Q&A ON OSHA’S BLOODBORNE PATHOGENS STANDARD

 WHO IS COVERED UNDER OSHA’S BLOODBORNE PATHOGENS STANDARD?

• Anyone exposed to human blood, blood by-products, or other potentially infectious materials during their job duties. (See the following question)

• Anyone whose job requires them to provide 1st Aid or CPR. (i.e., Student Health nurse, USP Public Safety)

• Anyone whose job requires them to drive an injured employee or student to the hospital. (i.e., USP Public Safety)

• Anyone handling biohazardous or infectious waste. (i.e., Faculty, Environmental Health and Radiation Safety (EHRS) Department, Laboratory Personnel, Student Workers)

• Anyone cleaning up spills of blood, blood by-products, or other potentially infectious material. (i.e., Facilities Services Personnel, Faculty, Laboratory Personnel, EHRS)

WHAT ARE THE DEFINITIONS OF BLOOD, BLOODBORNE PATHOGENS AND "OTHER POTENTIALLY INFECTIOUS MATERIALS (OPIM)"?

• "Blood" means human blood, human blood components and products made from human blood.  The term "human blood components" includes plasma, platelets, and serosanguinous fluids (e.g., exudates from wounds).  Also included are medications derived from blood, such as immune globulins, albumin, and factors 8 and 9.

• "Bloodborne Pathogens" means pathogenic microorganisms that are present in human blood and can cause disease in humans.  While Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) are specifically identified in the standard, the term includes any pathogenic microorganism that is present in human blood or OPIM and can infect and cause disease in persons who are exposed to blood containing the pathogen.   Pathogenic microorganisms can also cause diseases such as hepatitis C, malaria, syphilis, asbestosis, brucellosis, leptospirosis, arboviral infections, relapsing fever, Creutzfeldt-Jakob disease, adult T-cell leukemia/lymphoma (caused by HTLV-I), HTLV-I associated myelopathy, diseases associated with HTLV-II, and viral hemorrhagic fever.

• "Other Potentially Infectious Materials" include:   semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, all body fluids in situations where it is difficult or impossible to differentiate between body fluids.

        Any unfixed tissue or organ (other than intact skin) from a living or dead human being.  

        HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV - containing culture
        media or other solutions; and blood, organs, or other tissues from experimental animals
        infected with HIV or HBV.

        Other diseases transmitted by bloodborne pathogens include, but are not limited to,
        Hepatitis C, malaria, syphilis, and leptospirosis.

WHERE IS OUR EXPOSURE CONTROL PLAN LOCATED?

WHO SHOULD CLEAN UP A SPILL?

• No one is to clean up a blood/body fluid spill as part of their job duties until they have had the bloodborne pathogens training and have been offered the Hepatitis B vaccine.

• If the spill is a hazardous material in a special use area, e.g., laboratory or storage area for chemicals or biohazardous materials, the person directly responsible for that area should make sure that it is cleaned up properly.

• If the spill contains blood or body fluids from an injury or incident on campus, the Facilities Services Department is responsible for cleaning up the spill. (Contact Facilities Services at X8955)

• Anyone that does not feel comfortable cleaning up a spill can call the Environmental Health and Radiation Safety (EHRS) Department! (X8925)

See the Biological Safety Emergency Response section for spill clean-up procedures.

WHAT CLEANING AGENTS CAN BE USED TO CLEAN UP A SPILL?

• OSHA states that an EPA-registered tuberculocidal disinfectant, or EPA-registered disinfectants effective against both HIV and HBV, a diluted bleach solution (solution of 5.25 percent sodium hypochlorite (household bleach) diluted between 1:10 (1cup of bleach to 9 cups of water) and 1:100 (1/4 cup bleach per gallon of water) are acceptable for clean-up of a contaminated surface or item. This should be mixed daily. However, it may be corrosive to some equipment and environmental surfaces and therefore may not be an appropriate choice for all situations.
• When using disinfectant products, it is required that there be strict adherence to the instructions on the label.

• Warn others in the area and isolate the contaminated area. (Prevent others from walking through or near the spill.)
• Put on personal protective equipment (PPE) appropriate for the spill size. (e.g., gloves, long-sleeved coveralls, safety goggles).
• Remove glass or sharps, if necessary, with forceps, tongs or scoop.
• For a wet spill, cover with disinfectant-soaked absorbent towels, wipe, and remove toweling. (This decreases the likelihood of causing a splash.) The blood or body fluid must be cleaned thoroughly before proceding to the next step.
• Apply appropriate disinfectant to the area.
• Allow adequate contact time. (Approximately 10 minutes to help ensure bloodborne pathogens are killed.)
• Wipe up and clean again with soap and water.
• Properly dispose of clean-up materials into red biohazard waste bags/containers. Also, place glass, needles, rigid plastic or other sharps into red biohazard sharps containers. No items are allowed to stick out of any biohazard container. (e.g., mops, etc.) The containers must be kept closed.
• Remove gloves, place in waste, but put on a new pair of gloves.
• Bring the biohazard waste containers to the Griffith Hall or McNeil Science and Technology Center stockrooms for proper disposal.
• Remove gloves.Throw in normal trash (if not contaminated).
• Wash your hands.
• While cleaning, work from the outside of the spill and move in, using a circular motion.

DO I HAVE TO GET THE HEPATITIS B VACCINE?

• No. You may decline the vaccinations, but you do have to sign a form indicating that you do not want it.

DO I HAVE TO PAY FOR THE VACCINE?

• If you are an employee or a student doing work at the University, and your job duties expose you to blood and other potentially infectious materials, you do not have to pay for it.

WHAT IS POST-VACCINATION TESTING FOR IMMUNE RESPONSE AND DO I NEED IT?

• Post-vaccination testing is when you have your blood drawn to determine if there is an adequate immune response or if there are adequate antibodies after receiving the 3 doses of vaccine. Post-vaccination testing should be completed 1 - 2 months after the 3rd dose. However, OSHA does not require or recommend having the post-vaccination testing unless you are routinely exposed to blood or body fluids. [It is always required after an exposure incident.] Job descriptions on campus that require the University to offer and pay for post-vaccination testing are: student health nurse/and other staff routinely exposed, individuals who clean up blood spills, research conducted with human blood, cells, or tissue that have not been certified to be free of Hepatitis B, Hepatitis C, HIV, HTLV, syphilis, etc. Other job descriptions may be evaluated for routine exposure to blood or body fluids. Post-vaccination testing will be conducted at the Hospital of the University of Pa. Occupational Medicine Department. You may decline the testing.

IF I ATTENDED THE TRAINING CLASS LAST YEAR, DO I HAVE TO GO AGAIN THIS YEAR?

• Training must be done every year.  However, an employee may complete a Safety Discussion Guide with a quiz on Bloodborne Pathogens.

WHAT IS AN EXPOSURE INCIDENT?

• An exposure incident is when blood or other potentially infectious materials gets into your eye, mouth, or any other mucous membrane (mucous membrane splash), or if it comes in contact with non-intact skin (open wound exposure). If you stick yourself with a contaminated needle or other contaminated sharp object, that is an exposure incident also (percutaneous exposure). [Remember:  Hepatitis B virus can survive on surfaces, dried, and at room temperature for at least one week].

WHAT DO I DO IF I HAVE AN EXPOSURE?

• Immediately flood the exposed area with copious amounts of water, and clean any wound with soap and water or a skin disinfectant if available. Do not rub hard and abrade the skin. For eye splashes, flush copiously with water. (Flush eyewashes once a week for a minimum of 3 minutes to prevent the buildup of amoeba and bacteria. This will prevent eye infections, which can lead to blindness, during its use in an emergency.)

  When an injury or exposure occurs:

See the Accident Reporting section in the Safety Manual for more information.

WHERE DO I PUT MY BIOHAZARD WASTE?

• All contaminated or infectious dry solid type waste (i.e., gloves, personal protective equipment, paper towels, gauze/bandages, bodily fluid/blood saturated items, etc.) should be placed in red bags stored inside proper boxes. (Bags must be stored in labeled biohazard boxes with lids.) Do not put sharps of any kind into red-bagged bozes. Keep the weight of box reasonable, 25 lbs. or less.
  
• All contaminated needles or other contaminated sharps (i.e.; glass and plastic pipettes, slides, rigid plastic, capillary tubes, culture dishes, scalpels, broken glass, etc.) should be placed in red sharps containers or buckets that are puncture-resistant and leakproof. Anything that could potentially puncture a bag should be placed into a sharps container. This includes plastic pipettes, too. By law, non-contaminated needles/blades and syringes must still be placed into a red sharps container. Containers must be closed and disposed of when 3/4's of the way full.
  
• Contaminated liquid waste (aqueous biological or infectious solutions such as blood, urine, cells, microbial cultures) must be autoclaved or chemically disinfected (i.e., bleach) prior to disposal. Upon obtaining a one time approval from Environmental Health & Radiation Safety (EHRS), the disinfected waste may be flushed into the sanitary sewer system if flushed with large amounts of water. Otherwise, these liquids must be in containers that are break-resistant and tightly sealed before being placed into red biohazard waste buckets. There should be sufficient absorbent material in the bucket to absorb the entire contents of liquid in the event of a release. (e.g., absorbent pads or vermiculite)
  
• The bags, boxes, lids, containers and absorbents can be obtained from the Griffith Hall and McNeil Science & Technology Center Stockrooms.
  
• Do not place any hazardous pharmaceuticals (including chemo drugs), chemicals, radioactive waste, or regular garbage into the biohazard waste containers.
  
• Do not autoclave bleach treated waste, flammables, corrosives, reactives, cancer drugs, volatile chemicals or radioactive materials.
• Infectious biohazard waste containing virulent pathogens must be autoclaved before being placed into biohazard waste containers for disposal.

While storing these bags and containers in the laboratory, THEY MUST BE KEPT CLOSED, unless adding waste. Before transport from the laboratory, also check to make sure that they are not leaking.

Non-contaminated sharps or decontaminated sharps, whether plastic or glass, should be placed into blue and white broken glassware boxes or sturdy double bagged boxes labeled as "broken glassware." (Not in regular trashcans) However, place ALL needles,blades and syringes into a red sharps container.

Do not store biohazard waste in hallways or near general traffic. Biohazard waste, excluding used sharps, may be stored at room temperature until the storage container is full, but no longer than 30 days from the date of generation. It may be refrigerated for up to 30 days and frozen for up to 90 days from the date of generation. Biohazard waste must be dated when refrigerated or frozen for storage. Storage of biohazard waste in a freezer must be approved by the Environmental Health and Radiation Safety Department.

As a reminder, hazardous pharmaceuticals and cytotoxic/antineoplastic drugs may not be disposed of in any biohazard waste containers. These must be disposed as hazardous chemical waste. However, discarded contaminated items containing trace amounts of these drugs and non-hazardous pharmaceuticals may still be disposed of as biohazard waste.

See the Biohazard Waste Disposal procedures in the Biosafety Manual for more information.

HOW CAN I PROTECT MYSELF?

• Your risk of infection of Hepatitis B or HIV is very small, but you do need to protect yourself.
  
• Assume that all blood and body fluids are infectious.  This is called "universal" precautions.
  
• Wear appropriate personal protective equipment (PPE) for the job that you are doing.   Wear gloves whenever there's a possibility of contact with blood or other body fluids.
  
• Wear face shields or goggles if there is the possibility of blood or body fluids splashing.
  
• Other types of PPE include:  masks, gowns, coveralls, shoecovers, pocket mouth to mouth resuscitation mask. Check with your supervisor or the EHRS Department, if you are unsure if these are needed.
  
• Dispose of all waste properly.
  
• Report any exposure to infectious materials immediately.   

If anyone has any additional questions, please do not hesitate to contact the EHRS Department (X8925)