Occupational Exposure to Bloodborne Pathogens
Monday, April 13th, 2020
Bloodborne pathogens (BBP) are microorganisms present in our blood that can cause diseases such as Hepatitis B and C and Human Immunodeficiency Virus (HIV), which are the three common bloodborne pathogens we can be exposed to occupationally. These microorganisms don’t have to be only viruses. They can be bacteria, fungi, or even parasites. The term “bloodborne pathogens” can be misleading since these pathogens are not only found in blood but can be present in any bodily fluid such as semen, vaginal secretions, vomit, urine, feces, skin tissues, and more.
Human Immunodeficiency Virus, also known as HIV, can lead to Acquired Immunodeficiency Syndrome (AIDS) if not treated. The Human Immunodeficiency Virus attacks healthy white blood cells within our immune system. Our immune system is what keeps us healthy; fighting off any foreign bodies that we may be infected with. When our immune system is compromised with HIV, we can’t accurately fight off any other illnesses we may have; i.e. common cold, pneumonia, etc. and we get very sick from these relatively simple illnesses we were once able to fight off.
It’s still a common misconception that you can contract HIV from shaking an HIV positive person’s hand or touching something they just touched. HIV generally does not survive outside of the body for long. There is debate as to exactly how long it can survive outside of the body.
Not everyone has signs or symptoms that they have contracted HIV. Its incubation period can be anywhere from one to three months. General symptoms of HIV include but are not limited to fever, fatigue, weight loss, rash. There is no vaccine currently available for HIV but there are effective treatments available to help those infected live a long, healthy life.
Hepatitis is a virus that causes inflammation of the liver and can lead to cirrhosis, liver disease, cancer, even death. Just like HIV, some infected persons with Hepatitis don’t have any signs or symptoms. Others can have presented symptoms like jaundice, fatigue, abdominal pain, nausea, and vomiting. Hepatitis can present itself as an acute or chronic illness and has a variety of strains; Hepatitis A, B, C, D, and E. Hepatitis B and C are the two strains we worry about when it comes to occupational exposure.
One important thing to note about Hepatitis B (Hep. B) is that it can survive outside of the body for quite a long time; up to or even longer than 7 days if conditions support the virus’ growth and survival. Hepatitis B is also the only of the three occupation bloodborne pathogens that has a vaccine available. This vaccine is required to be offered for free to employees that have a risk of exposure to Hep. B. Workers have the personal choice to accept or decline the three-part series vaccination. But it is highly recommended since it significantly reduces the risk of contracting the virus if exposed.
The Hep. B vaccine will not protect a person from contracting Hepatitis C. There is no vaccine available yet for Hep. C, but treatment these days, much like HIV treatment, can help an infected person live a long, healthy life, without spreading the virus to others.
Workers can be exposed to these bloodborne pathogens through various routes of exposure:
- Broken skin; rashes, cuts, dry skin
Jobs and roles that have the highest risk of exposure include:
- Medical & Dental staff
- Janitorial staff
- First Aid/CPR team members
- Paramedics & Firefighters
These workers can be exposed to bloodborne pathogens by simply coming into contact with a bleeding coworker, while administering Fist Aid, touching a contaminated surface, or cleaning up and decontaminating a contaminated surface or piece of equipment.
Because of this, OSHA requires organizations to have a written Exposure Control Plan in place. This document identifies the jobs and tasks that have a potential of exposure to BBP, outlines training requirements, describes engineering and administrative control along with personal protective equipment for use, and lays out procedures for handling biohazard waste, cleaning and disinfecting contaminated or potentially contaminated surfaces and objects, and notes recordkeeping requirements.
The first step in reducing risk of exposure to BBP is by always practicing universal precautions. Since we can’t see these bloodborne pathogen viruses with the naked eye, we must treat all blood and bodily fluid as if it is infected with these viruses. That is what practicing universal precautions is about.
Along with universal precautions, we must utilize engineering and administrative controls provided prior to the use of PPE. Engineering and administrative controls can include items such as:
- Sharps container
- Red biohazard waste bags
- Biohazard waste container
- Self-sheathing needles
- Proper BBP cleaning & decontaminating procedures
- General garbage handling procedures (i.e. never reaching into a garbage bag, never sling over your shoulders, etc.)
- Handwashing procedures
- Post exposure procedures
- Safe glove removal procedures
Once engineering and administrative controls are implemented and used, PPE is required as a last line of defense. Depending on the job or task, PPE should include latex/nitrile gloves, safety goggles, apron/gown/Tyvek suit, and face shield.
Many workers get confused when it comes to what becomes regulated medical waste and what can be disposed of as regular trash. Regulated medical waste must be placed in red biohazard bags and waste containers or sharps containers that are appropriately labeled with the universal biohazard symbol.Engineering controls, administrative controls, and PPE significantly reduce the risk of an employee being exposed to BBP. However, sometimes it happens where someone is exposed or thinks there was a chance they were exposed. In this case, it is crucial that the employee reports the exposure to his/her organization and immediately seeks medical attention.
If the employee has not had a Hep. B vaccine, getting it within 24 hours will significantly help. Medical testing will be done to see if the employee has been previously exposed to a bloodborne pathogen, and if not, preventative care can be prescribed.
Bloodborne pathogens don’t have to be something employees are afraid of, if they are protected against properly with necessary controls and work practices. Bloodborne pathogens, however, can be life changing illnesses so it is crucial workers understand the severity of exposure and how to protect themselves.