Protect Staff From Bloodborne Pathogen Contamination
Identify all employees whose job exposes them to blood.
Although nursing staff are the most at-risk, any worker handling sharp devices or equipment (scalpels, sutures, hypodermic needles, blood collection devices, or phlebotomy devices) is at risk. This would include all employees who provide first aid, clean up blood and other body fluid spills, wash contaminated laundry, decontaminate surfaces where human tissue, blood or body fluids are handled, who handle regulated waste.
Even public entities that are not providing healthcare or clinical services need to evaluate the possibility that employees will encounter needlestick contamination before thinking this doesn’t pertain to their staff. For instance, workers cleaning up the grounds in an area where intravenous drug users dispose of hypodermic needles (parks, playgrounds, schoolyards, streetscapes); housekeeping staff who empty trash and bag it; and program staff who work with people who have infections that can be transmitted through contact with blood and body fluids; and any employees who are required to provide first aid as part of their jobs (e.g., child care workers) are at risk.
Write an exposure plan
- The purpose of the plan is to limit employee’s occupational exposure to blood and other potentially infections materials (i.e., recreation staff providing first aid versus an employee assisting a co-worker with a nosebleed. The first is an occupational exposure, the second is not). Review and update the plan annually.
- Identify safety hazards that the entity’s employees face.
- Consider what can be done to remove, eliminate or isolate hazards.
- Determine how the organization will proceed to treat staff members who have been exposed to bloodborne pathogens or other potentially infectious materials (OPIM).
- Name a person who will be responsible for writing up an exposure incident and reporting it to OSHA, as appropriate.
- Track who was trained and when.
- Refer to www.osha.gov and read up on hazards and potential solutions.
- Include all employees whose job responsibilities expose them to blood.
- Offer training at no cost to staff members during their normal working hours.
- Include information about ways staff might be exposed, what personal protective equipment (PPE) to wear, how to dispose of the PPE and any infected items, how to identify biohazard waste containers, what to do immediately if they are contaminated.
- Make certain employees receive training before they are placed in a situation where it could be reasonably anticipated that they would be exposed to bloodborne pathogens as part of their job responsibilities.
- Label individual units of blood or blood products.
- Label regulated waste containers prominently with universal biohazard sign. Red bags or containers may be substituted for the labels.
- Provide personal protective equipment for exposure to blood (i.e., gloves, gowns, laboratory coats, masks, face shields, eye protection, mouthpieces, resuscitation bags, pocket masks, or other ventilation devices).
- Purchase appropriate PPE that does not permit blood or other potentially infectious materials to pass through to or reach the employee’s work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used.
- Insist that gloves be worn when contact with blood, mucous membranes, other potentially infectious materials (OPIM), or non-intact skin is anticipated, and when performing vascular access procedures, or when handling contaminated items or surfaces.
- Provide designated area or container for PPE storage, washing, decontamination or disposal.
- Prohibit eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses in work areas where there is the potential for exposure to bloodborne pathogens.
- Select needle devices with safer design features (i.e., a self-sheathing needle) to help prevent injuries before, during and after use.
- Require that staff members wash hands and other exposed skin with soap and hot water immediately after contact.
- Provide antiseptic cleaner and paper towels where sinks and soap are not available.
- Instruct staff to flush mucous membranes with water (15 minutes) if come in contact with blood or other potentially infectious materials.
NOTE: People who do not work in clinical settings (hospitals, medical, dental or emergency clinics) will usually have less personal protective equipment than those who do. For instance, personnel picking up trash where used intravenous needles might be scattered with litter and garbage or in weeds can be provided with heavy-duty work gloves and mechanical devices that allow them to pick up objects from the ground.
Housekeeping staff should be instructed only to remove trash by: lifting up a trash bag liner and sealing it, or dumping the waste container into a larger trash bag or container for disposal. They should be instructed NEVER to reach into a waste container to pull out or retrieve the contents.
Employees who work with members of the public who have a bloodborne disease (HIV, hepatitis A, B, or C or others) should be educated about safety issues, provided appropriate PPE, soap and sinks or antiseptic cleansers, and methods to interact with them without ostracizing them or endangering themselves.
Report Exposure Incidents
- Require employees report exposure incidents right away to permit immediate medical follow-up.
- Employers must provide free medical evaluation and treatment to employees who experience an exposure incident,
- OSHA standard requires the employer make the hepatitis B vaccine available, at no cost to the employee, to all employees who have occupational exposure to blood and other potentially infectious materials.
- Medical records must remain confidential between the employee and health care provider; they are not available to the employee.
Create a chart with person’s name; date of first training; HBV vaccination acceptance or rejection; date of annual in-service refresher training.
Federal Register (1991). Bloodborne pathogen rules and regulations. 29 CFR part 1910.1030. Vol. 56, No. 235
OSHA Bloodborne Facts: Hepatitis B Vaccine—Protection for You
OSHA Bloodborne Facts: Reporting Exposure Incidents
OSHA Hospital eTool — HealthCare Wide Hazards Module: Bloodborne Pathogens
OSHA Hospital eTool — HealthCare Wide Hazards Module: (Lack of) Personal Protective Equipment
OSHA Hospital eTool — HealthCare Wide Hazards Module: (Lack of) Universal Precautions
OSHA Hospital eTool — HealthCare Wide Hazards Module: Needlesticks/Sharps Injuries
OSHA Office of Training Education and Training Resources