• OSHA Bloodborne Pathogens Standard


    The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard, incorporating the Needlestick Safety and Prevention Act of 2000, is designed to protect at-risk employees from exposure to blood and other potentially infectious materials. Employees and healthcare workers covered by this standard include those who:

    Have direct patient/resident contact.
    Draw blood.
    Work with blood and other bodily fluid specimens.
    Handle contaminated equipment.


    BLOODBORNE PATHOGENS are viruses, bacteria, and other microorganisms in human blood or other potentially infectious materials that can cause disease in persons who are exposed to blood or other potentially infectious materials containing the pathogens. These microorganisms can cause diseases such as Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV), and many others.

    OSHA STANDARDS for reducing risks of bloodborne pathogens include:

    Implementation of a written Exposure Control Plan (ECP), designed to eliminate or minimize employee exposure, and ensures that employees with occupational exposure to bloodborne pathogens receive appropriate training. The training shall be provided to the employee free of charge and during work hours.

    Use of standard precautions during care of all patients/residents and all tasks that involve a reasonable likelihood for exposure to blood or body fluids.

    Use of personal protective equipment (PPE) whenever there is reasonable anticipation of exposure to blood or other potentially infectious materials.

    Hand washing after the removal of PPE; following contact with blood or other potentially infectious material; and/or prior to, or following, patient/resident care.

    Hand washing prior to or after patient/resident care.

    Use of safer needle devices and needleless devices to decrease needlestick or other sharps exposures.

    Implementation of engineering and work practice controls for proper handling and disposal of needles and other sharps to help prevent exposures.

    Avoid splashing, spraying, spattering, or creating droplets of blood or other fluids.

    Use of containers for transfer or disposal of anything contaminated with blood or infectious materials. The containers should display the biohazard label, be leak-proof and able to close.

    Discarding blood and other potentially infectious body substances in amounts sufficient to cause infection in red bags or containers labeled Infectious Waste or marked with the biohazard label.

    Use of health care organization-approved disinfectant on all contaminated items before use on another patient/resident.

    Appropriate use of Personal Protective Equipment, a health-care organization-approved disinfectant, and a blood spill kit for containing and cleaning spills of blood or body substances.

    A plan that ensures a Post-Exposure Evaluation and Follow up is in place to address exposure to blood or body fluids via needlestick, sharps injury, splash to mouth, nose or eyes, or to non-intact skin for all employees.

    A plan that ensures Hepatitis B vaccination has been given or is offered to all employees and health care workers who have the potential for occupational exposure to blood and other potential infectious materials.

    Prohibition of eating, drinking, applying cosmetics or lip balm, and/or handling contact lenses in work areas where there is a likelihood of occupational exposure to blood or other potentially infectious materials.

    STANDARD PRECAUTIONS

    Standard precautions require that all human blood and other potentially infectious materials be treated as if known to be infectious for HIV, HBV, HCV, or other bloodborne pathogens, regardless of the perceived “low risk” status of a source individual. These precautions are “standard” because they are used for all patients/residents, regardless of whether or not they have a diagnosis of infectious disease. OSHA's Bloodborne Pathogens Standard recommends that employers and all health care workers, including students implement standard precautions when dealing with blood and other potentially infectious materials, which have the capability of transmitting a bloodborne pathogen. Standard Precautions are used in the health care organizations to:

    Prevent the transmission of infectious agent among patients/residents and healthcare providers.

    The OSHA Bloodborne Pathogens Standards apply to blood or Other Potentially Infectious Material (OPIM), which includes:

    cerebrospinal fluid
    synovial fluid
    pleural fluid
    amniotic fluid
    pericardial fluid
    peritoneal fluid
    unfixed tissue or body organs other than intact skin
    semen
    vaginal secretions
    any body fluid contaminated with blood
    saliva in dental procedures
    body fluids in emergency situations that cannot be recognized
    blood, organs, and tissue from experimental animals infected with HIV or HBV

    Respiratory Hygiene/Cough Etiquette is a new component of Standard Precautions and is targeted at patients/residents and accompanying family members and friends with undiagnosed transmissible respiratory infections. They apply to any person with signs of illness including cough, congestion, rhinorrhea, or increased production of respiratory secretions when entering a healthcare facility. The concepts of respiratory hygiene and cough etiquette involve using control measures to prevent patients/residents with respiratory infections from transmitting their infection to others. These measures include asking coughing or sneezing persons to:

    Cover their mouth and nose with tissues and dispose of used tissues in waste containers.
    Use a mask if coughing (when a mask can be tolerated).
    Perform hand hygiene (wash with soap and warm water for 15 seconds or clean hands with alcohol-based hand product if hands are not visibly soiled) after contact with respiratory secretions.
    To stand or sit at least 3 feet from other persons, if possible.

    EXPOSURE

    An exposure is contact with blood or other potentially infections material with eyes, nose, mouth, nonintact skin, or parenteral contact, which is an injury that results in a piercing of the skin or mucous membranes, such as needlestick, bite, cut, or abrasion.

    Steps for Exposure to Blood or Other Potentially Infectious Material

    Immediately:

    Wash needlestick and cuts with soap and water.
    Flush splashes to the nose, mouth or skin with water.
    Irrigate eyes with clean water, saline, or sterile irrigates.
    Report exposure to your instructor, preceptor or supervisor.
    Seek medical evaluation because treatments are most likely to be effective if administered as soon as possible after the exposure.

    REFERENCES

    Department of Health and Human Services Center for Disease Control and Prevention. (2007). 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Retrieved from www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html.


    U.S. Department of Labor Occupational Safety & Health Administration. (n.d.). Bloodborne Pathogens and Needlestick Prevention. Retrieved from www.osha.gov/SLTC/bloodbornepathogens/index.html.


    U.S. Department of Labor Occupational Safety & Health Administration. (n.d.). Regulations (Standards - 29 CFR) Bloodborne pathogens. - 1910.1030. Retrieved from www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051.