Bloodborne Pathogens for Employees with Occupational Exposure

Blood, OPIM and universal precautions

Bloodborne pathogens are disease-causing microorganisms present in human blood, including hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

Other potentially infectious materials (OPIM)

Besides blood, OPIM includes certain body fluids (semen, vaginal secretions, cerebrospinal, synovial, pleural, pericardial, peritoneal and amniotic fluid, and saliva in dental procedures), any body fluid visibly contaminated with blood, all body fluids when you cannot tell them apart, and unfixed human tissue or organs other than intact skin.

Reference: 29 CFR 1910.1030(b) "Bloodborne Pathogens" · 29 CFR 1910.1030(b) "Other Potentially Infectious Materials" · 29 CFR 1910.1030(b) "Occupational Exposure" · 29 CFR 1910.1030(b) "Exposure Incident" · 29 CFR 1910.1030(b) "Parenteral" · 29 CFR 1910.1030(d)(1)

Your training, and what it must include

Your employer must train each employee with occupational exposure, at no cost to you and during working hours:

• At the time of initial assignment to tasks where occupational exposure may take place
• At least annually after that

The training must explain your employer's exposure control plan and how you can get a copy of the written plan.

Reference: 29 CFR 1910.1030(g)(2)(i) · 29 CFR 1910.1030(g)(2)(ii)(A) · 29 CFR 1910.1030(g)(2)(ii)(B) · 29 CFR 1910.1030(g)(2)(vii)(D) · 29 CFR 1910.1030(g)(2)(vii)(N) · 29 CFR 1910.1030(g)(2)(viii)

Hands, sharps and food

Wash

• Wash your hands immediately or as soon as feasible after removing gloves or other PPE.
• After contact with blood or OPIM, wash hands and any other skin with soap and water, or flush mucous membranes (eyes, nose, mouth) with water, immediately or as soon as feasible.
• When antiseptic hand cleansers or towelettes are used, wash your hands with soap and running water as soon as feasible.

Sharps

• Never shear or break a contaminated needle.
• Contaminated needles and other sharps are not bent, recapped or removed unless the employer shows no alternative is feasible or a specific medical or dental procedure requires it. Then it must be done with a mechanical device or a one-handed technique.

Food and personal habits

Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where occupational exposure is reasonably likely. Food and drink are not kept in refrigerators, freezers, shelves, cabinets or on counters where blood or OPIM are present.

Reference: 29 CFR 1910.1030(d)(2)(v) · 29 CFR 1910.1030(d)(2)(vi) · 29 CFR 1910.1030(d)(2)(iv) · 29 CFR 1910.1030(d)(2)(vii) · 29 CFR 1910.1030(d)(2)(vii)(A) · 29 CFR 1910.1030(d)(2)(vii)(B) · 29 CFR 1910.1030(d)(2)(ix) · 29 CFR 1910.1030(d)(2)(x)

Gloves, face protection and gowns

When there is occupational exposure, your employer must provide appropriate PPE at no cost to you, such as gloves, gowns, face shields or masks and eye protection, and pocket masks or other ventilation devices for rescue breathing. Your employer must ensure you use it. The only exception is rare and extraordinary: a brief, temporary decision by the employee, in professional judgment, that PPE would have prevented delivering care or created a greater hazard, and that decision is then investigated and documented.

Gloves

• Wear gloves when you can reasonably anticipate hand contact with blood, OPIM, mucous membranes or non-intact skin, and when handling or touching contaminated items or surfaces.
• Replace disposable gloves as soon as practical when contaminated, or as soon as feasible if they are torn, punctured or no longer work as a barrier.
• Never wash or decontaminate disposable gloves for re-use.

Face and body

Wear a mask with eye protection (goggles or glasses with solid side shields), or a chin-length face shield, whenever splashes, spray, spatter or droplets may be generated and eye, nose or mouth contamination can be reasonably anticipated. Gowns, aprons or similar outer garments are worn in occupational exposure situations; the type depends on the task and the degree of exposure.

Reference: 29 CFR 1910.1030(d)(3)(i) · 29 CFR 1910.1030(d)(3)(ii) · 29 CFR 1910.1030(d)(3)(ix) · 29 CFR 1910.1030(d)(3)(ix)(A) · 29 CFR 1910.1030(d)(3)(ix)(B) · 29 CFR 1910.1030(d)(3)(x) · 29 CFR 1910.1030(d)(3)(xi)

Taking PPE off

• If blood or OPIM soaks through a garment, remove it immediately or as soon as feasible.
• Remove all PPE before leaving the work area.
• Put removed PPE in the designated area or container for storage, washing, decontamination or disposal.
• Your employer cleans, launders and disposes of required PPE at no cost to you. Do not take it home to wash.

Then wash your hands.

Reference: 29 CFR 1910.1030(d)(3)(vi) · 29 CFR 1910.1030(d)(3)(vii) · 29 CFR 1910.1030(d)(3)(viii) · 29 CFR 1910.1030(d)(3)(iv) · 29 CFR 1910.1030(d)(2)(v)

Spills, broken glass and sharps containers

• Decontaminate contaminated surfaces with an appropriate disinfectant immediately or as soon as feasible after a spill of blood or OPIM, or when surfaces are overtly contaminated.
• Never pick up broken glass that may be contaminated with your hands. Use mechanical means such as a brush and dust pan, tongs or forceps.
• Discard contaminated sharps immediately or as soon as feasible in a container that is closable, puncture resistant, leakproof on sides and bottom, and labeled or color-coded.
• Keep sharps containers upright during use, and have them replaced routinely. Do not let them overfill.

Reference: 29 CFR 1910.1030(d)(4)(ii)(A) · 29 CFR 1910.1030(d)(4)(ii)(D) · 29 CFR 1910.1030(d)(4)(iii)(A)(1) · 29 CFR 1910.1030(d)(4)(iii)(A)(1)(i)-(iv) · 29 CFR 1910.1030(d)(4)(iii)(A)(2)(ii) · 29 CFR 1910.1030(d)(4)(iii)(A)(2)(iii)

Regulated waste, laundry and labels

Regulated waste

Regulated waste, such as items caked with dried blood that could release it during handling, goes in containers that are closable, built to prevent leakage, labeled or color-coded, and closed before removal.

Contaminated laundry

Bag or containerize it where it was used. Do not sort or rinse it there. Wear protective gloves and other appropriate PPE when you handle it.

Warning labels

Reference: 29 CFR 1910.1030(d)(4)(iii)(B)(1) · 29 CFR 1910.1030(d)(4)(iv)(A)(1) · 29 CFR 1910.1030(d)(4)(iv)(B) · 29 CFR 1910.1030(g)(1)(i)(A) · 29 CFR 1910.1030(g)(1)(i)(C) · 29 CFR 1910.1030(g)(1)(i)(E) · 29 CFR 1910.1030(b) "Regulated Waste" · 29 CFR 1910.1030(d)(4)(iii)(B)(1)(ii) · 29 CFR 1910.1030(d)(4)(iii)(B)(1)(iii) · 29 CFR 1910.1030(d)(4)(iii)(B)(1)(iv) · 29 CFR 1910.1030(d)(4)(iii)(B)(1)(i)

The hepatitis B vaccine offer

Your employer must make the hepatitis B vaccine and vaccination series available to all employees with occupational exposure, at no cost to you.

• When: after you receive the training on the vaccine, and within 10 working days of initial assignment.
• Exceptions: you have already had the complete series, antibody testing shows you are immune, or the vaccine is contraindicated for medical reasons.
• If you decline: you sign the declination statement in Appendix A of the standard.
• Changed your mind? If you decline at first and later accept while still covered, your employer must make the vaccination available at that time.

Reference: 29 CFR 1910.1030(f)(1)(i) · 29 CFR 1910.1030(f)(1)(ii)(A) · 29 CFR 1910.1030(f)(2)(i) · 29 CFR 1910.1030(f)(2)(iii) · 29 CFR 1910.1030(f)(2)(iv) · 29 CFR 1910.1030(f)(1)(ii)

After an exposure incident

1. Wash or flush right away. Wash skin with soap and water, or flush eyes, nose or mouth with water, immediately or as soon as feasible.
2. Report it using the method your employer's training explains. The medical follow-up starts with your report.
3. Get evaluated. After a report, your employer must make a confidential medical evaluation and follow-up immediately available, at no cost to you. It includes at least documentation of how the exposure happened, identification and documentation of the source individual (unless that is infeasible or prohibited by law), collection and testing of your blood after you consent, post-exposure prophylaxis when medically indicated, counseling, and evaluation of reported illnesses.
4. Get the written opinion. Your employer must give you a copy of the healthcare professional's written opinion within 15 days of the completion of the evaluation.

Reference: 29 CFR 1910.1030(d)(2)(vi) · 29 CFR 1910.1030(g)(2)(vii)(K) · 29 CFR 1910.1030(f)(3) · 29 CFR 1910.1030(f)(3)(i) · 29 CFR 1910.1030(f)(3)(iii)(A) · 29 CFR 1910.1030(f)(3)(iv) · 29 CFR 1910.1030(f)(5) · 29 CFR 1910.1030(f)(1)(ii)(A) · 29 CFR 1910.1030(f)(1)(ii) · 29 CFR 1910.1030(f)(3)(v)-(vi) · 29 CFR 1910.1030(f)(3)(ii)