Prevention of hepatitis C Similar precautions to those used for HBV can help to prevent infection with HCV. It is important always to use barrier protection during vaginal, anal, or oral contact;
practice good personal hygiene; and never share needles, razors, toothbrushes, or pierced earrings with anyone. Although no HCV vaccine is available, research is ongoing (HIV.gov, 2022c; Rizza, 2020). UNIVERSAL AND STANDARD PRECAUTIONS WHEN DEALING WITH HIV AND OTHER BLOODBORNE PATHOGENS
Universal precautions Universal precautions (UP) describe the practice of avoiding contact with bodily fluids by means of wearing nonporous articles, such as gloves, goggles, and face shields. In this approach to infection control, all human blood and some body fluids are treated as though they are infectious. Standard precautions In 1996, the CDC added more infection prevention elements to universal precautions to protect healthcare workers from bodily fluids that had not been included in universal precautions. The new term was “standard OSHA Bloodborne Pathogens Standard To protect healthcare workers (and their patients), OSHA developed the Bloodborne Pathogens Standard. The CDC includes mortuary and funeral personnel under the category of healthcare workers. The universal precautions guidelines were the foundation for OSHA’s 1991 development of precautions to prevent occupational exposure to bloodborne pathogens in healthcare settings, including the funeral industry. OSHA (2011b) defines bloodborne Exposure control plan In keeping with paragraph 1910.1030(c)(1)(i) in OSHA’s Bloodborne Pathogens Standard, employers need to establish an exposure control plan and update the plan annually (OSHA, 2011b). This written plan is designed to eliminate or at least minimize occupational exposure to bloodborne pathogens. In the plan: ● The employer prepares an exposure determination containing a list of job classifications in which all workers have occupational exposure, a list of job classifications in which workers have some exposure, and a list of tasks and procedures that result in exposure.
In the early 1990s, OSHA mandated the use of universal precautions, which were particularly meant to protect against potentially infectious blood and other bodily fluids. Although OSHA’s Bloodborne Pathogens Standard incorporates universal precautions, they are no longer used on their own (OSHA, n.d.b). precautions” (SP; Gamma Compliance Solutions, 2021; OSHA, n.d.b). These precautions cover bloodborne and airborne transmission and assume that all patients are potentially infectious. pathogens as infectious microorganisms present in human blood that can cause disease in humans. These pathogens include, but are not limited to, HIV, HBV, and HCV. OSHA covers bloodborne pathogens under Standard Number 1910.1030 (OSHA, n.d.a). The OSHA Bloodborne Pathogens Standard can be accessed at https://www.osha. gov/laws-regs/regulations/standardnumber/1910/1910.1030 ● The employer includes annual updates reflecting changes in tasks, procedures, and positions that affect occupational exposure, along with technological changes that reduce or eliminate occupational exposure. ● The employer documents having solicited input from frontline workers in identifying, evaluating, and selecting effective engineering and work practice controls. (OSHA, 2011b) State requirements may be more stringent than those of OSHA, and it is therefore important to be aware of state regulations (Denault & Gardner, 2022).
CDC recommendations concerning universal versus standard precautions Although the OSHA Bloodborne Pathogens Standard incorporates universal precautions into its mandates for dealing with such threats as HIV, HBV, and HCV, the Centers
for Disease Control and Prevention prefers that funeral professionals incorporate the extra protection offered by standard precautions (NFDA, n.d.).
PERSONAL PROTECTIVE EQUIPMENT (PPE)
PPE refers to a variety of barriers and respirators, used alone or in combination, to protect mucous membranes, airways, skin, and clothing from contact with infectious agents. The selection of PPE is based on the nature of the interaction or Gloves Gloves are used to prevent contamination when anticipating direct contact with blood or body fluids, mucous membranes, nonintact skin, and other potentially infectious material, as well as for handling or even touching visibly or potentially contaminated equipment and environmental surfaces (Siegel et al., 2007 [updated in 2022]).
the likely mode of transmission. Hand hygiene is always the final step after removing and disposing of PPE. The following sections highlight the primary uses and methods for selecting PPE equipment: For contact with blood and body fluids during nonsurgical procedures, a single pair of gloves generally provides adequate barrier protection. Vinyl gloves have higher failure rates than latex or nitrile gloves (Siegel et al., 2007/2022). Either latex or nitrile gloves are preferable for procedures that require manual dexterity or that will involve more than brief contact with potentially infectious materials. For embalmers, nitrile gloves are in any case preferred because of nitrile’s higher chemical resistance against formaldehyde (NFDA, 2010).
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