Bloodborne Pathogen Program
The OSHA
Bloodborne Pathogen Program is implemented through the EVMS Exposure Control
Plan. A summary of the Exposure Control Plan is provided for reference.
All job categories in which it is reasonable to
anticipate exposure to skin, eye, mucous membrane, or parenteral contact with blood or
other potentially infectious materials (OPIM) are included in the Bloodborne Pathogen
Program. These job categories are listed in the Exposure Control Plan.
Elements of the Exposure Control Plan are:
Definitions
- Blood: Human blood, human blood components (plasma,
red cells, white blood cells, platelets), and products made from human blood.
- Other Potentially Infectious Materials (OPIM)
- Body Fluids
- Semen
- Vaginal secretions
- Cerebrospinal fluid
- Pleural fluid
- Pericardial fluid
- Peritoneal fluid
- Amniotic fluid
- Breast milk
- Any body fluid visibly contaminated with blood
- Saliva in dental procedures
- All body fluid in situations where it is difficult or
impossible to differentiate between body fluids
- Other Materials
- Any unfixed tissue or organ (other than intact skin) from
a human (living or dead)
- HIV/HBV containing cell or tissue cultures, organ
cultures, and culture medium
- Blood, organs, or other tissues from experimental animals
deliberately infected with HIV or HBV
Universal Precautions
"Universal Precautions" assume that all blood
and OPIM contain bloodborne pathogens. Using these procedures reduces the likelihood of an
exposure to blood and other potentially infectious materials.
Personal protective devices include gloves, lab coat or
gown, and eye protection (goggles and/or a shield) if splashes are likely. Upon completion
of tasks involving blood and removal of personal protective devices, thoroughly wash your
hands. Frequent handwashing is a component of infection control that should not be
underestimated.
When handling specimens with blood or blood products, use
mechanical devices such as pipettes, splash guards, and biological safety cabinets to
contain contaminants. Blood tubes should only be opened behind a splash guard and with
gauze pads over the tube stopper to control splashing or spills.
Sharps Management
Sharps are needles, lancets, slides and cover slips, and
other sharp materials capable of injuring someone handling the items. Sharps should not be
bent, broken, sheared or cut since this action may result in aerosolizing their contents.
 Sharps containers should be used for sharps disposal.
These containers are puncture resistant, leak-proof, and should be red
in color with a biohazard symbol readily visible. Sharps containers are available in
various sizes and may have different types and shapes of openings. Do not fill these
containers completely. Doing so may result in a sharps injury to a fellow employee. When
they are about two thirds full, they should be disposed of a via commercial disposal
service.
Personal Protective Equipment (PPE)
PPE should be worn when there is a reasonable likelihood
of exposure to the skin, eyes, mouth or other mucous membranes. As stated under Universal
Precautions, PPE may consist of gloves, eye protection (goggles and splash shield) and a
lab coat or gown. The level of PPE should be based on the tasks to be performed.
Waste Disposal
The Commonwealth of Virginia regulates disposal of
medical waste. Human blood and OPIM, as well as materials they have come in contact with,
is considered regulated medical waste. The only authorized methods of disposal are incineration
or steam sterilization.
To dispose by incineration, contact a local
regulated medical waste vendor (contact the Environmental Health & Safety Office for a
vendor list), and determine the type of containers to use. The waste containers should be
leakproof (lined with a red biohazard bag), closeable, and constructed to contain all
contents and prevent leakage during handling, storage and transport. Containers must be
red or labeled with a biohazard warning and symbol. The label must be attached to the
container to prevent separation. It is important to have the vendor return a copy of the
manifest verifying the waste containers were incinerated, sometimes known as a
"certificate of destruction".
Steam sterilization creates a condition of high
temperature and pressure. Excessive quantities of material placed in an autoclave bag that
is improperly loaded may result in ineffective sterilization or release of the material
into the autoclave chamber. Also, fluids treated by steam sterilization may undergo
violent boiling if removed from the sterilizer too promptly after exposure. Please review
the manufacturer's suggested procedure before using an autoclave. The following are
general guidelines:
- Material to be autoclaved should not be taken to the
autoclave area until it is ready to be loaded into the chamber.
- Autoclave bags shall be red
in color and capable of passing the ASTM 125 pound drop test.
- Autoclave bags shall be sealed by lapping the gathered
open end and binding with tape or a closing device such that no liquid leaks. Bags must
contain at least 16 ounces of water to generate steam.
- Evaluate the effectiveness of steam sterilization under
full loading with spores of Bacillus stearothermophilus each month. Record these
results in the Autoclave Use Log.
- Attach an "autoclave tape" to each package of
regulated medical waste that will indicate if the steam sterilization temperature was
reached.
- Attach a label or tag to each bag of treated waste that
contains the following words:
| THE GENERATOR CERTIFIES THAT THIS WASTE HAS BEEN TREATED
IN ACCORDANCE WITH VIRGINIA MEDICAL WASTE MANAGEMENT REGULATIONS AND IS NOT REGULATED
MEDICAL WASTE. Treated: ___________________________
Generator: ___________________________ |
These self-adhesive labels are available in packages of
50 from Central Stores.
- Place all solid waste that has been steam sterilized in an
opaque bag, seal the bag and place the bag in general trash. The opaque bag may not be
red or orange.
For additional details on managing regulated medical
waste, see the Virginia regulation in the Environmental Health & Safety Office.
Hepatitis B Vaccinations
All employees exposed to bloodborne pathogens are offered
the hepatitis B vaccination series at no cost through Employee Occupational Health.
In addition, employees are offered post exposure evaluation and follow-up for actual
exposures occurring on the job.
The hepatitis B vaccination series consists of
three injections. The second injection is given one month after the initial and the third
injection is given six months after the initial dose. At present there is no indication
for a booster shot. The vaccination will be made available to employees after they receive
information on the hepatitis vaccine and within 10 days after initial assignment to a job
category with potential exposure. Employees declining the hepatitis vaccine must sign a
declination statement. If the employee changes their mind after completing declination
procedures, they may receive the vaccination at no charge to them.
Exposure Incident
Employees experiencing an exposure incident must immediately
report their exposure to the Employee Occupational Health office, at 446-5870, or
page 533-2595. When an employee reports an exposure incident, they will immediately be
offered a confidential medical evaluation and follow-up. If chemoprophylaxis is
indicated, it should be started within 2 hours of the exposure.
- Specific post exposure guidance is described
in the "Employee/Resident and
Student Body/Blood Fluid Exposure Protocol"
If the infectivity status of the source individual or
specimen is unknown, the individual's blood will be tested as soon as feasible after
consent is obtained. If the source blood is available, the blood shall be tested and
the results documented. The employee will be informed of the results of the testing.
The exposed employee's blood shall be collected as soon
as feasible after consent is obtained, and tested for HIV and HBV serological status. If
the employee consents to baseline blood collection but does not give consent at that time
for HIV serologic testing, the sample shall be preserved for at least 90 days. If, within
90 days of the exposure incident, the employee elects to have the baseline sample tested
for HIV, such testing shall be done as soon as practical.
The exposed employee will be offered post-exposure
prophylaxis, when medically indicated, as recommended by the U.S. Public Health Service.
Counseling and medical evaluation of reported illnesses will also be offered
through the Occupational Health Nurse.
For additional details about the follow-up program see
the Exposure Control Plan and Employee/Resident and
Student Blood/Body Fluid Exposure Protocol.
Training
Individuals working with blood and OPIM shall receive
"initial" and "annual refresher" training. Initial training is
provided during employee orientation and annual refresher training is the responsibility
of the individual department.
Training will be tailored to the educational level,
literacy, and language of the employee and may be presented through a variety of methods,
e.g., lecture, demonstration, videotape and written materials. The training plan will
allow an opportunity for the employee to ask questions and have a staff member available
to answer the questions.
Content of the training should include:
- Explanation of the bloodborne pathogen standard
- General explanation of the epidemiology, modes of
transmission and symptoms of bloodborne disease
- Explanation of this Exposure Control Plan and how it is
implemented
- Procedures that may expose employees to blood or OPIM
- Control measures to use to prevent/reduce the risk of
exposure to blood or OPIM
- Basis for the selection of personal protective equipment
- Information on the hepatitis B vaccination program
- Procedures to use in an emergency involving blood or OPIM
- Procedures to follow if an exposure incident occurs
- Explanation of post exposure evaluation and follow-up
procedures, and
- Explanation of warning labels and color coding.
Audiovisual materials are available from Human Resources
to augment departmental training. Departmental training should review elements of the
Exposure Control Plan and concentrate on issues and procedures unique to their use of
blood and OPIM.
Spill Procedures
In event of a spill on a bench or floor, the following
general procedures should be initiated:
- Contain the spill with absorbent materials (paper towels,
bench paper, pads, etc.),
- Wet the spill with a bleach solution (10 to 1, water to
household bleach) and leave in contact for at least 10 minutes,
- Pick up the absorbents, place them in a biohazard bag,
- Blot up remaining liquid with absorbents and also place
them in the biohazard bag.
- If a second wetting is necessary due to gross quantities
of blood, apply it with a spray, then blot up with absorbents after sufficient contact
time.
- Place all materials used to decontaminate the spill,
including gloves, in the biohazard waste bag and dispose of properly.
If additional assistance is required, call the
Environmental Health & Safety Office at 446-5798.
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