In common with anyone who works with young children, childcare providers are inevitably exposed to blood at some point in their working lives and, by extension, are at risk of exposure to bloodborne pathogens.
Children are prone to nose bleeds; they also frequently have slips and falls, suffer cuts and scrapes, and sometimes get into other dangerous situations as part of play.
So it’s very important that providers familairize themselves with the OSHA 29 CFR 1910.1020 Bloodborne Pathogens Standard and what is required of them and their staff to protect themselves and their charges from becoming infected.
bloodborne pathogens are transmitted through exposure to infected blood or body fluids that contain infected blood, and can cause serious diseases and infections.
Essential BBP info for Childcare Providers
Early educators and childcare providers are at risk of exposure to several infectious diseases that can be transmitted by bloodborne pathogen exposure. OSHA developed the Bloodborne Pathogens Standard 29 CFR 1910.1030 to prevent the transmission of human immunodeficiency virus (HIV), Hepatitis B virus, and others (Hepatitis C virus, Ebola).
The most common top three bloodborne pathogens are HIV/AIDS, Hepatitis B, and Hepatitis C.
They are transmitted through blood, semen, vaginal fluids and several other body fluid types that would usually only present a risk to healthcare workers. Urine, tears, sweat, and vomit do not transmit bloodborne diseases unless they are contaminated with infectious blood.
Performing first aid or CPR puts early educators and other staff that have contact with young children at risk for exposure to blood or other potentially infectious body fluids while at work. Because of this risk, the Bloodborne Pathogens (BBP) standard, applies to all staff who receive CPR and First Aid training.
Transmission of Bloodborne diseases in childcare settings
Fortunately, casual contact does not transmit bloodborne diseases. You cannot contract a bloodborne disease from touching, hugging or kissing; sharing pots, dishes, forks or spoons; using a public bathroom or swimming pool; or coughing or sneezing, so that’s great news for child care workers and kids alike!
In order to contract a bloodborne disease, blood or blood-containing body fluids from an infected person must be introduced directly into a person’s bloodstream via a needlestick, abrasion, cut or opening in the skin or through the mucous membranes of the eye, nose or mouth.
Childcare providers are typically exposed to bloodborne pathogens when performing certain activities like diapering, toileting, feeding or cleaning up the vomit of children in their care.
Childcare providers dealing with older children may be exposed when breaking up fights between children; or if bitten by a child.
Requirements of the BBP Standard
According to OSHA’s Bloodborne Pathogens Factsheet, the standard requires employers to:
- Establish an Exposure Control Plan which clearly outlines the steps taken to protect employees from exposure to bloodborne pathogens. The exposure control plan must be accessible to all employees at all times.
- Apply Universal Precautions by treating all blood and other potentially infectious material as if it is infected with bloodborne pathogens
- Use devices that are engineered for safety, such as puncture proof sharps disposal containers
- Implement work practices that reduce the risk of exposure, such as the methods used to complete hand washing procedures.
- Provide and ensure the use of Personal Protective Equipment (PPE), such as gloves, and eye protection.
- Make Hepatitis B vaccinations available to all employees at risk of exposure (i.e. all staff who are responsible for direct care or accompany children when they are off-premises)
- Offer medical evaluation and follow-up after any exposure at no cost to the worker
- Use labels and signs to communicate hazards
- Provide information and Bloodborne Pathogen training free to workers
- Maintain worker medical and training records.
Written Exposure Control Plan
The Bloodborne Pathogen Standard requires child-care facilities to protect employees by following a written Exposure Control plan. The plan should include:
- A list of employees may be at risk
- how the exposure control program will mitigate these risks
- What to do if a situation occurs that puts an employee at risk.
- The Exposure Control Plan must be reviewed annually, and updated if necessary.
Hepatitis B vaccination protection
Employers must offer employees information about the Hepatitis B vaccine, including
- The effectiveness of the vaccine,
- safety information,
- how the vaccine is administrated
- the benefits of vaccination.
The hepatitis B vaccine must be offered at no cost to the employee. It must be offered within 10 days of starting employment. If the employee declines the vaccination, they must sign a standardized waiver form. If the employee changes their mind after declining the vaccination and decides they would like to be vaccinated the employer must offer the vaccination as soon as practically possible.
If providing first aid and CPR is not the primary job responsibility of an employee, employers are allowed, so long as their plan for doing so is detailed in their Exposure Control Plan, to offer the Hepatitis B vaccine after an incident involving blood exposure rather than at the beginning of employment.
More information is available on the OSHA Fact Sheet – Hepatitis B Vaccination Protection
The OSHA standard requires that employees receive training on bloodborne pathogens when they begin work, annually thereafter, and whenever new work tasks are introduced. This training should cover:
- How HIV, hepatitis B, and other bloodborne diseases are spread
- How to use universal standard precautions
- How to use work practice controls
- an orientation to the program’s Exposure Control plan
- reporting procedures and any other program policies
Newborns from Mothers with Bloodborne Viral Infections
Although slightly outside the main scope of this article, it is worth mentioning that the risk of mother to newborn infant transmission is a risk. As stated by Wiley-Liss, Inc 2007:
“Infants born from mothers with multiple blood-borne viral infections are at risk of multiple transmissions. Whether the risk of transmission of multiple infections increases with the number of viruses infecting the mother is still unknown. The aim of this study was to describe the risk of mother-to-infant transmission of multiple infections from multi-infected mothers. Sixty-four pregnant women infected by at least two viruses among human immunodeficiency virus-type 1 (HIV-1), hepatitis C virus, TT virus, and GB virus type C, together with their 64 infants, were studied. Maternal blood samples were collected in the third trimester of pregnancy and all infants were prospectively followed for evaluation of transmission within 3 months after birth and two times in the subsequent 24 months. Transmission of single and of dual infection from mothers infected by two viruses was, respectively, 10/40 (25%) and 5/40 (12.5%) and from mothers infected by three viruses 9/20 (45%) and 2/20 (10%). One (25%) infant infected by one virus was born from the four mothers infected by four viruses. Transmission of single or dual infection was not significantly associated with the number of viruses infecting the mother (P = 0.9) in the linear regression analysis. Present study suggests the absence of a synergistic effect from viral interactions toward mother-to-infant transmission of multiple infections and supports the hypothesis that transmission from multi-infected mothers is the result of the specific interaction between each virus and the host. These observations may be of clinical relevance in perinatal counseling.”
For this reason newborn screening programs are a great help in identifying potential issues related to mother/infant blood-borne virus transmission.
How to protect yourself
Follow these simple steps to protect yourself and your charges from bloodborne illnesses:
- Practice Universal Precautions. Remember, this means assuming that everyone, including the children in your care, are infected, and taking the appropriate precautions.
- Always wear disposable gloves when there is a chance of coming into contact with blood or other body fluids.
- Always wash your hands before putting on and after removing gloves.
- Get a Hepatitis B vaccination – this should be provided free by employers.
If you think you’ve been exposed
If you believe you have been exposed to a bloodborne pathogen, wash the affected area immediately with soap and water; then report the incident immediately to the appropriate personnel; and proceed immediately to your personal physician or the nearest emergency room.
The federal Occupational Health and Safety Administration’s (OSHA) exists to protect the health and safety of workers and ensure that employers protect their employees from work-related hazards, including exposure to diseases carried in the blood.
What bloodborne pathogens training course do childcare providers need to take?
The vast majority of childcare facility staff, teachers, daycare staff and other employees who care for the young will need to do the Bloodborne Pathogens: General Workplace course.
Certain staff who have particular medical responsibilities may need to take the Healthcare Worker course which has additional modules on blood cleanup amongst other things related to working in a healthcare environment, where exposure risk may be greater and different types of PPE may be used.
If you are an individual, you can take our course and be training within 30 seconds.