Intent

• Being careful requires diligence.medical supplies image by Joseph Dudash from Fotolia.com
  
  The "Bloodborne Pathogens" standard was implemented to educate and train employers and employees of the possible danger of exposure to blood, identify potential risks of exposure, how to minimize the risk and how to proceed if exposure occurs. The standard targets two main pathogens: Hepatitis B virus (HBV) and Human Immunodeficiency virus (HIV). While others exist, the focus was selected to reduce the number of new HBV and HIV cases. By following the simple safeguards learned in training, people reduce their risk of exposure to HBV, HIV and other pathogens.
  
  

Practice

• Practice is broken down into two parts, mental and physical. The most important mental aspect in practicing bloodborne pathogen safeguards is awareness. Treating all body fluids as a potential threat to health is an excellent start. The most important physical aspect is using personal protective equipment (PPE), which may be as simple as putting on gloves. Other equipment that may be needed include goggles, face shields, surgical masks, protective gowns and pocket masks for cardiopulmonary resuscitation (CPR). Simply being aware and taking a few seconds to put on and use PPE can provide protection. Employers are responsible for obtaining and maintaining PPE.
  
  

Occupational Exposure Defined

• OSHA's "Bloodborne Pathogens" standard defines an occupational exposure as a "reasonably anticipated skin, eye, mucous membrane, or parenteral (breaking the skin) contact with blood or other potentially infectious materials that may result from the performance of an employee's duties."
  
  A pathogen is a microscopic organism that is present in blood and can cause disease or illness. Some are deadly. An infectious material can be any bodily fluid or tissue that came into contact with or mixed with blood. Sometimes it is difficult to know whether or not blood mixed with those elements. That is the reason for treating any fluid or tissue as potentially infectious. This is probably the main point during training.
  
  Only employees who are designated by their employer as someone to provide first aid are impacted. Doctors, nurses, emergency medical technicians and firefighters are some of the obvious occupations covered by this standard. Others include police officers, security officers, first responders, industrial safety teams and housekeeping staff.
  
  

Exposure Incident

• "Exposure" is exactly what it infers: exposure by someone to blood, body fluids or tissue. The OSHA definition is: "a specific eye, mouth or other mucous membrane, non-intact skin, parenteral (piercing mucous membranes or the skin barrier through such events as needlesticks, human bites, cuts, and abrasions) contact with blood or other potentially infectious materials that result from the performance of an employee's duties."
  
  Training for the "Bloodborne Pathogens" standard teaches workers to stop immediately after an exposure incident and to turn over their duties to another responder as soon as possible; they also are taught to wash the affected area with running water and soap. If the exposed area is the mucous membranes of the eyes or mouth, the standard advises flushing the area with copious amounts of water. An emergency eye wash station is perfect for this task. Contaminated PPE are collected and saved for testing, and the incident is reported to the team leader without delay.
  
  

Post-Exposure

• Training also covers what happens later. A post-exposure evaluation, confidential medical examination and followup must be made immediately available to the exposed employee by his employer. At this point, several actions must be taken. One is that a written report of the exposure's route and circumstances of the exposure must be made. Also, identification of the source individual is documented, unless it is prohibited by state or local law; the company exposure control plan should have this already answered. The source individual must give permission before his blood is tested for HIV or HBV. If he refuses to give consent, testing will not be done. If state or local laws do not require consent, then the specimen is tested. Results of the source individual's blood tests are disclosed to the exposed employee, and she is counseled about the laws and regulations of keeping the information confidential. The exposed employee's blood is tested for HBV and HIV, and she also is offered the HBV vaccine.
  
  

Housekeeping

• Housekeepers are just as vulnerable to bloodborne pathogens as emergency responders and need to be trained in the standard. If an exposure happens, the affected area must be washed with large amount of running water and soap. Members of the janitorial crew must use PPEs when cleaning up from an exposure incident. Approved cleanup kits must be used and supplied by the employer. These kits contain minimal PPE, brush and dustpan to pick up debris (nothing gets picked up by the fingers), special trash bags and cleaning solution. The employer may make up its own kits as long as the items to be used are approved for cleanup; cleaning solutions, heavy trash bags, special stickers to label the trash and brushes/brooms cannot be made of natural hair.
  
  

Considerations

• OSHA's "Bloodborne Pathogens" standard is in place to protect the employee and employer. An exposure to a pathogen can occur at any time to anyone no matter how much care is taken.
  
  For PPE to be effective, familiarity with equipment supplied by the employer is a must, making it much easier to use if needed.