Blood Borne Pathogens and Sources of Infection
Opportunistic infection material includes:
- Vaginal secretions
- Blood products
- Gut fluid
- Spinal fluid
- Heart fluid
- Lung fluid
- Amniotic fluid
Urine, feces and vomit is not considered a HIV threat unless blood is present. However, other infections can occur if handled improperly.
Types of Blood Borne Pathogens
Blood borne pathogens include: HCV, hepatitis A, B, C, and D, malaria, syphilis, babesiosis, brucellosis, leptospirosis, arboviral infections, Creutzfeldt-Jakob disease, and adult T-cell leukemia. Hepatitis in particular thrives in blood, blood laced feces, and sexual fluids.
Universal Policy for Blood Borne Pathogens
Instead of having a procedure for each disease, procedures treat all blood borne pathogens the same. So gloves, masks, and gowns must be worn when appropriate, such as when you are dealing with blood splatters to the face and body. Gloves are used most often because they provide a skin barrier for most common procedures.
Employee Information and Consent
Employees must be informed about the hazards of their job, how to protect themselves and what to do if an exposure occurs. Employees must be retrained annually by law. If employees are trained on the job, they must have a qualified teacher to answer any questions. Otherwise, employees may be referred to other qualifying training sites.
If employees can contract an infection, they must, at minimum, be offered the hepatitis B vaccine. Employees are free to pursue their own vaccine; however, employers are required by OSHA to provide them free of charge when asked. If the vaccination is denied by the employee they are entitled to exposure counseling. Either option must be done within 10 days of completed training. Employees must sign a disinclination form if they don't want to take it. Employees may go back for the vaccine at any time.
In the Event of Contamination
If you believe you have come into contact with a blood borne pathogen, it is best to contact a nearby employee, if possible (help! can someone come to the "named room"). Medical facilities are required to have a designated supervisor or first aid attendant in the event of an exposure. Once this is done, immediately use soap and water around the potentially infected site, then rinse and dry, doing your best to avoid spreading the contaminant, and applying pressure to the wound (as necessary). The person that helps you should put on gloves to protect themselves while they help bandage the wound (or direct you to rinse your wound). The supervisor must be contacted in order to document everything as it happened. Keep a cool head and explain what happened when the time comes. If you end up contaminating the sink, or other areas, make sure to explain so a cleaning solution can be applied to it. This is usually for the benefit of everyone else.
Supervisor Follow Up
Supervisors will usually follow up with testing and counseling within 7-10 days of the incident. Afterwards, they will offer to draw your blood and have it tested. You may elect to turn down blood testing with a disinclination form. If you proceed, your blood will be tested and stored for 90 days. You will also have the option to receive prophylaxis, gamma globulin or a HBV vaccine to reduce transmission risks. You again have the option to decline. In any event, the point of counseling is to teach you how to avoid possible transmission, to get care and what to look out for symptom wise to cut the chances of infection. The results of the incident will be reported on an OSHA 200 form.
In time you will receive a summary of the results. Your summary includes your social security number, test results, your hepatitis B vaccination and disinclination records, a written medical opinion and a copy of the incident report your employer took. This file is confidential; it must be held by your employer for 30 years, plus the duration of your employment.
Who Can Access Your File?
- Representatives of OSHA
- People with your written permission
- State health agencies
Employers are legally not allowed to view your record for any reason, unless you give them permission in writing. Their job is to make sure you are tested, counseled, offered treatment, and that the incident information was compiled. It is illegal to fire employees when confirmation is known. High risk fields may decline hiring infected individuals, but only if there are no practical means to prevent exposure to people. A medical worker, or food handler, for example, would have access to gloves and soap and water. Results may be delivered by another employee, so long as confidentiality is upheld (Information provided by Delmar's Clinical Medical Assisting, 3rd Edition, 2006).