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Bloodborne Pathogens
Could you contract a disease at work? What if someone sneezes on you? Or using a tool with dried blood on it? How about cleaning the restrooms? The simple answer is YES! Not to mention the type and scope of much of the work that we perform on a daily basis. For example, installation, inspection, and repairs to wastewater systems, sewer systems, pump repairs, and the like.
This is why we are going to learn about Bloodborne Pathogens. A bloodborne pathogen is a disease-producing bacteria or microorganism.
OSHA defines a bloodborne pathogen as a pathogenic microorganism present in human blood that can lead to disease and the OSHA standard can be found here: 29 CFR 1910.1030
There are many disease-carrying pathogenic microorganisms that are covered by the Bloodborne Pathogen Standard; however, the most common and those of primary concern are Human Immunodeficiency Virus (HIV), Hepatitis B (HBV), and Hepatitis C (HCV).
Human Immunodeficiency Virus (HIV):
- HIV is the virus that leads to acquired immunodeficiency syndrome (AIDS). A person can carry HIV for many years and not have symptoms until it turns into full-blown AIDS.
- AIDS attacks the person’s immune system, which makes it difficult for the body to fight off disease.
- Scientists and medical authorities agree that HIV does not survive well outside the body. Drying of HIV-infected human blood or other body fluids reduces the risk of environmental transmission to essentially zero.
- HIV is found in very low quantities in saliva and tears from some AIDS patients. HIV has not been found in the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in the transmission of HIV.
Hepatitis B Virus (HBV):
- 1 to 1 ¼ million Americans are chronically infected
- Symptoms include: jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea, vomiting
- May lead to chronic liver disease, liver cancer, and death
- Vaccination available since 1982
- HBV can survive for at least one week in dried blood
Hepatitis C Virus (HCV):
- An estimated 3.9 million Americans have been infected with HCV of whom 2.7 million are chronically infected.
- Persons chronically infected with HCV may not be aware of it because they are not clinically ill. Sometimes it can take two decades before symptoms are recognized.
- Chronic liver disease occurs in approximately 70 percent of infected persons.
- There are some drugs that have been licensed for the treatment of HCV; however, they are only effective in 10–40 percent of persons.
- 8,000–10,000 deaths occur each year as a result of chronic liver disease.
- There are some drugs that have been licensed for the treatment of HCV; however, they are only effective in 10–40 percent of persons.
Potentially Infectious Bodily Fluids are the bodily fluids that you are most likely to encounter in the workplace like:
- blood,
- saliva,
- vomit, or
- urine.
If blood is not present in a bodily fluid, bloodborne pathogens cannot be present.
Remember, sometimes the blood may be present in microscopic quantities and difficult to see with the naked eye. To be safe, you must assume that all bodily fluids are contaminated with infectious blood. This is called the universal precautions concept. We will discuss this in further detail later.
Bloodborne pathogens can only be transmitted to you if you physically make contact with an infected person’s blood or bodily fluid containing blood. Even then, your healthy skin is an excellent barrier to bloodborne pathogens. The contaminated blood or bodily fluid can enter your body through mucous membranes such as your eyes, mouth, or nose. If your skin is not intact at the point of contact with the contaminated blood or bodily fluid, the bloodborne pathogen could potentially be transmitted. Examples of non-intact skin include dermatitis, hangnails, cuts, abrasions, acne, etc.
Obviously, a contaminated sharp, such as a needle or broken glass, could potentially transmit bloodborne pathogens because of the penetration of the skin.
The Bloodborne Pathogens standard requires employers to identify the jobs, tasks, and activities that could expose employees to potentially infected blood or bodily fluids. Exposure could occur when near someone who is involved in an industrial accident. Obviously, when administering first aid to someone who is bleeding, you are potentially exposed. Employees expected to clean up work surfaces, equipment, or machinery after an accident are also potentially exposed. Janitorial workers are potentially exposed when cleaning up urine, vomit, sanitary napkins, etc. Maintenance workers might potentially be exposed when repairing the plumbing on a toilet.
This is why you always want to use the Universal Precautions Concept – TREAT ALL BLOOD AND BODILY FLUIDS AS IF THEY ARE CONTAMINATED. Always wear appropriate PPE when handling any type of bodily fluid. Universal precautions require adequate cleanup and decontamination of yourself, equipment, and tools. Always wash your hands after handling any type of bodily fluid, even when wearing gloves.
Safe Work Practices:
Remove contaminated clothing or PPE as soon as possible. If blood were to splash onto your shoes, pants, or shirt, remove those items as soon as possible. Wash your skin in the area underneath the clothing that was contaminated with bodily fluid. Remove contaminated PPE, such as gloves, as soon as you are done administering first aid or decontaminating equipment or work surfaces. Cleaning/disinfecting tools, work surfaces, or equipment will prevent the next user from unknowingly coming into contact with potentially infected bodily fluids. Thoroughly wash your hands, face, or any other areas of your skin that may have come into contact with bodily fluids. If you believe that blood or other potentially contaminated bodily fluid was splashed into your eyes, immediately go to an emergency eyewash station and flush your eyes. Properly disposing of contaminated items inappropriately labeled bags or containers will help prevent someone from accidentally being exposed.
Hepatitis B Vaccination:
The use of the HBV vaccine is strongly endorsed by medical, scientific, and public health communities as a safe and effective way to prevent disease and death. There is no confirmed evidence that indicates the HBV vaccine can cause chronic illness. Reports of unusual illnesses following a vaccine are most often related to other causes and are not related to the vaccine. The hepatitis B vaccination is a series of three injections that are effective in preventing infection with hepatitis B.
Currently, there is no requirement for routine boosters; however, this is still being assessed. Any employee that rendered first aid in a situation involving the presence of blood or other potentially infectious material, whether or not a specific exposure occurred, will be offered the full immunization series. This vaccination is paid for by the employer. If you decline the hepatitis B vaccination, you will be asked to sign a form that states you waived your opportunity to receive the vaccination. However, even if you sign the form now, you may still change your mind later and accept the vaccination. The form basically states that at this time you do not want to have the shots. The language on the declination form is straight out of the OSHA Bloodborne Pathogens standard
For more information, OSHA has published a Fact Sheet on the topic and you can find it here: http://www.osha.gov/OshDoc/dataBloodborneFacts/bbfact01.pdf