Engineering and Administrative Control Measures
Employers must take appropriate preventative measures to prevent occupational exposure to blood or OPIMs. Engineering controls include biohazard fume hoods, puncture-resistant sharps containers, biohazard waste containers, mechanical pipette devices and others to permanently remove the hazard or help isolate the worker from exposure. These also include needleless devices, needles with sheaths and blunt suture needles. As new devices become available due to updated technologies, they should be incorporated as engineering controls.
Work practice controls include hand-washing policies, sharps handling procedures, proper waste disposal techniques and more to reduce the likelihood of exposure through the alteration of the manner in which the task is performed (29 CFR 1910.1030(d)(2)).
Employers must provide PPE to employees to minimize the risk of exposure to blood or OPIMs. PPE is appropriate only if it does not permit blood or OPIMs to pass through or reach the employees' outer clothing, undergarments, skin, eyes, mouth or other mucous membranes under normal conditions of use. Following is a list of suggested PPE and when it should be used:
- Gloves: Wear whenever hand contact with blood or OPIMs is possible. Disposable (single-use) gloves, such as examination gloves, must be replaced as soon as possible when contaminated or when their ability to function as a barrier is compromised. They are not to be reused (29 CFR 1910.1030(d)(3)(ix)(A)). Utility gloves can be reused if decontaminated, but must be discarded if cracked, discolored, punctured or showing any signs of deterioration (29 CFR 1910.1030(d)(3)(ix)(c)).
- Masks, eye protection and face shields: Use in combination whenever splashes, spray or droplets of potentially infectious materials are generated (29 CFR 1910.1030(d)(3)(x)).
- Gowns, aprons and other protective clothing: Wear when exposure to the body, head, feet, or clothing is possible. The type and characteristics of the covering will depend on the task and the exposure anticipated (29 CFR 1910.1030(d)(3)(ix)).
- Cardiopulmonary resuscitation (CPR) masks: Use when CPR is given. Masks or face shields should have a one-way valve to prevent contamination from the victim (29 CFR 1910.1030(d)(3)(i)).
Once employees receive training, HBV vaccinations should be made available to those who run the risk of exposure to contaminated blood and OPIMs (29 CFR 1910.1030(f)(2)).
Post-Exposure Evaluation and Follow-Up
Employers must provide a confidential medical evaluation for any employees involved in an exposure incident. The purpose of this evaluation is to document the exposure route and circumstances surrounding the incident, blood testing, HIV/HBV status of source and appropriate medical and psychological treatment (29 CFR 1910.1030(f)(3))
All blood or OPIMs contaminated items that could release infectious materials must be placed in appropriate sharps containers or closable, color-coded or properly labeled leak-proof biohazard waste containers or bags. OPIM waste must be disposed of in accordance with federal, state and local regulations (29 CFR 1910.1030(d)(4)(iii)).
Communication of Hazards
Warning labels must be attached to all containers used for the storage or transport of potentially infectious materials. The labels must be orange or red-orange with the biohazard symbol in a contrasting color. Red containers or bags can be substituted for warning labels (29 CFR 1910.1030(g)).
Housekeeping and Laundry Practices
Employers must create a schedule for periodic cleaning and appropriate disinfecting to ensure that the worksite is kept clean and sanitary. Contaminated laundry must be placed and transported in properly labeled or color-coded bags and containers (29 CFR 1910.1030(d)(4)), (29 CFR 1910.1030(d)(4)(iv)).
The employer must maintain medical and training records for each employee who faces the possibility of being exposed or who has been occupationally exposed to a bloodborne pathogen (29 CFR 1910.1030(h)). Employers are also required to establish and maintain a sharps injury log.
29 CFR 1910.1030, Bloodboorne Pathogens Standard
OSHA Fact Sheet, OSHA’s Bloodborne Pathogens Standard, 2011
Centers for Disease Control and Prevention (CDC) Bloodborne Infectious Disease Page