Bloodborne Pathogens Standard

Scope and Key Definitions

The Bloodborne Pathogens Standard applies to all occupational exposure to blood and other potentially infectious materials (OPIM). Occupational exposure means reasonably anticipated — not just accidental — skin, eye, mucous membrane, or parenteral contact that results from job duties. Home health nurses, aides, and therapists who perform wound care, draw blood, handle sharps, or provide personal care all have occupational exposure.

OPIM includes: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid visibly contaminated with blood, and any unfixed human tissue or organ. Sweat, tears, urine, feces, nasal secretions, sputum, and vomitus are NOT OPIM unless visibly bloody — an important distinction for PPE decisions.

The Exposure Control Plan

Every employer with employees who have occupational exposure must have a written Exposure Control Plan (ECP). The ECP must identify: which job classifications have exposure, the tasks and procedures that involve exposure, the schedule for implementing the plan, procedures for evaluating exposure incidents, and the hepatitis B vaccination program. It must be accessible to employees, reviewed and updated annually, and updated whenever new tasks or procedures create additional exposure.

Engineering and Work Practice Controls

Engineering controls remove or isolate the hazard: safety-engineered sharp devices (retractable needles, needleless IV systems), sharps disposal containers at the point of use, and puncture-resistant containers. These are the most effective controls. Work practice controls change how tasks are performed: never recap needles using two hands, do not bend or break contaminated sharps, discard sharps immediately after use, handle contaminated equipment with care to prevent splashing or spraying, and wash hands immediately after glove removal.

Post-Exposure Protocol

After any exposure incident: immediately wash the wound with soap and water (or flush eyes/mucous membranes with water). Report the incident to the supervisor immediately. Complete an incident report. Seek medical evaluation — within hours, not days, for potential HIV exposure (post-exposure prophylaxis is most effective when started within 2 hours). The employer must offer a confidential medical evaluation and follow-up at no cost. The source patient's blood may be tested for HBV, HCV, and HIV with consent. Maintain confidentiality of all medical records and source patient information.