Activities involving blood, blood samples and other body fluids
Hazards:
Laboratory workers may intentionally handle blood, blood products, body fluids, or be exposed to contaminated items and equipment. Cleaning staff and other college workers may also be exposed to blood contaminated articles. First aiders and others who treat casualties may be exposed to blood or blood soaked dressings.
The hazards of blood include:

Disease caused by contact with blood carrying infectious viruses

Especially Human immunodeficiency viruses HIV1 and HIV2 and

Hepatitis viruses HBV, HCV, and HDV;

Infection of the exposed person without signs and symptoms of disease;

Bacterial infections such as syphilis;

Parasitic infections such as malaria.
Risk Factors:

Collecting, handling or working with blood or other samples from individuals in high risk categories or those from high risk populations
(injecting drug users, those from populations where blood borne infections are endemic, those suffering from jaundice);

Handling articles (including needles, discarded dressings and sanitary dressings, clothing and bedding) or equipment contaminated with blood or body fluids from an infected person or person in an high risk category with bare hands;

Accidental injection by handling blood contaminated needles or other sharp objects that are improperly discarded;

The presence of unprotected wounds, abrasions or scratches on the hands, arms or face which may come into contact or be splashed when working with blood or blood contaminated articles;

Touching the mouth or eyes with hands or fingers or with gloved hands which may be contaminated;

First aid treatment of casualties resulting in splashing of large amounts of blood onto unprotected skin.
Risk Control Measures:
1. Treat all blood, blood or human tissue samples as if they are infected with a blood-borne pathogen;
2. Containment level 2 laboratory facilities must be the minimum requirement for work involving blood, blood products or other human tissue unless the infectious agent is to be intentionally propagated or concentrated when other control measures may be needed.
3. Avoid the use of sharp objects, such as needles and glassware where possible, if their use is unavoidable handle all such items with care and disinfect or safely dispose of them as soon as possible after use;
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4. Wear gloves and other personal protective clothing when handling bloodstained articles, clearing up blood spills and splashes, and when carrying out first aid, if the casualty is bleeding heavily, carefully remove personal protective clothing after use and place in a detergent or disinfectant solution, autoclave bag or clinical waste container for incineration, gloves should be items of clothing removed last, if they are contaminated keep the gloves on whilst you wash them with soap and water.
5. Wear heavy-duty re-usable gloves e.g. of thick rubber or leather when handling contaminated waste or waste bags or bins which may contain discarded needles, glass or plastic items;
6. Do not re-sheath needles unless using a safe procedure, do attempt to bend or break any needle or sharp object but dispose of it as soon as possible into an appropriate ‘sharps’ or puncture resistant container.
7. Do not eat, drink, smoke apply cosmetics in any area where blood or blood products are handled or where blood-stained articles may be present;
8. Carry or transport blood and other human tissues and samples only in effectively sealed, robust labelled containers, samples of high risk origin should be put into sealed plastic bags which are then placed in a leakproof plastic box or tray if it is to be moved to another work room or laboratory unless it has been made safe by autoclaving or disinfection;
9. give first aid to heavily bleeding casualties after putting on disposal gloves and apron and according to the adv ice of the Red Cross and St. John’s ambulance Societies;
10. Decontaminate used samples, stained equipment and surfaces as soon as possible after use, sterilisation by autoclaving, disinfection using hypochlorite, other chlorine-releasing agents, formaldehyde or glutaraldehyde, or in the case of contaminated clothing by laundering;
11. Wash blood splashes from exposed skin (e.g. hands and face) without delay using soap and water, puncture or other wounds caused by bloodstained articles should be encouraged to bleed (e.g. by gently squeezing the skin around the wound) for a few minutes then covered with a dry dressing before immediately seeking medical advice;
12. Those who are regularly at risk of exposure to blood-borne infections and those who occasionally handle blood or human tissue from a high risk source should receive HBV immunisation.
Persons at Special Risk:
Provided that the safety precautions listed above are adopted there should be no persons at special risk. However, those who regularly collect blood samples from infected high risk persons (phlebotomists and laboratory staff) may be at moderate risk.
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Health Surveillance:
Those at moderate risk should be given HBV immunisation; those who receive injuries from blood contaminated needles or items should receive medical attention without delay and may be given prophylaxis and counselling.
Exclusions:
This model assessment may not be suitable for work where blood-borne pathogens are intentionally propagated or concentrated or there is risk of aerosolisatiion of any blood-derived product or human tissue.
Relevant Statutory Provisions and Other Guidance:

Control of Substances Hazardous to Health (COSHH) Regulations,2002, as amended
 http://www.hse.gov.uk/coshh/index.htm
HSE COSHH home page:
 http://www.hse.gov.uk/pubns/misc208.pdf
Classification of Biological Agents 2004
 http://www.hse.gov.uk/biosafety/infection.htm
HSE Infections in the workplace home page.
 http://www.hse.gov.uk/pubns/indg342.pdf

HSE guidance on blood borne viruses in the work place
 http://www.hse.gov.uk/biosafety/biologicalagents.pdf
Biological agents, managing the risks in labs & healthcare premises
 http://www.dh.gov.uk

TSE, safe working & prevention of infection, ACDP & SEAC, 2003
 http://www.hsebooks.com
Management & design of microbiological containment laboratories,
ACDP & HSE 2003
 http://www.hsebooks.com
Safe working and the prevention of infection in clinical laboratories & similar facilities, HSAC & HSE, 2003

Protection against blood-borne infections in the workplace: HIV and hepatitis, ACDP, 1995

The safe use and disposal of sharps, British Medical Association, 1990.

BS 7320:1990 Sharps containers, British Standards Institution.
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