Healthcare-Associated Infections: Reportable Exposures
An exposure requiring evaluation and medical attention occurs when blood or any other potentially infectious material (OPIM) is involved in:
- A puncture of the skin with a needle, lancet, or other contaminated sharp item.
- A splash, spray, or other transmission into the eyes, mouth, or nose.
- Contact with blood or OPIM onto an open wound, an oozing lesion, or other area where there is significant skin breakdown.
Occupational Safety and Health Administration (OSHA) issued the Bloodborne Pathogens Standard 29 CFR Part 1910.1030 to protect health care workers and others who come in contact with blood and OPIM during their occupational duties. The purpose of the standard is to prevent occupational exposure to bloodborne pathogens (BBP), and to reduce the chances of infection when exposure does occur.
BBPs are microorganisms that cause disease and are present in human blood. They include, but are not limited to:
- Human immunodeficiency virus (HIV)
- Hepatitis B virus (HBV)
- Hepatitis C virus (HCV)
In addition to blood, the following human body materials are considered to be potentially infectious with HIV, HBV, or HCV:
- All body fluids where it is difficult or impossible to differentiate between body fluids
- Amniotic fluid
- Any body fluid visibly contaminated with blood
- Any unfixed tissue or organ (other than intact skin) from a human (living or dead)
- Blood, organs, or other tissues from experimental animals infected with BBPs
- Cell, tissue, or organ cultures containing BBPs
- Cerebral spinal fluid
- Culture media or other solutions containing BBPs
- Pericardial fluid
- Peritoneal fluid
- Pleural fluid
- Saliva in dental procedures (whether or not there is visible blood present)
- Semen
- Synovial fluid
- Vaginal secretions
The Bloodborne Pathogens Standard 29 CFR Part 1910.1030 requires employers to write and implement an exposure control plan for employees with occupational exposure to blood and OPIM, using administrative, engineering, and work practice controls to prevent or minimize employee exposure.
The exposure control plan must contain at least the following elements:
- Cleaning or disinfection of contaminated equipment and surfaces
- Exposure determination:
- A list of all job classifications in which all employees in those classifications have occupational exposure (example: all employees classified as phlebotomists).
- A list of job classifications in which some employees have occupational exposure.
- A list of all tasks and procedures in which occupational exposure occurs (example: administering immunizations, doing finger sticks).
- Most local public health agencies will probably not have entire job classifications in which all persons have occupational exposure, but may have certain personnel with assigned duties that involve occupational exposure.
- Handling laundry
- Hazard communication
- Hepatitis B vaccination
- Maintenance of sharps injury log
- Post-exposure follow-up
- Provision for hand hygiene practices
- Safe management and disposal of sharps
- Standard precautions: set of practices used with all clients to prevent contact with blood and OPIM
- Use of personal protective equipment (PPE)
- Use of sharps with safety devices: Needlestick Safety and Prevention Act
- Waste management
- Work practices that reduce or eliminate exposure to blood and OPIM (for example, no eating or drinking in potentially contaminated areas, using leak-proof containers for specimen storage)
Department of Health Services resources
- Infection Preventionist Lunch and Learn: Bloodborne Pathogens–What Does an IP Need to Know?: Listen to the Wisconsin HAI Prevention Program Infection Preventionist Lunch and Learn session on bloodborne pathogens and other exposures.
- Infection Preventionist Lunch and Learn: Bloodborne Pathogens: Listen to the Wisconsin HAI Prevention Program Infection Preventionist Lunch and Learn session on preventing significant exposures and how to follow up if they happen.
- Occupational Health: The Wisconsin Occupational Health and Safety Surveillance Program shares information and resources about workplace safety and health for workers.
External resources
- Occupational Exposures to HIV and Recommendations for Post-Exposure Prophylaxis: Guidelines and recommendations from CDC, updated 2013.
- Model Bloodborne Pathogens Exposure Control Plan (PDF): An OSHA form that can be filled in to create your own plan.
Questions about HAIs? Contact us!
Phone: 608-267-7711 | Fax: 608-261-4976