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Bloodborne Pathogens Information

7.1   What Puts Lab Workers At Risk For BBP Exposure, Level Of Risk, And Exposure Controls

7.2  What Is Considered A Bloodborne Pathogen?

7.3  How The OSHA Bloodborne Pathogens Standard Applies To Lab Workers

7.4   The Exposure Control Plan Requirements and Guidance Table

7.5  Hepatitis B Vaccination Program For Workers With BBP Exposure Risk

7.6  What Constitutes A BBP Exposure

7.7  What To Do In the Event of a BBP Exposure

7.8  Reporting  A BBP Exposure

7.9  BBP Exposure Follow-Up

7.10  BBP Record Keeping

7.11  HIV / HBV/ HCV Research Laboratory Practices


7.1   What Puts Lab Workers At Risk For BBP Exposure, Level Of Risk, And Exposure Controls

If you work with or around one or more of the biohazardous materials listed below in your laboratory research, you are considered at risk for BBP exposure:

  • Human blood/ blood products/ blood components
  • Human or NHP tissue cell cultures (primary or established lines)
  • Unfixed tissue or organs from humans, living or dead
  • Other potentially infectious materials of human origin: sexual fluids, cerebrospinal fluid, organ fluids, joint fluids, amniotic fluid, saliva (from dental procedures), or any body fluid containing visible blood
  • HIV or HBV-containing cell or tissue cultures, culture medium or other solutions
  • Blood, organs, other tissues or cell lines from experimental animals infected with HIV or HBV

Practices that increase your exposure risk in the lab include:

  • Use of needles with no safety devices
  • Using needles preferentially over alternative or safer means
  • Careless handling and disposal of sharps (e.g., needles, broken glass, scalpels, blades, etc.)
  • Failing to use splash guards, face shields, safety glasses, disposable gloves or lab coats in situations that require them for protection
  • Failing to use containment equipment
  • Failing to wash hands
  • Failing to properly decontaminate surfaces and lab equipment
  • Failing to properly decontaminate and dispose of hazardous waste
  • Failing to follow Universal Precautions

Your risk of infection resulting from an exposure depends on:

  • The specific pathogen involved and its concentration in the contaminated material
  • The type and volume of contaminated material you contacted
  • The way you contacted the material, and for how long
  • How effectively you used PPE

The typical research lab worker who works responsibly with established human cell lines has a very low risk of BBP exposure. Lab workers at a higher level of risk include those who:  

  • Collect and /or manipulate human blood, tissue or fluid specimens.
  • Work with primary human cell lines which have not been evaluated for presence of pathogens.
  • Perform research experiments with HIV or HBV In all risk situations, however, the consequences of an exposure leading to infection are immense, thus an abundance of caution must be practiced.  

Exposure control practices to follow in the lab (See Table in Section 7.4):

  • Use of safety needles
  • Minimizing use of needles/ sharps; proper handling and disposal of sharps
  • Use of PPE to protect hands and mucous membranes; use barriers and containment equipment to protect against aerosols, sprays, splashes, etc.
  • Washing hands every time after glove removal and before leaving lab
  • Following surface disinfection and lab equipment decontamination procedures
  • Properly handling of hazardous waste/sharps waste
  • Following Universal Precautions

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7.2  What Is Considered A Bloodborne Pathogen?

“Bloodborne pathogen” is a phrase applied to a variety of bacteria and intracellular parasites that can infect humans via the blood stream and cause disease. Human Immunodeficiency virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are the BBP of greatest concern, but there are a number of other significant pathogens that can be transmitted from exposure to human blood, some of which are involved in research on this campus.

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7.3  How The OSHA Bloodborne Pathogens Standard Applies To Lab Workers

OSHA Bloodborne Pathogens Standard 29 CFR 1919.1030 prescribes safeguards to protect at-risk workers against the health hazards caused by BBP, and these safeguards must be provided by employers as mandated by federal law. The Standard is designed primarily for the health care industry, but also must be applied to research activities and practices which involve manipulation of certain human/NHP biological materials.

If you can reasonably anticipate contact or risk of contact with human/NHP blood or other potentially infectious materials as a result of performing your research laboratory duties, the BBP Standard applies to you. In the research lab setting, the BBP Standard also applies to people who work in areas where these materials are manipulated by others.

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7.4   The Exposure Control Plan Requirements and Guidance Table

Employers are mandated by OSHA to provide an Exposure Control Plan (ECP) to employees with BBP exposure risks in their jobs. Exposure Control Plans are intended to provide information and promote work practices that will decrease/eliminate occupational risks of BBP exposure.  ECPs must include:  

  • The specific BBP risks in manipulating biohazardous material, or performing particular tasks
  • The practices and controls in place to mitigate those risks
  • What to do in the event of an exposure, including how to report it
  • What to expect from an exposure investigation and follow-up
  • The types of records to be kept regarding BBP training, exposures, etc.
  • Where to find the ECP if employees need to refer to it

Virginia Tech maintains a University Exposure Control Plan, which is a document used by facilities on campus that draw human blood and/or handle human clinical/diagnostic material. Because OSHA allows employers to include the content of an ECP in other documents (such as Biosafety Manuals), and because this content is now included in the University Biosafety Manual (UBM) and your completed Lab-Specific Biosafety Manual (LSBM), Virginia Tech research laboratories do not have to maintain duplicate information in a separate ECP.

In reading this Manual and your LSBM, you will have reviewed all required topics, including lab-specific information. See the following guidance table for topic locations in each manual. The table is also provided in Appendix C of your LSBM.

Exposure Control Plan Topics

READ ABOUT IT IN THESE SECTIONS OF THE UNIVERSITY BIOSAFETY MANUAL (UBM):

(Crosslinked for ease of use.)

find details for your lab in these sections of the Lab-Specific Biosafety Manual (LSBM):

BBP Risks for Lab Workers

7.1

 

OSHA BBP Standard & Exposure Control Plan

7.3

 

Universal Precautions

4.1

 

Engineering Controls:

· Handwashing facilities

 

3.2

· Needle safety; Sharps containment

4.5

13.2

· Biosafety cabinet containment

4.16

11

Personal Protective Equipment

4.6

15

Work Practices:

· Handwashing

4.4

 

· Sharps handling and disposal

4.5

13.2

· Avoiding aerosols

4.22

13.1

· Avoiding ingestion

4.2 4.3

 

· Decontaminating surfaces

4.10

14.1

· Decontaminating equipment

4.11

 

· Waste handling

4.8

16

Housekeeping Practices

3.11

8

Labels and Signs

3.1

 

Occ. Health Medical Services

· Hepatitis B vaccination

 

7.5

 

·  What constitutes an exposure

7.6

 

·  BBP exposure response

7.7

 

·  BBP exposure reporting

7.8

 

· BBP exposure investigation and follow-up

7.9

 

BBP Recordkeeping

7.10

 

HIV/ HBV/ HCV Lab Practices

7.11

 

 

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7.5  Hepatitis B Vaccination Program For Workers With BBP Exposure Risk

Purpose

  • To provide and offer the Hepatitis B Vaccination to all employees who have potential for an occupational exposure to bloodborne pathogens.
  • To provide testing, evaluation, and counseling to employees who have BBP exposure incidents.
  • To document employee Hepatitis B vaccinations and declinations.

General

  • All medical services will be provided at NO COST to the employee.
  • The University will provide, through Environmental Health and Safety (EHS), all approved services.
  • All medical services will be available at a reasonable time and place.    

Receiving the Hepatitis B Vaccination Series

  • Employees must attend a BBP training class, or complete EHS Biosafety for Research Labs online training prior to requesting the vaccinations.  Vaccinations will be provided to those who have never been vaccinated, and who express their intentions to receive this service on a written declaration (in class training) or through choosing that response option in the online training.
  • Instructions for arranging for appointments for Hepatitis B vaccinations will be provided to these individuals.
  • The series involves three separate injections, spaced at one and six month intervals.
  • Employees may choose to decline the vaccinations; this must be document on a Declination Form (in class training) or by choosing that response option in the online training.  If an employee declines the vaccination, but at a later date is still at risk for occupational exposure  to BBP and decides to receive the vaccination series, he/she can contact EHS to expedite that request at no cost to the individu
  • The U.S. Public Health Service currently does not recommend a routine booster for Hepatitis B.  

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 7.6  What Constitutes A BBP Exposure 

When a potentially infectious material (human blood, tissue or other potentially infectious material) makes contact, or may have made contact with:

  • an injury site on your body (needlestick or cut)
  • a non-intact skin surface (chapped, abraded skin, open sores, dermatitis, etc.)
  • mucous membranes of your eyes, nose or mouth, this is considered a risky exposure.

We must respond to BBP exposures in the ways described below.

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7.7  What To Do In the Event of a BBP Exposure

  1. Remove PPE and provide immediate care to the exposed site by washing wounds and skin with soap and water for 15 minutes, or flush eyes/ mucous membranes with fresh water for 15 minutes.
  2. Call 911 if serious injury has occurred; administer first aid as needed.
  3. Inform your direct supervisor about the incident immediately, even if it is only a potential exposure.
  4. Visit your medical provider or an Emergency Department for evaluation within 1-2 hours of the incident.  Inform your medical provider about the specific material to which you have been (or may have been) exposed.

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7.8  Reporting A BBP Exposure

  1. Complete the Employers Accident Report.  
  2. Contact EHS at 231-3600 during regular business hours; call 911 after hours, and the dispatcher will connect you with EHS personnel.
  3. Complete Exposure Incident Report Form and return it to EHS.
  4. Receive instructions from EHS regarding the Occupational Health Physician’s recommended testing and treatment.

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7.9  BBP Exposure Follow-Up

Following a BBP exposure incident, EHS will immediately arrange a confidential medical evaluation and follow up.    Post-exposure services include:

  • Documenting the route(s) of exposure, and the circumstances under which the exposure occurred.
  • Identifying and documenting the source individual, unless it is infeasible or prohibited by law to do so.
  • Testing the source individual's blood to determine HBV and HIV infectivity, if unknown.   Consent of the source individual must be obtained prior to testing.  
  • Collecting and testing of the exposed employee's blood to determine serological status for HBV, HCV, and HIV.   This collection must occur as soon as possible after exposure.
  • Administering of post-exposure prophylaxis, when medically indicated, as recommended by the U.S. Public Health Service.
  • Counseling
  • Evaluating reported illnesses
  • Conducting follow-up testing of exposed employee's blood

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7.10  BBP Record Keeping

EHS will maintain records on each Virginia Tech employee with occupational exposure to human materials.  Records will be maintained for the duration of the individual's employment at Virginia Tech, plus 30 years.

Employee written consent is necessary prior to release of any information.   However, records will be made available to representatives of OSHA upon request.

Information maintained by EHS includes:

  • Name of employee
  • VT Identification Number of employee
  • Exposure Incident Report and Physician's Written Opinion forms, if applicable
  • Copies of evaluation and testing results associated with an exposure incident
  • Training records
  • A copy of the employee's hepatitis records

The following information is included in the hepatitis records:

  • Vaccination Records
  • Titer Results (if available)
  • Declination Forms
  • Attachments to Declination Forms

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 7.11  HIV / HBV/ HCV Research Laboratory Practices 

Labs working with the HIV/ AIDS virus, or with Hepatitis B or C viruses are required to use a number of special practices.  These are discussed in detail in the OSHA BBP Standard 1910.1030 (e)(1) through (e)(5); extra training requirements are discussed in 1930.1030 (g)(2)(ix).  If your laboratory is engaged in research with these agents/materials, you must read these Standards and comply with them.

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