Bloodborne Pathogens
OSHA 29 CFR 1910.1030
University of Kentucky
Department of Biological Safety
The Bloodborne Pathogens Standard
covers all occupational exposures to blood
or other potentially infectious materials
and serves to provide methods to protect
workers from exposure to bloodborne
pathogens.
For a copy of the standard:
http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051
How does the Bloodborne
Pathogen Standard apply to my
research lab?
• Work with human blood or tissue
• Work with human cell lines
• Work with viral vectors derived from
bloodborne viruses, Lentiviral vectors
• Use of infectious agents that are
bloodborne pathogens, HIV, HBV,
Cytomegalovirus, Malaria, Leptospirosis,
Herpesviruses, Syphilis
Definitions
• Blood:
– Human blood,
– Human blood components,
– And products made from human blood.
– This includes plasma and products derived from
plasma such as human serum albumin (HSA).
– This definition also includes human umbilical cord
blood cells (hUCB).
Definitions
• Bloodborne Pathogens:
– Pathogenic microorganisms that are present in
human blood and can cause disease in humans.
– These pathogens include, but are not limited to,
human immunodeficiency virus (HIV) and hepatitis
B virus (HBV).
Human Immunodeficiency Virus (HIV)
• A retrovirus that causes AIDS (Acquired Immune
Deficiency Syndrome) by infecting helper T cells of
the immune system.
• HIV is transmitted through direct contact with
infected material, such as a needlestick injury.
• Initial symptoms of HIV may be a mild flu-like
illness developing within 1 to 6 weeks of exposure.
• After a latent period which may last several years,
AIDS develops and the disease is characterized by
the loss of T cell function and prevalence of
opportunistic infections
Human Immunodeficiency Virus (HIV)
The probability of being infected following an
exposure to a known HIV positive source is
only about 0.4% and there are only 5 reported
cases of laboratory acquired HIV infections.
If the probability of infection is so low, why are all these
precautions recommended?
While the onset of AIDS may be delayed through drug
therapy and opportunistic infections may be treatable,
AIDS is at this time incurable and fatal.
Hepatitis B Virus (HBV)
• A member of the Hepadnaviridae, HBV is a DNA
virus that affects primarily the liver.
• HBV is transmitted by percutaneous and mucosal
exposures to blood and other potentially infectious
material.
• Initial infection may have few or no symptoms but
can develop into a chronic infection leading to
cirrhosis, chronic active hepatitis, and liver cancer.
• Nearly 1/3 of the world’s population has been or is
actively infected with HBV. This high prevalence
leads to great potential for infection following
exposure to blood or other potentially infectious
material (OPIM).
Definitions
• Contaminated Sharps:
– Any contaminated object that can penetrate the
skin including, but not limited to, needles, scalpels,
broken glass, broken capillary tubes, and exposed
ends of dental wires.
– This includes serological pipets and pipet tips
contaminated with other potentially infected
materials such as human cell and tissue cultures.
http://www.uspinc.com/pipettips.htm
www.coleparmer.ca
Definitions
• Engineering Controls:
– Controls that isolate or
remove the bloodborne
pathogens hazard from the
workplace.
– These may include sharps
disposal containers, self-
sheathing needles, or
needleless systems.
Fisher Scientific
15-353-25, 15-353-24
Safer Sharps
http://catalog.bd.com/ecat/help/f12/safetywithoutcompromise.pdf
Definitions
• Exposure Incident:
– A specific eye, mouth, other mucous
membrane, non-intact skin, or parenteral
contact (needle-stick) with blood or other
potentially infectious materials that results
from the performance of an employee’s
duties.
Preventing Exposure
One way to prevent exposure to
bloodborne pathogens is through the
practice of universal precautions.
Universal precautions are an approach
to infection control in which all human
blood and certain human body fluids
are treated as if known to be infectious
for HIV, HBV, and other bloodborne
pathogens.
Definitions
• Other Potentially Infectious Material (OPIM)
– The following human fluids are considered potentially infectious:
• Semen
• Vaginal Secretions
• Cerebrospinal Fluid
• Pleural Fluid
• Pericardial Fluid
• Peritoneal Fluid
• Amniotic Fluid
• Saliva in dental procedures
• Any body fluid visibly contaminated with blood
• All body fluids when it is difficult or impossible to differentiate between
body fluids
Definitions- OPIM Continued
• Other Potentially Infectious Material (OPIM)
– Any unfixed tissue or organ (other than skin)
from a human (living or dead)
– HIV-containing cell or tissue cultures, organ
cultures
– HIV- or HBV-containing culture medium or other
solutions
– Blood, organs or other tissues from experimental
animals infected with HIV or HBV
Definitions
• Regulated Medical Waste:
– Liquid or semi-liquid blood or OPIM
– Contaminated items that would release blood
or OPIM in a liquid or semi-liquid state if
compressed
– Items that are caked with dried blood or OPIM
and are capable of releasing these materials
during handling
– Contaminated sharps
– Pathological and microbiological wastes
containing blood or OPIM
Engineering and Work Practice
Controls
• The equipment and procedures that are
used to minimize or eliminate employee
exposure to bloodborne pathogens.
• Any exposure risk remaining after the
institution of engineering and work practice
controls shall be mitigated via the use of
personal protective equipment (PPE).
Fisher Scientific 14-827-109
Engineering and Work Practice
Controls
• Handwashing facilities should be readily
available for employee use.
• Hands should be washed after removing
gloves and after any exposure incident.
• Waterless hand sanitizer can be utilized
if handwashing facilities are not
available but hands should be washed
with soap and water as soon as
feasible.
• For more information on hand hygiene:
http://ehs.uky.edu/biosafety/handhyg.html
Engineering and Work Practice
Controls
• Examples:
– Performing human cell culture in a Biological
Safety Cabinet.
– Discarding used needles in an approved
sharps container without recapping the needle.
– Performing procedures involving blood or
OPIM in a manner which minimizes splashes
and generation of aerosols.
Personal Protective Equipment (PPE)
• All employees should have access to PPE that is
task appropriate and the correct size.
• Employee training on PPE should include:
– Location
– Proper Use
– Proper Disposal
– Decontamination Procedures for Reusable Equipment
– Selection of Proper PPE for the Task
• PPE may include, but is not limited to, gloves,
gowns, lab coats, face shields, and goggles.
Recognizing Exposure Potential
To evaluate the effectiveness of engineering and
work practice controls and PPE, you need to
assess the risk of the task being performed.
• Potential for needlestick?
– Example, tail vein injections of tumor cells into rodents.
• Potential for splash?
– Example, vortexing human cell lines.
Waste Disposal
• Sharps
– Approved red sharps container
with biohazard symbol
(UK Supply Center 320144)
– Close and decontaminate the
outside when full
– Medical Center custodial staff
or Environmental Management www.vwr.com
(323-6280) will collect for
disposal by Medical Waste
Contractor
Hazardous Waste Pick-up Request
Waste Disposal
• Human blood or other body fluids and
pathological specimens and containers
grossly contaminated with human blood
(ex. blood bags)
– Dispose of in red, biohazard labeled waste
bags in red, lidded waste containers
– Medical Center custodial staff or
Environmental Management (323-6280) will
collect for disposal by Medical Waste
Contractor when full.
Waste Disposal
• Human Cell and Tissue Culture Waste
– Disposable tissue culture supplies and solid waste
• Collect in an orange or clear autoclave bag labeled with
biohazard symbol
• Autoclave and dispose in regular trash
– Serological Pipets, Pipet Tips, Contaminated Broken
Glassware
• Collect in a plastic-lined cardboard container and place in an
orange or clear autoclave bag labeled with biohazard symbol
• Autoclave and dispose in regular trash
– Liquid Waste
• Autoclave or decontaminate with bleach for disposal in
sanitary sewer
Contaminated Laundry
Reusable lab coats should never be taken
home to be laundered.
Lab coats worn during the manipulation of
blood or OPIM should be bagged and
appropriately labeled with the universal
biohazard symbol prior to pick-up or drop-off
for laundry service. Attempts should be
made to limit contact with contaminated
laundry.
Exposure Control Plan (ECP)
• A manual for how to work safely with blood
and OPIM.
• A comprehensive, workplace-specific
document that outlines in detail all
measures that will be taken to minimize or
eliminate employee exposure.
UK Exposure Control Plan Template:
http://ehs.uky.edu/docs/doc/bio_attachment_ecp.rtf
Exposure Control Plan (ECP)
• The components of the ECP:
– Exposure Determination
– Methods of Compliance
– Hepatitis B Vaccination
– Communication of Hazards
– Post Exposure Evaluation and Follow-up
All labs utilizing human blood or OPIM must
have an Exposure Control Plan.
Exposure Determination
• Considers the type of materials being
utilized and the tasks and procedures that
will be performed in the lab
• Risk assessment for exposure to
bloodborne pathogens
• Allows personnel to familiarize themselves
with the hazards present
Methods of Compliance
Summary of methods to prevent personnel
from exposure to blood or OPIM including:
– Engineering Controls
– Work Practice Controls
– PPE
– Housekeeping Procedures
– Training Documentation
– Exposure Incident Contact Information
Bloodborne Pathogens Training
• Bloodborne pathogen training must be taken
on an annual basis by all employees with
occupational exposure to blood or OPIM
• This training requirement is met by reviewing
this on-line training and successfully
completing the accompanying quiz
• Training certificates should be maintained in
the Lab Safety Manual
• Research labs utilizing HIV and HBV require
additional training
Hepatitis B Vaccination
• Immunization primary measure for
prevention
• Administered as a series of 3 injections
• Provided at no cost to UK employees who
may be exposed to bloodborne pathogens
in the workplace
• Imparts immunity in over 95% of
vaccinated individuals
• Safe and effective
Hepatitis B Vaccination
To decline vaccination, sign a declination form stating:
I understand that due to my occupational exposure to blood or
other potentially infectious materials I may be at risk of
acquiring hepatitis B virus (HBV) infection. I have been given
the opportunity to be vaccinated with hepatitis B vaccine, at no
charge to myself. However, I decline hepatitis B vaccination at
this time. I understand that by declining this vaccine, I continue
to be at risk of acquiring hepatitis B, a serious disease. If in the
future I continue to have occupational exposure to blood or
other potentially infectious materials and I want to be
vaccinated with hepatitis B vaccine, I can receive the
vaccination series at no charge to me.
Communication of Hazards
• Labels containing the universal biohazard
symbol should be placed anywhere blood
or OPIM is used or stored.
• This includes labeling of contaminated
laundry and waste.
Post Exposure Evaluation
and Follow-up
In the event of an exposure incident:
– Wash the area with soap and water or flush with water
– Notify your supervisor of the incident
– Your supervisor will contact Workers’ Care at 1-800-
440-6285 and an appointment will be scheduled for you
at University Health Services
For more information on post-exposure response:
http://ehs.uky.edu/ohs/LabExposureProtocol.pdf
Questions?
Department of Biological Safety
505 Oldham Court
Lexington, KY 40502
http://ehs.uky.edu/biosafety/
E-mail: ehsbiosafety@uky.edu
Marcia Finucane
Biosafety Officer
Phone: 859-257-1049
Cell: 859-699-1553
Holley Trucks Eric Rouse
Senior Biosafety Specialist Biosafety Specialist
Phone: 859-257-8655 Phone: 323-5728
Cell: 859-699-6082 Cell: 859-797-8431