OSHA’s standard "Occupational Exposure to Bloodborne Pathogens" (29CFR 1910.1030) was designed to limit occupational exposure to human blood and other potentially infectious materials in the workplace. This standard covers all employees who, as a result of performing their job duties, may reasonably have an anticipated exposure to human blood, unfixed tissues, or contact with blood and other potentially infectious materials. "Good Samaritan" acts (for example, assisting a co-worker with a nosebleed), are not considered occupational exposure under this standard.
This standard requires the College to have a written Exposure Control Plan which outlines tasks, procedures, job classifications, engineering controls, universal precautions, and personal protective equipment. This handout provides an overview of our Exposure Control Plan and is designed to re-familiarize you with the basics learned in your Initial Bloodborne Pathogens Training class. This handout serves as your annual refresher which is required by OSHA. Please refer to your copy of the College’s Exposure Control Plan or call Environmental Health and Safety at (718) 430-4150 for additional information.
Bloodborne Pathogens
According to OSHA, bloodborne pathogens are microorganisms that are present in human blood and can cause disease in humans. Two pathogens of concern are the Hepatitis B Virus (HBV) and the Human Immunodeficiency Virus (HIV); however, there are many other pathogens which can be transmitted through blood (i.e. T. cruzi, Malaria). While working in the laboratory, It is important that you know to which pathogens you may be exposed. Additional training should be provided by your supervisor.
Hepatitis B:
Over one million people in the U.S. are carriers of the Hepatitis B Virus (HBV) and an additional 300,000 people become infected each year. In 1983, 17,000 healthcare employees were infected by contact with blood and body fluids of infected patients. This number has dropped dramatically to 400 in 1995, due to the increased use of the HBV vaccine. Hepatitis dangers can be reduced by: wearing PPE, using disinfectants to clean the work surfaces, washing hands between patients’ visits, using puncture-resistant sharps containers, and using the Biological Safety Cabinets.
Symptoms:Hepatitis symptoms include: jaundice (yellow hue to the skin and eyes), loss of appetite, nausea, and elevated liver function tests.
Hepatitis B Vaccine: All employees are encouraged to be vaccinated against Hepatitis B Virus if there is a risk of exposure to blood or other potentially infectious material including human cells, tissue cultures, blood products, and blood components. The vaccine is offered free of charge to all employees who may have an occupational exposure. The vaccine is administered at
Occupational Health in a series of three shots. The second shot is given one month after the first, and the third given six months after the initial dose. Employees who decline the Hepatitis B vaccine must sign an Informed Refusal Form at Occupational Health. At any time after a worker initially declines to receive the vaccine, he or she may opt to take it.
Human Immunodeficiency Virus
HIV is the virus which causes the disease, "Acquired Immune Deficiency Syndrome", or as it is more commonly known, AIDS. AIDS weakens a persons immune system, therefore weakening the body’s ability to fight off infections. In the healthcare and laboratory setting, HIV is much less contagious than HBV, but whereas there is a HBV vaccine, HIV is incurable and ultimately leads to death. Once a person becomes infected with HIV, it may be years before AIDS develops.
Symptoms:
Symptoms of AIDS include: fatigue, fever, weight loss, pneumonia, nausea, night sweats, rashes, mouth sores, sore throat, and swollen lymph glands.
Modes of Transmission:
HIV and HBV are transmitted through contact with infected human blood and other potentially-infectious body fluids, including:
- semen
- vaginal secretions
- cerebrospinal fluid
- synovial fluid
- pleural fluid
- pericardial fluid
- peritoneal fluid
- amniotic fluid
- saliva in dental procedures
- body fluid that is visibly contaminated with blood
- unfixed tissue or organ (other than intact skin from a human, living or dead)
- HIV-containing tissue cultures
- HIV- or HBV-containing culture medium or other solutions
- blood or other tissues from experimental animals infected with HIV or HBV
In laboratories and clinical settings, transmission is most likely to occur due to: accidental needlestick, cut from contaminated glass, razor, scalpel, etc., contact with damaged skin (open sores, acne, cuts, abrasions, blisters), or contact with mucous membranes (eyes, nose and mouth). According to the Center for Disease Control, all blood and body fluids must be considered infectious, therefore, they have set up "Universal Precautions" which are recommendations that are enforced by OSHA to protect workers from infection.
Protecting Yourself from Bloodborne Pathogens
When working with human blood or other potentially-infectious material, it is important to take steps to protect yourself. Engineering controls (i.e. biological safety cabinets, safety syringes, centrifuge cups, mechanical pipetting devices, etc.), will minimize any risk of infection along with the following precautions:
- Assume that all blood or blood-related products are infectious. Follow "Universal Precautions".
- Wear personal protective equipment (gloves, lab coats, goggles, mask).
- Replace torn or defective personal protective equipment (PPE).
- Remove PPE before leaving the work area.
- Use biological safety cabinets to contain procedures which generate aerosols.
- Handle all materials carefully to minimize potential for splashing and spraying.
- DO NOT mouth pipette - use mechanical devices.
- Clean contaminated areas with a solution of 10% bleach in water.
- Never bend or cut needles or recap them using a two-handed technique.
- NEVER eat, drink, smoke, apply cosmetics or lip balm, or insert/remove contact lenses in the lab.
- Wash hands with soap and water: before gloving, after gloves are removed, after contact with each patient, before leaving the laboratory or medical office, before eating, or after your hands have touched a potentially-contaminated surface.
- Dispose of infectious waste properly.
Decontamination
Always keep your work area neat and orderly. Clean and disinfect the medical or laboratory environment with a 10% Clorox solution in water or an equivalent disinfectant. At the end of each work shift, clean all equipment and surfaces that may have come into contact with blood and other infectious agents. Medical or laboratory instruments should be disinfected with approved hospital disinfectants (tuberculocidal at recommended dilutions) or in autoclaves.
Spill Clean-Up
Spills within work areas are to be cleaned by laboratory or research personnel. Janitorial staff are NOT authorized to clean spills of potentially-infectious material. If a spill occurs, notify coworkers in the immediate area and do the following:
- Wear appropriate PPE (gloves, lab coat, etc.), carefully covering the spill with paper towels.
- Gently pour fresh 10% bleach solution or other disinfectant around the edges of the towels.
- Wait 10 minutes to ensure proper contact time.
- Wipe up the spill from the perimeter in, placing contaminated towels in an autoclave bag.
- Wipe down the area again with fresh disinfectant.
In the event of a particularly large spill, contact Environmental Health and Safety at X4150.
Infectious Waste
Prior to disposal of regulated medical waste, infectious waste should always be inactivated, either chemically or by autoclaving. Medical waste containers must be well constructed and leak proof with a solid, tight-fitting cover and can be ordered from Housekeeping, X2352.
Sharps
Needlestick or other puncture injuries often occur when cleaning or disposing of sharp instruments and needles. Sharps containers must be located close to work area where sharps are used. They must be puncture-resistant, leak-proof, labeled and color-coded. They must NOT be overflowing.
At Albert Einstein College of Medicine, the following items must be disposed as sharps: all types of needles, syringes, Pasteur pipettes, glass culture dishes, glass blood vials, glass pipettes, scalpel blades, surgical staples, slides, cover slips, lancets, tweezers, and razor blades.
Broken bottles which are infectious, should be placed in a cardboard box and autoclaved before being placed in a new medical waste bin. If broken bottles are non-infectious, the bottle should be placed in a cardboard box and placed in the ordinary trash. See Albert Einstein College of Medicine’s Waste Disposal Guidelines for additional information on proper disposal of infectious waste and sharps.
Warning Tags, Signs and Labels
The biohazard symbol warns of actual or potential presence of biological hazards. It must be displayed on equipment (refrigerators, incubators, etc.), containers (sharps and infectious waste), and rooms that contain, or are contaminated with, hazardous biological agents. Labels must have the biohazard symbol visibly displayed on a fluorescent orange or red background. These labels are available from the EH&S Office.
Emergency Procedures
If an exposure occurs:
- Wash the affected area for 15 minutes with soap and water. If a splash occurs to the eyes or mucous membranes, flush the affected area with running water for at least 15 minutes.
- Report the exposure to your supervisor, as soon as possible.
- Report to Occupational Health for post-exposure treatment and evaluation. Occupational Health will treat you according to OSHA guidelines. Occupational Health will also seek to identify the source patient for HIV or HBV. If the emergency occurs off hours, go to the nearest Emergency Room.
- File an exposure report and notify EH&S at X4150.
The physician who evaluates you will determine if prophylaxis or medical treatment is necessary. The employer does not have a right to know the actual results of the source individual’s blood tests.
Medical follow up must include a confidential medical evaluation which documents the circumstances of exposure, identifying and testing the source individual (when feasible), and counseling and evaluation of the reported illness. Follow-up testing, plus any related laboratory tests by an accredited laboratory will be provided at no cost to you.
Keep in mind that the effects of exposure can be improved by prompt action. Report any potential exposure and visit Occupational Health immediately!