In 1991, the Occupational Safety and Health Administration (OSHA) developed the Occupational Exposure to Bloodborne Pathogens Standard, designed to protect approximately 5.6 million employees in health care and related occupations. It was developed to protect them against exposure to bloodborne pathogens like Hepatitis B Virus (HBV) and the Human Immunodeficiency Virus (HIV).
OSHA Bloodborne Pathogens Standard
This standard has numerous requirements, including the development of an Exposure Control Plan. There are specific rules concerning the disposal of certain wastes that health-care facilities generate. These wastes are referred to as "regulated wastes" and include blood and items contaminated with blood or other potentially infectious materials (OPIM).
Exposure Control Plan
The employer must develop a written program outlining protective measures to be taken to eliminate or minimise employee exposure to blood and OPIM. Job classifications, tasks and procedures must be identified where there is exposure to blood and OPIM. Employers must insure universal precautions are being followed and must provide gloves, masks and protective equipment. Procedures must be developed to evaluate exposure incidents promptly, to comply with the standards, to communicate hazards to employees and keep necessary records.
Disposal of Regulated Waste
OSHA uses the term "regulated waste" when referring to the following categories of waste: liquid or semi-liquid blood or OPIM, items contaminated or caked with OPIM or blood that could release these substances if compressed, contaminated sharps, and pathological and microbiological wastes containing OPIM or blood. Disposal must be in accordance with state regulations and basic OSHA requirements. Waste must be placed in containers that are closable, constructed to prevent leakage, labelled or colour-coded. The containers must be closed prior to removal to prevent spillage and, if contamination of the outside occurs, the container must be placed in a second container that meets the above requirements.
Sharps containers must be labelled with the universal biohazard symbol and the word "Biohazard" or colour-coded red. The containers should be easily accessible to employees and located as close as possible to area where sharps will be used. The containers must not be overfilled, must be kept upright and closed before disposal, storage or transport. They should be placed inside a secondary container if leakage may occur. This secondary container must be closable and constructed to prevent leakage. These containers must be labelled or colour-coded.
Hazards Must Be Communicated
Warning labels that include the standard biohazard symbol and the term "Biohazard" must be included on bags, labels, containers of regulated waste, contaminated laundry, refrigerators and freezers used to store blood or OPIM and on containers used to store, dispose of, transport or ship blood or OPIM. Contaminated equipment must be labelled.
All employees with occupational exposure to bloodborne pathogens must receive initial and annual training. Training must be provided by persons who are knowledgeable about the subject and can demonstrate expertise in the area of occupational hazards of bloodborne pathogens. Health care professionals who are qualified include infection control nurses, nurse practitioners and registered nurses. Epidemiologists and professional trainers with demonstrated expertise are also qualified.