PREREQUISITES: BLOODBORNE PATHOGENS (BBP) STANDARD

Establishing an Employee Exposure Control Plan (ECP)

All employers are required to have a written Exposure Control Plan (ECP) to identify potential BBP employee exposures and to eliminate or minimize exposures, including engineering practices, personal protective equipment, hepatitis B virus vaccination program and training. The standard applies to all employees whose job classification and duties result in a potential for occupational exposure. Occupational exposure means reasonably anticipated skin, eye, mucous membrane or parenteral contact with human blood or other potentially infectious material as may result from the performance of an employee=s duties in handling human blood components, human blood products, human body fluid (including semen, vaginal fluids, cerebrospinal fluid, synovial fluid, pleural fluid, amniotic fluid, saliva from dental procedures, or any body fluid visibly contaminated with blood), unfixed human organs or tissues, HIV (Human immunodeficiency virus), or HBV (Hepatitis B virus) containing cell cultures, organ cultures or HIV animal infected tissues).

1. Occupational Exposure: In the context of potential for Bloodborne Pathogen Exposure as well as biohazards exposure as addressed in this document, the following employees may be at risk for exposure:

a. Individuals handling infectious material in the course of teaching or research include faculty, researchers, visiting scientists, teaching assistants and laboratory technicians.

b. All laboratory animal care staff (veterinarians and technicians) or research personnel providing husbandry, veterinary care or support care for animals infected with human pathogens.

c. Individuals assisting in waste disposal including custodial and refuse management personnel.

d. Individuals overseeing routine management of /or responding to incidents involving infectious BBP material including safety officers and university police.

2. Occupational Bloodborne Pathogen Risks:

a. Occupational risks of exposure to Bloodborne pathogens, in order of highest risk include healthcare workers (physicians, nurses, phlebotomists, dentists, etc.), followed in order by laboratory personnel, emergency medical technicians, firefighters/policemen/corrections officers, lifeguards, first aid responders and postal handlers.

b. Acquired Immunodeficiency Syndrome (AIDS) caused by the Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) are the two most important bloodborne pathogen risks to workers. Although the greatest risk is among health care workers, these two agents are the two most critical risks to any worker handling biohazardous materials of human origin.

c. Hepatitis B Virus:

i. HBV attacks the liver and can cause acute hepatitis, chronic HBV infection (In this category individuals can serve as carriers and spread the infection to others: There are approximately 750,000 to 1,000,000 infectious carriers in the U.S.), chronic hepatitis, fulminant hepatitis, cirrhosis of the liver and primary liver cancer.

ii. In the United States HBV causes 300,000 new cases of hepatitis B infection each year. There are over 6,800 cases among healthcare workers.

d. Human Immunodeficiency Virus:

i. There is a higher prevalence among exposed workers (i.e., handling HIV cases or blood) than nonexposed workers and the general population. There is a correlation between HIV and the frequency of blood and needle exposure.

ii. The Human Immunodeficiency Virus attacks the immune system and targets macrophages and T4 lymphocytes. It causes acute retrovirus syndrome, persistent generalized lymphadenopathy and AIDS illness including Pneumocystis carinii pneumonia, fungal diseases, Kapotsi=s sarcoma and bacterial infections, and other ailments.

iii. The Center for Disease Control 1994 data noted 130 cases of possible occupational HIV infections. Of those, only 42 could be documented as to cause: 36 of these were by percutaneous exposure, 1 was through mucotaneous exposure, 1 was by percutaneous and mucotaneous exposure, and one was unknown.

iv. Approximately 0.3% of healthcare workers with exposure to HIV infected blood from needle stick injuries seroconvert or become HIV positive.

3. Occupational Bloodborne diseases such as AIDS and HBV are spread through the following:

a. Splashes to mucous membranes which can happen during medical procedures or breaking glassware.

b. Inoculation by needle stick or sharps contaminated with blood (used needles, scalpels, broken glassware, dental wires).

c. Contaminated environmental surfaces (bench tops or equipment).

4. Control measures workers can take to reduce or minimize risks to Bloodborne hazards include the following:

a. Engineering Controls:

i. Use sharps containers for disposal of sharps.

ii. Use self-sheathing needles instead of non-self-sheathing needles.

iii. Use needleless systems for IV lines.

iv. In the laboratory and similar situations, use Plexiglas shields to control spatter.

b. Always use personal protective equipment to prevent exposure to Bloodborne pathogens, including laboratory coats, gloves and masks, goggles and face shields; and when appropriate, booties and Tyvek 8 Suits (See Universal Precautions below).

c. Observe Bloodborne pathogens risk reduction work habits including the following:

i. Do not recap needles and use the one-hand recappping technique only if recapping is unavoidable.

ii. Observe proper disposal of sharps and contaminated wastes.

iii. Assure that all specimens that pose a Bloodborne pathogen risk are properly labeled: Label specimens with BIOHAZARD label and place specimen in a red or orange BIOHAZARD bag or container.

iv. Keep work surfaces clean and use appropriate and approved disinfections on contaminated environmental surfaces (Use tuberculocidal agent or a 1:10 solution of household bleach.).

v. Attend training sessions annually to remain current and knowledgeable of risks and measures to further minimize risks to Bloodborne pathogens.

vi. Acquire vaccination against HBV.

vii. Observe Universal Precautions (below).

viii. Additional biohazards risk reduction measures:

(1) Do not eat, drink or apply cosmetics or handle contact lens in area where biohazards like blood or blood products are used.

(2) Do not store food or drink in refrigerators used for storage of blood or blood products.

(3) Place specimens of blood or blood products in leak-proof containers during collection, handling, processing, storage, transport or shipping.