongoing infection with unknown timing. (B)</p> Signup and view all the answers

    When can the Hepatitis B e antigen (HBeAg) be detected?

    <p>In both acute and chronic Hepatitis B infections. (D)</p> Signup and view all the answers

    What does a positive Anti-HBs result generally indicate?

    <p>Immunity from hepatitis B virus infection. (D)</p> Signup and view all the answers

    Which statement about Hepatitis C Virus (HCV) is true?

    <p>It can survive for a maximum of 4 days outside the body. (C)</p> Signup and view all the answers

    What does the presence of Anti-HBe correlate with?

    <p>Loss of replicating virus. (D)</p> Signup and view all the answers

    Which of the following hepatitis markers appears at the onset of symptoms in acute hepatitis B?

    <p>Anti-HBc (C)</p> Signup and view all the answers

    What is the average risk of HCV infection after exposure to HCV-infected blood?

    <p>1.8% (A)</p> Signup and view all the answers

    What percentage of individuals with acute HCV infection present no symptoms?

    <p>70-75% (C)</p> Signup and view all the answers

    Which of the following is a common symptom of Chronic Hepatitis C?

    <p>Jaundice (D)</p> Signup and view all the answers

    What is considered the average risk for HIV infection after a needle stick exposure to HIV-infected blood?

    <p>0.3% (A)</p> Signup and view all the answers

    What factor does NOT influence the decision to begin Hepatitis B Post Exposure Prophylaxis?

    <p>Source individual's travel history (C)</p> Signup and view all the answers

    How long after exposure should Hepatitis B prophylaxis ideally begin?

    <p>24 hours (D)</p> Signup and view all the answers

    Which of the following statements about HIV is true?

    <p>HIV does not spread through tears, saliva, or urine if free from blood. (C)</p> Signup and view all the answers

    Which of these is NOT a commonly reported symptom of HIV infection?

    <p>Jaundice (C)</p> Signup and view all the answers

    Which of the following fluids is categorized as Other Potentially Infectious Materials (OPIM)?

    <p>Saliva in dental procedures (A)</p> Signup and view all the answers

    What is one of the primary modes of transmission for bloodborne pathogens?

    <p>Puncture wounds or cuts (D)</p> Signup and view all the answers

    What is the average incubation period for Hepatitis B Virus (HBV)?

    <p>12 weeks (B)</p> Signup and view all the answers

    Which of the following is a complication of Hepatitis B virus infection?

    <p>Cirrhosis (B)</p> Signup and view all the answers

    What is the risk percentage of infection from a single needle stick with HBV-infected blood for an unvaccinated person?

    <p>6%–30% (C)</p> Signup and view all the answers

    What symptom is associated with Hepatitis B infection?

    <p>Fever (B)</p> Signup and view all the answers

    Which of the following statements regarding Hepatitis B virus is incorrect?

    <p>It can be transmitted by saliva. (A)</p> Signup and view all the answers

    How long can Hepatitis B virus remain viable on environmental surfaces?

    <p>A few days (D)</p> Signup and view all the answers

    What does occupational exposure primarily entail?

    <p>Anticipated contact with blood or OPIM during work duties (D)</p> Signup and view all the answers

    Which test is preferred for latent tuberculosis infection screening in new healthcare workers?

    <p>Interferon Gamma Release Assay (IGRA) (B)</p> Signup and view all the answers

    What is NOT considered a part of the reaction in a Mantoux test?

    <p>Redness around the area (C)</p> Signup and view all the answers

    What is indicated by a positive skin test for tuberculosis?

    <p>The person has a latent TB infection or TB disease (B)</p> Signup and view all the answers

    Which of the following is a blood test approved by the FDA for tuberculosis screening?

    <p>QuantiFeron-TB Gold In-Tube test (A)</p> Signup and view all the answers

    Which statement correctly summarizes post-exposure management?

    <p>Evaluation is necessary if there is potential contact with infected materials (C)</p> Signup and view all the answers

    What does a negative IGRA result suggest?

    <p>The person has never been exposed to TB bacteria (D)</p> Signup and view all the answers

    Which of the following is included in standard pre-employment examinations for healthcare workers?

    <p>Physical exam and TB screening (B)</p> Signup and view all the answers

    What does a negative IGRA indicate?

    <p>LTBI or MTB disease is not likely. (A)</p> Signup and view all the answers

    What is the recommended interval for administering the second dose of the HBV vaccine?

    <p>1 month after the first dose. (C)</p> Signup and view all the answers

    What should be done if the anti-hbs level is less than 10 miu/ml?

    <p>A 2-dose or 3-dose series should be administered. (C)</p> Signup and view all the answers

    In the case of an occupational exposure incident, which of the following is the first immediate measure?

    <p>Wash the exposed areas with soap and water. (D)</p> Signup and view all the answers

    How often is the meningococcal vaccine for HCWs who work in clinical research repeated?

    <p>Every 5 years if conjugate type. (B)</p> Signup and view all the answers

    What is a necessary testing requirement for employees regarding immunoglobulin G (IgG)?

    <p>Testing for Measles and Varicella IgG. (C)</p> Signup and view all the answers

    What action should NOT be taken if an occupational exposure occurs?

    <p>Inject antiseptics into the wound. (B)</p> Signup and view all the answers

    Which of the following tests is required for all employees?

    <p>Testing for Immunoglobulin G (IgG). (D)</p> Signup and view all the answers

    Study Notes

    Occupational Safety And Management Of Occupational Exposures

    • Occupational exposure involves anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM (Other Potentially Infectious Materials) during job duties
    • Healthcare workers face risks from bloodborne pathogens like HBV and HIV through needlesticks, cuts, or contact with infected patients' blood, potentially causing disease
    • Most exposures don't cause infection, yet prompt healthcare evaluation is critical

    Outline

    • What is Occupational Health?
    • Pre-employment assessment and management
    • Vaccination
    • Post-exposure management

    Pre-Employment Assessment And Management

    • Standard pre-employment examinations include:
      • Physical exam
      • TB screening
      • Documentation of immunizations

    TB Screening

    • All new healthcare workers (HCWs) need TB screening for latent tuberculosis infection (LTBI)
    • Methods include Interferon Gamma Release Assay (IGRA) or Two-Step Tuberculosis Skin Testing (TST) using PPD (purified protein derivative)

    Tuberculosis Skin Testing

    • The Mantoux test is the standard skin test
    • 0.1 ml of PPD solution is injected intradermally
    • The reaction (raised area/swelling) is measured 48 to 72 hours later
    • Positive result indicates TB infection; further testing is needed to determine if it is active or latent
    • Negative result suggests no active TB infection

    TST Reaction Sizes and Considerations

    • ≥5 mm: HIV-infected persons, recent contacts of TB cases, prior TB, organ transplant recipients, and immunosuppressed individuals
    • ≥10 mm: Recent immigrants from high-prevalence countries, injection drug users, high-risk congregate settings residents/employees (prisons, jails, etc.), healthcare facility personnel, and homeless shelters residents
    • ≥15 mm: Persons with no risk factors for TB

    Interferon Gamma Release Assays (IGRAs)

    • IGRAs are blood tests to determine TB infection
    • Two approved IGRAs: T-Spot TB test and QuantiFERON-TB Gold In-Tube test (QFT-GIT)
    • Positive IGRA indicates TB infection; further evaluation is needed to determine if it is active or latent
    • Negative IGRA suggests no infection

    Immunization Of Healthcare Personnel

    • All employees need repeat testing for:
      • HIV
      • Hepatitis B (HBV)
      • Hepatitis C (HCV)
      • Hepatitis A (HAV)
    • Testing for Immunoglobulin G (IgG) for:
      • Rubella
      • Measles
      • Varicella (chickenpox)

    Vaccine Indications and Schedules

    • Specific vaccines are recommended based on the risk of exposure
    • Vaccination routes, doses, and schedules differ; review relevant documentation or consult healthcare providers for details

    HBV Vaccination Schedule

    • HBV vaccine is administered in three doses over six months
    • Immune response is assessed by measuring antibody levels after 6 to 8 weeks
    • If anti-hbs is below 10 mIU/mL (negative), a booster dose series may be needed

    Meningococcal Vaccine

    • HCWs involved in (Hajj or similar) or clinical research with N. meningitides (meningococcal bacterium) need a single dose, repeated periodically depending on the type of meningococcal vaccine

    Occupational Exposure Incidents

    • Occupational exposure involves skin, eye, mucous membrane, or parenteral contact with blood or OPIM
    • Essential steps if exposure occurs are:
      • Immediate measures (soap and water, flush, don't use caustic agents)
      • Report and document incident
      • Seek immediate medical evaluation
      • Follow employer's exposure control plan

    Reporting an Incident

    • Reporting procedures vary based upon the institution, but typically include:
      • Date and time of incident
      • Job classification
      • Location within the worksite
      • Work practices & procedures followed
      • Types of engineering controls in use
      • Work procedures being performed
      • Personal Protective Equipment (PPE) in use

    Management Of Occupational Exposure To Biological Hazards

    • Bloodborne pathogens are microorganisms in human blood capable of causing disease
    • OSHA defines other potentially infectious materials (OPIM) as body fluids (synovial, pleural, peritoneal, saliva in dental procedures, cerebrospinal fluid, HIV or HBV cultures, bloody body fluids, unfixed tissues).

    Modes of Transmission

    • Exposure can occur through a variety of methods including:
      • Puncture wounds/cuts
      • Contact (touch, splashes, sprays) with blood/OPIM on mucous membranes, non-intact skin, or contaminated sharps.

    Specific Bloodborne Pathogens

    • Hepatitis B virus (HBV)
    • Hepatitis C virus (HCV)
    • Human immunodeficiency virus (HIV)

    Hepatitis B Virus (HBV)

    • Affects the liver
    • Prevalence among healthcare workers is high
    • Transmitted by direct contact with infected blood/body fluids
    • Relatively hardy virus, surviving environmental surfaces and fomites
    • Incubation period averages 12 weeks
    • Chronic liver disease can develop in 6-7% of infected individuals

    Hepatitis C Virus (HCV)

    • Common chronic bloodborne infection in the US
    • HCV can persist on surfaces for 4 days
    • Risk of infection after needle-stick is 1.8%
    • Symptoms include jaundice, fatigue, etc.

    Human Immunodeficiency Virus (HIV)

    • HIV causes AIDS
    • Does not spread easily through casual contact
    • Does not survive for long outside the body
    • Risks are reduced significantly when surfaces are dry
    • Incubation period from infection to AIDS can vary from 8-10 years

    Post-Exposure Prophylaxis (PEP)

    • Medical response to prevent bloodborne pathogen transmission following potential exposure
    • Includes hepatitis B, C, and HIV PEPs
    • PEP for HBV should start within 24-72 hours to be effective

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    Occupational Safety And Management Of Occupational Exposures PDF

    Description

    This quiz focuses on the principles of occupational safety and the management of exposures in healthcare settings. It covers essential topics like health assessments, vaccination protocols, and post-exposure management for healthcare workers. Dive into the importance of preventing infections and ensuring worker safety in the face of potential hazards.

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