Bloodborne Pathogens: Be safe, not sorry

Sept. 1, 2002
Bloodborne Pathogens Be safe, not sorryBy Barb Zuehlke

Every day can be a challenge, but some days the challenges might be life-threatening. And because of those days, the Occupational Safety and Health Administration (OSHA) created regulation 29 CFR 1910.1030 regarding bloodborne pathogens.
OSHA determined that employees face a significant health risk due to occupational exposure to blood and other infectious materials as they may contain bloodborne pathogens.

Pathogens include HBV which causes hepatitis B; human immunodeficiency virus (HIV) which causes acquired immunodeficiency syndrome (AIDS); hepatitis C virus; human T-lymphotrophic virus Type 1; and pathogens causing malaria, syphilis, babesiosis, brucellosis, leptospirosis, arboviral infections, relapsing fever, Creutzfeldt-Jakob disease, and viral hemorrhagic fever.

These hazards can be minimized or eliminated through training, work practices, personal protective clothing and equipment, and signs and labels among other safety methods.

Training is the most effective means of reducing injury rates. And it should start with a written exposure control plan or policy. The plan should be reviewed annually to reflect new or modified procedures, technology, and equipment. New employees should be provided with training and recurrent training should be done on a regular basis as deemed necessary by the company as procedures and technology change to maintain safety.

The training program should include a copy of the regulation, and an explanation of its contents, along with an explanation of the epidemiology and symptoms of bloodborne diseases, an explanation of the modes of transmission of bloodborne pathogens, the employer's exposure control plan, a method to recognize tasks that may involve exposure, and methods to prevent or reduce exposure. A copy of the company's control plan should be provided to you.

Personal protection equipment
In situations that might involve exposure to bloodborne pathogens, it's important to ensure you have the appropriate personal protective equipment (PPE). This includes latex or protective gloves, masks, eye protection, and complete protective clothing. It is essential to have a barrier between you and the potentially infectious material.

It's important to have the necessary equipment, have it in good condition, and know how to dispose of it after use. Items can be allocated to each employee or stored in a central area for easy access. Garments and equipment should be placed in a designated area after use for cleaning, decontamination, or disposal. Containers should be closable, puncture-resistant, leak-proof on the sides and bottom, and marked with the appropriate biohazard label.

After removal of gloves or other PPE, employees should have access to handwashing facilities. Soap and running water are needed to adequately flush possibly contaminated material from the skin. As an interim measure antiseptic hand cleaner and a clean cloth or paper towel can be used until soap and water are more readily available or feasible to use.

While some companies make employees responsible for their own uniforms, this doesn't apply when there is the possibility of contamination. Special arrangements are usually made with an outside source to decontaminate and clean personal protective clothing at no cost to employees. A designated area or container should be clearly labeled to place worn or contaminated items.

Storage and handling

Whoever is responsible for cleanup should be on the alert and take the necessary protective measures. Broken glassware or objects shouldn't be picked up by hand, but swept or brushed into a receptacle. When moving contaminated materials, make sure containers are closed so that further contamination doesn't occur during storage or transport. Reusable containers shouldn't be opened, emptied, or cleaned manually which could increase employee injury.

Documentation and follow-up
If an incident does occur, it should be reported immediately so that the correct measures can be taken. Report it to your supervisor and the designated safety coordinator or staff medical personnel. Documentation should include the route of exposure, a description of the circumstances surrounding the exposure, and the identification of the source if possible.

An employee then should undergo confidential medical treatment so that blood testing can occur to evaluate the exposure status to hepatitis B (HBV) or human immunodeficiency virus (HIV). (See related sidebar.) The healthcare professional evaluating an employee should also have the medical records and vaccination status of the employee. All medical evaluations will be made by or under the supervision of a licensed physician or licensed healthcare professional. All laboratory tests must be conducted by an accredited laboratory at no cost to the employee.

Counseling is also an important part of the process. Employees should be made aware of any possible long-term conditions and if further evaluation or treatment will be required.

Work shouldn't be life-threatening. To ensure your safety, make sure you're aware of your company's policies. Know what's available in terms of personal protection equipment and use it when necessary.

The diseases Bloodborne pathogens can be transmitted through contact with infected human blood and other potentially infectious fluids such as semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, amniotic fluid, saliva, and any body fluid visibly contaminated with blood.Hepatitis B (HBV) is a virus that infects the liver. It is primarily transmitted through blood-to-blood contact. While it usually causes inflammation of the liver, it can lead to cirrhosis and liver cancer. While there is no cure, many people who contract the disease develop antibodies which help them get over the infection and provide protection from getting it again. The virus is very durable and can survive in dried blood for up to seven days.For this reason, maintenance personnel must be on the alert. The symptoms are like a mild flu. There is a sense of fatigue, possible stomach pain, loss of appetite, and nausea. As the disease progresses, jaundice (a yellowing of the skin and eyes) and a darkened urine will often occur. After exposure, it can take months for the symptoms to become noticeable. Loss of appetite and stomach pain usually appear within one to three months, but can occur after two weeks or as long as six to nine months after infection.Human immunodeficiency virus (HIV) causes AIDS or acquired immune deficiency syndrome. Once a person has been infected, it may be years before AIDS actually develops. It attacks the body's immune system and weakens it so it can't fight off other diseases. Treatment is improving but there is no known cure. The HIV virus is fragile and won't survive long outside the body. It becomes a concern when situations involve fresh blood or other bodily fluids. The chances of contracting HIV in a workplace environment are estimated at 0.4 percent. The devastating nature of the disease, however make safety concerns paramount. Symptoms vary but include weakness, fever, sore throat, nausea, headaches, diarrhea, a white coating on the tongue, weight loss, and swollen lymph glands. AIDS occurs in three stages: first when infected, second when symptoms begin to appear, and the third and final stage when the body becomes unable to fight off life-threatening diseases. If you believe you've been exposed or have experienced the symptoms listed above please contact your physician as soon as possible.