Bloodborne pathogens are disease-causing microorganisms that can be present in human blood and OPIM. Exposure to these pathogens can lead to serious, life-threatening illnesses. Common BBPs include:

• Hepatitis B Virus (HBV): Hepatitis B is a liver infection, caused by HBV, spread through contact with infected blood, semen, or other body fluids. This can occur through sharing needles, unprotected sex, or accidental needlesticks. HBV can lead to chronic infection, cirrhosis, and liver cancer. A safe and effective vaccine is available and highly recommended for preventative or post exposure treatment.

• Hepatitis C Virus (HCV): Hepatitis C is a liver infection, caused by HCV, primarily transmitted through contact with infected blood. This often occurs through sharing needles, other drug injection equipment. Less commonly, it can be spread through sexual contact, mother-to-child transmission during birth, or accidental needlestick injuries. HCV can lead to chronic infection, cirrhosis, and liver cancer. There is no vaccine for Hepatitis C, but highly effective antiviral treatments are available.

• Human Immunodeficiency Virus (HIV): HIV is a virus that attacks the body's immune system, leading to Acquired Immunodeficiency Syndrome (AIDS) if left untreated. HIV is primarily spread through sexual contact, sharing needles, or from mother to child during birth. While there's no vaccine for HIV, highly effective prevention methods like Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) exist, alongside consistent condom use and not sharing needle

Beyond visible blood, Other Potentially Infectious Materials (OPIM) refers to a range of human body fluids and tissues that can contain bloodborne pathogens. Cal/OSHA defines OPIM to include:

• Semen

• Vaginal secretions

• Cerebrospinal fluid (fluid surrounding the brain and spinal cord)

• Saliva in dental procedures (where blood is often present)

• Any body fluid that is visibly contaminated with blood

• Any unfixed tissue or organ (other than intact skin) from a human (living or dead)

At Cabrillo, awareness of OPIM is crucial in environments such as healthcare training labs, athletic training facilities, and some science labs, where contact with these materials might occur.

In an occupational setting, exposure to BBPs primarily occurs when infected blood or OPIM enter the bloodstream or mucous membranes of an uninfected individual. Here are the common routes of exposure:

Percutaneous Injuries (Needlestick/Sharps Injuries):

Definition: This is the most common route of occupational BBP transmission, especially in healthcare and laboratory settings. It involves the skin being punctured or cut by a contaminated sharp object.

Examples:

• Sticking oneself with a used needle (e.g., after drawing blood, administering an injection, or suturing).

• Cuts from contaminated broken glass, scalpels, lancets, or other sharp instruments.

• Puncture wounds from exposed ends of dental wires or contaminated broken capillary tubes.

Mucous Membrane Exposure:

Definition: This occurs when infected blood or OPIM splashes or makes direct contact with the mucous membranes of the eyes, nose, or mouth.

Examples:

• A splash of blood into the eye when cleaning up a spill or during a procedure.

• Blood or OPIM coming into contact with the inside of the nose or mouth (e.g., from coughing, sneezing, or direct splash).

Non-Intact Skin Exposure:

Definition: This route involves contact of infected blood or OPIM with skin that has a break in its integrity such as a cut or abrasion. Even minor breaks can be entry points.

Examples:

• Contact with blood or OPIM on skin that has cuts, abrasions, dermatitis, chapped areas, hangnails, or a fresh wound.

• Blood seeping through a small cut on a gloved hand if the glove is compromised.

Human Bites (less common but possible):

Definition: If a human bite breaks the skin of both the person biting and the person bitten, and blood or OPIM from an infected individual enters the wound of the uninfected person. While the risk is generally lower than needlesticks, it can transmit BBPs if blood exchange occurs.

Examples:

• A patient with a BBP biting a healthcare worker during an emergency or agitated state, resulting in a broken skin barrier for both.

The most effective way to prevent BBP exposure is through a multi-layered approach, prioritizing controls that eliminate or reduce the hazard at its source. This aligns with the "Hierarchy of Controls," with engineering and administrative controls being the most effective.

Engineering Controls: Eliminating or Isolating the Hazard

Engineering controls are physical or mechanical systems designed to isolate or remove BBP hazards from our campus environment. They are our first line of defense. At Cabrillo, these include:

• Sharps Disposal Containers: Puncture-resistant, leak-proof, and properly labeled sharps containers are strategically placed in labs, healthcare classrooms, and other areas where contaminated sharps (needles, scalpels, broken glass) may be used. These are easily accessible at the point of use.

• Safer Needle Devices: Where applicable in our instructional programs (e.g., Nursing), we utilize devices with built-in safety features or mechanisms that effectively reduce the risk of needlestick injuries, such as self-sheathing or retracting needles and needleless IV access systems.

• Biosafety Cabinets: In relevant science and health labs, biosafety cabinets are utilized to provide enclosed, ventilated workspaces that protect students and faculty when handling infectious materials.

• Handwashing Facilities: Readily available sinks with soap and running water are present throughout campus. In areas where immediate handwashing isn't feasible, antiseptic hand cleansers and towelettes are provided, with full handwashing to follow as soon as possible.

• Mechanical Aids: Tools like tongs, brooms, and dustpans are provided for safe cleanup, preventing direct hand contact with contaminated materials.

Administrative Controls: Changing Work and Learning Procedures

Administrative controls involve changes in work and learning procedures, college policies, and training to reduce the likelihood, frequency, and severity of exposure for our campus community. These controls focus on how tasks are performed. Key administrative controls at Cabrillo College include:

• Exposure Control Plan (ECP) Implementation: Strict adherence to Cabrillo's written ECP, including regular review and updates by relevant departments and safety committees.

• Universal Precautions Policy: Enforcing the consistent application of universal precautions in all situations involving blood or OPIM across all campus departments and programs.

• Work Practice Controls: Specific procedures that alter the way tasks are performed to minimize exposure, such as:

  • Prohibiting eating, drinking, smoking, applying cosmetics, or handling contact lenses in labs or other areas where there's a possibility of BBP or OPIM exposure.

  • Never bending, recapping (unless using a mechanical device or one-handed technique), or breaking contaminated needles.

  • Avoiding mouth pipetting or suctioning of blood or OPIM.

  • Washing hands immediately and thoroughly after removing gloves or other PPE, and after any contact with blood or OPIM.

  • Proper handling and disposal of contaminated laundry generated on campus.

  • Decontaminating equipment and work surfaces after any contact with blood or OPIM, following established schedules and procedures.

• Training and Education: Comprehensive and ongoing training programs for all employees and students at risk, covering all aspects of BBP safety, including the ECP, control measures, and emergency procedures.

• Hepatitis B Vaccination Program: Ensuring the availability and promotion of the Hepatitis B vaccine for eligible Cabrillo employees and students. More information on Cabrillo's HBV Vaccination Program can be found in the next section.

• Post-Exposure Protocols: Establishing clear and accessible procedures for reporting, evaluating, and following up on all exposure incidents that occur on campus or during college-related activities. Immediate reporting to your supervisor or instructor is crucial.

• Warning Labels and Signs: Using appropriate biohazard symbols and color-coding on regulated waste containers and in areas where BBPs and OPIM are present across campus.

By diligently implementing these engineering and administrative controls, alongside appropriate personal protective equipment (PPE), Cabrillo College strives to significantly reduce the risk of occupational exposure to bloodborne pathogens and foster a safer, healthier learning and working environment for our entire campus community.

Cabrillo College is subject to the Cal/OSHA Bloodborne Pathogens Standard (Title 8, California Code of Regulations, Section 5193). This standard is designed to protect our employees, including student employees, who may reasonably anticipate contact with blood or OPIM as part of their job or instructional duties. Key requirements that Cabrillo College adheres to include:

• Exposure Control Plan (ECP): Cabrillo College has developed and implemented a written ECP that identifies job classifications and tasks with potential exposure, details exposure minimization strategies, and outlines emergency response protocols. Job classifications are divided into one of three categories based on the potential for exposure to BBPs.

  • Category I - Tasks that involve exposure to human blood, body fluids, or tissues.

  • Category II - Tasks that involve no exposure to human blood, body fluids, or tissues but employment may require performing unplanned Category I tasks.

  • Category III - Tasks that involve no exposure to human blood, body fluids or tissues, AND Category I tasks are not a condition of employment.

This plan is accessible to all employees and students with potential exposure and is reviewed and updated annually by the appropriate college departments.

• Universal Precautions: All human blood and certain human body fluids (OPIM) must be treated as if they are known to be infectious for HIV, HBV, HCV, and other bloodborne pathogens. This means consistently using appropriate precautions, regardless of perceived risk, in all campus settings, from labs to healthcare practicums.

• Training: Employees and students in programs with occupational exposure risks (e.g., Nursing, EMS, Dental Hygiene, certain labs) receive initial training and annual refresher training on BBPs, the Cabrillo College ECP, methods to reduce exposure, proper use of personal protective equipment (PPE), and post-exposure procedures.

• Hepatitis B Vaccination: The HBV Vaccine is a very effective way to prevent infection either before OR after exposure. The vaccine is most effective for post exposure therapy if it is given within 48 hours of exposure or suspected exposure. You may need to be tested for HBV at least nine weeks after exposure. It is given as a series of three shots over the course of several months. Employees in positions designated as either Category I or Category II will be offered an HBV vaccine at no cost. Any employee who does not wish to be vaccinated, for any reason, must fill out a vaccination declination form. If they change their mind in the future the vaccine will still be provided at no cost. For more information contact your supervisor, human resources, or the Cabrillo College BBP policy at cabrillo.edu/human-resources/blood-borne-pathogens

• Post-Exposure Evaluation and Follow-up: A clear protocol for immediate action, medical evaluation, and follow-up is in place for any exposure incidents occurring on campus or during college-related activities.