Marlene walked by the chemistry department and noticed several lab safety issues with Doug who was working there that day. Doug was wearing mesh sneakers. He had on a lab coat but his sleeves were rolled up. He was chewing gum, and he was placing open specimens on the analyzer with no face protection. When Marlene approached Doug about these issues, he acted confused. He understood why his lab coat sleeves should be rolled down, and he knew he should be wearing a face shield, but he did not agree with Marlene’s comments about his shoes and the gum. What was unsafe about that?
OSHA’s Bloodborne Pathogens Standard was signed into law in 1991, and its impact in the laboratory to this day is massive. The regulation has an effect on a wide variety of lab safety policies and procedures, but it means little if the staff is not aware of it. The concept of Standard Precautions – treating all samples as if they are infectious – has its basis in this important standard, and education about this for laboratory staff is critical. Let’s take a look at some of the elements of the Bloodborne Pathogens Standard and connect them directly to processes that should be followed in the lab:
Exposure Risk:
One of the first safety tasks that should be performed in a lab is to look at each different job title and assign to it a level of risk of exposure to blood or body fluids. Then each lab task needs to be assessed for that same risk of exposure. These determinations will help you to design safe work practices and utilize proper engineering controls to protect staff. They also play a large role in understanding what PPE should be used for the various lab tasks and procedures.
Regulated Medical Waste:
The handling of RMW (bio-hazardous waste and sharps) is clearly defined by the standard. Do lab trash cans need lids? Not necessarily, but they are required to have tight-fitting lids if and when they are moved out of the department. Sharps containers need lids on them at all times, and they must be prevented from tipping over. An exposure from an unknown source should be avoided at all costs.
No Eating/Drinking in Lab:
The BBP Standard and OSHA’s Chemical Hygiene Standard forbid eating, drinking, smoking, applying lip balm, cosmetics, and handling contact lenses in the lab. Their goal is to reduce hand-to-face contact in order to prevent the accidental transmission of bloodborne pathogens. While the BBP Standard does not mention chewing gum, the Chemical Hygiene Standard does – “Eating, drinking, smoking, gum chewing, applying cosmetics, and taking medicine in laboratories where hazardous chemicals are used or stored should be strictly prohibited.” In case staff asks you, this includes throat lozenges and hard candy.
Personal Protective Equipment:
Proper PPE training and use in the lab is required for all employees. Fluid-resistant lab coats and gloves are required, and face protection is needed “whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated.” That can happen any time staff handles open specimens in the lab. Proper footwear is also required. The BBP Standard states that “personal protective equipment will be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through to or reach the employee’s …skin.” Since exposures can occur via this route, protective footwear must be worn. This means that shoes worn in the lab must be made of a solid material. OSHA’s separate PPE Standard does not require employers to pay for this protective type of footwear as it is not considered “specialized.”
Other BBP Elements:
The above items are just some of the topics covered by the very wide set of regulations known as the Bloodborne Pathogens Standard. Other subjects important to the lab include exposure follow-up, vaccination requirements, and signage and labeling. The standard even goes into detail about pneumatic tube use and specimen packaging.
The last section of the standard discusses the training that is required for all staff. When done properly, you might avoid confrontations like the one between Marlene and Doug. Staff is required to have initial and at least annual education about bloodborne pathogen epidemiology, exposure reduction methods, PPE selection and use, exposure response, and signs and labels. This one set of regulations should be explored and discussed regularly with your lab staff. A solid exposure control plan will reduce the number of laboratory acquired infections and work to improve the safety of our highly-valued staff.