A Complete Guide to Bloodborne PathogensGreg Garner
Do you work in a hospital, clinical lab, or another setting where you may come in contact with bodily fluids? If so, you’re at risk of being exposed to bloodborne pathogens.
Bloodborne pathogens can cause several serious and potentially fatal diseases. To keep yourself and those around you safe from exposure, staying informed about what they are and how to avoid them is key.
Read on for an overview of bloodborne pathogens and the diseases they cause, how they spread, and how to avoid them in the workplace.
What Are Bloodborne Pathogens?
Bloodborne pathogens (BBPs), by definition, are any disease-causing organisms that pass from one entity to another through blood or other potentially infectious materials (OPIM). These include:
- blood serum
- vaginal secretions
- cerebrospinal fluid
- pleural, peritoneal, and other joint capsule or organ fluids
- amniotic fluid
Bloodborne pathogen transmission isn’t well documented from samples of all bodily fluids. Pure saliva, urine, feces, and sweat are considered “low-risk” fluids from a BBP standpoint, though clinicians should always wear appropriate PPE in case of the fluids mixing with blood or carrying other infectious diseases. Contact with semen or vaginal secretions is considered a high BBP risk during intercourse or when exposed to other mucous membranes.
Examples of Bloodborne Pathogens
There are several unique diseases caused by bloodborne pathogens. Even so, only three of them are a primary concern in American healthcare settings. Let’s go over a list of bloodborne pathogens that covers these and a few more uncommon bloodborne diseases.
Hepatitis B, caused by the Hepatitis B Virus (HBV), is one of two types of bloodborne hepatitis. Hepato- refers to the liver, and -itis refers to an inflammatory condition. Thus, hepatitis is an inflammation of the liver.
Hepatitis B comes in two forms: acute, in which infection lasts up to six months before complete recovery, and chronic, in which the infection lingers for over six months. An HBV infection can be a life-long struggle for people with a compromised immune system.
The symptoms of hepatitis B include:
- joint pain
- abdominal discomfort
- a decrease in appetite and/or weight loss
- dark-colored urine
If the condition is chronic, long-term inflammation and damage can lead to liver cancer, liver failure, or cirrhosis.
There are two reasons hepatitis B is so dangerous to healthcare workers. First, it’s highly infectious, with an estimated 6-30% chance of infection after only a single needle stick. Second, because most people don’t get symptoms until 1-4 months in (and young children may not get symptoms at all), your patients may not know they’re infected.
There is a vaccination to prevent HBV infection, but there’s no cure once infected.
Hepatitis C is the other bloodborne type of liver inflammation, caused by the Hepatitis C Virus (HCV). Like Hepatitis B, it’s an acute disease that can also become chronic.
The CDC estimates that as of 2016, 2.4 million Americans were living with an HCV infection. The symptoms of both diseases are similar, and unfortunately, it is possible to be infected with both hepatitis B and C viruses at the same time. Even so, some people with HCV never develop symptoms.
There’s no vaccination to prevent hepatitis C, but due to expanding research, there are effective treatments available. Known as direct-acting antivirals, these drugs can help people overcome the infection in as few as twelve weeks. Some people will recover completely while others may deal with a lifelong infection.
HIV and AIDS
Human Immunodeficiency Virus (HIV) is the bloodborne pathogen responsible for Acquired Immunodeficiency Syndrome (AIDS). Once infected, a person will test positive for the presence of HIV for the rest of their life.
This virus acts by killing white blood cells known as T Cells or CD4 Lymphocytes. These cells are essential for helping your body fight off pathogens. When the number of T Cells in your body drops, you’re vulnerable to opportunistic infections—pathogens that can take hold due to your already compromised immune system.
AIDS, the advanced form of HIV infection, usually waits 2-10 years to take hold. Today, antiretroviral therapy can help your body fight off HIV’s effects well enough to prevent AIDS from developing for an extended amount of time.
Many viral hemorrhagic fevers (VHF) are also the result of bloodborne pathogens. While these aren’t common in America, they can be found in some parts of Africa and the Middle East where their non-human host species live. Examples of VHF include Ebola virus disease, Lassa fever, Marburg, and Dengue.
How Do BBPs Spread?
As we already discussed, bloodborne pathogens spread when an uninfected person comes in contact with an infected person or animal’s blood or OPIM. But how much contact is required for actual transmission to occur?
Sexual contact and sharing hypodermic needles—usually associated with illicit drug use—are the two main methods of transmission. Contact between mucous membranes of the mouth, eyes, nose, or genital regions even outside of traditional sex can also pass diseases along. Infected mothers can transmit some BBPs to their babies while pregnant, but the risk increases during birth when they’re no longer protected by the placental barrier.
Healthcare workers and other at-risk professionals should be most aware of the methods of accidental exposure. These include:
- needle sticks
- punctures from medical sharps or broken glass
- inhalation of contaminated aerosols, such as when a patient coughs up bloody sputum
- accidental blood or OPIM contact with a mucous membrane (eyes, nose, mouth)
- accidental blood or OPIM contact with damaged or broken skin
Contact with healthy, undamaged skin holds the lowest risk of infection but should still be avoided at all times. Even if you aren’t treating a patient in-person, a puncture from a contaminated object or cleaning up infected fluids can still result in transmission.
How Do You Stop Them From Spreading?
The best way to prevent bloodborne pathogens from spreading is to follow universal precautions. In short, this means treating all blood and OPIM as if they were carrying BBPs.
These precautions begin with engineering controls like installing authorized sharps and biohazard disposal containers. At-risk persons should also wear appropriate PPE including gloves, masks, eye protection, face shields, and gowns. Employers of at-risk persons must label hazardous items/areas and offer the hepatitis B vaccine.
To reduce risks, all re-used items and surfaces should be disinfected between uses. All policies and procedures should also be safety-focused to minimize exposures.
Anyone who is at risk of accidental exposure to BBPs, whether or not they’re a healthcare worker, should undergo training and pass a bloodborne pathogens test. The list of professions that should go through BBP training includes:
- doctors, nurses, and other direct patient care providers
- paramedics, EMTs, firemen, and other first responders
- medical laboratory teams and researchers
- rehab, nursing home, and home health care providers
- dentists, hygienists, and dental assistants
- law enforcement
- janitorial, laundry, and housekeeping teams
- blood and tissue bank staff and blood drive volunteers
- medical equipment technicians
- teachers, school nurses, and school employees
- morticians and funeral home employees
- tattoo and piercing artists
This is not an exhaustive list. Anyone whose job could cause them to come in contact with blood, OPIM, or potentially contaminated items (like needles and syringes) should take an accredited BBP course.
How to Handle Exposure to Bloodborne Pathogens
Despite our best efforts at following safety precautions, accidental BBP exposures do happen. Statistics show that more than 50% of nurses will suffer a needle stick accident at least once in their careers, and other medical professionals are at risk of BBP exposure as well.
If you do get exposed, it’s vital to act quickly. If the exposure happens at work, follow your workplace’s established exposure control plan. OSHA requires employers to offer post-exposure evaluation and follow-up appointments to their at-risk employees at no cost.
After an accidental contact or needle stick, immediately wash the area with soap and water. Flush mucous membranes with copious amounts of water. If the fluid comes in contact with your eyes, irrigate them with sterile water or saline.
After cleaning the area thoroughly, seek prompt medical attention. Make sure to document and report the incident according to your workplace’s policy.
Getting Trained on Bloodborne Pathogens
Bloodborne pathogens and OPIM cause a wide range of serious diseases. To keep both others and yourself safe from infection, it’s vital to have adequate BBP training.
If you or your medical team needs trained, HIPAA Exams has everything you need to get started. Our hour-long course and exam cover all the information touched on in this article in greater detail, along with deeper instruction on OSHA regulations and work practice. To sign up for this affordable, comprehensive course and get a competitive group rate, visit our website today.