Methods of Compliance:
The Bloodborne Pathogen Standard
OSHA estimates that 5.6 million workers in the health care industry and related occupations are at risk of occupational exposure to bloodborne pathogens, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and others. All occupational exposure to blood or other potentially infectious materials (OPIM) place workers at risk for infection with bloodborne pathogens.
OSHA defines blood to mean human blood, human blood components, and products made from human blood. Other potentially infectious materials (OPIM) means:
- 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;
- Any unfixed tissue or organ (other than intact skin) from a human (living or dead);
- 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.The Bloodborne Pathogen Standard is located in 29CFR1910.1030.
Types of Bloodborne Pathogens
- This training will focus on the three most common bloodborne pathogens in the United States. These pathogens are HIV, Hepatitis B, and Hepatitis C.
- Bloodborne pathogens are transmitted when contaminated blood or body fluids enter the body of another person. In the workplace setting, transmission is most likely to occur through:
- An accidental puncture by a sharp object, such as a needle, broken glass, or other "sharps" contaminated with the pathogen.
- Contact between broken or damaged skin and infected body fluids
- Contact between mucous membranes and infected body fluids
- *Some laboratories may have different types of bloodborne pathogens that you may be exposed. Please check with your supervisor.
- Human immuno-deficiency virus (HIV)-affects the immune system. Symptoms can include sore throat, nausea, headaches, weight loss, and a white coating on the tongue. HIV is destroyed quickly when contacted with air.
- Hepatitis B (HBV)-affects the liver and causes flu like symptoms, including jaundice. HBV survives up to a week in dried blood. A vaccine has been available since 1982.
- Hepatitis C (HCV)-leading cause of liver transplants. Most common chronic bloodborne infection. No vaccine yet.
- You cannot "catch" HBV, HCV, HIV:
- Through the air (like a cold or the flu)
- Through casual, everyday contact (sharing bathrooms, kitchens, etc.)
- Through nonsexual social situations
- Through insects or mosquitoes
- Through urine, feces, nasal secretions, vomit, sweat or tears from an infected person
Exposure Control Plan
- The Bloodborne Pathogen Standard requires that employers develop an Exposure Control Plan and make it accessible to all employees.
- The Exposure Control Plan is a written plan that identifies the tasks and procedures, as well as job classifications, where occupational exposure to blood occurs--without regard to personal protective clothing and equipment.
- The plan also establishes the schedule by which the employer will implement other provisions of the standard, and specifies the procedure for evaluating circumstances surrounding exposure incidents.
Employers must update their Exposure Control Plan to include:
- changes in technology that reduce/eliminate exposure
- annual documentation of consideration and implementation of safer medical devices
- solicitation of input from non-managerial employees
To view ETSU's Exposure Control Plan Click Here
To select the proper engineering and work practice controls to implement in the workplace, the employer must make an exposure determination. This determination must contain:
- A list of all job classifications in which all employees in those job classifications have occupational exposure;
- A list of job classifications in which some employees have occupational exposure
- A list of all tasks and procedures or groups of closely related task and procedures in which occupational exposure occurs and that are performed by employees in job classifications listed in accordance with the provisions of paragraph (c)(2)(i)(B) of this standard.
This exposure determination shall be made without regard to the use of personal protective equipment
Universal Precautions embraces the concept of treating all body fluids and materials as infectious. The use of Universal Precautions will be employed in all workplaces with occupational exposures to blood or other potentially infectious materials (OPIM).
Engineering and Work Practice Controls
The objective for engineering and work practice controls are to eliminate/reduce employees exposure to blood or OPIM.
- Hand washing facilities shall be readily available to all employees. Employees must wash hands immediately or as soon as possible, after removing gloves and/or other protective clothing , after hand contact with blood or OPIM. If hand washing facilities are not feasible, employees shall use an appropriate cleanser (> 60% alcohol).
- Sharps containers are used for needles, broken glass, and razor blades that have been in contact with blood/bodily fluids. Sharps containers are closable, puncture resistant, labeled or color-coded.
Engineering and Work Practice Controls
- Needlestick Safety for healthcare workers and students needs to be prioritized in order to reduce or eliminate potential needlestick injuries. *Please check with supervision on these devices.
- Hand washing is the simplest and most effective practice used to prevent the transmission of blood borne pathogens. Thoroughly wash hands or other exposed skin with soap and water as soon as possible following an occupational exposure to blood/bodily fluids and when removing gloves. If hand washing facilities are not available, use antiseptic hand cleansers or towelettes.
- Personal hygiene requires sound judgment when working in areas with the potential for exposure. Refrain from eating, drinking, and applying cosmetics where there is a potential for exposure.
- Hepatitis B vaccination can protect you from HBV and will be offered to any employee who may be occupationally exposed, free of charge. If you decline the vaccination, you may accept the vaccination at a later date.
Personal Protective Equipment (PPE)
Depending on the type of exposure for blood/bodily fluids will depend on the type of personal protective equipment (PPE) that will need to be worn. All PPE will be provided at no cost to the employee.
- Gloves are the minimal protection against blood/bodily fluids. Gloves should be made of latex, rubber, nitrile or other impervious materials.
- Safety glasses or goggles provide protection against potential splashing into the eyes.
- Masks and face shields provide additional protection against potential splashing into the eyes, nose, and mouth.
- Lab coats, gowns, and aprons provide protection from splashing onto clothing and can easily be discarded.
All PPE must be replaced or discarded after exposure or if equipment has been flawed. Remove all garments when leaving the exposed area.
Labels and Signs
Warning labels shall be affixed to containers of regulated waste, refrigerators and freezers containing blood or OPIM; and other containers used to store, transport or ship blood or OPIM, with the following exceptions:
- Red bags or red containers may be substituted for labels.
- Containers of blood, blood components, or blood products that are labeled as to their contents and have been released for transfusion or other clinical use are exempted from the labeling requirements.
Labels required shall include the following legend:
These labels shall be fluorescent orange-red or predominately so, with lettering or symbols in a contrasting color.
Labels required shall be affixed as close as feasible to the container by string, wire, adhesive or other method that prevents loss or unintentional removal.
Labels required for contaminated equipment shall also indicate which portions of the equipment remains contaminated.
Cleaning and Disinfecting
- Clean and decontaminate all equipment and working surfaces after contact with blood and /or body fluids.
- Decontaminate with an approved EPA registered solution or a 1:10 ratio of bleach and water. *Bleach is an irritant and corrosive and may not be used in all areas. Check with supervision.
- Clinics and laboratories may have a routine cleaning schedule.
Exposure and Follow-Up
An exposure incident is an event resulting from an employee's duties where:
- they have been splashed with blood or other potentially infectious materials to the eyes, mouth or mucous membranes
- a potentially contaminated needle has broken the skin
Report all exposures to your supervisor immediately. Following a report of an exposure incident, the medical facility providing the patient care shall file a confidential medical evaluation and follow-up and make it available to the affected employee.
Bloodborne Pathogens training must be provided prior to any person that may be occupationally exposed and annually thereafter.
Once you have completed and passed the quiz, your training will be documented by EH&S.