Table of Contents
INTRODUCTION ................................................................................................................ 2
BLOODBORNE DISEASES ............................................................................................... 2
HBV ................................................................................................................................ 2
HIV.................................................................................................................................. 3
W ORKPLACE TRANSMISSION............................................................................................. 3
MEANS OF TRANSMISSION ................................................................................................ 3
CONTAMINATED SURFACES .......................................................................................... 4
EXPOSURE CONTROL PLAN .......................................................................................... 4
WORK PRACTICE CONTROLS ........................................................................................ 4
AVOIDING NEEDLE-STICKS ................................................................................................ 5
HAND-WASHING................................................................................................................ 5
PERSONAL HYGIENE ......................................................................................................... 5
PERSONAL PROTECTIVE EQUIPMENT ......................................................................... 6
GENERAL RULES FOR PPE ............................................................................................... 6
RESUSCITATION DEVICES ................................................................................................. 7
GLOVES ........................................................................................................................... 7
HOUSEKEEPING ............................................................................................................... 8
HBV VACCINATION .......................................................................................................... 8
ADDITIONAL INFORMATION ........................................................................................... 9
QUIZ ................................................................................................................................. 10
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Bloodborne Pathogens
Bloodborne Pathogens
Introduction
There once was a time when you could come to the rescue of a co-worker
without much thought given to your own safety. Unfortunately, today that
is no longer the case due to bloodborne pathogens. When most people
think of bloodborne pathogens, or diseases transmitted through contact
with blood or other body fluids, HIV (human immunodeficiency virus) and
AIDS (acquired immunodeficiency syndrome) are the diseases that most
readily comes to mind. However, there is another disease that is just as
deadly, called HBV or hepatitis B virus. In fact, you’re more likely to be
infected with HBV in the workplace than with HIV or AIDS.
The Occupational Health and Safety Administration (OSHA) has
developed and implemented a standard designed to protect you from
bloodborne pathogens called 29 CFR 1910.1030. It details how you and
your employer can reduce your risk of contracting a bloodborne disease
while on the job. You are covered under this standard if it is reasonably
anticipated that you could be exposed to bloodborne pathogens while
performing your job.
Bloodborne Diseases
While on the job, you could be exposed to any number of bloodborne
diseases, including non-A hepatitis, non-B hepatitis, delta hepatitis,
syphilis, and malaria, among other diseases. However, the two most
significant are HBV and HIV.
HBV
Hepatitis B virus attacks the liver, one of the body's organs that detoxifies
the blood. HBV can be very damaging, leading to cirrhosis in the
advanced stages and almost certain death. Unlike HIV or AIDS, hepatitis
B virus can be cured if caught in time. There is even a vaccine to prevent
infection with HBV, which may result in one or more of the following:
 Flu-like symptoms that become so severe that hospitalization is
required.
 No symptoms at all, thus making you unaware that you are
infected.
 Blood, saliva, and other body fluids may be infectious. Body fluids
DO NOT include sweat or tears.
 It is possible to spread the virus to sexual partners, family
members, and unborn infants.
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Bloodborne Pathogens
HIV
The human immunodeficiency virus attacks the body’s immune system,
leaving it vulnerable to any number of diseases that normally would not be
dangerous or deadly to human beings. Once a person becomes
susceptible to these illnesses and diseases, they have what is known as
AIDS, or Acquired Immune Deficiency Syndrome. There currently is no
cure or vaccine for HIV or AIDS. Infection with HIV results in one or more
of the following:
 May carry the virus without developing symptoms for several years.
 Will eventually develop AIDS.
 May suffer from flu-like symptoms, fever, diarrhea and fatigue.
 May develop AIDS-related illnesses including
problems, cancer and other opportunistic infections.
neurological
HIV is transmitted primarily through sexual contact, but may also be
transmitted through contact with blood and some body fluids. HIV is NOT
transmitted by touching or working around people who carry the disease.
Workplace Transmission
In the workplace, bloodborne pathogens can be transmitted in a multitude
of ways. HBV, HIV, and other pathogens may be present in:
 Body fluids such as saliva, semen, vaginal secretions,
cerebrospinal fluid, amniotic fluid, blood, and other body fluids.
Body fluids DO NOT include sweat and tears.
 Unfixed tissue or organs other than intact skin from living or dead
humans.
Means of Transmission
There are a number a ways that bloodborne pathogens can be
transmitted in the workplace. Some of the most common include:
 Accidental injury with a sharp object contaminated with infectious
material. This would include needles, broken glass, nails, and
sharp metal edges.
 Indirect transmission, such as touching a contaminated surface or
object and transferring the infectious material to open cuts, nicks
and skin abrasions, as well as the mucous membranes of the
mouth, eyes or nose.
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Bloodborne Pathogens
Contaminated Surfaces
Keep in mind, just because there is no visible blood or other body fluids
on a surface where there has been a spill does not mean that a
bloodborne pathogen is not lingering, waiting for a host. HBV is an
extremely hardy virus, able to survive on a dry surface at room
temperatures for at least a week. It is able to do this by forming a cyst, or
a cocoon-like shell that maintains a moist environment within the shell
allowing the virus to survive. This cyst, when picked up by a host,
deteriorates when it comes into contact with fluid, releasing the virus into
the host body.
Because of this potential, it is important that the area is cleaned and
disinfected with a strong disinfectant, such as bleach, as soon as possible
after an accident.
Exposure Control Plan
As stated before, due to the seriousness of bloodborne diseases in the
workplace, OSHA has developed a standard to help employers minimize
the risks to their employees. Under the standard, 29 CFR 1910.1030,
your employer needs to have a written exposure control plan. A copy of
this plan should be available to you at your request. This plan will cover
the following:
 Identification of employees covered by the standard.
 Specific measures you and your facility must take to minimize your
risk of exposure.
 Procedures to follow if there is an exposure incident.
A written program can only identify the problems and list the procedures
needed to safely address those problems. It is up to you to follow
procedures. You are ultimately responsible for you own safety, not your
supervisor or your company. Familiarizing yourself with the written
program and knowing what to do BEFORE an incident occurs are two
steps towards taking responsibility for your own safety.
Work Practice Controls
There are specific procedures to follow in order to reduce your exposure
to bloodborne pathogens or infectious materials. The following are general
procedures, intended to be informative. Consult your company’s written
program to know the specific procedures to be used.
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Bloodborne Pathogens
Avoiding Needle-sticks
 Do not bend, recap, shear or break contaminated needles and
other sharps.
Remember that all used needles should be
considered contaminated.
 Recap or remove contaminated needles from disposable syringes
only when medically necessary.
To recap needles, use a
mechanical device, such as forceps, or a one-handed technique.
 Place disposable and reusable contaminated sharps in an
appropriate puncture-resistant, leak-proof container immediately
after use.
 Report any sharps containers that are mounted too high or
otherwise not easily accessible.
Hand-washing
If infectious material gets on your hands, the sooner you wash it off, the
less chance you have of becoming infected. The following work practices
will help reduce your risk:
 Every time you remove your gloves you must wash your hands with
a non-abrasive soap and running water as soon as possible.
 Wash or flush skin or mucous membranes as soon as possible if
there is a direct contact with blood or other body fluids.
 Where hand-washing facilities are not available, such as an
emergency medical van, your employer will provide an antiseptic
hand cleanser or antiseptic towelettes. Use these as a temporary
measure only. You must still wash your hands with soap and water
as soon as you can.
Personal Hygiene
Additional self-protective controls should be followed; most of which would
appear to be common sense. These would include:
 When working around blood or other potentially infectious
materials, minimize splashing, spraying, and splattering as much as
possible.
 Do not eat, drink, smoke, or apply cosmetics or lip balms, or handle
contact lenses where you may be exposed to blood or other
potentially infectious materials.
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Bloodborne Pathogens
 Avoid petroleum-based lubricants that may eat through latex
gloves. Applying hand cream is OK if you thoroughly wash your
hands first.
 Don’t keep food and drinks in refrigerators, freezers, and cabinets
or on shelves, countertops or bench-tops where blood or other
potentially infectious materials may be present.
Personal Protective Equipment
Under normal work conditions, personal protective equipment (PPE) must
not allow potentially infectious materials to contact your clothing, skin or
mucous membranes. The type of PPE used for a given task depends on
the degree of exposure you anticipate. Such equipment would include
gloves, masks, gowns, protective eyewear, resuscitation bags or other
ventilation equipment.
If your job requires you to be exposed to potential bloodborne pathogen
containing material, your employer will:
 Provide appropriate protective equipment at no cost to you.
 Clean, launder, repair, replace or dispose of PPE at no cost to you.
General Rules for PPE
Certain rules have been developed to insure that your protective
equipment does its job. Both you and your employer must follow these
guidelines.
 You must be trained in the proper use of the equipment.
 The equipment must be appropriate for the task.
 You must use appropriate equipment each time you perform a task.
 Your equipment must be free of physical flaws that could
compromise safety.
 Your gloves must fit properly.
 If, when wearing equipment, blood or other potentially infectious
materials penetrate it, remove it as soon as feasible.
 Before leaving the work area, remove all protective equipment and
place it in a designated area or container for washing,
decontamination or disposal.
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Bloodborne Pathogens
There is an exception to these rules. If you believe the use of PPE would
prevent proper delivery of medical attention, or jeopardize your safety or
that of a co-worker’s, you may temporarily and briefly abandon its use in
an emergency. After the incident, your employer must investigate the
circumstances to determine if such a situation could be prevented in the
future. The use of PPE is required under all other circumstances.
Resuscitation Devices
Mechanical emergency respiratory devices and pocket masks are types of
PPE designed to isolate you from contact with a victim’s saliva during
resuscitation. Avoid unprotected mouth-to-mouth resuscitation. The
person may expel saliva, blood, or other body fluids during resuscitation.
Gloves
Gloves are the most widely used forms of personal protective equipment.
They act as a primary barrier between your hands and bloodborne
pathogens. Latex or vinyl gloves are used most frequently. Heavy-duty
utility gloves should be used for housekeeping duties.
There are certain guidelines governing the use of gloves, and they include
the following:
 You must wear gloves when you anticipate hand contact with
blood, potentially infectious materials, mucous membranes or noncontact skin.
 If you are allergic to latex or vinyl gloves, your employer will provide
hypoallergenic gloves, glove liners, powder-less gloves or another
alternative.
 Since gloves can be torn or punctured by sharps, bandage any cuts
before being gloved.
 Replace disposable single-use gloves, such as examination gloves,
as soon as possible if contaminated, torn, punctured or damaged in
any way. Never wash or decontaminate for reuse.
 Utility gloves may be decontaminated and reused unless they are
cracked, peeling, torn, punctured, or no longer provide barrier
protection.
Taking gloves off would at appear to be a relatively easy thing to do.
However, there is a safe procedure for glove removal that must be
followed. It is designed to limit the potential for exposure from soiled
gloves and is as follows:
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Bloodborne Pathogens
1. With both hands gloved, peel one glove off from top to bottom and
hold it in the gloved hand.
2. With the exposed hand, peel the second glove from the inside, tucking
the first glove inside the second.
3. Dispose of the entire bundle promptly.
4. Remove gloves when they become contaminated, damaged or before
leaving the work area.
5. Wash your hands thoroughly.
Housekeeping
In your facility’s Exposure Control Plan, specific housekeeping procedures
should be addressed. Here are some general rules:
 Clean and decontaminate at the end of each work shift.
 Clean all equipment and environmental working surfaces as soon
as possible after contact with potentially infectious materials.
 Do not pick up broken glass that may be contaminated with gloved
or bare hands. Use tongs or a brush and a dustpan.
 Place contaminated sharps and infectious wastes in designated
sharps containers. The containers should be labeled or colorcoded leak-proof containers that are sealed and easily accessible
to those who use them. Do not allow containers to over-fill.
 Handle contaminated laundry as little as possible and with minimal
agitation. Place soiled laundry in labeled or color-coded leak-proof
bags or containers without sorting or rinsing.
Container labels for potentially infectious materials must have a readily
visible biohazard warning sign or symbol. Such a label should also be
used to designate contaminated equipment.
HBV Vaccination
As a designated first responder, should you be exposed to blood or other
infectious materials, your employer will make the hepatitis B vaccination
available to you at no cost. Administration of the vaccination should begin
within 24 hours of exposure. A complete series of vaccinations includes
three injections over a six-month period. Such a vaccination is highly
effective in preventing the development and carrying of the hepatitis B
virus for nine years or longer.
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Bloodborne Pathogens
You should not be vaccinated if:
 You have already received the complete hepatitis B vaccination
series.
 Antibody testing reveals you are immune.
 There are other specific medical reasons.
Additional Information
 If you are exposed, report the incident immediately to your
supervisor.
 If you consent, your employer will provide you with a confidential
medical evaluation, including blood tests, any available postexposure preventive treatment and follow-up counseling.
 Your employer will provide you with a free training program during
working hours before you assume a job with occupational exposure
and annually thereafter.
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Bloodborne Pathogens
Quiz
Name _________________________
Circle the appropriate response to the following:
1) True
False
The hepatitis B virus is easily cured.
2) True
False
HIV and HBV may be present in body fluids
other than blood.
3) True
False
A broken windshield is considered a potentially
contaminated sharp.
4) True
False
You can find your employer’s Exposure Control
Plan at the local library.
5) True
False
When recapping needles, it is important to use
two hands.
Circle the letter that most correctly answers the question or statement.
6) Which of the following is not a potential route of entry into the body for
bloodborne pathogens.
a) facial acne
b) cold sore
c) skin absorption
d) hangnail
7) If you are exposed to blood or other body fluids without proper PPE,
you should report the incident to your supervisor:
a) immediately
b) sometime within 4 hours
c) just before you leave work
d) wait to see if you develop symptoms
8) The only time that you do not have to wear PPE is:
a) when it is uncomfortable
b) when it is not fashionable to do so
c) if the victim tells you that they do not have a bloodborne pathogen
d) if use of the equipment will prevent proper medical attention or is a
safety hazard
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9) A rule governing the use of PPE would be:
a) it must be appropriate for the task
b) it must be color coordinated
c) it must comfortable to wear at all times
d) it must be reusable
10) What is not true about HBV vaccinations?
a) must be made available at no cost if you have been exposed to
blood or other body fluids
b) is a series of three injections
c) only good for 1 year
d) must be administered within 24 hours of exposure
11) Describe the five steps for safely removing gloves.
12) List three means of transmission for bloodborne pathogens.
13) What bloodborne pathogen can exist on a dry surface for at least a
week?
14) Name the two most significant bloodborne diseases in the workplace.
15) What are the five major tactics used to reduce your risk of exposure?
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