Bloodborne Pathogens are viruses and bacteria present in blood or other bodily fluids that can cause infection. Since many signs and symptoms of exposure do not occur initially, all bodily fluids should be considered potentially infectious and proper protective measures should be taken.

How Disease Spreads:

For a pathogen to spread, multiple factors are required:

• A pathogen must be present.
• The pathogen must be present in sufficient quantity.
• There must be an entry route.
• The victim must be susceptible to the pathogen.

If one of these factors is removed, the pathogen is prevented from spreading. 

• A pathogen must be present. 
• In some cases, it may be possible to eliminate contact with bodily fluids.
• The pathogen must be present in sufficient quantity.
• Some pathogens are not present in some bodily fluids in enough quantity to pose a significant risk. Nonetheless, we consider ALL bodily fluids to be potentially infectious.
• There must be an entry route.
• Use of Body Substance Isolation measures, such as gloves, will deny a route of entry.
• The victim must be susceptible to the pathogen.
• Some pathogens, such as the Hepatitis B virus, have a vaccine to help prevent its spread.

Entry Routes:

There are several different routes for infection by a pathogen.

• Mucous Membranes (eyes, nose, mouth)
• Skin Contact (areas of non-intact skin)
• Inhaled
  

If any blood or bodily fluids reaches the areas above, there is a potential for disease to spread.


There are several means that can be used to prevent the spread of pathogens.

• Bodily Substance Isolation (BSI):
• Provides a protective barrier to keep pathogens away from vulnerable areas.
• Examples:
• gloves
• face shields
• gowns
• CPR shields / CPR masks
• Vaccinations
• Hepatitis B vaccine
• Hand washing
• Considered by the Centers for Disease Control (CDC) to be the single most effective barrier against disease transmission.
• Soap and water or alcohol based hand washes may be used with equal effectiveness.
• Engineering Controls
• Use of devices, such as needle less systems and sharps containers, to prevent the spread of disease.

The above measures will help protect you against the spread of blood borne pathogens.

Specific Protective Measures:

BSI measures:

There are several types of BSI measures available. These include, but are not limited to, gloves, gowns, face shields, CPR barriers and more.

Gloves:

Gloves are available in three types of common materials:

• Nitrile, Vinyl
• Synthetic materials, does not cause allergic reactions.
• Latex
• Commonly available still, has chance of causing allergic reason in persons allergic to latex.

Due to the risk of allergy, you should avoid use of latex gloves whenever possible.

To properly use gloves, they should be available in several different sizes. Most gloves are in available in at least three sizes; small, medium and large. You must also be aware of how to properly take off contaminated gloves to avoid contaminating your self.

Please click here to view a video on how to properly remove gloves.

CPR Barriers:

There are three primary CPR barriers in use today. These include CPR shields, pocket masks and bag-mask units (for health care providers). All will help protect you against possible exposure to blood borne pathogens. You should have at least one type of barrier device available for your use if CPR must be performed.  Current American Heart Association CPR guidelines do allow for chest compression only CPR if a barrier device is not available and the rescuer does not feel comfortable with providing direct mouth to mouth breaths.

Vaccines:

Of the specific diseases of concern, including Hepatitis B, Hepatitis C and HIV, only Hepatitis B has a vaccine available at this time. Per OSHA regulations, Hepatitis B vaccine must be made available to anyone expected to provide first aid or otherwise reasonably expected to have exposure to pathogens as part of their job. The employee may choose to decline the vaccine.

The Hepatitis B vaccine is generally safe, however you should speak to your health care provider regarding the risks and benefits of receiving this vaccine. Please click here for the CDC Vaccine Information Sheet on the Hepatitis B vaccine. The vaccine provides protection over three doses and may be given in one of two schedules: first dose, 2 months and 4 months after the first, or first dose, 1 month and 6 months after the first.

The Hepatitis B vaccine is generally considered to provide a lifetime of immunity. If you are concerned about your status, you should speak to your health care provider. A blood draw called a titer is available to determine if you are still immune to Hepatitis B.

Please click here to view the vaccine information sheet on the Hepatitis B vaccine from the Centers for Disease Control.

Hand washing:

The CDC considered hand washing to be the single most important defense against disease transmission. To wash your hands, you must follow special procedures to avoid cross-contamination.

1. Turn on the water.
2. Wet your hands.
3. Apply soap.
4. Rub your hands together, causing friction, for at least 15 seconds. This is also about the amount of time that it takes to sing the alphabet.
5. Rinse your hands.
6. Use a dry paper towel to turn the water off (avoids recontamination of your hands).

The use of alcohol based hand washes has also been proven to be equally effective. Be sure to use an alcohol based hand wash with at least 60% alcohol content. To disinfect your hands with an alcohol based hand wash, simply apply the hand wash and rub the entire surface area of your hands together until dry. Do not dry your hands if any hand wash agent is still present, continue to rub your hands together until dry.

Engineering / Work Practice Controls:

Several devices and work practices are available to further reduce the possibility of infection. Many of these involve safety around needles or other sharps.

When possible, avoid the use of needles unless absolutely necessary. Many devices exist, such as needle less ports and blunt  cannula systems which make it unnecessary to use a needle when drawing up medications into a syringe or injecting a medication into IV tubing.

Sharps such as needles and scalpels should never be thrown away in the regular trash. Always use a properly labeled sharps container to dispose of any used sharps. Never force sharps into a sharps container or place sharps into a full container (as indicated by the full line). If a sharps container is unavailable, use a puncture resistant container such as a bleach bottle and label it with a biohazard label until a more proper means of disposal is available.

Needles should never be recapped. Avoid the use of needles that do not have a safety device. Many systems are available today that have a safety device. Examples include syringes that have a plastic cover that extends and locks in place over the needle once the injection is given.


Please review this chart for information about Hepatitis B, Hepatitis C and HIV. The chart is from the State of Colorado Universal Precautions for Child Care Providers training manual.

  

If you are exposed to blood or bodily fluids, the first action is to take basic first aid steps. Rinse the affected area with copious quantities of water and prevent others from coming into contact with the pathogen, if applicable.

Your supervisor should be notified immediately, and the incident should be documented. Click here for an example of a post-exposure incident report form.

Medical attention should be sought as soon as possible. Studies have documented the fact that post-exposure care, such as receiving a hepatitis B vaccine or prophylaxis medications for HIV, can reduce the spread of disease.

Also, following any exposure incident, the circumstances surrounding the exposure incident should be reviewed, to include the incident report form, to determine if any additional steps to prevent a exposure in the future can be taken.


The safe decontamination of surfaces is a vitally important task in preventing the spread of disease.

A blood spill clean up kit is available from many different sources. While individual contents may very, all include these common components:

• Personal protective equipment (gloves, face shield/mask combination, gown, etc)
• Solidification agent (Red-Z)
• Reg bag (biohazard bag)
• Plastic scoop
• Hard surface disinfectant wipe
• Alcohol based hand wipe

To disinfect a hard surface, use the following steps:

1. Don personal protective that will be needed, such as gloves.
2. Open the packet of solidification agent, and pour evenly over the spill area.
3. Once the solidification agent has absorbed the spill to the greatest extent possible, use the plastic scoop to collect the spill.
4. Place the scoop with the biohazardous material in the red bag.
5. Open the hard surface disinfectant wipe and thoroughly clean the surfaces touched by the spill. The hard surface disinfectant should be allowed to air dry for maximum effectiveness.
6. Place the disinfectant wipe in the biohazard bag.
7. Properly remove your protective equipment and place them in the biohazard bag.
8. Open the alcohol based hand wipe and clean your hands. Do not dry your hands; rub your hands together until they are dry. 

The following questions will check your comprehension of the above material. Upon submitting your answers, the next page will ask for payment and ask for skills check options.

1. Which of the following are examples of blood borne pathogens:

Hepatitis A, Influenza, TB

Hepatitis B, Hepatitis C, HIV

Hepatitis A, Hepatitis B, Hepatitis C

HIV, influenza, TB

2. What is the single most effective way to control the spread of disease:

Hand washing.

Wearing disposable gloves.

Disposing of used needles in sharps containers.

Disposing items with blood or OPIM in a biohazard bag.

3. It is permissable to throw away a used needle in the regular trash:

True

False

4. You should seek medical attention after an exposure to blood borne pathogens occurs:

True

False

5.  When using a hard surface disinfectant, you should dry the surface right after applying the disinfectant:

True

False

6. Vaccines are available for Hepatitis C and HIV:

True

False

7. Which of the following types of gloves are considered safest with respect to their ability to cause allergic reactions:

Nitrile and Vinyl

Latex

8.  Areas of non-intact skin; your eyes, nose, mouth; and inhalation routes are all possible routes for pathogens to enter your body:

True

False

9.  For disease to spread, there must be a pathogen present and in adequate quantities, there must be an entry route and a susceptable host:

True

False

10. Sharps containers and alcohol based hand washes are considered forms of body substance isolation (BSI):

True

False


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