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BLOODBORNE PATHOGENS 2014
The goal of this course is to provide information that helps increase employee awareness and
knowledge of bloodborne pathogens and to further promote safety, protection, and prevention
practices.
Course Objectives
At the completion of this program, participants should be able to:
• Define and identify various types of bloodborne pathogens.
• Implement standard and universal precautions in various situations.
• Identify and properly utilize various forms of personal protective equipment.
• Follow safe work practices.
Bloodborne Pathogens
Bloodborne pathogens are pathogenic microorganisms that are present in human blood and
can cause disease in humans. These microorganisms can be transmitted through contact with
contaminated blood and bodily fluids.
Exposure to blood and other bodily fluids occur across a wide variety of occupations and affect
personnel from all walks of life. Healthcare workers, emergency responders, public safety
officers, sanitation workers, and housekeeping personnel are at an even greater risk because
their occupations place them closer to blood exposure through skin exposures, mucous
membrane, needle stick, and other sharps injuries.
Bloodborne pathogens that pose the highest risk to humans are the human immunodeficiency
Virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV).
HIV
HIV stands for human immunodeficiency virus. This is the virus that causes AIDS. HIV is
different from most other viruses because it attacks the immune system. The immune system
gives our bodies the ability to fight infections. HIV finds and destroys a type of white blood cell
that the immune system must have to fight disease.
HBV
Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). It ranges in severity from a
Mild illness, lasting a few weeks (acute), to a serious long-term (chronic) illness that can lead to
liver disease or liver cancer. The greatest bloodborne risk to workers is infection from the
hepatitis B virus.
HCV
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). HCV infection sometimes
results in an acute illness, but most often becomes a chronic condition that can lead to cirrhosis
of the liver and liver cancer.
Potentially Infectious Bodily Fluids
While it is important that persons are protected from bloodborne pathogens, it is equally
important that precautions are in place to protect persons from potentially infectious bodily
fluids as well. Potentially infectious bodily fluids from humans are:
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Semen
Vaginal secretions
Cerebrospinal fluid – brain and spine
Synovial fluid - joints
Pleural fluid – around lungs
Pericardial fluid – around heart
Peritoneal fluid – abdominal cavity
Amniotic fluid - sac of water surrounding fetus
Saliva in dental procedures
Any body fluid that is visibly contaminated with blood
All body fluids in situations where it is difficult (or impossible) to identify specific body fluids
Any exposed tissue or organ (other than intact skin) from a living or deceased human
Cell or tissue cultures containing HIV
Organ cultures
Culture medium or other solutions containing HIV or HBV
Blood, organs, or other tissues from experimental animals infected with HIV or HBV
Standard precaution
The Centers for Disease Control and Prevention recommends the implementation of standard
precautions. This includes:
· Hand washing
· Personal protective equipment (i.e. gloves, gowns, masks whenever touching or exposure to
patient bodily fluids is anticipated). Standard Precautions apply to blood, all body fluids, nonintact skin, mucous membranes, secretions, and excretions (except sweat, regardless of
whether or not they contain visible blood).
Potential exposure
Along with HIV and Hepatitis A, B, and C; other infections that can be transmitted through
contact with blood and body fluids include:
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Staph and Strep infections
Gastroenteritis-salmonella and shigella
Pneumonia
Syphilis
Tuberculosis
Malaria
Measles
Chicken Pox
Herpes
Urinary tract infections
Blood infections
The greatest risks of these are from HIV and Hepatitis B and C.
Potential transmission
It‟s easy to get the impression that pathogens are transmitted by direct blood or bodily fluid
contact, but the truth is that pathogens are transmitted in a number of ways.
· Airborne: Spread in small particles in the air such as chicken pox
· Droplets: Spread in large droplets by coughing, talking, or sneezing such as influenza
· Direct Contact: Spread by skin to skin contact or contact with other surfaces such as the
Herpes simplex virus
Preventative Methods
Workers and employers must take advantage of preventative methods and work practices to
avoid exposure to blood and other body fluids.
Bloodborne Pathogens Standard
In 1991, the Occupational Safety and Health Administration (OSHA) issued the Bloodborne
Pathogens Standard to protect workers from risks of hazardous transmission. The standard
established requirements for employers with workers exposed to blood or other potentially
infectious materials. In an effort to reduce or eliminate the hazards of occupational exposure,
employees must be given an exposure control plan by their employer with details on employee
protection measures. The plan must:
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Describe how an employer will use a combination of engineering and work practice controls
Ensure the use of personal protective clothing and equipment
Provide training
Provide medical surveillance
Provide hepatitis B vaccinations
Post signs and labels (among other provisions.)
Engineering controls are the primary means of eliminating or minimizing employee exposure
and include the use of safer medical devices, such as:
· Needleless devices
· Shielded needle devices
· Plastic capillary tubes
Needlestick Safety and Prevention Act
10 years following the passage of the Bloodborne Pathogens Standard, many different medical
Devices were developed to reduce the risk of needlesticks and other sharps injuries. Despite
these advances in technology, needlesticks and other sharps injuries continued to occur.
The Centers for Disease Control and Prevention reported that healthcare workers sustain nearly
600,000 injuries annually involving contaminated sharps.
The standard requires employers to maintain a log of injuries from contaminated sharps.
To prevent needlestick injuries, needles should not be recapped by hand, purposely bent or
broken by hand, removed from disposable syringes, or otherwise manipulated by hand. After
they are used, disposable syringes and needles, scalpel blades, and other sharp items must be
placed in puncture resistant containers for disposal. The puncture-resistant containers should
be located close to the use area. All reusable needles must be placed in a puncture-resistant
container for transport to the reprocessing area.
Universal Precautions
· Universal precautions apply to blood, tissues, semen, vaginal secretions, and other body fluids
containing visible blood.
· Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and
vomitus unless they contain visible blood.
· Universal precautions do not apply to saliva except when visibly contaminated with blood or in
the dental setting where blood contamination of saliva is predictable.
NOTE: Although universal precautions apply when blood is visible, many health workers
Implement universal precautions at all times as an additional safeguard from hazardous
exposure.
Under universal precautions, especially for health care workers, it is recommended that persons
Take precautions to prevent injuries that are caused by needles, scalpels, and other sharp
instruments or devices.
1. Never touch blood, other body fluids, sharps (such as hypodermic needles), or materials
which may be infected, unless you have received training and are wearing protective
equipment.
2. Always wear personal protective equipment when handling any waste or material which may
contain blood, other body fluids, or other infected materials. Personal protective equipment
for safely handling materials which might contain blood borne pathogens include disposable
surgical gloves, gowns, aprons, masks or protective eyewear.
3. Clean up any blood, other body fluids, sharps, or materials which may be infected as soon as
possible. Clean the area with a disinfectant or diluted bleach solution to kill the
microorganisms which cause disease. Wash your hands with warm water and soap for several
minutes after cleaning any potentially infectious waste or handling any potentially infectious
material, even if you wear protective gloves!
4. Always dispose of any blood, other body fluids, sharps, or materials which may be infected in
approved and labeled infectious waste containers. These are red bags or containers which
have the infectious waste universal precaution label. Make sure the waste is taken away
immediately for safe storage and disposal.
Daily Precautions
All health care workers should take precautions to prevent injuries caused by needles, scalpels,
and other sharp instruments or devices. Precautions should be practiced during daily operations.
• When cleaning used instruments.
• During disposal of used needles.
• When handling sharp instruments after procedures. Personal Protective Equipment
If you are a health care worker, you should routinely use appropriate barrier precautions to
prevent skin and mucous membrane exposure during contact with any patient's blood or bodily
fluids that require universal precautions.
Gloves should be worn for:
 Touching blood and bodily fluids requiring universal precautions, mucous membranes, or
nonintact skin of all patients.
 Handling items or surfaces soiled with blood or bodily fluids to which universal precautions
apply.
Gloves need to be changed after contact with each patient. Hands and other skin
surfaces should be washed immediately after gloves are removed. Gloves should reduce the
incidence of blood contamination of hands during phlebotomy, but they cannot prevent
penetrating injuries caused by needles or other sharp instruments.
Masks, gowns, aprons, protective eyewear, and/or face shields should be worn by health care
workers to prevent exposure of mucous membranes of the mouth, nose, and eyes during
procedures that are likely to generate droplets of blood or body fluids requiring universal
precautions.
Decontamination
An important part of preventing exposure to bloodborne pathogens is proper decontamination
and cleanup. As you would with all bodily fluids, assume contamination and wear protective
gloves. A bodily fluid disposal kit contains fluid cleanup materials like:
• Absorbent powder
• Disinfectant solution
• Disposal bag
Sprinkle the powder on liquid body fluids, like blood. When the powder absorbs the fluid, scoop
it up and place it in the disposal bag. If you do not have a disinfectant solution available,
substitute with a solution of a 1/4 cup of bleach per gallon of water. Thoroughly wipe down all
contaminated surfaces with the disinfectant solution to ensure that all bloodborne pathogens
are destroyed. Properly dispose of all contaminated gloves, towels, rags, absorbent powder,
etc. and place it all in the disposal bag.
Safe Work Practices
Listed here are a few common sense safe work practices that will help prevent exposure.
 Remove contaminated clothing or personal protective equipment as soon as possible.
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If blood (or any other bodily fluid) is on your shoes, pants, skirt, or shirt; remove those
items as soon as possible.
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Thoroughly wash your hands, face, and any other areas of your skin that may have come
into contact with bodily fluids.
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Remove contaminated personal protective equipment (like gloves) as soon as you are
finished administering first aid or decontaminating equipment and/or work surfaces.
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Cleaning and disinfecting equipment, work tools, and/or surfaces will prevent the next
person from coming into contact with potentially infected bodily fluids.
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If you believe that blood or other potentially contaminated bodily fluid was splashed into
your eyes, go to an emergency eyewash station immediately and flush your eyes.
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Properly disposing of contaminated items in appropriately labeled bags or containers will
help prevent someone from being exposed.
Warning Labels and Signs
Warning labels must include the universal biohazard symbol with the term
„Biohazard‟ listed and be affixed to containers used to store, transport, or ship regulated waste.
Refrigerators and freezers containing blood or other potentially infectious materials must also
be labeled.
Please note that food must not be placed or stored in refrigerators or freezers containing blood
or other potentially infectious materials.
Regulated Medical Waste
Regulated medical wastes include blood or other potentially infected bodily fluids that are in a
liquid form. If absorbed liquids can be released when compressed (like liquid wringing from a
sponge), it is also a regulated medical waste.
Items like small bandages or tissue, which we normally throw in the wastebasket, are not
considered as regulated medical waste, however, they are considered regulated wastes at
medical facilities where the amount of this type of waste is extensive.
If you are able to literally „wring out‟ the blood in a bandage or tissue, it would then be
considered regulated medical biowaste. A good rule to follow is, when in doubt, treat all waste
as regulated waste to avoid contamination. Make sure that all sharps (including needles and
broken glass) go into the appropriate sharps container to avoid contamination via impalement
or laceration caused by the sharps.
Exposure Incident
An exposure incident is a specific incident of contact with potentially infectious bodily fluid. If
there was no infiltration of mucous membranes or open skin surfaces, it is not considered an
occupational exposure. If an employee administering first aid on normal bleeding is wearing the
appropriate gloves; an exposure incident does not exist.
After an incident, an accident investigation report must be completed. If blood is spilled,
thoroughly document the spill location, who cleaned it up, what cleanup method was used, and
note the waste disposal location.
Remember to report all incidents involving blood or bodily fluid to your supervisor so the
company can determine if an exposure incident occurred and offer a post-exposure medical
evaluation if necessary.
Post-exposure Medical Evaluation
The post-exposure medical evaluation helps to determine if the person was exposed to infected
bodily fluids. The medical evaluation is completely confidential for both the exposed person and
the source person. An employer will never know the results of such testing. The evaluation
documents the route of exposure and identifies the source individual. If the source individual
consents, the evaluation includes testing his or her blood.
Only the source individual and the exposed employee will receive the results of the postexposure medical evaluation by medical personnel.
HBV Vaccination
The Hepatitis B Virus (or HBV) vaccine is a safe and effective way to prevent disease and
death. There is no confirmed evidence that indicates the HBV vaccine can cause chronic illness.
Reports of unusual illnesses following a vaccine are most often related to other causes and are
not related to the vaccine.
The HBV vaccination is a series of three injections that are effective in preventing infection with
HBV. Currently, there is no requirement for routine boosters; however, this is still being
assessed.
The HBV vaccination is paid for by the employer.
If an employee declines the HBV vaccination, they will be asked to sign a form that states they
waived their opportunity to receive the vaccination. If they decline the vaccination and sign the
form, they still have the opportunity to change their mind later and accept the vaccination. The
signed form basically states that they declined the shots when first offered. The language on
the declination form is from the OSHA Bloodborne Pathogens Standard.
Exposure Control Plan
The mission of the Occupational Health and Safety Administration (OSHA) is to save lives,
prevent injuries, and protect the health of America‟s workers. OSHA‟S bloodborne pathogens
standard protects employees who work in occupations where they are at risk of exposure to
blood or other potentially infectious materials. This standard requires employers to develop
written documents to explain how they will implement each standard, provide training to
employees, and protect the health and safety of their workers.
OSHA developed the Bloodborne Pathogens and Hazard Communications Standard publication
to assist employers with developing a plan that meets the requirements of the OSHA bloodborne
pathogens standard. This document can be used as a template for employers when developing
a customized workplace exposure control plan program. Plans must be tailored to the specific
requirements of the employers work establishment.
The Bloodborne Pathogens and Hazard Communications Standard publication contains sample
plans, which contain all of the elements that are required by the bloodborne pathogens and
hazard communication standards; therefore, employers must not eliminate any items when
converting them for customized use.
If the reader has questions, they should consult the OSHA bloodborne pathogens and hazard
communication standards in their entirety for specific compliance requirements.
Written plans must be accessible to all employees, either on-line or in an area where they are
available for review by all work shifts.
Recordkeeping
All work-related needlesticks, cuts, and injuries from contaminated sharps must be recorded on
the OSHA 300 Log. The record must include the type and brand of device involved in the
incident, the department or work area where the exposure incident occurred, and an
explanation of how the incident occurred.
To protect confidentiality, the employee‟s name should not be entered on the log.
Additionally, medical records are kept confidential; however, they are available to each
employee upon request. The records will include your hepatitis B vaccination status, any
postexposure evaluation and follow-up results, and any written opinions or other specific
information provided by healthcare professionals.
Training records include date of training, content, trainer‟s qualifications, names, and job titles
of the trainees.
When NOT to Include an Employee’s Name on the OSHA 300 Form
There are times when you must not enter an employee‟s name on the OSHA 300 form. You
must consider the following types of injuries or illnesses to be privacy concern cases:
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An injury or illness to an intimate body part or to the reproductive system
An injury or illness resulting from a sexual assault
A mental illness
HIV infection, hepatitis, or tuberculosis, a needle-stick injury or cut from a sharp object
that is contaminated with blood or other potentially infectious material
other illnesses
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If the employee independently and voluntarily requests that his or her name not be
entered on the log
Again, you must not enter the employee‟s name on the OSHA 300 for these cases. Instead,
enter “privacy case” in the space normally used for the employee‟s name. You must keep a
separate, confidential list of the case numbers and employee names for your organization‟s
privacy concern cases so that you can update the cases and provide information to the
government if asked to do so. If you have a reasonable basis to believe that information
describing the privacy concern case may be personally identifiable - even though the employee‟s
name has been omitted, you may use discretion in describing the injury or illness on both the
OSHA 300 and 301 forms. You must enter enough information to identify the cause of the
incident and the general severity of the injury or illness, but you do not need to include details
of an intimate or private nature.
Summary
The Occupational Safety and Health Administration's Bloodborne Pathogens Standard is
designed to protect millions of workers by preventing the spread of infections due to exposure.
Bloodborne pathogens are pathogenic microorganisms that are present in human blood and can
cause disease in humans. They include the hepatitis B and C virus and the human
immunodeficiency virus (better known as HIV), which leads to AIDS.
It is our shared responsibility to implement safe work practices to better protect ourselves and
Others from exposure. Practice safety by utilizing personal protective equipment when
administering care to a patient, cleaning potentially hazardous spills, handling used needles, and
discarding waste; and remember to record and report exposure incidents immediately after an
occurrence.
Final
Thank you for joining us for this course on Bloodborne Pathogens.
Please take test below and assess your learning.
OSHA Bloodborne Pathogens - 2014
TEST
1. Bloodborne pathogens are pathogenic microorganism that are present in human blood and can
cause disease in humans. These microorganisms can be transmitted through contact with
contaminated blood and bodily fluids. Which bloodborne pathogen poses the highest risk to
humans?
a. HIV
b. HBV
c. HCV
2. While it is important that persons are protected from bloodborne pathogens, it is not as
important that precautions are in place to protect persons from potentially infectious bodily
fluids.
a. True
b. False
3. Emergency Responders, Healthcare Workers, Public Safety Officers, and ____________ are all
placed at an even greater risk because their occupations place them closer to blood exposure
through skin exposures, mucous membrane, needle stick, and other sharps injuries.
a. Retail Clerks
b. Sanitation Workers
c. Business Office Personnel
4. Blood, organs, or other tissues from experimental animals infected with HIV or HBV pose little
to no risk for humans.
a. True
b. False
5. Pathogens can be spread by sneezing.
a. True
b. False
6. In an effort to reduce or eliminate the hazards of occupational exposure, employees must be
given an exposure control plan by their employer with details on employee protection
measures. The plan must describe how an employer will use a combination of engineering and
training, provide medical surveillance, and ____________.
a. Provide hepatitis C vaccinations
b. Post signs and labels
c. Establish a record that names personnel who were exposed to potential bloodborne
pathogens
7. Needles should always be recapped by hand, bent or broken by hand, removed from disposable
syringes, or otherwise manipulated by hand to prevent injury and possible exposure to a
bloodborne pathogen.
a. True
b. False
8. Masks, gowns, aprons, protective eyewear, and/or face shields should be worn by health care
workers to prevent exposure of mucous membranes of the mouth, nose, and
________________ during procedures that are likely to generate droplets of blood or body
fluids requiring universal precautions.
a. The ear canal
b. Sweat glands
c. Eyes
9. All work-related needlesticks, cuts, and injuries from contaminated sharps must be recorded on
the OSHA 300 Log. The injured employee‟s name must be entered on the log.
a. True
b. False
10. In recordkeeping, training records include date of training, content, trainer‟s qualifications,
names of the trainees _________________.
a. Group Discussions
b. Job titles of the trainees
c. Personal Testimonies