Although this chapter will focus primarily on HBV and HIV, it is important to know which bloodborne pathogens (from humans or animals) you may be exposed to at work, especially in laboratories.

It is important to know the ways exposure and transmission are most likely to occur in your particular situation, whether it be providing first aid or medical assistance, handling blood samples in the laboratory, cleaning up blood from a hallway, or restraining an unruly person.

HBV and HIV are most commonly transmitted through:

In most work or laboratory situations, transmission is most likely to occur because of accidental puncture from contaminated needles, broken glass, or other sharps; contact between broken or damaged skin and infected body fluids; or contact between mucous membranes and infected body fluids. For example, if someone infected with HBV cut his or her finger on a piece of glass and then you cut yourself on the now infected piece of glass, it is possible that you could contract the disease. Anytime there is blood-to-blood contact with infected blood or body fluids, there is a slight potential for transmission.

Unbroken skin forms an impervious barrier against bloodborne pathogens. However, infected blood can enter your system through:

Bloodborne pathogens may also be transmitted through the mucous membranes of the:

For example, a splash of contaminated blood to your eye, nose, or mouth could result in transmission.

Universal Precautions is the name used to describe a prevention strategy in which all blood and potentially infectious materials are treated as if they are, in fact, infectious, regardless of the perceived status of the source individual. In other words, whether or not you think the blood/body fluid is infected with bloodborne pathogens, you treat it as if it is. This approach is used in all situations where exposure to blood or potentially infectious materials is possible. This also means that certain engineering and work practice controls shall always be utilized in situations where exposure may occur.

Hands should also be washed immediately (or as soon as feasible) after removal of gloves or other personal protective equipment.

Because hand washing is so important, you should familiarize yourself with the location of the hand-washing facilities nearest to you. Laboratory sinks, public restrooms, janitor closets, and so forth may be used for hand washing if they are normally supplied with soap. If you are working in an area without access to such facilities, you may use an antiseptic cleanser in conjunction with clean cloth/paper towels or antiseptic towelettes. If these alternative methods are used, hands should be washed with soap and running water as soon as possible.

If you are working in an area where there is reasonable likelihood of exposure, you should never:

No food or drink should be kept in refrigerators, freezers, shelves, cabinets, or on countertops where blood or potentially infectious materials are present.

You should also try to minimize the amount of splashing, spraying, splattering, and generation of droplets when performing any procedures involving blood or potentially infectious materials, and you should never pipette or suction these materials by mouth.

Decontamination should be accomplished by using:

If you are cleaning up a spill of blood, you can carefully cover the spill with paper towels or rags, then gently pour the 10% solution of bleach over the towels or rags, and leave it for at least 10 min. This will help ensure that any bloodborne pathogens are killed before you actually begin cleaning or wiping the material up. By covering the spill with paper towels or rags, you decrease the chances of causing a splash when you pour the bleach on it.

If you are decontaminating equipment or other objects (be it scalpels, microscope slides, broken glass, saw blades, tweezers, mechanical equipment upon which someone has been cut, first aid boxes, or whatever), you should leave the disinfectant in place for at least 10 min before continuing the cleaning process.

Of course, any materials you use to clean up a spill of blood or potentially infectious materials must be decontaminated immediately as well. This would include mops, sponges, reusable gloves, buckets, pails, etc.

Organizations which provide first aid and cardiopulmonary resuscitation (CPR) response to injured employees are not currently mandated to comply with all of the new regulations recently enacted by OSHA, as long as these employees who provide emergency care are not paid rescuers. However, serious consideration should be given to incorporating certain aspects of the new regulation into the overall emergency plan of a facility.

As part of the emergency preparedness plan, first aid responders should be advised, in writing, of the steps that will be taken in an effort to minimize exposure to bloodborne pathogens, which include the following:

Provided that employees are merely assisting their fellow employees in providing first aid or CPR, the OSHA regulations pertaining to an infection control program do not apply. However, as a practical manner, and because it is likely that in the future OSHA may address first aid responses and infection control, organizations should implement the practical precautions outlined in this section. Organizations that have taken the time to properly prepare and identify these concerns will head-off any undue stress or concern on the part of those employees who receive first aid and CPR training and who are asked and expected to come to the aid of their fellow employees during an emergency.

By using Universal Precautions and following these simple engineering and work practice controls, you can protect yourself and prevent transmission of bloodborne pathogens.

Labels should display this universal biohazard symbol.

Regulated waste refers to

All regulated waste must be disposed in properly labeled containers or red biohazard bags. These must be disposed at an approved facility. Most departments or facilities that generate regulated waste will have some sort of contract with an outside disposal company that will pick up their waste and take it to an approved incineration/disposal facility.

Nonregulated 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.

If you are exposed, however, you should:

Your employer may administer postexposure prophylaxes, when medically indicated, as recommended by the U.S Public Health Service; provide counseling; and evaluate reported illnesses.Apart from the circumstances surrounding the exposure itself, all other findings or diagnosis by health care professional(s) will remain entirely confidential.

In these cases they need not be offered the series.

Although your employer must offer the vaccine to you, you do not have to accept that offer. You may opt to decline the vaccination series, in which case you will be asked to sign a declination form. Even if you decline the initial offer, you may choose to receive the series at any time during your employment thereafter, for example, if you are exposed on the job at a later date.

As stated previously, if you are exposed to blood or potentially infectious materials on the job, you may request a hepatitis B vaccination at that time. If the vaccine is administered immediately after exposure, it is extremely effective at preventing the disease.

The hepatitis B vaccination is given in a series of three shots. The second shot is given 1 month after the first, and the third shot follows 5 months after the second. This series gradually builds up the body’s immunity to the hepatitis B virus.

The vaccine itself is made from yeast cultures; there is no danger of contracting the disease from getting the shots, and, once vaccinated, a person does not need to receive the series again. There are booster shots available, however, and in some instances these may be recommended (for example, if there is an outbreak of hepatitis B at a particular location) [2].

Finally, if security officers’ interest in safety/loss control is heightened, they should consider obtaining further training in the profession.

Most injuries involving security officers are of the slipping or falling variety. Many injuries are sustained by security officers while on a foot or perhaps vehicle patrol. Prevention is essential in reducing the likelihood of serious accidents occurring to security officers. Prevention is best served when security personnel ensure they have the proper resources before beginning their shift. Those resources include the following:

Nonissued pants, shirts, or jackets that are of thin material or torn and frayed place an officer in a position where they may injure themselves if they brush up against machinery or equipment. Likewise, if a security officer were wearing shorts and were to fall, a greater chance exists of them receiving a cut or scrape on the exposed part of their legs. After dark, light reflective jackets or vests may be required to be worn if outside the facility assisting in traffic direction.

Tennis shoes are generally not considered permissible in factory settings. In some facilities, steel-toe shoes must be worn when walking through the facility. Be certain your employer has approved the type of shoes worn while on the job.

Safety glasses may be required to be worn while on the protected facility’s property. Side-shields may also be required.

Some form of head protection such as a hard hat may be required personal protection equipment to be worn by all security personnel.

It is possible that when patrolling dimly lit areas of a facility, interior lights may need to be turned on. In a dark area, all security personnel should carry suitable portable flashlights if other adequate lighting is not available.

Security personnel are responsible for insuring that they have the proper personal protective equipment with them, prior to beginning their shift.

Information to Identify