Potential Hazard
Employee exposure to bloodborne pathogens from blood and
Other Potentially
Infectious Materials (OPIM) because employees are not using Universal Precautions.
- Bloodborne pathogens are pathogenic microorganisms that are present in human blood and can cause disease in humans.
- Some infections that can be transmitted through contact with blood and body fluids include:
- HIV,
Hepatitis A,
B,
C, Staph and Strep
infections, Gastroenteritis-salmonella, and shigella, Pneumonia, Syphilis, TB, Malaria, Measles, Chicken Pox, Herpes, Urinary tract
infections, and Blood infections. The greatest risks are from HIV and Hepatitis B and C.
Possible Solutions
Use Universal Precautions. Universal precautions
is an approach to infection control to treat all human blood and
certain human body fluids as if they were known to be infectious for
HIV, HBV and other bloodborne pathogens, (Bloodborne Pathogens
Standard
29 CFR 1910.1030(b)
definitions).
- Bloodborne Pathogen Standard
29 CFR 1910.1030(d)(1)
requires:
- Employees to observe Universal Precautions to prevent contact with
blood or other potentially infectious materials (OPIM).
- Under circumstances in which differentiation between body fluid types
is difficult or impossible, all body fluids shall be considered
potentially infectious materials.
- Treat all blood and other potentially infectious materials with
appropriate precautions such as:
- Use gloves, masks, and gowns if blood or OPIM exposure is anticipated.
- Use engineering and work practice controls to limit exposure.
OPIM is defined in
29 CFR 1910.1030(b)
as:
- The following human body fluids: semen, vaginal secretions,
cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid,
peritoneal fluid, amniotic fluid, saliva in dental procedures, any body
fluid that is visibly contaminated with blood, and all body fluids in
situations where it is difficult or impossible to differentiate between
body fluids;
- Any unfixed tissue or organ (other than intact skin) from a human
(living or dead); and
- HIV-containing cell or tissue cultures, organ cultures, and HIV- or
HBV-containing culture medium or other solutions; and blood, organs, or
other tissues from experimental animals infected with HIV or HBV.
The Bloodborne Pathogens Standard allows for hospitals to
use acceptable alternatives [OSHA Directive CPL 02-02-069, (2001, November 27)] to universal precautions:
- Alternative concepts in infection control are called Body Substance
Isolation (BSI) and Standard Precautions. These methods define
all body fluids and substances as infectious.
These methods incorporate not only the fluids and materials covered by the
Bloodborne Pathogens Standard but expands coverage to include all body
fluids and substances.
- These concepts are acceptable alternatives to universal precautions,
provided that facilities utilizing them adhere to all other provisions of
the standard.
- For compliance with OSHA Standards, the use of either Universal
Precautions or Standard Precautions are acceptable.
The CDC recommends Standard Precautions for
the care of all patients, regardless of their diagnosis or presumed
infection status.
- Standard Precautions apply to 1) blood; 2)
all body fluids, secretions, and excretions,
except sweat, regardless of whether or not
they contain visible blood; 3) non-intact skin; and 4) mucous membranes.
Standard precautions are designed to reduce the risk of transmission of
microorganisms from both recognized and unrecognized sources of infection
in hospitals.
- Standard precautions includes the use of: hand washing, appropriate
personal protective equipment such as gloves, gowns, masks, whenever
touching or exposure to patients' body fluids is anticipated.
- Transmission-Based Precautions
(i.e., Airborne Precautions, Droplet Precautions, and Contact
Precautions), are recommended to provide additional precautions beyond
Standard Precautions to interrupt transmission of pathogens in hospitals.
- Transmission-based precautions can be used for patients with known or
suspected to be infected or colonized with epidemiologically important
pathogens that can be transmitted by airborne or droplet transmission or
by contact with dry skin or contaminated surfaces. These precautions
should be used in addition to standard precautions.
- Airborne Precautions used for infections
spread in small particles in the air such as chicken pox.
- Droplet Precautions used for infections
spread in large droplets by coughing, talking, or sneezing such as
influenza.
- Contact Precautions used for infections
spread by skin to skin contact or contact with other surfaces such as
herpes simplex virus.
- Airborne Precautions, Droplet Precautions, and Contact Precautions.
May be combined for diseases that have multiple routes of transmission.
When used either singularly or in combination, they are to be used in
addition to Standard Precautions.
For additional information, see HealthCare Wide
Hazards -
Needlesticks/Sharps Injuries.
Additional Information:
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