It was just after lunch when Judy came to the lab manager’s office, looking pale and shaky. She had been working in hematology when an unstained glass blood smear slide slipped from her gloved hands and shattered on the floor. A shard bounced up, nicking her wrist just above the glove line. She cleaned the cut, reported the incident, and followed all the right steps. But as Judy talked, her anxiety was written all over her face. “It was a blood sample,” she said. “Do we know if the patient has anything? What if it was HIV-positive?” That fear, that unknown, is something many laboratorians have faced, and it’s something no one forgets.
Bloodborne pathogen (BBP) exposures in the lab are more common than we’d like to admit. Even with gloves, face protection, sharps containers, and engineered safety devices, things happen. Tubes break, needles get left where they shouldn’t, and sometimes, we simply let our guard down. It’s human. But unlike a chemical spill or a glass cut, a BBP exposure brings with it a unique set of worries—physical, emotional, and long-term professional consequences. Whether the exposure source is known or unknown, the impact can be deep and lasting.
Let’s start with the known source. Imagine a phlebotomist accidentally sticking herself after drawing blood from a known hepatitis B positive patient. The process of managing that exposure begins immediately: wash the site, report the incident, and head to employee health or the emergency department. From there, it becomes a blur—blood tests, vaccine verification, possible post-exposure prophylaxis (PEP), and follow-ups that stretch over weeks or months. Even when the risk is low or manageable, there is a mental toll. The tech may begin to worry every time he or she feels a little off. They might become overly cautious at work, or on the flip side, develop a “why bother” attitude. The stress of the waiting—of not knowing if this one mistake will change everything—is fairly powerful.
Now consider the unknown source. This scenario is especially unsettling because the consequences and the worry are worse. Maybe the source tube was mislabeled. Maybe it was a blood spill from a garbage bag someone picked up and got stuck with a hidden lancet. There is no patient name, no diagnosis, and no clear next step. You report it, but the unknowns stack up like weights. You’re tested, given medications “just in case,” and told to follow up repeatedly. For the next six months, you may wake up wondering if your next blood test will show something life-changing. All from a job you do every day.
There are also operational and organizational consequences that ripple from these events. First, the paperwork starts piling up—exposure logs, incident reports, safety committee reviews, and OSHA recordkeeping. If the incident results in a lost-time injury or requires significant medical intervention, it could be flagged during an inspection. The lab may need to provide proof of BBP training, evidence of work practice controls, and documentation of proper PPE availability and use. And if there's any gap in those records, the regulatory penalties can be steep. The reputational hit to the lab’s safety culture might be even more damaging.
Financially, exposures are costly. The initial medical evaluation, PEP, lab work, and follow-ups don’t come cheap. Worker’s compensation claims, potential legal concerns, and staffing shortages due to time off add to the burden. And in a worst-case scenario—if a tech contracts a chronic illness from an exposure—there’s a human cost that can’t be measured.
It’s easy to fall into the trap of thinking “this won’t happen to me.” After all, you’re careful. You wear your PPE, follow the policies, and know the risks. But I’ve spoken to dozens of laboratorians who’ve had near misses or actual exposures, and none of them thought it would happen to them either. One tech got a splash in the eye while opening a biohazard bag. Another sliced a finger opening a plastic tube top that broke under pressure. These are the everyday tasks we all do without thinking. That’s exactly why they’re dangerous.
So what do we do? First, we keep talking about it. A lab culture that values safety makes reporting exposures normal, not shameful. People should never fear blame for reporting an incident—that only leads to silence and more risk. Second, we double down on training. Annual BBP refreshers aren’t enough if staff forget how to use an eye wash station or where the PEP kit is stored. We need visual reminders, hands-on drills, and discussions at staff meetings. Third, we need to stay vigilant with our safety devices. That safety-engineered needle only works if it’s activated. That splash shield helps only if it’s actually used. Finally, we need to support our colleagues after an exposure. Whether the source is known or not, this is not just a clinical event—it’s an emotional one. A quick follow-up text, a supportive conversation, or even just asking how they’re doing can mean the world. It reminds them they’re not alone in this.
Bloodborne pathogen exposures are part of our reality in the lab world. But they don’t have to be common, and they certainly don’t have to define a person’s career. Each exposure is a chance to learn, to improve, and to recommit to safety—not just for ourselves, but for everyone who walks into that laboratory.