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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


   


 

HOW TO AVOID CONTRACTING A DISEASE FROM A BLOODBORNE PATHOGEN

(PRIVATE BLOODBORNE PATHOGENS EXPOSURE CONTROL PROCEDURES)

http://spokanerisk.org/Risk%20Files/R&S%20Manual/Part%20C-Annual%20Compliance%20Plans/C2%20-%20Bloodborne%20Pathogens%20Chapter.doc

Bloodborne pathogens are microscopic organisms, which cause disease and are found in and transmitted through human blood.  The most known Bloodborne pathogens are Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV).

HBV is a virus that causes the disease, Hepatitis B.  Hepatitis B is a serious public health problem that affects people of all ages in the United States and around the world.  Each year, more than 300,000 persons get Hepatitis B in the United States.  The disease can lead to severe illness, liver damage, and in some cases, death. 

HCV is a virus that causes the disease, Hepatitis C.  This virus is being identified more frequently and there is no vaccination at this time.

HIV is a virus that eventually develops into a disease called Acquired Immunodeficiency Syndrome (AIDs).  HIV is a relatively recent public health problem that has become increasingly more prominent among people in the United States and around the world.  Approximately 750,000 Americans have AIDs. 

 HIV lowers the immune system making those infected with the virus extremely susceptible to other diseases.  Because there is no cure for AIDs, the virus continues to attack the immune system until another disease or condition causes death. 

HIV and HBV are considered the most threatening of the Bloodborne pathogens because they are the most common, and they are easily transmitted through small amounts of blood or other body fluids. 

The City of Spokane recognizes that many employees are at risk of infection by the more common Bloodborne pathogens, especially HBV and HIV.  These Bloodborne pathogens can live in and be transmitted through blood, semen, vaginal secretions, and unfixed human tissue.  Transmission usually occurs when the materials mentioned above come in contact with a person’s bloodstream through a needle stick, a cut, or a break in the skin.  Some city employees perform duties that require them to come in contact with blood or other potentially infectious materials.  Because these employees can reasonably anticipate such contact, they are considered “occupationally exposed.”  And, under WISHA’s Bloodborne Pathogen Standard, these designated employees must go through special training and follow certain procedures to prevent infection from Bloodborne pathogens.

The City’s Bloodborne Pathogens Exposure Control Plan endorses such procedures and provides specialized training as required by the Bloodborne Pathogen Standard, WAC 296-823, found in the Washington Industrial Safety and Health Act (WISHA)

   


 

The City’s Bloodborne Pathogen Exposure Control Plan is designed to prevent exposure to Bloodborne pathogens by establishing preventive practices that should be used when working around blood or other potentially infectious materials.  Remember that HBV, Hepatitis B, is the only Bloodborne pathogen with a vaccine at this time.  Components of this program are appropriate for all employees to prevent exposure.

The plan has been put in place to reduce your risk of exposure to Bloodborne pathogens by with the following activities:

a)    Creating a list of employees with occupational exposure to blood or other potentially infectious materials

b)   Making the Hepatitis B vaccine available to all employees with occupational exposure

c)    Educating employees on methods for preventing exposure to Bloodborne pathogens

d)   Providing necessary personal protective equipment and training in proper use.

e)    Keeping records on employee vaccinations and training as it relates to Bloodborne pathogens

f)      Providing medical treatment when employees become exposed to blood or other potentially infectious materials.

g)    Investigating blood and body fluid exposure incidents.

The following chapter clarifies the responsibilities of both supervisors and employees in implementing the City’s Bloodborne Pathogens Exposure Control Plan and complying with WISHA’s Bloodborne Pathogen Standard. 

Note:  Copies of the City’s Written Bloodborne Pathogen Exposure Control Plan are available at www.spokanerisk.org and are on file in the Risk Management office.  WISHA’s Bloodborne Pathogen Standard (WAC 296-823) is available at  http://www.lni.wa.gov/Safety/Rules/default.htm

Who participates in the City’s Bloodborne Pathogens Exposure Control Plan?

The City’s Bloodborne Pathogens Exposure Control Plan is designed to protect employees who can reasonably anticipate being exposed to blood and other potentially infectious materials during work.  Therefore, all employees with occupational exposure must be enrolled in the City’s plan.  Employees with occupational exposure include, but are not limited to, custodians, firefighters, police, police property clerks, code enforcement workers, refuse collectors, paramedics, hazardous waste technicians, and parks and recreation workers.

Communication, engineering controls and personal protection tools are available to all employees whether in the program or not, to minimize accidental exposure

Note:  A complete list of employee classifications which are required to enroll in the City’s “Bloodborne Pathogens Exposure Control Plan” can be found in this manual’s appendix: Part F- Appendix, FC2.1.

What are some of the methods used to prevent infection from Bloodborne pathogens?

There are several methods for preventing infections from Bloodborne pathogens.  The City encourages every employee (even those employees who are not enrolled in the Bloodborne Pathogen Exposure Control Plan) to use these methods when encountering blood or other potentially infectious materials.  Methods for preventing infections from Bloodborne pathogens include:

a)    Universal precautions

b)   Engineering controls

c)    Work practice controls

d)   Personal protective equipment

What are “universal precautions”?

“Universal precautions” are methods that control exposure to Bloodborne pathogens by treating all human blood, body fluids, detached tissue and other potentially infectious materials as if they were infected with HIV, HBV, or another Bloodborne disease.

The use of universal precautions is the most important measure one can take to control the transmission of HBV, HIV, and other Bloodborne diseases.  Because of this, the City’s Bloodborne Pathogens Exposure Control Plan requires employees to treat all blood and other potentially infectious materials as if they were infectious.

Universal precautions must be observed to prevent contact with infected blood or other potentially infectious materials.  Because it is difficult to tell the difference between blood and other potentially infectious materials, all body fluids should be considered potentially infectious.

What are engineering controls and how do they control Bloodborne pathogens?

The use of engineering controls is another important measure one can take to control the transmission of HBV, HIV, and other Bloodborne diseases.  Engineering controls use special technologies to isolate or remove hazards from the worker.  Examples of engineering controls include puncture resistant containers for needles and broken glass (sharps), splashguards, and self-sheathing needles.

What kinds of engineering controls does the City require, and how should employees use them?

The use of color-coded containers is one of the major controls the City requires to prevent employee exposure to Bloodborne pathogens.  The City uses these color-coded containers in a number of departments to collect, handle, and store contaminated clothing, equipment, and waste.

All containers used for holding potentially infectious sharps (used needles, contaminated pieces of glass, etc.) must be puncture resistant, leak proof, and appropriately labeled and color-coded as a “biohazard.”

Containers used for holding other potentially infectious materials (human tissue, contaminated laundry, used condoms, etc.) do not need to be puncture resistant.  However, they still must be labeled and color-coded as a “biohazard.”

If you handle potentially infectious materials, you must place those materials in the appropriate color-coded container immediately after use.  If the outside of a container becomes contaminated, the container must be placed within a second protective container.

Note:  All department first aid kits should be equipped with “spill clean up kits”.  Biohazard bags both small and large can also be ordered through a first aid supplier. 

What kind of sharps container should I provide?

Guidance for selecting an appropriate sharps container can be found at http://www.cdc.gov/niosh/sharps1.html.  If you are unsure or unable to access this website, contact your Safety Coordinator.

What are work practice controls?

Work practice controls are alterations in the way tasks are performed to reduce your potential for exposure to blood or other potentially infectious materials.  A good example of a work practice control that reduces your chances of becoming exposed is correctly removing your gloves and washing your hands immediately after coming in contact with body fluids.

What kinds of work practice controls does the City require, and how should employees use them?

The City’s Bloodborne Pathogen Exposure Control Plan requires City employees to use several work practice controls to minimize exposure to Bloodborne pathogens.

Hand washing is an important practice.  Most City departments have hand-washing facilities that are readily accessible to employees.  Employees working in departments with hand washing facilities should wash their hands and other exposed skin with non-abrasive soap and water as soon as they come in contact with any blood or other potentially infectious materials.

Other cleansing issues. Mucous membrane (eyes, nose, mouth) may also become exposed to potentially infectious materials.  When eyes are affected, eye wash facilities or clean water should be used to rinse the eyes.  If eye wash facilities are not available, use hand-washing facilities.  When rinsing mucous membrane, do not use soap.  Simply flush the area with clean, cool water.

When it is not feasible to have a hand and/or eye washing facility at a work site, supervisors shall provide employees with a waterless antiseptic hand cleanser containing 60 to 95 % alcohol, and portable eyewash solution.    Those employees who use antiseptic hand cleansers must also use soap and water as soon as they are able.

Decontamination is another important work practice that minimizes exposure to Bloodborne pathogens.  Equipment and work areas contaminated with blood or other potentially infectious materials must be decontaminated unless decontamination is not feasible.  When contaminated equipment and/or work areas have not been decontaminated, the supervisor shall notify all affected employees so appropriate precautions can be taken.

To protect employees from being unknowingly exposed to potentially infectious materials, all departments with equipment or work areas that can reasonably anticipate becoming contaminated with blood or other potentially infectious materials must develop and implement a written schedule for cleaning and decontaminating those work areas and equipment.  Cleaning and decontamination methods must be reasonable based on the location and condition of the work area or equipment, types of surfaces to be cleaned, and tasks and procedures being performed.  

When blood or potentially infectious materials are introduced to a work area, all equipment and working surfaces in that area must be cleaned and decontaminated immediately.  Pieces of broken glass or sharp objects should be cleaned up with a brush and dustpan.  Never use your bare hands.  Decontamination can be achieved using a freshly prepared solution of household bleach diluted 1:10 parts with water.  Gloves should be worn during the decontamination process to protect hands from contamination and chemical irritation.

Contaminated waste shall be disposed of in the color-coded containers labeled “biohazard.”  Non-disposable items such as linen, mop heads, and other equipment must be placed in a 10% chlorine bleach solution for 20 minutes. 

Note:  Employees must always wear protective rubber gloves when handling and washing contaminated items.  Double gloving is recommended.

Contaminated laundry can also hold Bloodborne pathogens.  Therefore, contaminated laundry must be handled as little as possible.  If you must handle contaminated laundry, there are special procedures you must follow.

Most important, always wear gloves when handling contaminated laundry.  Secondly, when work clothes, towels, or any other laundry items become contaminated, they must be placed in bags or containers at the location where they became contaminated.  All bags or containers holding contaminated laundry must be labeled or color-coded “biohazard.”  Furthermore, laundry cannot be sorted or rinsed at the location of use.  If laundry is soaked and looks like it may leak, it must be placed in leak proof bags or containers labeled or color-coded “biohazard.”

Once contained, someone wearing protective gloves can transport contaminated laundry.  Remember, always label or color-code contaminated laundry with the biohazard label before shipping it off-site to a second facility.  

What are some other work practices that minimize employee exposure to Bloodborne pathogens?

Food, drink, and other personal items can become infectious when they come in contact with a Bloodborne pathogen.  Consequently, you should never eat, drink, apply cosmetics or lip balm, smoke, or handle contact lenses in work areas where blood or other potentially infectious materials are present.  Similarly, you should never keep food or drink in or on refrigerators, freezers, shelves, cabinets, countertops, or anything else in these work areas.  When outside these work areas, all employees should wash their hands with soap and hot water or an antiseptic hand cleanser before eating, smoking, or handling contact lenses.

Working with blood and other potentially infectious body fluids presents the highest risk for infection by Bloodborne pathogens.  Public safety workers like firefighters, emergency response staff, and police can come in contact with blood or other potentially infectious materials as part of their everyday work duties.  If you must work with blood or any other potentially infectious material, you can reduce your chances of becoming exposed to a Bloodborne pathogen by using procedures which minimize splashing, spraying, spattering, and the generation of droplets.

Needles present a high risk for infection by Bloodborne pathogens.  Needles can transmit infected blood to otherwise healthy employees through accidental needle sticks.  Some employees are included in the City’s Bloodborne Pathogens Exposure Control Plan simply because their jobs require them to perform duties which put them at risk for an accidental needle sticks.  Firefighters and emergency response staff work with needles on a regular basis to provide citizens with emergency medical treatment.  Refuse collectors and janitors transport and handle needles within the waste stream (usually unknowingly).  Other employees may run into needles in the public places where they work.

Because there is such a high risk of infection from accidental needle sticks, all employees who can reasonably anticipate coming in contact with or using needles while performing their duties must take special precautions.  For example, do not bend, break, cut, recap or remove a contaminated needle from its syringe.  Qualified emergency response staff may bend, recap, or remove a needle when no alternative is feasible or a specific medical procedure requires it.  However, such recapping or needle removal must be done using a mechanical device or a one-handed technique.

Always be cautious of needles when handling waste.  All garbage bags and other containers should be transported on a cart, if heavy, or with your arms extended out and away from your body, if light.  Needles can easily penetrate bags and stick you.

If you discover a used needle, do not pick the needle or its syringe up with your hands.  Instead use gloves, a broom, and a dustpan to sweep the needle up.  Then, drop the needle into a container that is puncture-resistant, leak-proof, and labeled as a biohazard.  Finally, throw the container away.  

Disposal of Biological Waste.

General waste that contains bloodborne pathogens may be disposed of in the solid waste stream after being appropriately bagged or put into puncture and leak proof plastic containers with the bio-waste hazard markings. (A sharps container.)  This includes first-aid waste, general public waste, and waste generated as the result of an industrial accident.

Programs such as clinics or paramedics who generate medical sharps such as hypodermic needles or lancets should collect sharps in a sharps container.  Sharps containers may be disposed of through a service or safely transported with the sharps container in a leak-proof bag to the North Side Land Fill.  The Disposal fee is currently $7.00.

How does personal protective equipment minimize my exposure to Bloodborne pathogens?

Personal protective equipment minimizes your exposure to Bloodborne pathogens by separating you from potentially infectious blood or other materials.  Personal protective equipment includes, but is not limited to, gloves, gowns, lab coats, fluid-resistant aprons, head and foot coverings, face shields or masks, eye protection, mouthpieces, and ventilation devices.

Who is responsible for the proper use, maintenance, and storage of personal protection equipment?

Department supervisors are responsible for ensuring that appropriate personal protection equipment is provided and properly used.  Employees using personal protection equipment are responsible for the proper operation, maintenance, and storage of personal protection equipment.  Because of this, both supervisors and employees must be familiar with the techniques and procedures used to operate, maintain, and store personal protection equipment.

What am I responsible for regarding the use, maintenance, and storage of personal protection equipment?

As part of the City’s Bloodborne Pathogen Exposure Control Plan, all occupationally exposed employees must do the following:

            ·  Complete training on personal protective equipment and become knowledgeable on how personal protection equipment is used to minimize exposures

            ·  Make sure personal protection equipment fits and does not cause allergic reactions

            ·  When garments or personal protective equipment become penetrated by blood or other potentially infectious materials, remove the exposed items immediately at the work area

            ·  After removing exposed garments and personal protective equipment, place the items in a bag or container labeled “biohazard” for storage, washing, decontamination, or disposal

            ·  Wear gloves whenever there is a possibility that your hands may come in contact with blood or other potentially infectious materials

·        Properly dispose single use gloves immediately after use

            ·  Decontaminate multiple-use utility gloves for re-use only if they can still function as a barrier between you and any blood or other potentially infectious material

            ·  Wear masks and eye protection devices such as goggles, glasses with solid side shields, or chin-length face shields whenever splashes, spray, spatter or droplets of blood or other potentially infectious materials might contaminate the eyes, nose, or mouth

            ·  Wear protective clothing such as gowns, aprons, lab coats, clinic jackets, or similar outer garments whenever there is a high potential for exposure to blood or other potentially infectious materials

            ·  Wear surgical caps, hoods, or shoe covers whenever there is a high potential for exposure to blood or other potentially infectious materials

Note:  Decisions about what types of personal protective equipment to use for a particular job must be based on the conditions of the work environment and the likelihood for exposure.  If there is any doubts about what types of personal protection equipment should be worn, employees should contact their supervisor.  If the supervisor has doubts, he or she should contact the Safety Coordinator.

What are supervisors responsible for regarding the use, maintenance, and storage of personal protection equipment?

As part of the City’s Bloodborne Pathogen Exposure Control Plan, supervisors will be responsible for the following duties:

            ·  Becoming trained on how personal protection equipment is used to minimize exposure

            ·  Providing, at no cost to the employee, all “appropriate” personal protective equipment necessary to prevent infection

Note:  Personal protective equipment will be considered “appropriate” only if it does not permit blood or other potentially infectious materials to reach an employee’s skin, eyes, mouth, or other mucous membranes.

            ·  Ensuring that appropriate personal protection equipment is available to all employees including those employees who have allergies or other conditions which may prevent them from using    common types of personal protective equipment (powdered latex gloves, one-size-fits-all face masks and shields, etc.)

            ·  Designating areas and providing containers where exposed personal protection equipment can be stored, washed, decontaminated, and disposed.

            ·  Enforcing the proper use of personal protection equipment (except when it prevents the delivery of health care or poses a greater risk than not using it)

            ·  Making arrangements for cleaning or disposal of personal  protection equipment when it is penetrated by blood or other potentially infectious materials, at no cost to the employee

            ·  Making arrangements for the repair or replacement of personal protection equipment when needed, at no cost to the employee

·         First aid kits must be equipped with mouth guards and gloves

·         Sharps containers must be routinely replaced, and not allowed to over fill.

Does a Department have to maintain their own Exposure Control Plan and how often do we need to do that?

This document is the “basic” exposure control plan for the City.  However, if your department has regular contact with BBP such as Police or Fire, there should be a more specific control plan that is reviewed with your policies and procedures annually. 

In that review, you must make sure the exposure control plan reflects changes in technology that would reduce or eliminate exposure; Document annual consideration and implementation of commercially available safer medical devices; and include provisions for employees to take part in the identification, evaluation and selection of engineering controls and work practices as they would apply to BBP exposures.

Where is our “Needle Stick Log?”

Risk Management will maintain a “contaminated sharps injury log” and distribute it to the City Wide Safety Committee and effected departments annually to aid in reviewing the engineering controls and work practices.  A copy of the master log may be requested at any time throughout the year from Risk Management.

What is the Safety Coordinator responsible for concerning the use, maintenance, and storage of personal protection equipment?

As part of the City’s Bloodborne Pathogen Exposure Control Plan, the Safety Coordinator will be responsible for the following duties:

            ·  Training supervisors and employees on how personal protection equipment is used to prevent infections from Bloodborne pathogens

            ·  Encouraging the proper use of personal protection equipment

What if I have questions about Bloodborne Pathogens?

U.S. HealthWorks is the Medical Provider for our Bloodborne Pathogens Program and a doctor is available for answering any questions by calling 747-0776

Are there vaccinations to protect employees from infections caused by Bloodborne pathogens?

There is a vaccination for the Hepatitis B virus (HBV).  However, there are no vaccinations for the other Bloodborne pathogens, such as Hepatitis C and HIV.

The Hepatitis B vaccination is a three shot series, which prevents infection by the Hepatitis B Virus.  The second injection is given one month after the first.  The third is given five months later.

In over 90% of individuals who complete the vaccination series, long-term protection against Hepatitis B is provided for at least 10 years.

Who gets the Hepatitis B vaccination?

The City will offer the Hepatitis B vaccine free of charge to all employees who can reasonably anticipate contact with blood or other potentially infectious materials (employees with occupational exposure).  According to Washington State Law (WISHA), the City must offer such employees the vaccine series within 10 working days of an employee’s assignment to duties causing occupational exposure.  Employees retain the right to refuse the vaccination.  However, if an employee refuses to be vaccinated, the City must obtain a signed declination statement from that employee.  Employees who sign the declination statement may request and obtain the vaccination at a later date at no cost if they continue to be occupationally exposed.   

Note:  The City’s “Hepatitis B Vaccination Declination Form” can be found in this manual’s appendix: Part F- Appendix, FC2.3.    

A sample letter to Regional Health for issuing the Hepatitis Vaccine can be found in appendix: Part F – Appendix, FC2.3.

What if I become exposed to blood or another potentially infectious material?

If you have an exposure, it is extremely important to wash exposed skin and to contact the appropriate medical professionals immediately.  You should follow any medical recommendations and complete the proper paperwork as soon as it is possible.

If you do have an exposure, call U.S.HealthWorks at 747-0776 immediately.(Within two-hours of exposure or sooner!)  If it is after office hours you will hear a series of beeps.  Enter the phone number where you can be reached followed by a # sign and then hang up.  A physician will call you back within 15 minutes.  When you contact a medical professional, let them know you work for the City of Spokane and have been exposed to blood or another potentially infectious material.  The medical professional will want to know the following information:

   


 

·        Materials you were exposed to (blood, vomit, needle stick, etc.)

·        Parts of your body exposed

·        Open cuts, sores, or rashes exposed

·        Circumstances of the incident

·        Identification of the source individual if possible

After you provide this information, you will be given advice and counseling.  If you had “significant exposure,” the medical professionals on the hotline will notify the emergency room to let them know you will need post-exposure treatment.

Note:  A “significant exposure” is contact between blood and another potentially infectious material and an open cut break in the skin, or mucous membrane (eyes, mouth, and nose). Blood to skin contact is not considered a significant exposure.  However, it should still be reported.   

If you are told that you’ve had a significant exposure and require post-exposure treatment, you should obtain an Exposure Incident Form and go to the emergency room for post exposure treatment immediately.  When you arrive at the emergency room, you should fill out the Exposure Incident Form if you are able. 

Note:  The City’s “Exposure Incident Report” form can be found in this manual’s appendix: Part F- Appendix, FC2.4.    

If the medical professional on the other end of the hotline determines that you haven’t had a significant exposure, you don’t need post-exposure treatment.  However, you should still fill out an Exposure Incident Form for record keeping and prevention purposes.

What will the doctor do if I’ve had a significant exposure?

The doctor will make a post exposure evaluation and treat you for exposure.  State law (WISHA) requires the City or its health care provider to do the following in post exposure evaluation and treatment:

·        Identify and record the routes of exposure and how the exposure occurred

·        Identify and record the identity of the individual who was the source of the exposure

·        Identify and describe your work duties as they relate to the exposure incident

·        Attempt to obtain consent and test the source individual’s blood as soon as possible to determine whether or not the individual is infected with either a Bloodborne pathogen.

·        Document the test results of the source individual

·        Inform you about the source individual’s test results and disclosure laws and regulations concerning confidentiality

·        Collect your blood

·        Test your blood for HBV and HIV

·        Give you the post-exposure Hepatitis B vaccine if your blood tests positive for HBV

·        Provide you with post-exposure counseling

·        Within 15 days, provide you with a written professional opinion on any medical conditions resulting from the exposure incident and whether any further evaluation and/or treatment are recommended.

What if the Doctor cannot obtain consent to test the other persons blood?

Talk with the physician.  Mandatory testing for HIV may be attainable under RCW 70.24.340(4) or WAC 246-100-206 for employees who have experienced a substantial exposure to another person’s bodily fluid in the course of employment.  Testing can be requested from the Regional Health District at 324-1534.  Request a Health Officer Mandate and/or a court ordered blood draw.  The exposed person may also petition the Superior Court within (7) days for the blood draw if the Health Officer does not provide the test.

What are the supervisor’s responsibilities when an employee is exposed to blood or another potentially infectious material?

Immediately after the exposure, supervisors should provide exposed employees with the U.S. HealthWorks phone number 747-0776, the Exposure Incident Form, and transportation to the emergency room for post-exposure treatment if the medical professional at the hotline recommends such treatment.

Within one working day after the exposure, supervisors must send copies of the completed Exposure Incident Form to both Risk Management and Occupational Medicine Associates.

If I’m treated for exposure, will I have medical records somewhere?  If so, where will they be?  Are they confidential?

If you have been vaccinated for HBV, you should already have some records at Risk Management and the City’s vaccination provider.  If you have an exposure incident, additional and more sensitive records will be kept by both Risk Management and the City’s healthcare provider.  These records are kept for workers’ compensation purposes.  OSHA and WISHA require the City to track incidents; however the names of employees will not be disclosed per appropriate privacy laws.  They will include your name and social security number; your vaccination status; the results of your examination, medical testing, and any follow-up procedures; copies of the healthcare professional’s written opinion; and the exposure incident form. 

All of these records will be kept confidential.  No records will be made public or reported outside Risk Management or the City’s healthcare provider without your written consent or a subpoena from an official body of law.

Definitions

 “Blood” means human blood, human blood components, and products made from human blood.

“Bloodborne pathogens” means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

 “Contaminated” means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.

“Contaminated laundry” means laundry which has been soiled with blood or other potentially infectious materials or may contain contaminated sharps.

“Contaminated sharps” means 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.

“Decontamination” means the use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal.

“Engineering controls” means controls (e.g., sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needle less systems) that isolate or remove the bloodborne pathogens hazard from the workplace.

“Exposure incident” means a specific eye, mouth, other mucous membrane, nonintact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties.

“Hand washing facilities” means a facility providing an adequate supply of running potable water, soap and single use towels or hot air drying machines.

 “HBV” means hepatitis B virus.

“HIV” means human immunodeficiency virus.

 “Occupational exposure” means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.

“Other potentially infectious materials” means:

(a) The following human body fluids: Semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids;

(b) Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and

(c) HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

“Parenteral” means piercing mucous membranes or the skin barrier through such events as needlesticks, human bites, cuts, and abrasions.

“Personal protective equipment” is specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g., uniforms, pants, shirts, or blouses) not intended to function as protection against a hazard are not considered to be personal protective equipment.

“Regulated waste” means liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials.

 “Sharps with engineered sharps injury protections” means a nonneedle sharp or a needle device used for withdrawing body fluids, accessing a vein or artery, or administering medications or other fluids, with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident.

“Source individual” means any individual, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to the employee. Examples include, but are not limited to, hospital and clinic patients; clients in institutions for the developmentally disabled; trauma victims; clients of drug and alcohol treatment facilities; residents of hospices and nursing homes; human remains; and individuals who donate or sell blood or blood components.

“Sterilize” means the use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores.

“Universal precautions” are an approach to infection control. According to the concept of universal precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.

“Work practice controls” means controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g., prohibiting recapping of needles by a two-handed technique)