Health: Bloodborne Pathogens

Hazard Overview: Human blood and body fluids can contain microorganisms—called bloodborne pathogens—that can lead to disease.  Exposure to bloodborne pathogens takes place in several ways:

1. Direct blood or body fluid contact through broken skin or mucous
2. Membranes (including the mouth, nose or eyes)
3. Needlesticks

Human immunodeficiency virus (HIV) and hepatitis B are two prevalent and deadly bloodborne diseases. Others include syphilis, malaria, babesiosis, brucellosis, leptospirosis, arboviral infections, relapsing fever and Creutzfeldt-Jakob (Mad Cow) disease.

Persons infected with HIV or Hepatitis B may not have any signs or symptoms of illness or even know they are sick.  When it comes to bloodborne pathogens, the “golden rule” is to always assume that all blood and body fluids are infectious; this is called taking Universal Precautions. Universal Precautions requires error on the side of safety rather than exposure.  Since there is currently no cure for HIV, AIDS or Hepatitis B, Universal Precautions should always be taken. Hepatitis B can live for a week on surfaces like countertops but HIV usually dies in minutes when exposed to air.

Potentially infectious materials include blood, semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, and any body fluid visibly contaminated with blood and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.  Also included are any unfixed tissue or organ other than intact skin from a living or dead human; HIV-containing cell or tissue cultures; organ cultures; HIV- or hepatitis B (HBV)-containing culture medium or other solutions as well as blood; and organs or other tissues from experimental animals infected with HIV or HBV.

Precautions:  If an employee might come in contact with blood and body fluids, then an exposure control plan should be developed, which may include the following components:

1. Exposure determination, which identifies jobs where workers face bloodborne exposure
2. Procedures for evaluating the circumstances surrounding an exposure incident
3. A schedule of how and when other provisions of the plan should be implemented, including methods of compliance, hepatitis B vaccination and post-exposure follow-up, training, and recordkeeping

Universal Precautions: Treat all body fluids/materials as if they were infectious. Engineering and administrative controls, such as safe needles, sharps disposal containers, hand washing and disinfection should be used if possible. Decontamination practices should be identified and disposal methods for contaminated materials (i.e., linens and needles) addressed.

Personal protective equipment, such as gloves, face shields, splash goggles, gowns, and one-way breather valves and breather bags for CPR, should be available.  Employees assigned to a job with exposure to blood or body fluids should have hepatitis B vaccination made available.

Employees should be trained initially upon assignment and annually thereafter. Training should include bloodborne diseases and their transmission, exposure control plan, engineering and work practice controls, personal protective equipment, hepatitis B vaccine, response to emergencies involving blood, how to handle exposure incidents, the post-exposure evaluation and follow-up program, and signs/labels/color-coding.