Mandatory Blood Testing Act (MBTA)

The MBTA, 2006 allows eligible persons, who have been exposed to another person’s blood and bodily fluids to request a blood sample be taken from the person they came in contact with and tested for certain communicable diseases.

Who is eligible for MBTA?

A person may apply to a Medical Officer of Health (MOH) to have a blood sample of another person analyzed if the applicant came into contact with a bodily substance of the other person in any of the following circumstances:

• As a result of being the victim of a crime.

  • While providing emergency health care services or emergency first aid to the person, if the person was ill, injured or unconscious as a result of an accident or other emergency.
  •  In the course of his or her duties, if the person belongs to a prescribed class.
  • While being involved in a prescribed circumstance or while carrying out a prescribed activity.

Prescribed classes The following are prescribed as classes of persons who may make an application under Section 2 of the Act:

• Persons who are employed in a correctional institution as defined in the Ministry of Correctional Services Act, or in a place of open custody or place of secure custody, as those terms are defined in the Child and Family Services Act.

• Police officers as defined in the Police Services Act, employees of a police force who are not police officers, First Nations Constables and auxiliary members of a police force.

•  Firefighters as defined in subsection 1 (1) of the Fire Protection and Prevention Act, 1997.

• Paramedics and emergency medical attendants, as those terms are defined in the Ambulance Act.

• Paramedic students engaged in field training.

• Members of the College of Nurses of Ontario.

• Members of the College of Physicians and Surgeons of Ontario.

• Medical students engaged in training.

• Special constables appointed under section 53 of the Police Services Act who are not employees of a police force.

What diseases are tested under the MBTA?

• Human Immunodeficiency      Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS)

• Hepatitis B Virus (HBV)

• Hepatitis C Virus (HCV)

Assessing your risk.

An exposure requires both an injury (Example: percutaneous needle or other sharp object, a splash of blood or other body fluid onto a mucous membrane or non-intact skin, or human bite that breaks the skin) and contact with blood or body fluid capable of transmitting HBV, HCV and/or HIV.

Anyone who believes that they have been exposed to a communicable disease as a result of coming into contact with blood or bodily fluid of another person should initiate first aid and immediately seek medical attention to assess the risk of infection, have baseline and serologic bloodwork ordered, decide whether to initiate prophylaxis and/or other preventative measures (immunization or immune globulin).

How to initiate the act?

The applicant must submit a Ministry of Community Safety and Correctional Services Form 2 “Application Report” and a ministry of Community Safety and Correctional Services Form 1 “Physician Report” to the medical officer of health. If you are initiating the act, please call the CDC program who will provide further information.

For more information.

If you have further questions about the MBTA and blood borne exposures, please call 705-474-1400 or 1-800-563-2808 ext. 5229, to speak to a public health nurse. After hours press ‘0’ for the answering service, and ask to speak with the CDC nurse on call.

Resources

http://www.mcscs.jus.gov.on.ca/english/MandatoryBloodTesting.html

http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/MinistryResults?Openform&SRT=T&MAX=5&ENV=WWE&STR=1&TAB=PROFILE&MIN=008&BRN=10&PRG=11

https://www.ontario.ca/laws/statute/06m26

 Newsletters

Designated Officer Newsletter 2019

The role of the Designated Officer is essential to protecting the health and safety of all Emergency Service Workers. Each year the North Bay Parry Sound District Health Unit provides a newsletter to update Designated Officers on important infection prevention information. The purpose of this year’s newsletter is to provide education to Designated Officers about current diseases of significance, risk assessments, proper use of personal protective equipment (PPE) and immunization for Hepatitis B and Measles. 

Current Diseases of Significance

The following list of communicable diseases is not a comprehensive list of all current diseases of significance.

1)     Measles

• A highly contagious viral illness spread from person-to-person through droplets from an infected person’s nose or throat (coughing or sneezing).
• The virus can remain in the air of closed spaces for up to two hours after an infected person leaves the room.
• Initial symptoms include fever, runny nose, cough, drowsiness, red eyes and Koplik spots (small blue-white spots on the inside of the mouth and throat).
• Three to seven days after initial symptoms start, a red blotchy rash appears
• Thirty percent of infected persons will develop some kind of complication.
• Measles is vaccine preventable.
• As of June 13, 2019, 12 cases of measles in Ontario have been confirmed this year.
• No cases of measles have been confirmed in the North Bay Parry Sound District in 2019.

 2)    Hepatitis B (HBV)

• HBV is spread through contact with infected blood or bodily fluids.
• Most infected persons do not have any symptoms. Those who so may present with jaundice, fatigue, loss of appetite, joint pain, abdominal pain and/or nausea and vomiting.
• HBV can be either acute or chronic. Acute HBV is a short-term illness that occurs within the first six months after exposure to the virus. Chronic HBV is a long-term illness that occurs when the HBV remains in the person’s body after six months.
• The risk of developing an infection after percutaneous exposure is six to 30 percent if unvaccinated.
• HBV is vaccine preventable.

 3)    Hepatitis C (HCV)

• HCV is spread through blood-blood contact.
• Most infected persons do not have symptoms for many years. For those with symptoms, they present very similarly to symptoms of HBV.
• The risk of exposure after percutaneous exposure is 1.8 percent.
• There is no vaccine available for HCV.
• 89 cases of HCV were confirmed in the North Bay Parry Sound District in 2018
• Common risk factors for both HCV and HBV include:
  • Coming into contact with infected blood.
  • Injection drug use and sharing needles.
  • Tattooing, piercing or acupuncture with unsterile equipment.
  • Sexual contact with an infected person.

Risk Assessments

Risk assessments are performed to determine what intervention(s) is the most appropriate to prevent the spread of infectious agents in a particular situation. Step-by-step instructions for how to conduct an effective risk assessment can be found below.

1. Assess the anticipated interaction with client and/or environment. Ask yourself the following questions.

• What task am I performing?
• What is the risk of exposure to blood, bodily fluids (including respiratory secretions), non-intact skin, mucous membranes, body tissues and/or contaminated equipment?
• Do I have access to personal protective equipment?
• Will the client be cooperative?

1. After reflecting on the above questions, then ask yourself if the client has a known infection or symptoms of an infection. If you answered yes, you are required to follow the appropriate Additional Precautions. If you answered no, or if you are unsure, proceed to step three.
2. Ask yourself if you will be exposed to the following risks: blood, bodily fluids, secretions, excretions, contaminated equipment and/or the client’s environment?
3. If you answered no, no further action is required. If you answered yes to any of the above questions, you must then consider the following scenarios.

• Will my hands be exposed to the above risks?
• Will my face be exposed to splashing and/or spray of the above risks, a cough or a sneeze?
• Will my clothing or skin be exposed to splashes/spray or items contaminated with blood, bodily fluids, excretion and/or secretions?

1. If you determine that your hands will be exposed the previously listed risks, you are required to wear gloves.
2. If you determine that your face will exposed to splashing or spray of the previously listed risks, you are required to wear eye protection and a mask.
3. If you determine that your clothing or skin will be exposed to splashes/spray or items contaminated with blood, bodily fluids, excretion and/or secretions, you are required to wear protective clothing as per your organization’s policies (ie a gown).

Personal Protective Equipment

Personal protective equipment (PPE) such as gloves, masks, eye protection and gowns are used to place a barrier between yourself and infectious agents. The proper donning and doffing order of PPE is outline below.

Donning Order

1. Hand hygiene
2. Gown
3. Mask
4. Eye protection
5. Gloves

Doffing Order

1. Gloves
2. Gown
3. Hand hygiene
4. Eye protection
5. Mask
6. Hand hygiene

Immunization

Vaccines are our best defence against the spread of infectious diseases. The following list of is not a comprehensive list of recommended vaccines. This list was composed to complement the current diseases of significance previously listed in this newsletter.

1. Hepatitis B Vaccine

• This vaccine is typically given to grade seven and eight students in Ontario schools.
• Hepatitis B vaccination after 18 years of age is not covered by OHIP. It is, however, publicly funded for some high risk groups including those with needle stick injuries occurring outside of hospital.

    2. Measles Vaccine

• This is a live-attenuated vaccine combined with mumps and rubella vaccines (MMR).
• The first dose recommended at 12 months of age and second dose between four and six years of age.
• Administration of the vaccine should be given to adults over 18 years of age if not previously immunized.
• The MMR vaccine is covered by OHIP for individuals over 18 years of age.

It is strongly recommended that all Emergency Service Workers ensure all of their immunizations are to date.

Further Information

For more information please contact the Communicable Disease Control program at 1-800-563-2808 ext 5229. 

Print current or past newsletters

2019 Designated Officers Newsletter -  Highlights: Current Diseases of Significance

2018 Designated Officers Newsletter - Highlights: Chain of Transmission

2017 Designated Officers Newsletter - Highlights: Influenza ' The Flu"

2016 Designated Officers Newsletter -   Highlights: Routine Practices and Additional Precautions; Exposed - the Next Steps;

2015 Designated Officers Newsletter -   Highlights: Ambulance Service Communicable Standards; Ontario Association of Designated Officers; Mandatory Blood Testing Act