Workers who are exposed to bloodborne pathogens must use appropriate personal protective equipment (PPE) to protect themselves from dangerous microorganisms. PPE refers to specific garments or equipment that protect you from being exposed to blood or other potentially infectious materials (OPIM). Through the use of personal protective equipment, blood and other potentially infectious materials are shielded away from your skin, eyes, nose and mouth.
Infectious microorganisms in human blood that can cause disease in humans are termed bloodborne pathogens. Hepatitis B (HBV), hepatitis C (HCV), and the human immunodeficiency virus (HIV) are examples of these pathogens. Pathogens can infect employees through numerous exposure risks, primarily through occupational exposure or job-related contact with human blood.
Which Bloodborne Pathogens are the most common?
Approximately 20 different infections have been associated with the spread of bloodborne infections. The most common bloodborne viruses that pose a threat to health care workers are the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV).
When personal protective equipment is not available or accessible, employees are less likely to use it. As a consequence, individuals are at risk of coming into contact with blood and bodily fluids, along with being subjected to the following blood-borne viruses:
1. Human immunodeficiency virus (HIV)
The Human Immunodeficiency Virus (HIV), according to the Centers for Disease Control and Prevention (CDC), weakens the immune system until it can no longer fight infection. Weight loss, low-grade fever, night sweats, and flu-like symptoms are all signs that a person’s immune system is compromised.
2. Hepatitis B virus (HBV)
Hepatitis B virus is a long-term infection that affects roughly 5% of adult patients and is linked to a 20% lifetime risk of developing cirrhosis and a 6% lifetime risk of dying from liver cancer. Its symptoms include jaundice, nausea, fever, abdominal pain.
3. Hepatitis C virus (HCV)
Because there is no vaccine for HCV, it is a pathogen of great importance in cases of occupational risk. In addition, the hepatitis C virus causes serious liver damage that can be fatal. Infection can present itself with no symptoms or with very minimal ones.
What is Personal Protective Equipment for Bloodborne Pathogens?
All healthcare personnel may encounter a variety of occupational hazards. Hence, it is common to come into contact with different fluids and hazardous substances, including blood, when working with sick and infected individuals. Aside from blood, the OSHA bloodborne pathogen standard includes the following body fluids and substances:
- Amniotic fluid
- Cerebrospinal fluid
- HBV or Hepatitis B virus-containing culture materials or other solutions
- HIV or Human immunodeficiency virus-infected cell, tissue, or organ cultures
- Pericardial fluid
- Peritoneal fluid
- Pleural fluid
- Saliva from Dental Procedures
- Synovial fluid
- Tissue, blood, or organs from HIV-infected or HBV-infected experimental animals
- Tissues or organs that have not been fixed and do not have intact skin from living or deceased individuals
- Vaginal Secretions
Bloodborne illnesses such as the hepatitis B virus (HBV), the human immunodeficiency virus (HIV), which causes AIDS, and other pathogens can be contracted by workers who are exposed to blood and other potentially infectious materials on the job. In fact, each year, about 8,700 healthcare personnel become infected with HBV, with 200 of them dying as a result of the illness.
Although the chance of contracting HIV from workplace contact is low, wearing proper personal protective equipment can considerably reduce the chance of developing any bloodborne illness. Having the proper personal protective equipment, or PPE, for bloodborne pathogens, is essential for ensuring patient and worker safety and preventing the spread of possible infections.
Which Bloodborne Pathogen Exposures Requires PPE?
Employers must provide adequate personal protective equipment for their employees’ safety against blood-borne pathogens. Depending on the working area and conditions, the amount of PPE and the quantity of exposure can vary. Nevertheless, the following equipment should be provided to the employees to protect the well-being of the workers and patients:
- Eye and Face Shields
- Kits for Bloodborne Pathogens that include protective gear
- Laboratory coats
- Protective body clothing
- Resuscitation mouthpieces
- Safety Glasses with side shields
PPE for healthcare professionals must not permit the transmission of fluids in any circumstances. Employers must provide additional equipment in conditions where needles and other sharp instruments are being used to guarantee that nothing accidentally penetrates the skin.
Personal protective equipment should be stored in a designated space in the workplace for worn equipment, where it can be sanitized, washed, decontaminated, or disposed of according and depending to the manufacturer’s recommendations. Every PPE that has been contacted to blood or bodily fluids cannot be brought outside the workplace and cannot be washed at home. It should be washed either on-site or by an outside operator.
Dealing with Bloodborne Pathogens: OSHA and CDC Recommendations
The Occupational Health and Safety Administration (OSHA) and the Centers for Disease Control and Prevention (CDC) both have Bloodborne Pathogens regulations for dealing with bloodborne pathogens. These policies are designed to protect both workers and patients, and it is the employer’s responsibility to ensure that all personnel is properly protected.
Hence, universal precautions, standard precautions, and transmission-based precautions are all important approaches to infection prevention that employers and employees should be acquainted with.
Universal Precautions (UP)
As first proposed in the 1980s by CDC, UP, or ‘Standard Precautions’ was proposed as an approach for infection management to protect workers from HIV, HBV, and other bloodborne viruses in human blood and other body fluids, regardless of a patient’s infection status. UP is an infection-control strategy in which all human blood and various body fluids are considered as though they are infectious. Despite the fact that UP is included in the BBP standard, infection control practitioners no longer employ it in their workplace precautions.
Listed below are the provision found under the Standard Precautions:
- Hand hygiene
- Contaminated equipment and other items in the patient’s environment must be handled with caution.
- Safe injection practices
- The application of specific forms of personal protective equipment (PPE) based on predicted exposure
Even if a patient is not known or suspected to be infectious, SP is administered to them.
Transmission-based precautions (TBP)
TBP is a supplement SP with additional controls for contact, droplet, and airborne-transmissible diseases to interrupt the route(s) of transmission which might not be entirely interrupted by SP alone. The various forms of TBP are used depending on what is known or suspected about the infection of a patient.
How do I Decontaminate and Dispose of Personal Protective Equipment?
To eliminate cross-contamination subsequently, all PPE must be disinfected, sanitized, or properly disposed of after each usage. Disposable aprons, gloves, and gowns are common examples of equipment designed for single use. Face shields and goggles, for instance, can be disinfected and reused. Here’s an overview of OSHA and CDC Personal Protective Equipment decontamination and disposal guidelines.
When blood or other bodily fluids are present, employees must clean areas as soon as possible with CDC-approved disinfectants and cleansers. Even if the worker is wearing gloves, it is recommended that tongs and other equipment be used to eliminate direct contact.
According to the Centers for Disease Control and Prevention (CDC), aerosols and sprays should be avoided since these could transmit germs by converting them into droplets in the air.
Regardless of whether or not the PPE is contaminated, it should be sealed and stored in leak-proof containers. Needles and other sharp objects should be placed in the appropriate safety bin to guarantee that they do not pose a risk.
All personal protective equipment (PPE) must be stored in properly sealed containers. Discarded materials must be segregated from those that will be cleaned and reused. A component that is damaged or worn must be properly disposed of.
Removal of PPE
Workers must properly wash their hands after removing all parts to prevent cross-contamination. Moreover, the workers must follow the order of removing PPE:
- Eye Protection
- Apron or Gown
- Surgical Mask
Industry Specific PPE
PPE requirements may differ in certain types of workplaced, for example tattoo studios and permanent cosmetic and micro-blading studios where slightly different standards are applied by OSHA to receive bloodborne pathogen certification for tattoo artists.
Bloodborne Pathogen Training
The Occupational Safety and Health Administration (OSHA) created the Bloodborne Pathogens Standard to protect all at risk employees from exposure to bloodborne pathogens.
What Does Bloodborne Pathogen Training Cover?
Free Bloodborne pathogens training teaches employees how to minimize their exposure to bloodborne pathogens through:
- Appropriate use of Personal protection equipment (PPE)
- Enforcing engineering controls, such as self-sheathing needles and sharps disposal containers
- Proper administration of safe work practices
- Standard precautions applications such as treating all blood and body fluids as though they were contagious
- Observing prescribed housekeeping procedures
Additionally, the fundamentals of the facility’s Exposure Control Plan should also be taught to the employees. As a first step in preventing infection, OSHA’s Bloodborne Pathogen Standard mandates businesses to prepare these control plans.
The plan should include a determination of each employee’s potential risk of exposure to bloodborne infections, as well as how the facility will satisfy the OSHA regulation’s requirements. Unless employees engage in a facility where they may come into contact with blood or blood-related products, the Exposure Control Plan will include how they can get Hepatitis B vaccinations under their employer’s vaccination program.
As part of the training, the instructors should present an overview of all labels and signs used in the working environment to indicate hazards. The following are included in the hazards with labels:
- Containers of:
- Equipment that has been contaminated and is being exported or serviced
- Laundry with contaminants
- Contaminated reusable sharps
- Sharps that are reusable and that have been contaminated
- Refrigerators and freezers which contains blood or OPIM
Who needs bloodborne pathogens training and how often is training conducted?
All employees who may be exposed to bloodborne pathogens in the workplace must receive training. This includes employees who work in a variety of industries, such as first responders, housekeepers, nurses, and other healthcare professionals, who could be affected.
On the other hand, training should be given by employers before the employee begins to work and whenever there are new or revised tasks or processes that may increase the risk of occupational exposure. To keep their free bloodborne pathogens certification, those who finish the training must retrain every year.
What is OSHA’s Bloodborne Pathogens Standard?
The Bloodborne Pathogens Standard applies to all employees who are exposed to bloodborne pathogens at the their workplace, either as a result of job-related exposure to blood or other potentially infectious materials or as a result of an accident.
Employers must, in general, comply with the following requirements:
1. Creating an exposure control plan
This is a documented plan that aims to eliminate or reduce workplace risks. The employer must provide an exposure determination that includes a list of job classifications where all workers are exposed and a range of job classifications where just some workers are exposed, as well as a description of the activities and procedures done by those workers that lead in their exposure.
Changes in tasks, methods, and roles that impact occupational exposure must be recorded, as well as technological advancements that eliminate or reduce the need for occupational exposure, should be indicated. Moreover, employers should also document in the plan on an annual basis that they have examined and started implementing relevant, commercially available, efficient better medical technologies to eliminate or reduce occupational exposure.
Employers must also indicate that they consulted frontline employees when defining, evaluating, and selecting appropriate engineering and work practice controls.
2. Identifying and employing engineering controls
These are systems that exclude or eliminate the threat of bloodborne microorganisms in the workplace. Sharps disposal containers, self-sheathing needles, and safer medical devices, including sharps with engineered sharps-injury protection and needleless systems, are among the items on the list.
3. Appropriate Personal Protective Equipment (PPE) Usage
This includes the distribution of gloves, gowns, eye protection, and masks. Employers are responsible for maintaining, repairing, and replacing this equipment as needed. The worker is not charged for provision, maintenance, repair, or replacement.
4. Hepatitis B vaccinations
Hepatitis B vaccinations must be available to all workers who are exposed to the pathogens at work. After the individual has obtained the required bloodborne pathogens training and within 10 days of being assigned to a job with occupational exposure, this vaccination must be given.
5. Post-exposure exam and follow-up for each occupationally exposed worker
Any specific eye, mouth, other mucous membranes, non-intact skin, or parenteral contact with blood or OPIM is defined as an exposure contact. Moreover, this regulation includes the following:
- During the evaluation and follow-up, it must be provided to the employees without charge. Moreover, it must also encompass records and documentation of the employees’ exposure routes and the circumstances surrounding the exposure.
- Unless the source individual consents or the legislation does not demand consent, detecting and screening the source individual for HBV and HIV immunogenicity.
- Blood samples from exposed workers are collected and analyzed with their permission.
- Providing Prophylaxis for post-exposure
- Assisting; and assessing diseases that have been reported.
All diagnoses must be kept confidential, and the healthcare provider shall provide the employer with a limited written opinion.
6. Communicating hazards through the use of labels and signs
Containers containing regulated waste must have warning labels attached to them:
- Contaminated reusable sharps containers
- Blood or OPIM-containing refrigerators and freezers
- Other containers for storing, transporting, or shipping OPIM or blood
- Equipment that is being shipped or serviced and is contaminated
- Contaminated laundry bags or containers, unless otherwise specified in the specification.
7. Record keeping of medical and training records of employees
Unless it is excluded under Title 29 of the Code of Federal Regulations, Part 1904 — Recording and Reporting Occupational Injuries and Illnesses, the employer must also keep a sharps injury log.
Through the bloodborne pathogen standard and the use of Personal Protective Equipment or PPE, you will be able to maximize safety for yourself and those around you. Training is required for employees in all industries who are at risk of occupational exposure to bloodborne pathogens – you can take free bloodborne pathogen training right here by entering your email below.