Bloodborne Pathogens

OSHAX.org - The Unofficial Guide To the OSHA 1

Introduction
 Approximately 5.6 million workers in health
care and other facilities are at risk of
exposure to bloodborne pathogens such as
human immunodeficiency virus (HIV – the
virus that causes AIDS), the hepatitis B virus
(HBV), and the hepatitis C virus (HCV)
 OSHA’s Bloodborne Pathogens standard
prescribes safeguards to protect workers
against the health hazards from exposure to
blood and other potentially infectious
materials, and to reduce their risk from this
exposure

OSHAX.org - The Unofficial Guide To the OSHA 2

Who is covered by the
standard?
 All employees who could be “reasonably
anticipated” as the result of performing
their job duties to face contact with
blood and other potentially infectious
materials
 “Good Samaritan” acts such as assisting
a co-worker with a nosebleed would not
be considered occupational exposure

OSHAX.org - The Unofficial Guide To the OSHA 3

Some Workers Who are at
Risk
 Physicians, nurses and emergency room personnel
 Orderlies, housekeeping personnel, and laundry workers
 Dentists and other dental workers
 Laboratory and blood bank technologists and technicians
 Medical examiners
 Morticians
 Law enforcement personnel
 Firefighters
 Paramedics and emergency medical technicians
 Anyone providing first-response medical care
 Medical waste treatment employees
 Home healthcare workers

OSHAX.org - The Unofficial Guide To the OSHA 4

How does exposure
occur?
 Most common: needlesticks
 Cuts from other contaminated sharps
(scalpels, broken glass, etc.)
 Contact of mucous membranes (for
example, the eye, nose, mouth) or
broken (cut or abraded) skin with
contaminated blood

OSHAX.org - The Unofficial Guide To the OSHA 5

Exposure Control Plan
 Identifies jobs and tasks where occupational exposure
to blood or other potentially infectious material occurs
 Describes how the employer will:
Use engineering and work practice controls
Ensure use of personal protective equipment
Provide training
Provide medical surveillance
Provide hepatitis B vaccinations
Use signs and labels

OSHAX.org - The Unofficial Guide To the OSHA 6

 Exposure Control Plan
 Written plan required
 Plan must be reviewed at least annually to reflect
changes in:
 tasks, procedures, or assignments which affect exposure, and
 technology that will eliminate or reduce exposure
 Annual review must document employer’s
consideration and implementation of safer medical
devices
 Must solicit input from potentially exposed
employees in the identification, evaluation and
selection of engineering and work practice controls
 Plan must be accessible to employees

OSHAX.org - The Unofficial Guide To the OSHA 7

Universal Precautions
 Treat all human blood and certain body
fluids as if they are infectious
 Must be observed in all situations where
there is a potential for contact with blood
or other potentially infectious materials

OSHAX.org - The Unofficial Guide To the OSHA 8

 Engineering and
Work Practice Controls
 These are the primary methods used to control
the transmission of HBV and HIV
 When occupational exposure remains after
engineering and work practice controls are put
in place, personal protective equipment (PPE)
must be used

OSHAX.org - The Unofficial Guide To the OSHA 9

Engineering Controls
These controls reduce
employee exposure by
either removing the hazard
or isolating the worker.
Examples:
 Sharps disposal containers
 Self-sheathing needles
 Safer medical devices
Needleless systems
Sharps with engineered sharps injury protections

OSHAX.org - The Unofficial Guide To the OSHA 10

Safer Medical Devices

 Needless Systems: a device that does not use

needles for the collection or withdrawal of body
fluids, or for the administration of medication or
fluids
 Sharps with Engineered Sharps Injury
Protections: a non-needle sharp or a needle
device used for withdrawing body fluids,
accessing a vein or artery, or administering
medications or other fluids, with a built-in safety
feature or mechanism that effectively reduces
the risk of an exposure incident

OSHAX.org - The Unofficial Guide To the OSHA 11

Work Practice Controls
These controls reduce the
likelihood of exposure by
altering how a task is
performed. Examples:
 Wash hands after removing
gloves and as soon as
possible after exposure
 Do not bend or break sharps
 No food or smoking in work
areas

OSHAX.org - The Unofficial Guide To the OSHA 12

Personal Protective
Equipment
 Specialized clothing or
equipment worn by an
employee for protection
against infectious materials
 Must be properly cleaned,
laundered, repaired, and
disposed of at no cost to
employees
 Must be removed when
leaving area or upon
contamination

OSHAX.org - The Unofficial Guide To the OSHA 13

Examples of PPE

 Gloves
 Gowns
 Face shields
 Eye protection
 Mouthpieces and
resuscitation
devices

OSHAX.org - The Unofficial Guide To the OSHA 14

Housekeeping

Must develop a written schedule for cleaning and

decontamination at the work site based on the:
 Location within the facility
 Type of surface to be cleaned
 Type of soil present
 Tasks or procedures being performed

OSHAX.org - The Unofficial Guide To the OSHA 15

Housekeeping (cont’d)

Work surfaces must be

decontaminated with an
appropriate disinfectant:
 After completion of
procedures,
 When surfaces are
contaminated, and
 At the end of the work shift

OSHAX.org - The Unofficial Guide To the OSHA 16

Regulated Waste
Must be placed in closeable,
leak-proof containers built to
contain all contents during
handling, storing, transporting
or shipping and be appropriately
labeled or color-coded.

OSHAX.org - The Unofficial Guide To the OSHA 17

Laundry
 Handle contaminated laundry as
little as possible and use PPE
 Must be bagged or containerized
at location where used
 No sorting or rinsing at location
where used
 Must be placed and transported in
labeled or color-coded containers

OSHAX.org - The Unofficial Guide To the OSHA 18

Hepatitis B Vaccination
Requirements
 Must make available, free of charge at
a reasonable time and place, to all
employees at risk of exposure within
10 working days of initial assignment
unless:
employee has had the
vaccination
antibody testing reveals
immunity
 The vaccination must be performed
by a licensed healthcare professional

OSHAX.org - The Unofficial Guide To the OSHA 19

Hepatitis B Vaccination
Requirements (cont’d)
 Must be provided even if employee initially
declines but later decides to accept the
vaccination
 Employees who decline the vaccination must
sign a declination form
 Employees are not required to participate in
antibody prescreening program to receive
vaccination series
 Vaccination booster doses must be provided
if recommended by the U.S. Public Health
Service

OSHAX.org - The Unofficial Guide To the OSHA 20

What to do if an exposure
occurs?
 Wash exposed area with soap and
water
 Flush splashes to nose, mouth, or skin
with water
 Irrigate eyes with water or saline
 Report the exposure
 Direct the worker to a healthcare
professional

OSHAX.org - The Unofficial Guide To the OSHA 21

Post-Exposure Follow-Up
 Document routes of exposure and how exposure
occurred
 Record injuries from contaminated sharps in a
sharps injury log, if required
 Obtain consent from the source individual and
the exposed employee and test blood as soon
as possible after the exposure incident
 Provide risk counseling and offer post-exposure
protective treatment for disease when medically
indicated in accordance with current U.S. Public
Health Service guidelines
 Provide written opinion of findings to employer
and copy to employee within 15 days of the
evaluation

OSHAX .org – The Unofficial Guide to the OSHA

22
Biohazard Warning Labels
 Warning labels required on:
 Containers of regulated waste
 Refrigerators and freezers
containing blood and other
potentially infectious materials
 Other containers used to store,
transport, or ship blood or other
potentially infectious materials
 Red bags or containers may be
substituted for labels

OSHAX .org – The Unofficial Guide to the OSHA

23
Training Requirements
 Provide at no cost to employees
during working hours
 Provide at time of initial assignment
to a job with occupational exposure
and at least annually thereafter
 Additional training needed when
existing tasks are modified or new
tasks are required which affect the
worker’s occupational exposure
 Maintain training records for 3
years

OSHAX .org – The Unofficial Guide to the OSHA

24
Training Elements
 Copy of the standard
 Modes of transmission
 Site-specific exposure control plan
 Hazard recognition
 Use of engineering controls, work
practices and PPE
 Live question and answer sessions

OSHAX .org – The Unofficial Guide to the OSHA

25
Medical Recordkeeping
Requirements
 Employee’s name and social security number
 Employee’s hepatitis B vaccination status
 Results of examinations, medical testing, and post-
exposure evaluation and follow-up procedures
 Health care professional’s written opinion
 Information provided to the health care professional
 Employee medical records must be kept confidential
and not disclosed or reported without the employee’s
written consent (unless required by law)
 Medical records must be maintained for duration of
employment plus 30 years according to OSHA’s rule
governing access to employee exposure and medical
records

OSHAX .org – The Unofficial Guide to the OSHA

26
Sharps Injury Log
 Employers must maintain a sharps injury
log for the recording of injuries from
contaminated sharps
 The log must be maintained in a way that
ensures employee privacy and must
contain, at a minimum:
Type and brand of device involved in the incident
Location of the incident
Description of the incident

OSHAX .org – The Unofficial Guide to the OSHA

27
Summary

 OSHA’s Bloodborne Pathogens standard

prescribes safeguards to protect workers
against the health hazards from exposure to
blood and other potentially infectious materials,
and to reduce their risk from this exposure
 Implementation of this standard not only will
prevent hepatitis B cases, but also will
significantly reduce the risk of workers
contracting AIDS, Hepatitis C, or other
bloodborne diseases

OSHAX .org – The Unofficial Guide to the OSHA

28