In December of 1991, The Occupational Safety and Health Administration (OSHA) put forth a regulation that was designed to minimize healthcare workers’ exposure to blood and other potentially infectious material (OPIM). The regulation came about in large part as a response to a rising trend of cases of employee exposure to HIV and HBV in the 1980s. As a laboratorian, no matter where you may be working, the Bloodborne Pathogens Standard applies to you.
One thing the standard provided was a cleaner definition of the term “Universal Precautions,” a phrase introduced by the Center for Disease Control (CDC) in 1985. Universal Precautions is the practice of treating all patient samples as if they were infectious, and avoiding contact with them by use of Personal Protective Equipment (PPE) such as gloves, lab coats, and face shields. Another term, “Body Substance Isolation,” has a similar meaning but became used widely with first responders such as Emergency Medical Technicians. In 1996 the CDC introduced a newer term, “Standard Precautions,” and it has since replaced the other phrases in the healthcare industry.
The Bloodborne Pathogen Standard contains many requirements that must be followed by those who work with blood or OPIM. One important requirement is the institution of an Exposure Control Plan. This plan must have information for employees about exposure risk, exposure control methods, Hepatitis B vaccinations, communication, staff training and records. Assessing the risk of pathogen exposure for lab staff is important, and it is an often-overlooked process in healthcare. OSHA requires that each job category is reviewed and that the employer determines the amount of exposure risk that is inherent in that job function. For example, a cytotechnologist who only reads slides in a clean office has low exposure risk as compared to a lab processor who handles and opens specimens all day long. Those duties create high exposure risk. Classifying low, medium and high risk for lab staff can help determine what type of safety training, engineering controls, and PPE would be necessary for the job.
The Bloodborne Pathogen standard also requires employee readiness to handle biohazard spills. Employees who work with blood or OPIM need to have proper training and supplies in order to properly handle such incidents. Blood and body fluid spills are not often large in the lab setting, but they may contain pathogens, and spatters or splashing need to be avoided. PPE should also be utilized including face protection. Use absorbent materials and bleach-based solutions for disinfecting the area. If there is broken glass involved, never pick it up with hands 9even if gloved), always use tongs or other implements.
The route to infection in a lab setting is potentially short, and OSHA designed its regulations to help staff decrease that risk. That is why food and drink in a lab area is forbidden, and that is why gum chewing, using throat lozenges or lip balm must be avoided. The standard mentions some specific actions to avoid such as applying make-up or touching contact lenses. Not all forbidden actions are discussed (nor can they be, much to the chagrin of some safety professionals), but it is clear the regulations are meant to keep hands in the lab away from the face and mucous membranes, common routes of pathogen entry.
Laboratorians should handle all specimens as if they were potentially infectious- and indeed they are. HIV, Hepatitis, and even prions are just some of the dangerous pathogens that can be contracted from mishandling specimens or from not following safe practices in the lab. There have been people who have become very ill and those who have died from exposure in the laboratory. Ensure that the regulations put forth by the Bloodborne Pathogens standard are enforced in your lab so that your staff will remain healthy and safe.