Safety Talk

WHAT’S AT STAKE?

Bloodborne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include, but are not limited to, hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). Needlesticks and other sharps-related injuries may expose workers to bloodborne pathogens. Workers in many occupations, including first responders, housekeeping personnel in some industries, nurses and other healthcare personnel, all may be at risk for exposure to bloodborne pathogens.

Bloodborne HC is designed for training employees in various industrial sites. Many employees encounter situations where infection from blood and other body fluids is a risk factor. This program is an essential employee safety component in this age of AIDS, Hepatitis, and other bloodborne diseases.

Your Employees Will Learn:

• Bloodborne Pathogens, including Hepatitis B and C, and HIV
• Modes of Transmission
• Exposure Situations
• Exposure Control Plans
• What to do if Exposed

The hepatitis C virus is a bloodborne virus: the most common modes of infection are through exposure to small quantities of blood. This may happen through injection drug use, unsafe injection practices, unsafe health care, transfusion of unscreened blood and blood products, and sexual practices that lead to exposure to blood.

The natural course of hepatitis C disease varies from one person to another.

• The first phase of disease is called acute hepatitis C and covers the first 6 months after a person is infected. During this phase, most people show no symptoms at all. Among those who do have symptoms, the illness is usually so mild that most don’t even recognize that they have liver disease.
• In 15-40% of persons with acute hepatitis C, the immune system successfully fights off the infection, the virus is cleared from the body within 6 months, and the liver heals completely. In everyone else, the immune system cannot clear the virus, and hepatitis C infection persists past 6 months (usually for the rest of the person’s life). This persistent state is known as chronic hepatitis C.

• In chronic hepatitis C, the liver becomes more and more inflamed and scarred over a period of years. However, the speed at which inflammation and scarring take place varies between people. About 1/3 develop severe liver scarring and the liver stops functioning normally (cirrhosis) within 20 years. Another 1/3 take 30 years for cirrhosis to occur. In the remaining 1/3, liver disease progresses slowly and does not become a major problem during their lifetime.

Hepatitis C can be treated and cured. Almost everyone living with HCV can now be cured with a one-pill-a-day regimen in eight-to-twelve weeks. These new medications are generally well-tolerated. In order to access HCV treatment, it is necessary to see your doctor to discuss treatment options. Access to treatment continues to improve as new medication regimens are made available by private health insurers and public health programs like the VA Medical Centers, the AIDS Drug Assistance Program, Medicaid, and MediCal.

How do People Get Hepatitis C?

Hepatitis C virus is found in the blood of people with HCV infection. It enters the body through blood-to-blood contact.

Until reliable blood tests for HCV were developed (around 1992), people usually got hepatitis C from blood products and blood transfusions. Now that blood and blood products are tested for HCV, this is no longer the typical means of infection.

Currently, people usually get hepatitis C by sharing needles for injection drug use. An HCV-infected woman can pass the infection to her baby during birth. It is also possible to get hepatitis C from an infected person through sexual contact, an accidental needlestick with a contaminated needle, or improperly sterilized medical, acupuncture, piercing, or tattooing

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WHAT’S THE DANGER?

• The hepatitis C virus is a bloodborne virus. It is most commonly transmitted through:
  • injecting drug use through the sharing of injection equipment;
  • the reuse or inadequate sterilization of medical equipment, especially syringes and needles in healthcare settings;
  • the transfusion of unscreened blood and blood products;
  • sexual practices that lead to exposure to blood (for example, among men who have sex with men, particularly those with HIV infection or those taking pre-exposure prophylaxis against HIV infection).

  HCV can also be transmitted sexually and can be passed from an infected mother to her baby; however, these modes of transmission are less common.

  Hepatitis C is not spread through breast milk, food, water or casual contact such as hugging, kissing and sharing food or drinks with an infected person.

  WHO estimates that in 2015, there were 1.75 million new HCV infections in the world (23.7 new HCV infections per 100 000 people).

  What are the Symptoms of Hepatitis C?

  During the acute phase (first 6 months after infection) most persons have no symptoms or might experience a mild illness.  Symptoms of acute HCV infection, when present, may include:

  • Jaundice (yellowing of the skin and eyes)
  • Dark-colored urine, light-colored stools
  • Fatigue
  • Abdominal pain
  • Loss of appetite
  • Nausea
  • Diarrhea
  • Fever

  During the chronic phase (> 6 months after infection) hepatitis C usually progresses silently, with no symptoms at all during the first 10-20 years. Signs of severe liver scarring (cirrhosis) may include:

  • Ascites (accumulation of fluid and swelling of the abdominal cavity)
  • Star-shaped vein pattern developing on the swollen belly
  • Jaundice
  • Itching
  • Easy bruising and bleeding

  Because symptoms of hepatitis C are usually absent, persons with risk for HCV infection should be tested. The blood test for hepatitis C infection is called the “hepatitis C antibody test.” People who have hepatitis C infection will show positive antibodies on this test. In many cases, it is necessary to confirm a positive hepatitis C antibody test with a more specific test, such as a test for HCV virus RNA.

  HOW TO PROTECT YOURSELF

The hepatitis C virus can be transmitted only through blood. But exposure to tiny amounts of blood is enough to infect you.

How to Prevent the Spread of Hep C

Here are some steps you can take to help prevent becoming infected with hepatitis C.

• Never share needles. Intravenous drug users have the highest chance of getting infected with hepatitis C because many share needles. Besides needles, the virus may be present in other equipment used with illicit drugs. Even sharing a straw or dollar bill when snorting cocaine could transmit hepatitis C. Bleeding in the nose frequently happens when taking cocaine this way, and microscopic droplets may enter the straw and be passed on to the next user, even if they can’t be seen.
• Avoid direct exposure to blood or blood products. If you are a medical worker or health care provider, avoid coming into direct contact with blood. Any tools that draw blood in the workplace should be thrown out safely or sterilized to prevent hepatitis C infection.
• Don’t share personal care items. Many items that we use on a daily basis will occasionally be exposed to blood. Often, people will cut themselves while shaving, or their gums will bleed while brushing their teeth. Even small amounts of blood can infect someone, so it is important not to share items such as toothbrushes, razors, nail and hair clippers, and scissors. If you already have hepatitis C, make sure you keep your personal items, such as razors and toothbrushes, separate and out of children’s reach.
• Choose tattoo and piercing parlors carefully. Only use a licensed tattoo and piercing artist who does the right sanitary procedures. A new, disposable needle and ink well should be used for each customer. If in doubt, ask about their disposable products and sanitary procedures before getting a tattoo or piercing.
• Practice safe sex. It is rare for hepatitis C to be transmitted through sexual intercourse, but there is a higher chance of getting hepatitis C if you have HIV, another sexually transmitted disease, multiple sex partners, or if you engage in rough sex.

Who is at Risk for Infection?

• People who inject drugs
• Hemodialysis patients
• Recipients of blood transfusions, blood products, or solid organ transplants before 1992
• Infants born to infected mothers
• Health care and public safety workers who may have contact with blood
• People having sex with an infected partner

How is Hepatitis C Infection Prevented?

Unfortunately, there is no vaccine to prevent hepatitis C. To reduce your risk of getting hepatitis C:

• Injection drug use is the most common way people get hepatitis C. Avoid injecting drugs to reduce your risk. If you do inject drugs, use sterile injection equipment. Avoid reusing or sharing.
• Avoid sharing personal care items that might have blood on them (razors, toothbrushes, nail clippers)
• If you are a health care or public safety worker, follow universal blood/body fluid precautions and safely handle needles and other sharps
• Consider the risks if you are thinking about tattooing, body piercing, or acupuncture – are the instruments properly sterilized?
• If you’re having sex with more than one partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases, including hepatitis C.

FINAL WORD

There is no vaccine to prevent hepatitis C. But there are common sense steps that people can take to reduce the risk of getting hepatitis C.