Handling, Storing, and Disposing of Hazardous Materials
Transmission of Bloodborne Pathogens
Bloodborne pathogens are transmitted when contaminated blood or bodily fluids enter the body of another person. In the workplace setting, transmission is most likely to occur through:
An accidental puncture by a sharp object, such as a needle, broken glass, or other "sharps", contaminated with the pathogen.
Contact between broken or damaged skin and infected bodily fluids
Contact between mucous membranes and infected bodily fluids
Unbroken skin forms an impervious barrier against Bloodborne pathogens. However, infected blood or bodily fluids can enter your system percutaneously through:
Any sort of damaged or broken skin such as sunburn or blisters
Bloodborne pathogens can also be transmitted through the mucous membranes of the eyes, nose, or mouth. For example, a splash of contaminated blood to your eye, nose, or mouth could result in transmission.
There are also many ways that Bloodborne pathogens are not transmitted. For example, Bloodborne pathogens are not transmitted by:
Touching an infected person
Coughing or sneezing
Using the same equipment, materials, toilets, water fountains or showers as an infected person
It is important that you know which ways are viable means of transmission for the Bloodborne pathogens in your workplace, and which are not.
Emergency Preparedness Plan
The Bloodborne Pathogen Standard requires that employers develop an Emergency Preparedness Plan and make it accessible to all employees. The Emergency Preparedness Plan is a written plan that identifies the tasks and procedures, as well as job classifications, where occupational exposure to blood occurs--without regard to personal protective clothing and equipment.
The plan also establishes the schedule by which the employer will implement other provisions of the standard, and specifies the procedure for evaluating circumstances surrounding exposure incidents.
Employers must update their Emergency Preparedness Plan to include:
Changes in technology that reduce/eliminate exposure
Annual documentation of consideration and implementation of safer medical devices
Solicitation of input from non-managerial employees
Methods of Compliance
The Bloodborne Pathogen Standard specifies methods that are to be used to minimize the transmission of Bloodborne pathogens in the work place. These methods include:
Engineering and Work Practice Controls
Personal Protective Equipment (PPE)
Appropriate Housekeeping Measures
The Bloodborne Pathogen Standard requires that employers implement a standardized approach to infection control called Universal Precautions.
The concept of Universal Precautions is that all blood and potentially infectious materials must be treated as if they are known to contain HIV, HBV, or other Bloodborne pathogens.
Body Substance Isolation (BSI)
Body Substance Isolation is an alternative infection control method in which all bodily fluids and substances are defined as infectious. Workplaces that use BSI as an alternative to Universal Precautions extend the coverage of the Bloodborne Pathogen standard to include all bodily substances. Such workplaces must also comply with the other provisions of the standard.
Work Practice Controls
Hand washing is one of the simplest and most effective practices used to prevent the transmission of Bloodborne pathogens. Hand washing keeps you from transferring contamination from your hands to other areas of your body, or to other surfaces you may contact later.
Here are a few useful hand washing guidelines:
Thoroughly wash hands or other exposed skin with soap and water as soon as possible following an occupational exposure to blood or other potentially infectious materials.
Wash your hands with soap and water every time you remove your gloves. If your gloves are intact and you have had no occupational exposure to blood or other potentially infectious materials, antiseptic hand cleaners may be used as an appropriate hand washing practice. However, washing with soap and running water every time you remove your gloves is the recommended practice.
Use soft, antibacterial soap, if possible. Avoid harsh, abrasive soaps, as these may open fragile scabs or other sores.
If skin or mucous membranes come in direct contact with blood, wash or flush the area with water as soon as possible.
Where hand-washing facilities are not available, use antiseptic hand cleansers or antiseptic towelettes. However, these should be used as a temporary measure only. You must still wash your hands with soap and running water as soon as you can.
Personal hygiene involves using good judgment when working in areas with the potential for exposure. Examples of good personal hygiene practices include:
Minimizing splashing, spraying, spattering and generation of droplets when attending to an injured person.
Refraining from eating, drinking, smoking, applying cosmetics or lip balms, or handling contact lenses where there is a reasonable likelihood of occupational exposure.
Keeping food or drink away from refrigerators, freezers, shelves, and cabinets or on countertops or bench tops where blood or other potentially infectious materials are present.
Refraining from mouth pipetting/suctioning of blood or other potentially infectious materials.
Personal Protective Equipment
The type of protective equipment appropriate for your job or research varies with the task and the degree of exposure you anticipate. Equipment that protects you from contact with blood or other potentially infectious materials (OPIM) may include:
Gloves should be made of latex, nitrile, rubber, or other water impervious materials. If gloves are particularly thin or flimsy, double gloving can provide an additional layer of protection. If you have cuts or sores on your hands, cover these with a bandage or similar protection as an additional precaution before donning your gloves. Always inspect your gloves thoroughly before putting them on. Never use gloves that are damaged, such as torn or punctured. Remove contaminated gloves carefully, avoiding touching the outside of the gloves with bare skin. Dispose of contaminated gloves in a proper container. Gloves that have come into contact with blood must be placed in a sealed plastic bag and discarded immediately.
Bloodborne pathogens can be transmitted through the mucous membranes of the eye. Consequently, you should use eye protection whenever there is a risk of splashing or vaporization of contaminated fluid, such as while cleaning up spills or during certain laboratory procedures.
Response to Emergencies Involving Blood or Bodily Fluids
If you are faced with a spill of blood or bodily fluids, here are some key points to keep in mind:
Wear appropriate Personal Protective Equipment (PPE).
Carefully cover the spill with an absorbent material, such as paper towels, to prevent splashing.
Decontaminate the area of the spill using an appropriate disinfectant, such as a solution of one part bleach to ten parts water. When pouring disinfectant over the area always pour gently and work from the edge of the spill towards the center to prevent the contamination from spreading out.
Wait 10 minutes to ensure adequate decontamination, and then carefully wipe up the spilled material. Be very alert for broken glass or sharps in or around the spill.
Disinfect all mops and cleaning tools after the job is done.
Dispose of all contaminated materials appropriately.
Wash your hands thoroughly with soap and water immediately after the clean up is complete.
Housekeeping and Waste Disposal
Keeping the worksite clean and sanitary is a necessary part of controlling worker exposure to Bloodborne pathogens. Cleaning schedules and decontamination methods depend on the type of surface to be cleaned, the type of soil that is present, and the particular tasks or procedures that are being performed. General housekeeping guidelines are:
Clean and decontaminate all equipment and working surfaces after contact with blood or other potentially infectious materials.
Contaminated work surfaces, such as counters, fume hoods, or biosafety cabinets, should be decontaminated with an appropriate disinfectant as follows:
after completing procedures
immediately, or as soon as feasible, if they are heavily contaminated or if there has been a spill of blood or other potentially infectious materials
at the end of the work shift if the surface may have become contaminated since the last cleaning
Inspect and decontaminate bins, pails, cans, and similar receptacles intended for reuse, which have a reasonable likelihood to becoming contaminated with blood or other potentially infectious substances on a regularly scheduled basis.
Clean and decontaminate receptacles immediately or as soon as feasible upon visible contamination
Handling and Disposing of Broken Glassware
Do not pick broken glassware up directly with your hands. Instead, use items such as a brush and dustpan, tongs, or forceps to clean it up.
Sterilize broken glassware that has been visibly contaminated with blood with an approved disinfectant solution before disturbing it or cleaning it up.
Dispose of decontaminated glassware in an appropriate sharps container. Sharps containers should be closable, puncture-resistant, leak-proof on sides and bottom, and appropriately labeled.
Dispose of uncontaminated broken glassware in a closable, puncture resistant container such as a cardboard box or coffee can.
Handling Contaminated Laundry
The Bloodborne Pathogens Standard does not generally cover soiled laundry in a non-healthcare setting. However, employees handling laundry that is soiled or contaminated with blood or other potentially infectious materials should follow the recommendations of the standard, which include:
Handle soiled linen as little as possible and with minimum agitations, to prevent exposure to the handler.
Facilities that use Universal Precautions for handling all soiled laundry may mark laundry bags or containers, containing contaminated laundry, with an alternative label or color-code provided all employees recognize the containers as requiring compliance with Universal Precautions. If the contaminated laundry is sent home with a parent for cleaning, it must be placed in a sealed plastic bag.
When sending soiled linen to an off-site facility for laundering, place and transport the linen in specially marked, leak-proof bags.
If laundry is washed on-site, ensure individuals performing the laundering are trained and use Universal Precautions. Wash laundry in accordance with decontamination practices recommended by the Centers for Disease Control (CDC).
Regulated waste refers to:
Any liquid or semi-liquid blood or other potentially infectious materials
Contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed
Items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling
Pathological and microbiological wastes containing blood or other potentially infectious materials
All regulated waste must be placed in properly labeled containers or red biohazard bags for disposal at an approved facility. Discarded feminine hygiene products, such as sanitary napkins, are not generally considered regulated waste. Under most circumstances, the absorbent material in such products prevents the release of liquid or semi-liquid blood or the flaking off of dried blood. Feminine hygiene products should be discarded into waste containers lined with plastic or wax paper bags to protect housekeeping employees from physical contact with the contents.
Non-regulated waste (i.e., does not fit the definition of regulated waste provided above) that is not generated by a medical facility or human health-related research laboratory may be disposed in regular plastic trash bags if it has been decontaminated or autoclaved prior to disposal. However, all bags containing such materials must be labeled, signed, and dated, verifying that the materials inside have been decontaminated according to acceptable procedures and pose no health threat.