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Staff Resources
Personal Protective Equipment, Work Practices, and Engineering Controls
It is extremely important to use personal protective equipment and work practice
controls to protect yourself from bloodborne pathogens.
"Universal
Standard Precautions" is the name used to describe a prevention
strategy in which all blood and other body substances are treated as
if they are, in fact, infectious, regardless of the perceived status
of the source individual. In other words, whether or not you think the
blood/body fluid is infected with bloodborne pathogens or other microorganisms
you treat it as if it is. This approach is used in all situations
where exposure to blood or other body substances is possible. This also
means that certain engineering and work practice controls shall always
be utilized in situations where exposure may occur.
Personal
Protective Equipment
Probably
the first thing to do in any situation where you may be exposed to bloodborne
pathogens is to ensure you are wearing the appropriate personal protective
equipment (PPE). For example, you may have noticed that emergency medical
personnel, doctors, nurses, dentists, dental assistants, and other health care
professionals always wear rubber or latex gloves. This is a simple precaution
that they take in order to prevent blood or potentially infectious body fluids
from coming in contact with their skin. To protect yourself, it is essential
to have a barrier between you and the potentially infectious material.
Rules to follow:
- Always wear personal
protective equipment in exposure situations.
- Remove PPE that
is torn or punctured, or that loses its ability to function as a barrier to bloodborne
pathogens.
- Replace PPE that
is torn or punctured.
- Remove PPE before
leaving the work area.
If you work in an
area with routine exposure to blood or potentially infectious materials, the necessary
PPE should be readily accessible. Contaminated gloves, clothing, PPE, or other
materials should be placed in appropriately labeled bags or containers until it
is disposed of, decontaminated, or laundered. It is important to find out where
these bags or containers are located in your area before beginning your work.
Gloves
Gloves should be
made of latex, nitril, rubber, or other water impervious materials. If glove material
is thin or flimsy, double gloving can provide an additional layer of protection.
Also, if you know you have cuts or sores on your hands, you should cover these
with a bandage or similar protection as an additional precaution before donning
your gloves. You should always inspect your gloves for tears or punctures before
putting them on. If a glove is damaged, don't use it! When taking contaminated
gloves off, do so carefully. Make sure you don't touch the outside of the gloves
with any bare skin, and be sure to dispose of them in a proper container so that
somebody else won't come in contact with them, either.
Always check your gloves for damage before using them
Goggles
Anytime
there is a risk of splashing or vaporization of contaminated fluids, goggles and/or
other eye protection should be used to protect your eyes. Again, bloodborne pathogens
can be transmitted through the thin membranes of the eyes so it is important to
protect them. Splashing could occur while cleaning up a spill, during laboratory
procedures, or while providing first aid or medical assistance.
Face
shields may be worn in addition to goggles to provide additional face protection.
A face shield will protect against splashes to the nose and mouth.
Aprons
may be worn to protect your clothing and to keep blood or other contaminated fluids
from soaking through to your skin.
Normal
clothing that becomes contaminated with blood should be removed as soon as possible
because fluids can seep through the cloth to come into contact with skin. Contaminated
laundry should be handled as little as possible, and it should be placed in an
appropriately labeled bag or container until it is decontaminated, disposed of,
or laundered.
Remember
to use universal precautions and treat all blood or potentially infectious body
fluids as if they are contaminated. Avoid contact whenever possible, and whenever
it's not, wear personal protective equipment. If you find yourself in a situation
where you have to come in contact with blood or other body fluids and you don't
have any standard personal protective equipment handy, you can improvise. Use
a towel, plastic bag, or some other barrier to help avoid direct contact.
Hygiene Practices
Handwashing is one of the most important (and easiest) practices used to
prevent transmission of bloodborne pathogens. Hands or other exposed skin should
be thoroughly washed as soon as possible following an exposure incident. Use soft,
antibacterial soap, if possible. Avoid harsh, abrasive soaps, as these may open
fragile scabs or other sores.
Hands should also
be washed immediately (or as soon as feasible) after removal of gloves or other
personal protective equipment.
Because handwashing
is so important, you should familiarize yourself with the location of the handwashing
facilities nearest to you. Laboratory sinks, public restrooms, janitor closets,
and so forth may be used for handwashing if they are normally supplied with soap.
If you are working in an area without access to such facilities, you may use an
antiseptic cleanser in conjunction with clean cloth/paper towels or antiseptic
towelettes. If these alternative methods are used, hands should be washed with
soap and running water as soon as feasible.
If you are working
in an area where there is reasonable likelihood of exposure, you should never:
- Eat
- Drink
- Smoke
- Apply cosmetics
or lip balm
- Handle contact
lenses
No food or drink should
be kept in refrigerators, freezers, shelves, cabinets, or on counter tops where
blood or potetially infectious materials are present.
You should also
try to minimize the amount of splashing, spraying, splattering, and generation
of droplets when performing any procedures involving blood or potentially infectious
materials, and you should NEVER pipette or suction these
materials by mouth.
Decontamination
and Sterilization
All surfaces, tools,
equipment and other objects that come in contact with blood or potentially
infectious materials must be decontaminated and sterilized as soon as possible.
Equipment and tools must be cleaned and decontaminated before servicing or
being put back to use.
Decontamination
should be accomplished by using
- A solution of
5.25% sodium hypochlorite (household bleach / Clorox) diluted between 1:10 and
1:100 with water. The standard recommendation is to use at least a quarter cup
of bleach per one gallon of water.
- Lysol or some
other EPA-registered tuberculocidal disinfectant. Check the label of all disinfectants
to make sure they meet this requirement.
If you are cleaning
up a spill of blood, you can carefully cover the spill with paper towels or rags,
then gently pour your 10% solution of bleach over the towels or rags, and leave
it for at least 10 minutes. This will help ensure that the bloodborne pathogens
are killed before you actually begin cleaning or wiping the material up. By covering
the spill with paper towels or rags, you decrease the chances of causing a splash
when you pour the bleach on it.
If you are decontaminating
equipment or other objects (be it scalpels, microscope slides, broken glass, saw
blades, tweezers, mechanical equipment upon which someone has been cut, first
aid boxes, or whatever) you should leave your disinfectant in place for at
least 10 minutes before continuing the cleaning process.
Of course, any
materials you use to clean up a spill of blood or potentially infectious materials
must be decontaminated immediately, as well. This would include mops, sponges,
re-usable gloves, buckets, pails, etc.
Sharps
Far
too frequently, housekeepers, custodians and others are punctured or cut by improperly
disposed needles and broken glass. This, of course, exposes them to whatever infectious
material may have been on the glass or needle. For this reason, it is especially
important to handle and dispose of all sharps carefully in order to protect yourself
as well as others.
Needles
- Needles or other
sharps should not be bent, recapped, or moved except as noted below:
- Needles may be
recapped only by using a mechanical device.
- Needles should
be moved only by using a mechanical device or tool such as forceps, pliers, or
broom and dust pan.
- Never break or
shear needles.
- Needles (both contaminated and clean) shall
be disposed of in labeled sharps containers only.
- Sharps containers
shall be closable, puncture-resistant, leak-proof on sides and bottom, and must
be labeled or color-coded.
- When sharps containers
are being moved from the area of use, the containers should be closed immediately
before removal or replacement to prevent spillage or protrusion of contents during
handling or transport.
Broken Glassware
- Broken glassware
that has been visibly contaminated with blood must be sterilized with an approved
disinfectant solution before it is disturbed or cleaned up.
- Glassware that
has been decontaminated may be disposed of in an appropriate sharps container:
ie. closable, puncture-resistant, leak-proof on sides and bottom, with appropriate
labels.
- Broken glassware
will not be picked up directly with the hands. Sweep or brush the material into
a dustpan.
- Uncontaminated
broken glassware may be disposed of in a closable, puncture resistant container
such as a cardboard box or coffee can.
By using Universal
Precautions and following these simple engineering and work practice controls,
you can protect yourself and prevent transmission of bloodborne pathogens.
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