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Bloodborne Pathogens
OSHA Regulation
• OSHA 29 CFR 1910.1030 – Bloodborne
Pathogens
– Covers any work involving human blood, body
fluids, or human cell lines
OSHA’s Standards Format
• All OSHA standards follow a similar format:
– Administrative Controls
– Engineering Controls
– Work Practices
– Personal Protection
– Training Programs
– Record Keeping Requirements
Specifics of Bloodborne Pathogen
Regulation
• Specific requirements for Bloodborne Pathogens
standard:
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Written Exposure Control Plan
Engineering/Work Practice Control Plan
Use of Universal Precautions
Personal Protective Equipment
Free Hepatitis B Vaccination
Annual Training
Labeling
Follow Up after an Exposure
Universal Precautions
• According to the concept of Universal
Precautions, all human blood and certain
human body fluids are treated as if known to
be infectious for HIV, HBV (Hepatitis B), and
other bloodborne pathogens.
Bloodborne Pathogen Transmission
• Bloodborne pathogens are transmitted through
contact with infected human blood and other
body fluids such as:
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Semen
Vaginal secretions
Cerebrospinal fluid
Synovial fluid
Pleural fluid
Peritoneal fluid
Amniotic fluid
Saliva
Occupational Exposure
• An occupational exposure is defined as an
exposure to broken skin, eyes, mucous
membrane, or a percutaneous injury (needle
stick) with blood or other potentially
infectious materials that may result from the
performance of an employee’s duties.
Skin Provides a Barrier
• Unbroken skin forms an impervious barrier
against bloodborne pathogens. However,
infected blood can enter your system through:
– Open sores
– Cuts
– Abrasions
– Acne
– Any sort of damaged or broken skin such as
sunburn or blisters
Mucous Membranes
• Bloodborne pathogens may also be
transmitted through the mucous membranes
of the:
– Eyes
– Mouth
– Nose
What Are Bloodborne Pathogens?
• Bloodborne pathogens are microorganisms
such as viruses or bacteria that are carried in
blood and can cause disease in people
Types of Bloodborne Pathogens
• Bloodborne pathogens include:
– Hepatitis B (HBV)
– Hepatitis C
– Human Immunodeficiency Virus (HIV)
– Other diseases
Hepatitis B (HBV)
• Is the most common bloodborne pathogen
• Is a virus that causes infection and
inflammation of the liver
• Is transmitted primarily through “blood to
blood” contact
• Can lead to serious conditions such as
cirrhosis and liver cancer
• Can survive in dried blood for up to seven days
No Cure for HBV
Currently, there is no “cure” or specific
treatment for HBV.
HBV Symptoms
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Mild flu-like symptoms
Fatigue
Possible stomach pain
Loss of appetite
Nausea
Jaundice
Darkened urine
About 30% of infected people demonstrate no
symptoms
– Even though these people don’t display symptoms, they
are still infectious
Hepatitis B Vaccinations
• Employees who have reasonably anticipated
exposure to bloodborne pathogens shall be
offered the Hepatitis B vaccine series at no
cost to themselves unless:
– They have previously received the vaccine series
– Antibody testing has revealed they are immune
– The vaccine is contraindicated for medical reasons
Hep B Vaccination Process
• Series of three shots
• Second shot is given one month after the first
• Third shot follows five months after the second
• It is very important to receive all three of the
vaccines
• This series gradually builds up the body’s
immunity to the Hepatitis B virus
• Complete immunity not reached until all three
vaccines are received
Hep B Vaccination
• After the 1991 Bloodborne Pathogens
Standard required that the vaccine be offered,
cases of hepatitis B in health care workers
dropped from 17,000 annually to 400
annually—and they continue to drop
• This demonstrates the effectiveness of the
hepatitis B vaccine
Human Immunodeficiency Virus (HIV)
• AIDS, or acquired immune deficiency
syndrome, is caused by a virus called the
human immunodeficiency virus, or HIV
• It may be many years before AIDS actually
develops
HIV
• HIV attacks the body’s immune system,
weakening it so that it cannot fight other
deadly diseases
• AIDS is a fatal disease, and while treatment for
it is improving, there is no known cure
HIV Symptoms
• Symptoms of HIV infection can vary, but often include:
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Weakness
Fever
Sore throat
Nausea
Headaches
Diarrhea
White coating on the tongue
Weight loss
Swollen lymph glands
• Even though some people that have HIV may not
display symptoms, they are still infectious
HIV and Direct Contact
• Although HIV virus is very fragile and will not
survive very long outside of the human body,
it is a primary concern to health care
employees
• As of June 2001, there were at least 57 CDCdocumented cases of health care workers with
occupationally acquired HIV and at least 137
cases of possible transmissions
Occupationally-Acquired HIV/AIDS
• United States Cases since
June 2001:
– 57 total cases documented
by the CDC
– Most occurred through
needle sticks or cuts (48)
– Some occurred through
exposures of eyes, nose, or
mouth to blood (6)
– Two from both a splash to
the face and a needle stick
– One unknown type of
exposure in an HIV
research lab
Mucocutaneous,
6
Both, 2
Unknown, 1.2
Percutaneous, 48
Protection
• Hand washing
• Personal Protective Equipment
Hand Washing
• Hand washing is one of the most important
(and easiest) practices used to prevent
transmission of bloodborne pathogens
• Wash hands or other exposed skin thoroughly
as soon as possible following an exposure
incident
Hand Washing
• Wash hands before eating, drinking, smoking,
handling contact lenses, applying lip balm or
cosmetics
• Keep hands away from eyes, nose, mouth
• Use antibacterial soap
• Don’t use harsh, abrasive soaps
Alcohol Based Products
• Hand sanitizers are ideal when there’s no soap
and water
– Apply to your palm (read label for amount)
– Rub hands together, covering all surfaces, until
they are dry
Ability of Hand Hygiene Agents to
Reduce Bacteria on Hands
120
Bacterial Reduction (%)
100
80
60
Alcohol-Based Handrub
(70% Isopropanol)
40
Antimicrobial Soap
(4% Chlorhexidine)
Plain Soap
20
0
-20
Baseline
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60
Time After Disinfection (minutes)
Adapted from: Hosp Epidemial Infect Control, 2nd Edition, 1999.
180
Personal Protective Equipment
• To protect yourself, it is essential to have a
barrier between you and the potentially
infectious material
• The best protection against exposure is to
ensure you are wearing the appropriate
personal protective equipment (PPE)
Goggles, Face Shields, & Lab Coats
• Use goggles if there is a risk of splashing or
vaporization of contaminated fluids
• Face shields provide additional face protection
for the nose and mouth
• A lab coat should be worn whenever working
with blood or body fluids
Gloves
• Gloves should be made of latex, nitrile, or
rubber
– Some people develop allergies to latex, so other
types of gloves will be available to you
• Inspect gloves before use
• Double gloving can provide an additional layer
of protection
Reducing the Risk of Infection
• Double Gloving
– Multiple studies indicate wearing two pairs of
gloves provides a “wiping” effect
– Gloves “wipe” the blood contamination off the
outside of the needle
– Double gloving reduces the amount of
contamination during a needle stick or cut
Gloves
• If you have cuts or sores on your hands, you
should cover these with a bandage or similar
protection as an additional precaution before
donning your gloves
• Don’t touch the outside of used gloves
Rules to follow:
• Treat all blood or potentially infectious body
fluids as if they are contaminated
• Always wear personal protective equipment in
exposure situations
• Replace PPE that is torn or punctured
Rules to follow:
• Remove PPE before leaving the work area
• Properly disinfect or dispose of used PPE
• Wash hands immediately after removing PPE
Hygiene Rules
• If you are working in an area where there is
reasonable likelihood of exposure, you should
never:
– Eat
– Drink
– Smoke
– Apply cosmetics
– Handle contact lenses
Food Rules
• Do not keep food or drink in refrigerators,
freezers, shelves, cabinets, or on countertops
where blood or potentially infectious
materials are present
Needle & Syringe (Sharps) Safety
• The Centers for Disease Control and
Prevention estimates that each year 385,000
needle sticks and other sharps related injuries
are sustained by hospital-based healthcare
personnel
• Data from National Surveillance System for
Health Care Workers (NaSH) show that nurses
sustain the highest number of percutaneous
injuries
Needle and Syringe (Sharps) Safety
Occupational Groups Exposed to Blood/Body Fluids
NaSH 6/95 to 12/01
Other, 5%
Dental, 1%
Nurse, 44%
Clerical/Admin, 1%
Student, 4%
Housekeeping/
Maintenance, 3%
Technician, 15%
Physician, 28%
Needle and Syringe (Sharps) Safety
• Injuries most often occur after use and before
disposal of a sharp device
• NEVER recap needles or syringes
• The majority of occupational acquired
infections have resulted from injuries from
hollow-bore, blood-filled devices
Safety Devices
• The BBP Standard has a requirement to
implement the use of engineering controls, which
includes safer medical devices
• The standard defines Engineering Controls as
“controls (e.g., sharps disposal containers, selfsheathing needles, safer medical devices, such as
sharps with engineered sharps injury protections
and needleless systems) that isolate or remove
the bloodborne pathogens hazard from the
workplace.”
Signs and Labels
• Warning labels must be placed on containers
of regulated waste, equipment such as
refrigerators and freezers containing blood or
other potentially infectious material; and any
other containers used to store, transport, or
ship blood or other potentially infections
materials
Emergencies
• In an emergency situation, always use
Universal Precautions
• Minimize your exposure by wearing:
– Gloves
– Splash goggles
– Other barrier devices
If you are exposed or
have a needle stick:
• Wash the exposed area thoroughly with soap
and running water
• Use non-abrasive antibacterial soap
• Flush mouth/nose/eyes for 15 minutes if
blood is splashed in mucous membranes
More Actions if Exposed
• Report the exposure to your supervisor
• Call University Police at (864) 503-7777 so the
Director of Health Services can be contacted
Decontamination & Sterilization
• All surfaces, tools, equipment, and other
objects that come in contact with blood or
potentially infectious materials must be
decontaminated and sterilized as soon as
possible
• Equipment and tools must be cleaned and
decontaminated before servicing or being put
back to use
Decontamination of Surfaces
• A solution of sodium hypochlorite (household
bleach) dilution of 1:10 with water (1 part
bleach, 9 parts water) should be used to
decontaminate biological spills
Contaminated Clothing
• Remove clothing that is contaminated with
blood as soon as possible
• Use Universal Precautions when handling
contaminated laundry
• Place clothing in approved and labeled bags or
containers
Spill Cleanup
• Carefully cover the spill with paper towels or
rags
• Gently pour 10% solution of bleach over the
towels or rags. Let sit for 10 minutes
• Collect & dispose of waste
Broken Glassware
• Don’t pick up broken glassware with your
hands
• All contaminated broken glass should be
removed with a mechanical device and
discarded directly into a puncture-resistant
biohazard sharps container
Infectious Waste
• All sharps (needles, syringes, scalpels) must be
disposed in a sharps container
• NEVER put a sharp in the normal trash
• All contaminated waste must be placed in a
medical waste receptacle
Summary
• Always act as if you are working with infectious
materials using Universal Precautions
• Select the proper PPE to reduce the potential for
exposure to bloodborne pathogens
• Report all suspected exposures
• Don’t handle sharps or broken glass with your
hands
• Properly dispose of infectious waste, PPE, and
sharps
For additional information, see the
BBP Exposure Control Policy
You may now finish this safety training tutorial
by completing the OSHA Assessment Quiz