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What are blood-borne pathogens?
Bloodborne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include but are not limited to, hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Needlesticks and other sharps-related injuries may expose workers to blood-borne pathogens. Workers in many occupations, including first responders, housekeeping personnel in some industries, nurses, and other healthcare personnel, all may be at risk for exposure to blood-borne pathogens.
What can be done to control exposure to blood-borne pathogens?
To reduce or eliminate the hazards of occupational exposure to blood-borne pathogens, an employer must implement an exposure control plan for the worksite with details on employee protection measures. The plan must also describe how an employer will use engineering and work practice controls, personal protective clothing and equipment, employee training, medical surveillance, hepatitis B vaccinations, and other provisions as required by OSHA’s Blood borne Pathogens Standard (29 CFR 1910.1030). Engineering controls are the primary means of eliminating or minimizing employee exposure and include the use of safer medical devices, such as needleless devices, shielded needle devices, and plastic capillary tubes.
How do I find out about employer responsibilities and workers’ rights?
Workers have a right to a safe workplace. The law requires employers to provide their employees with safe and healthful workplaces. The OSHA law also prohibits employers from retaliating against employees for exercising their rights under the law (including the right to raise a health and safety concern or report an injury). For more information see www.whistleblowers.gov or Workers’ rights under the OSH Act.
OSHA can help answer questions or concerns from employers and workers. To reach your regional or area OSHA office, go to the OSHA Offices by State webpage or call 1-800-321-OSHA (6742).
Small businesses may contact OSHA’s free On-site Consultation services funded by OSHA to help determine whether there are hazards at their worksites. To contact free consultation services, go to OSHA’s On-site Consultation webpage or call 1-800-321-OSHA (6742) and press number 4.
Workers may file a complaint to have OSHA inspect their workplace if they believe that their employer is not following OSHA standards or that there are serious hazards. Workers can file a complaint with OSHA by calling 1-800-321-OSHA (6742), online via eComplaint Form, or by printing the complaint form and mailing or faxing it to the local OSHA area office. Complaints that are signed by a worker are more likely to result in an inspection.
If you think your job is unsafe or if you have questions, contact OSHA at 1-800-321-OSHA (6742). Your contact will be kept confidential. We can help. For other valuable worker protection information, such as Workers’ Rights, Employer Responsibilities, and other services OSHA offers, visit OSHA’s Workers’ page.
Bloodborne pathogens, such as bacteria and viruses, are present in blood and body ﬂuids and can cause disease in humans. The blood-borne pathogens of primary concern are hepatitis B, hepatitis C, and HIV. These and other blood-borne pathogens are spread primarily through:
Direct contact. ■ Infected blood or body ﬂuid from one person enters another person’s body at a correct entry site, such as infected blood splashing in the eye. Indirect contact. ■ A person’s skin touches an object that contains the blood or body ﬂuid of an infected person, such as picking up soiled dressings contaminated with an infected person’s blood or body ﬂuid.
Respiratory droplet transmission. ■ A person inhales droplets from an infected person, such as through a cough or sneeze.
Vector-borne transmission. ■ A person’s skin is penetrated by an infectious source, such as an insect bite.
Follow standard precautions to help prevent the spread of blood-borne pathogens and other diseases whenever there is a risk of exposure to blood or other body ﬂuids. These precautions require that all blood and other body ﬂuids be treated as if they are infectious.
Standard precautions include maintaining personal hygiene and using personal protective equipment (PPE), engineering controls, work practice controls, and proper equipment cleaning and spill cleanup procedures.
TO PREVENT INFECTION, FOLLOW THESE GUIDELINES:
- Avoid contact with blood and other body ﬂuids.
- Use CPR breathing barriers, such as resuscitation masks, when giving ventilations (rescue breaths). Wear disposable gloves whenever providing care, particularly if you may come into contact with blood or body ﬂuids.
- Also wear protective coverings, such as a mask, eyewear, and a gown, if blood or other body ﬂuids can splash.
- Cover any cuts, scrapes or sores and remove jewelry, including rings, before wearing disposable gloves. Change gloves before providing care to a different patient.
- Remove disposable gloves without contacting the soiled part of the gloves and dispose of them in a proper container.
- Thoroughly wash your hands and other areas immediately after providing care. Use alcohol-based hand sanitizer where hand-washing facilities are not available if your hands are not visibly soiled.
- When practical, wash your hands before providing care.
TO REDUCE THE RISK 0F EXPOSURE, FOLLOW THESE ENGINEERING AND WORK PRACTICE CONTROLS:
- Use biohazard bags to dispose of contaminated materials, such as used gloves and bandages.
- Place all soiled clothing in marked plastic bags for disposal or cleaning.
- Biohazard warning labels are required on any container holding contaminated materials.
- Use sharps disposal containers to place sharps items, such as needles.
PREVENTING THE SPREAD OF BLOODBORNE PATHOGENS
- Clean and disinfect all equipment and work surfaces soiled by blood or body ﬂuids.
- Use a fresh disinfectant solution of approximately 1½ cups of liquid chlorine bleach to 1 gallon of water (1-part bleach per 9 parts water, or about a 10% solution) and allow it to stand for at least 10 minutes.
- Scrub soiled boots, leather shoes and other leather goods, such as belts, with soap, a brush and hot water. If worn, wash and dry uniforms according to the manufacturer’s instructions.
IF YOU ARE EXPOSED, TAKE THE FOLLOWING STEPS IMMEDIATELY:
- Wash needlestick injuries, cuts, and exposed skin thoroughly with soap and water.
- If splashed with blood or potentially infectious material around the mouth or nose, ﬂush the area with water.
- If splashed in or around the eyes, irrigate with clean water, saline or sterile irrigants for 20 minutes.
- Report the incident to the appropriate person identiﬁed in your employer’s exposure control plan immediately.
- Additionally, report the incident to emergency medical services (EMS) personnel who take over care.
- Record the incident by writing down what happened.
- Include the date, time, and circumstances of the exposure; any actions taken after the exposure; and any other information required by your employer.
- Seek immediate follow-up care as identiﬁed in your employer’s exposure control plan.
Occupational Safety and Health Administration (OSHA) regulations require employers to have an exposure control plan, a written program outlining the protective measures the employer will take to eliminate or minimize employee exposure incidents.
The exposure control plan guidelines should be made available to employees and should specifically explain what they need to do to prevent the spread of infectious diseases.
Additionally, OSHA requires that a hepatitis B vaccination series be made available to all employees who have occupational exposure within 10 working days of initial assignment after appropriate training has been completed. However, employees may decide not to have the vaccination. The employer must make the vaccination available if an employee later decides to accept the vaccination.
Post Exposure Evaluation and Follow-up Procedures will be as follows:
- Following a report of an exposure incident, the Agency shall refer the employee for consultation, serologic testing, treatment, and counseling, if necessary, and follow-up.
- The Agency will make immediately available to the exposed employee a confidential report of:
- Documentation of the route(s) of exposure and the circumstances under which the exposure incident occurred.
- Identification and documentation of the source individual, unless the employer can establish identification is not feasible or prohibited by state or local law.
- The Agency will assist in obtaining the source individual’s consent for serologic testing to determine HBV and HIV infectivity. If consent cannot be obtained, it will be established that legally required consent cannot be obtained.
- When the source individual is already known to be infected with HBV or HIV, testing for the source individual’s known HBV or HIV status need not be repeated.
- Results of the source individual’s testing shall be made available to the exposed employee and the employee shall be informed of applicable laws and regulations concerning disclosure of the identity and infectious state of the source individual.
- The exposed employee’s blood shall be collected as soon as feasible and tested after consent is obtained. If the employee consents to baseline blood collection but does not give consent at that time for HIV serologic testing, the sample must be preserved for 90 days. If, within 90 days of the exposure incident, the employee elects to have the baseline sample tested, such testing should be ordered as soon as possible.
- When post-exposure prophylaxis is determined by the physician to be medically indicated as per the standards of the U.S. Public Health Service, counseling and evaluation of the reported illness will be given.
- The Agency will ensure that the physician evaluating an employee after an exposure incident is provided with the following information:
- A copy of OSHA regulation 29 CFR.
- A description of the exposed employee’s duties as they relate to the exposure incident.
- Documentation of the route(s) of exposure and circumstances under which exposure occurred.
- Results of the source individual’s blood testing, if available.
- All medical records are relevant to the appropriate treatment of the employee including vaccination status.
- The Agency shall obtain and provide the employee with a copy of the written opinion for post-exposure and follow-up within 15 days of the completion of the evaluation. The physician’s written opinion for post-exposure evaluation and follow-up will be limited to the following information:
- The employee has been informed of the results of the evaluation.
- The employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials that require further evaluation or treatment.
- All other findings of diagnosis shall remain confidential and shall not be included in the written report.