LEARNING OUTCOME AND OBJECTIVES:  Upon completion of this continuing education course, you will have the knowledge to comply with OSHA’s Bloodborne Pathogens Standard and CDC directives regarding risks and precautions associated with exposure to blood and other potentially infectious materials. Specific learning objectives to address potential knowledge gaps include:

• State the OSHA definition for blood and other potentially infectious materials (OPIM).
• Summarize the employer requirements of OSHA’s Bloodborne Pathogens Standard.
• Describe the chain of infection as it applies to bloodborne diseases.
• Identify bloodborne diseases of concern to healthcare providers in the United States.
• Discuss how Standard Precautions protect against bloodborne pathogens.
• Discuss types of personal protective equipment, work practices, and engineering controls that reduce risk of exposure to bloodborne pathogens.
• Summarize employer and employee actions to be taken in case of an occupational exposure to a bloodborne pathogen.

INTRODUCTION

Bloodborne pathogens are microorganisms that may be present in human blood and can cause disease. There are a number of bloodborne pathogens, and those of primary concern are the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV).

Exposure to blood and other body fluids that may contain blood occurs in the general population as well as in a wide variety of occupations that include healthcare workers, emergency response and public safety personnel, those working in maintenance, and those working in the waste handling industry. Individuals in these occupations can be exposed to blood through needlestick and other sharps injuries as well as through contacts with mucous membranes and skin.

Recognizing the risk for those working in these occupations has resulted in efforts to ensure their safety in the workplace, and guidance is contained in the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard. Occupational exposure to bloodborne pathogens is often preventable.

Exposure Incidence

The U.S. Exposure Prevention Information Network (EPINet) Sharps Injury and Blood and Body Fluid Exposure Surveillance Research Group collects data annually from healthcare facilities around the United States. Participating hospitals vary in size, geographic location, and teaching status. The exposure patterns, however, are very similar, suggesting a high degree of standardization among medical devices and procedures.

In 2022 there were a total of 1,575 needlestick and sharp object injury records reviewed. Of this total:

• Nurses incurred 40.6% of exposures, followed by 17.2% among attending physicians.
• The greatest percentage of exposures (40.4%) occurred in the operating and recovery rooms, and 26.5% occurred in patient rooms or wards.
• A contaminated sharp object was involved in 1,450 injuries, with 25.4% occurring while giving an intramuscular or subcutaneous injection and 27.6% while suturing.
• The percentage of medical devices involved in injury that did not include a “safety design” was 62.6%.
• “Safety design” needles or medical devices were not activated in 66.0% of injuries and were partially activated in 26.3%.

In that same year, there were 514 blood and body fluid exposure records reviewed. Of this total:

• Nurses incurred 57.6% of exposures.
• The greatest percentage of exposures (39.4%) occurred in patient rooms or wards.
• The majority of exposures were to blood or blood products (54.2%).
• The barrier most commonly worn was a surgical mask (74.9%).
• The largest area of exposure was the face/head (81.8%).
• The greatest percentage of exposures (74.6%) was to the eyes (conjunctivae).
  (ISC, 2022)