The OSHA Bloodborne Pathogens (BBP) Standard
OSHA’s Bloodborne Pathogens standard (29 CFR 1910.1030) is designed to protect laboratory employees and others from the health hazards of exposure to bloodborne pathogens.
Employers are subject to the BBP standard if they have workers whose jobs put them at reasonable risk of coming into contact with blood or other potentially infectious materials (OPIM).
These employers must develop a written Exposure Control Plan, provide training to exposed workers, and comply with other requirements of the standard, including use of Standard
Precautions when dealing with blood and OPIM. In 2001, in response to the Needlestick Safety and Prevention Act, OSHA
revised the Bloodborne Pathogens standard. The revised standard clarifies the need for employers to select safer needle devices and to involve workers in identifying and choosing these devices.
The updated standard also requires employers to maintain a log of injuries from contaminated sharps.
OSHA estimates that 5.6 million workers in the healthcare industry and related occupations are at risk of occupational exposure to bloodborne pathogens, including HIV, HBV, HCV, and others.
All occupational exposure to blood or OPIM places workers at risk for infection with bloodborne pathogens. OSHA defines blood to mean human blood, human blood components, and
products made from human blood.
Other potentially infectious materials (OPIM) include:
- the following human body fluids:
- 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
- all body fluids in situations where it is difficult or impossible to differentiate between body fluids
- any unfixed tissue or organ (other than intact skin) from a human (living or dead); and
- HIV- or HBV-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.
The OSHA Bloodborne Pathogens (BBP) Standard (Continued)
The Centers for Disease Control and Prevention (CDC) notes that although more than 200 different diseases can be transmitted from exposure to blood, the most serious infections are:
- hepatitis B virus (HBV)
- hepatitis C virus (HCV)
- human immunodeficiency virus (HIV)
Fortunately, the risk of acquiring any of these infections is low. HBV is the most infectious virus of the three viruses listed above. For an unvaccinated healthcare worker, the risk of
developing an infection from a single needlestick or a cut exposed to HBV-infected blood ranges from 6-30%. The risk for infection from HCV- and HIV-infected blood under the same
circumstances is 1.8 and 0.3 percent, respectively.
Many factors influence the risk of becoming infected after a needlestick or cut exposure to HBV-, HCV- or HIV-contaminated blood. These factors include:
- the health status of the individual
- the volume of the blood exchanged
- the concentration of the virus in the blood
- the extent of the cut or the depth of penetration of the needlestick
Unsafe Activities in the Laboratory
Employees working in laboratories should not:
- perform mouth pipetting/suctioning of blood or OPIM;
- Eat, drink, smoke, apply cosmetics or lip balm, or handle contact lenses in work areas where there is a reasonable likelihood of exposure to blood or OPIM; and
- Store food or drink in refrigerators, freezers, shelves, cabinets or on countertops or benchtops where blood or OPIM are present.
Employers must provide employees with the following protective measures:
- Appropriate PPE for workers if blood or OPIM exposure is anticipated.
- Gloves must be worn when hand contact with blood, mucous membranes, OPIM, or non-intact skin is anticipated, or when handling contaminated items or surfaces.
- Surgical caps or hoods and/or shoe covers or boots must be worn in instances when gross contamination can reasonably be anticipated such as during autopsies or orthopedic surgery.
- Effective engineering and work practice controls to help remove or isolate exposures to blood and bloodborne pathogens.
- Hepatitis B vaccination (if not declined by a worker) under the supervision of a physician or other licensed healthcare professional to all workers who have occupational exposure to blood or OPIM.
When any blood, OPIM or infected animals are present in the work area, a hazard warning sign incorporating the universal biohazard symbol must be posted on all access doors.
Engineering Controls and Work Practices for All HIV/HBV Laboratories
Employers must ensure that:
- All activities involving OPIM are conducted in Biological Safety Cabinets (BSCs) or other physical-containment devices; work with OPIM must not be conducted on the open bench. For more information
on BSCs, see OSHA’s publication, Laboratory Safety – Biosafety Cabinets
- Certified BSCs or other appropriate combinations of personal protection or physical containment devices, such as special protective clothing, respirators, centrifuge safety cups, sealed
centrifuge rotors, and containment caging for animals, be used for all activities with OPIM that pose a threat of exposure to droplets, splashes, spills, or aerosols.
- Each laboratory contains a facility for hand washing and an eyewash facility which is readily available within the work area.
- The sink must be foot, elbow, or automatically operated and must be located near the exit door of the work area.
Additional Requirements for HIV and HBV Research Laboratories
Additional requirements for laboratories conducting HIV and HBV research include:
- Waste materials:
- All regulated waste must either be incinerated or decontaminated by a method such as autoclaving known to effectively destroy bloodborne pathogens.
- Contaminated materials that are to be decontaminated at a site away from the work area must be placed in a durable, leak-proof, labeled or color-coded container that is closed before being removed from the work area.
- Laboratory doors must be kept closed when work involving HIV or HBV is in progress.
- Access to the production facilities’ work area must be limited to authorized persons.
- Written policies and procedures must be established whereby only persons who have been advised of the potential biohazard, who meet any specific entry requirements, and who comply with all entry and exit procedures must be allowed to enter work areas.
- Access doors to the production facilities’ work area or containment module must be self-closing.
- Work areas must be separated from areas that are open to unrestricted traffic flow within the building. Passage through two sets of doors must be the basic requirement for entry into the work area from access corridors or other contiguous areas. Physical separation of the high-containment work area from access corridors or other areas or activities may also be provided by a double-doored clothes-change room (showers may be included), airlock, or other access facility that requires passing through two sets of doors before entering the work area.
- The surfaces of doors, walls, floors and ceilings in the work area must be water-resistant so that they can be easily cleaned. Penetrations in these surfaces must be sealed or capable of being sealed to facilitate decontamination.
The above requirements do not apply to clinical or diagnostic laboratories engaged solely in the analysis of blood, tissue, or organs.
For more information on Bloodborne Pathogens, be sure to check out OSHAcademy Courses 655, Bloodborne Pathogens in the Workplace
, and Course 755, Bloodborne Pathogens Program Management.
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