Bloodborne pathogens are infectious microorganisms present in blood and other body fluids that can cause disease in humans.1 Bloodborne pathogens include human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). Exposure to these and other bloodborne pathogens is certainly an exposure to workers in the health care industry, but should it be a concern in our industry? 

In a school setting employees who could be exposed to bloodborne pathogens as part of their job duties include:

• School nurses
• Health aides
• Custodial staff
• Athletic trainers
• First aid responders
• Staff working with  students prone to biting2

Evaluate school job responsibilities to identify staff duties that could reasonably be expected to involve being exposed to blood and other body fluids or other potentially infectious materials.

Exposures to blood and other body fluids occur across a wide variety of occupations. A key aspect of protecting workers is to treat any human blood and other potentially infectious materials as if they are known to be infectious. OSHA’s Bloodborne Pathogens Standard (29 CFR 1910.1030) outlines what is important for employers to do to protect employees who have occupational exposure (reasonably anticipated job-related contact with blood or other potentially infectious materials). 

The OSHA Standard requires employers to: 

• Establish an Exposure Control Plan - This is a written plan used to eliminate or minimize occupational exposures. In this  plan, include a list of job classifications where workers have occupational exposure, along with a list of the tasks performed by those workers that result in their exposure. Update the plan annually to reflect changes. A sample plan is available from OSHA at http://www.osha.gov/Publications/osha3186.html.

• Identify and Use Engineering Controls - Engineering controls include devices that isolate or remove bloodborne pathogen hazards from the workplace.

• Identify and Establish the Use of Work Practice Controls - Implement work practices that may reduce the possibility of exposure by changing the way a task is performed. Among others, this could include practices for handling and disposing of contaminated sharp materials, cleaning contaminated surfaces and items and handling laundry.

• Provide Personal Protective Equipment (PPE) - This includes items such as gloves, gowns, eye protection and masks. 

• Offer Hepatitis B Vaccinations - Offer the hepatitis B vaccination to workers assigned to positions that have been determined to have the potential for occupational exposure . According to the OSHA Standard, this vaccination must be offered after the worker has received the required bloodborne pathogens training and within 10 days of initial assignment to a job with potential occupational exposure.

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  Make Post-Exposure Evaluation and Follow-up Available - Following an occupational exposure incident, follow-up with the employee and medical provider to document the response to the incident. Provide this evaluation and follow-up at no cost to the worker. 

• Use Labels and Signs to Communicate Hazards - Facilities may use red bags or red biohazard containers in lieu of warning labels. 

• Provide Information and Training to Workers - Provide workers regular training that covers all elements of the standard including, but not limited to:

  • Information on bloodborne pathogens and diseases.

  • Methods used to control occupational exposure.

  • The employer’s exposure control plan.

  • Hepatitis B vaccine.

  • Medical evaluations and post-exposure follow-up procedures.

The OSHA Standard requires employers to offer this training on initial assignment and at least annually thereafter. Provide training when new or modified tasks or procedures affect a worker’s occupational exposure. During training, allow workers the opportunity to ask questions, and present the material at an educational level and in a language that any worker can understand.

• Maintain Worker Medical and Training Records - Recordkeeping requirements are addressed in detail within the OSHA standard.  

Summary

Working in occupations with potential exposure to blood and other potentially infectious materials carries a certain degree of risk. These risks can be controlled by developing and implementing an exposure control plan. In the plan, evaluate the tasks that need to be done, taking the potential exposures into consideration and outline how those tasks can be completed while still protecting the worker. 

1 OSHA Fact Sheet, OSHA’s Bloodborne Pathogens Standard, 2011.

2 Health and Safety Fact Sheet, Bloodborne Pathogens, New York State United Teachers, Division of Field Services, January, 2005