Bloodborne Pathogens and Needlestick Prevention

Bloodborne Pathogens Menu Workers' Rights

Hazard Recognition

The CDC estimates that there are approximately 18 million workers in the health care industry many of whom are at risk for occupational exposure to bloodborne pathogens. These bloodborne pathogens include human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Other organisms that can be transmitted through blood or other potentially infectious materials (OPIM) include cytomegalovirus (CMV), Epstein-Barr virus (EBV), zika virus, and human parvovirus B19. Less commonly encountered bloodborne pathogens are, syphilis, babesiosis, brucellosis, other mosquito-transmitted diseases, and agents that can cause viral hemorrhagic fever such as the Marburg and Ebola viruses. The following references aid in recognizing workplace hazards associated with bloodborne pathogens.

All occupational exposure to blood or other potentially infectious materials (OPIM) places workers at risk for infection from bloodborne pathogens. OSHA defines blood to mean human blood, human blood components, and products made from human blood. Other potentially infectious materials (OPIM) means: (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids; (2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and (3) HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV. See Worker protections against occupational exposure to infectious diseases for a comparison of OPIM covered by OSHA's Bloodborne Pathogens standard to other body fluids covered by standard and transmission-based precautions in healthcare.

Bloodborne Pathogens: Prevention, Immunization, Prophylaxis and Treatment
Bloodborne Pathogens: Healthcare Settings
Example of unsafe sharps handling: close up of uncovered hands removing needle cap
Figure 1. As per the BBP Standard, contaminated sharps must not be recapped but disposed of in a sharps disposal container immediately or as soon as feasible after use.
Sharps container
Figure 2. Example of puncture-resistant, closable, leak-proof, labeled sharps containers for immediate disposal of contaminated needles.

The major source of bloodborne infections in healthcare settings is via percutaneous injuries from needles or other sharps. Mucosal exposure also occurs but is less common.

Bloodborne Pathogens: Non-Healthcare Settings

Although most BBP exposures occur in healthcare settings, other occupational groups are at risk. These include home health aides, personal care aides, childcare workers, and personal care and service workers. According to the 2021 US Census Bureau there are 109,545,164 of these workers. Law enforcement officers (LEO) and firefighters are also at risk. In 2022, the National Fire Protection Association (NFPA) estimated that there were more than 800,000 sworn LEOs and1,041,200 firefighters. Additionally, while the BBP directive states that the BBP standard does not cover construction, the standard does apply to employees, such as plumbers, performing maintenance activities which involve making or keeping a structure, fixture, or foundation in proper condition in a routine, scheduled, or anticipated fashion and who have reasonably anticipated exposure to blood or other potentially infectious materials while performing their jobs. The standard also covers staff supporting intravenous drug users.

Needlesticks