Chapter 1: HIV/AIDS – Communicable Disease Education 1 CE Hour
By: Staff writer Learning objectives Understand OSHA’s Bloodborne Pathogen Standard. Understand proper sterilization and sanitation techniques for your instruments and workplace. Know the difference between HIV infection and AIDS. Bloodborne pathogens Bloodborne pathogens are microorganisms such as viruses or bacteria that are carried in the blood and can cause disease in people. There are many different bloodborne pathogens including malaria, syphilis, and brucellosis, but Hepatitis B Virus (HBV) and the Human Immunodeficiency Virus (HIV) are the two diseases specifically addressed by the OSHA Bloodborne Pathogen Standard. Hepatitis C Virus (HCV) is another virus that has dramatically increased in the United States. Background In March 1992, OSHA’s Bloodborne Pathogen Standard, 29 CFR 1910.1030 took effect. This standard was designed to prevent more than 200 deaths and 9,000 infections every year. While the standard was primarily aimed at hospitals, funeral homes, clinics, law enforcement agencies, emergency responders, and HIV/HBV research laboratories, anyone who can “reasonably expect to come in contact with blood or potentially infectious materials” as part of their job is covered by the standard. Purpose The purpose of the standard is to limit occupational exposure to blood and other potentially infectious materials since any exposure could result in transmission of bloodborne pathogens which could lead to disease or death. Scope The Standard covers all employees who could be “reasonably anticipated,” as the result of performing their job duties, to face contact with blood and other potentially infectious materials. OSHA has not attempted to list all occupations where exposure could occur. “Good Samaritan” acts such as assisting a co- worker with a nosebleed would not be considered occupational exposure. Infectious materials include semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, ammonic fluid, saliva, any body fluid visibly contaminated with blood and all body fluids in situations where it is difficult or impossible to differentiate between body fluids. They also include unfixed tissue or organ other than intact skin from a human (living or dead), Human Immunodeficiency Virus (HIV) containing cell or tissue cultures, organ cultures and HIV or Hepatitis B Virus (HBV)-containing culture medium or other medium or other solutions as well as blood, organs or other tissues from experimental animals infected with HIV or HBV. Exposure control plan The Exposure Control Plan requires employers to identify, in writing, tasks and procedures as well as job classification where occupational exposure to blood occurs without regard to personal protective clothing and equipment. It must also set forth the schedule for implementing provisions of the standard and specify the procedure for evaluating circumstances surrounding exposure incidents. The plan must be accessible to employees and available to OSHA. Employers must review and update it at least annually and more often if necessary to accommodate workplace changes.
Describe how HIV/AIDS infected employees should be treated. Describe the precautions you should take to limit exposure to bloodborne pathogens. Methods of compliance The Standard mandates universal precautions, (treating body fluids/materials as infectious) emphasizing engineering and work practice controls. The Standard stresses hand washing and requires employers to provide facilities and ensure that employees use them following exposure to blood. It sets forth procedures to minimize needlesticks, minimize splashing and spraying of blood, ensure appropriate packaging of specimens and regulated wastes and decontaminate equipment or label as contaminated before shipping to servicing facilities. Employers must provide, at no cost, and require employees to use appropriate personal protective equipment such as gloves, gowns, masks and must clean, repair and replace these when necessary. The Standard requires a written schedule for cleaning, identifying the method of decontamination to be used, in addition to cleaning following contact with blood or other potentially infectious materials. It specifies methods for disposing of contaminated sharps and sets forth standards for containers for these items and other regulated waste. Further, the standard includes provisions for handling contaminated laundry to minimize exposure. Hepatitis B vaccination Vaccinations need to be made available to all employees who have occupational exposure to blood within 10 working days of assignment, at no cost, at a reasonable time and place, under the supervision of a licensed physician/licensed healthcare professional and according to the latest recommendations of the U.S. Public Health Service (USPHS). Pre-screening may not be required as a condition of receiving the vaccine. Employees must sign a declination form if they choose not to be vaccinated, but may later opt to receive the vaccine at no cost to the employee. Should booster doses later be recommended by the USPHS, employees must be offered them. Post-exposure evaluation and follow-up Specific procedures are to be made available to all employees who have had an exposure incident plus any laboratory tests must be conducted by an accredited laboratory at no cost to the employee. Follow-up must include a confidential medical evaluation documenting the circumstances of exposure, identifying and testing the source individual if feasible, testing the exposed employee’s blood if he/she consents, post-exposure prophylaxis, counseling and evaluation of reported illness. Healthcare professionals must be provided specified information to facilitate the evaluation and their written opinion on the need for hepatitis B vaccinations following the exposure. Information such as the employee’s ability to receive the hepatitis B vaccine must be supplied to the employer. All diagnoses must remain confidential. Hazard communication Warning labels including the orange or orange-red biohazard symbol should be affixed to containers of regulated waste, refrigerators and freezers and other containers which are used to
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