The Complete Guide to OSHA Bloodborne Pathogens

Many cancer patients are immunocompromised. If you have cancer or are a cancer survivor, it’s…

Many cancer patients are immunocompromised. If you have cancer or are a cancer survivor, it’s important to take steps to mitigate your increased risk of infection. A course on bloodborne pathogens training helps medical practices keep you safe.
Pathogens can infect people via many routes. Food, animals waste, and skin-to-skin contact can all carry infectious diseases. But blood and other bodily fluids are particularly likely to carry germs.

Therefore, the Occupational Health and Safety Administration (OSHA) mandates safety standards. These regard blood and other bodily fluids. These mandates form the OSHA Bloodborne Pathogens Standard (BBP).

This standard protects people in medical offices from illnesses transmitted through risky fluids. In this guide, we’ll unpack what bloodborne pathogens are and how OSHA’s BBP Standard prevents transmission.

What Are Bloodborne Pathogens?

Bloodborne pathogens are harmful microscopic organisms that live in blood. These viruses, bacteria, and parasites transmit infectious material. Transmission happens when people come into contact with the blood, they live in.
Bloodborne pathogen infections can cause serious illness. There are three key types of bloodborne microbes.

Viruses

Viruses are dangerous organisms that inject their genetic code into living cells. Bloodborne viruses include:

  • the Human Immunodeficiency Virus (HIV)
  • the Epstein-Barr virus (EBV)
  • Hepatitis B (HBV)
  • Hepatitis C (HCV)

There are more than these four bloodborne viruses, but these pose significant risks.
EBV and HCV are known to cause cancer or to increase the risk a person will develop cancer. HCV causes liver cancer in some patients. EBV is associated with an increased risk of lymphomas and stomach cancers.

So, preventing bloodborne virus transmission protects current cancer patients. It also prevents new cancers from developing.

Bacteria

Bacterial infections can also transmit through blood. Methicilin-resistant Staphylococcus Aureus (MRSA) kills 19,000 people per year.

The deadliest MRSA infections onset in hospitals. MRSA is one of the most significant bloodborne bacteria.

Parasites

Malaria is an illness caused by a parasite. The Plasmodium parasite transmits through blood. It also transmits through animal vectors, like mosquitos.

Other Potentially Infectious Materials (OPIM)

Pathogens also live in other bodily fluids. These include human waste, spinal fluid, and saliva (among others).

Non-blood fluids are OPIM. It is wise to take precautions to prevent disease transmission via OPIM. These are the same steps you would take to prevent bloodborne transmission.

OSHA Bloodborne Pathogens Standard

OSHA set the Bloodborne Pathogens Standard in 1991. This standard is a set of regulations that mandates safety tools and precautions.

All organizations where an employee is “reasonably likely” to encounter blood must meet these standards. OSHA periodically updates the standard to address emerging threats and new technology.

Accidental Needlestick Amendment

In 2000, OSHA amended the BBP Standard with the Needlestick Safety and Prevention Act. This amendment set new regulations on how to design and use medical needles.
Needlesticks are a common cause of accidental bloodborne pathogen exposure. This amendment works to prevent needlesticks in medical offices, dental practices, and emergency medical situations.

OSHA Enforces BBP Standard Compliance

OSHA enforces BBP Standard compliance with fines and penalties. Employees can file a complaint with OSHA if their employer fails to meet the standard.

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Likewise, harmed patients may file lawsuits against organizations. Patients may sue organizations that expose them to bloodborne pathogens through negligence.

Twenty-eight states expand on the BBP Standard with additional safety regulations. OSHA links to these state regulations on its official site.

Prevent Bloodborne Pathogen Transmission

There are five key strategies to prevent bloodborne pathogen transmission. The BBP Standard mandates workplaces implement each strategy if it’s relevant to the work environment.

These strategies are:

  • Universal Precautions
  • Work Practice Controls
  • Engineering Controls
  • Hazard Isolation
  • Vaccination

A workplace integrates all five strategies. Then, it will effectively prevent bloodborne pathogen transmission. Look for these strategies in any healthcare practice.
Universal Precautions and Standard Precautions

The CDC created the Universal Precautions in 1985. These precautions assume all blood may be infectious. Processes stem from that assumption.

OSHA adopted the Universal Precautions into the Bloodborne Pathogens Standard in 1991. Later, in 1996, the CDC updated Universal Precautions.

This update included OPIM pathogen prevention practices. These are called the Standard Precautions.

Treating all blood and OPIM as if it is infectious encourages good hygiene practices. It also encourages the use of personal protective equipment.

Personal Protective Equipment (PPE)

Personal Protective Equipment (PPE) is a set of garments that protect skin and mucous membranes from exposure to pathogens. PPE includes

  • skin-tight gloves
  • googles or other protective eye-wear
  • protective masks that cover the nose and mouth
  • protective footwear
  • other protective clothing, including fluid-repellant scrubs

Which PPE is mandatory varies from job to job. But, the purpose of PPE remains the same. In studies, PPE dramatically decreases the risk of bloodborne pathogen transmission.

In a survey of paramedics, a lack of PPE dramatically increased contamination incidents. 80% of eye and nose contamination incidents happened when the employee was not wearing goggles or masks.

Other factors contribute to PPE’s effectiveness. One out of five paramedics surveyed said they want better training to use PPE properly.

One out of four paramedics wants better-designed PPE. Design improvements would make PPE better-fitting and more comfortable. Paramedics also want easier access to PPE at all times.

Design that maximizes access to resources in an engineering control. Engineering controls and work practice controls are critical. Together, they make up the bulk of bloodborne pathogen prevention tasks.

Work Practice Controls

Work practice controls are processes and procedures. They tell employees how to do a job in a way that prevents bloodborne pathogen exposure.

They can be unique to a specific workplace. For example, paramedics develop controls for safely extracting patients.

At the same time, these controls might apply to all workplaces that engage with blood. Each workplace must develop its own best practices from the BBP Standard guidelines.

Safer Sharps Handling and Disposal

Safer sharps handling and disposal practices prevent pathogen transmission via medical needles. These practices make blood tests safer. They also mandate prompt needle disposal after use.

These work practice controls prevent needle re-use. They also mandate Hygenic needle use methods.

Safer Specimen Handling

The CDC outlines the best practices related to handling blood specimens safely. The center’s best practice notes on sample collecting include:

  • timetables
  • procedures
  • variant practices for different sample types
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The CDC also details the best blood specimen processing practices. An employee must also meet specific procedural requirements when:

  • shipping
  • staining
  • examining blood under a microscope
  • extracting DNA from a blood sample

Employees should check CDC and OSHA handbooks for more in-depth instructions. Bloodborne pathogens training also covers safer specimen handling practices.

Safer Laundry Handling

Work practice controls make laundry handling safer. These controls prevent bloodborne pathogen transmission via contaminated fabrics.

Contaminated laundry must be bagged on site. Employees must not move un-bagged fabrics containing blood or OPIM. Staff must pack contaminated laundry in leak-proof biohazard bags.

Laundry bags must be red. They must showcase the biohazard symbol.
Employers must clean contaminated laundry at a facility that meets universal precautions. This means staff to wear PPE when they clean the fabrics.

Safer Contaminated Surface Cleaning Practices

Work practice controls detail best surface cleaning practices—the EPA and CDC note which disinfectants are appropriate for clean surfaces exposed to blood or OPIM. OSHA’s BBP Standard requires employers to abide by those disinfectant guidelines.
Cleaners must use tuberculocidal disinfectant. These are germicides that contain bleach. Or they contain chemically similar compounds.

Engineering Controls

Engineering controls regulate tool design and interior design. Employers prevent pathogen transmission by implementing safe design principles in healthcare practices.
Engineering controls may mandate the purchase and use of safer needles. Safer needles are built with mechanisms that prevent accidental needlesticks.

Controls may also require a safer sharps container design. Sharps containers must up upright, leak-proof, puncture-proof, and easy to access.

It is also helpful to apply engineering controls to the design of interior medical spaces. Controls ensure these spaces are easy to navigate, and sharps containers are easy to access at all times.

Vaccination

Vaccination protects individuals from specific bloodborne viruses, including HBV. Vaccines empower a person’s immune system to fight off a virus.

Cancer patients and survivors may have a weakened immune system. So, a vaccine may be less effective for a cancer patient.

This makes widespread vaccination more urgent. OSHA requires all employers to offer the HBV vaccine to workers whose occupation exposes them to Hepatitis B.

OSHA also mandates employers give staff accurate information about:

  • vaccines
  • vaccine safety
  • vaccine efficacy
  • the benefits of vaccination

Employers must integrate this information into the workplace. This is a key element of bloodborne pathogens prevention.

Hazard Isolation

Hazard isolation is the final strategy to prevent bloodborne pathogen transmission. Hazard isolation means employees must clear space around a blood or OPIM spill.
Hazard isolation also requires staff to communicate clearly about hazards. It also requires employers to contain sharps effectively.

Hazard communication requires clear signage. Signage must be bright red or orange. It must include the biohazard symbol.

Hazard isolation prevents bloodborne pathogen transmission. This lasts until the hazard can be safely cleaned up or disposed of.

Bloodborne Pathogen Communication

One of the best ways to prevent bloodborne pathogen transmission is with clear communication. Biohazard labels are a mandatory part of the communication under the BBP Standard.

Another vital form of communication is a notification of exposure. A workplace must notify anyone who has potentially been exposed. Communicate bloodborne pathogens exposure immediately after the incident.

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There must be a medical follow-up after an exposure incident. It’s important to communicate clearly about how an individual can access follow-up care. Follow-up care must check for any potential pathogens.

Track Patterns of Pathogen Transmission

Exposure incidents will happen. It’s important to track incidents and observe patterns.
An exposure incident is any instance where blood or OPIM comes into contact with an individual’s broken skin, mucous membranes,

Clear records can show factors in exposure incidents. This makes it easier to reduce incidents of exposure by limiting those factors.

OSHA requires employers to record all incidents of potential bloodborne pathogen transmission. In the record of an exposure incident, an employer must note the following:

  • the date and time of the incident
  • the type of exposure (needlestick, bite, etc.)
  • source of exposure
  • narrative details (what happened, in the employee’s own words)

These records may be used in an investigation. They can also determine if there are recurring risks.

For example, is there is a pattern of exposure from needles without safety mechanisms? A workplace can reduce risk by buying needles with engineering controls.

What Is Bloodborne Pathogens Training?

Bloodborne Pathogens Training is a seminar that trains employees to meet the BBP Standard. OSHA requires relevant organizations to attend Bloodborne Pathogens Training once per year.

Some OSHA bloodborne pathogens training courses are online. Others are hosted in-person events. Some employers bring a BBP Standard trainer to the workplace.
An OSHA bloodborne pathogen course varies in length. Training usually takes one to eight hours.

Online training typically lets students move at their own pace. At the end of the training, students must take an exam.

The exam evaluates an employee’s understanding of the BBP Standard. Once an employee passes the exam, they will get Bloodborne Pathogens Certification.

How to Enroll in BBP Training

Employees can enroll in BBP Training online. They may also sign up through their employer.

OSHA does not regulate trainers, but they do mandate minimum trainer requirements. Qualified trainers must be knowledgeable about the subject matter. They must also be available to answer questions during training.

The International Association for Continuing Education Training (IACET) features training courses. Likewise, the National Institutes of Health (NIH) catalogs available accredited training courses. Use these resources to find enrollment instructions.

Bloodborne Pathogens Certification

Employees and workplaces earn OSHA Bloodborne Pathogens Certification. They must complete a BBP Standard Training exam. The trainer grants this credential when a workplace meets the BBP Standard.

OSHA does not offer any certification. Only third-party trainers and evaluators can grant this credential.

Prevent Cancer-Causing Bloodborne Pathogens

Bloodborne pathogens can cause cancer. They also pose serious risks to cancer patients. So, cancer-treatment facilities must work urgently to prevent bloodborne pathogens.
Medical offices that see cancer patients and survivors must take pathogen transmission seriously. Fortunately, OSHA bloodborne pathogens prevention practices give us a validated solution.

Meet OSHA’s Bloodborne Pathogens Standard. To make sure your workplace implements the best possible practices, enroll in bloodborne pathogens training every year.