What To Do In Case of Blood or Other Potentially Infectious Material Exposure
Bloodborne pathogens are microorganisms present in human blood that can cause disease in humans, including hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).
Cabrillo Community College District maintains a Bloodborne Pathogens Exposure Control Plan to eliminate or minimize occupational exposure to human blood and Other Potentially Infectious Materials (OPIM) and to establish requirements for prevention, training, engineering and work-practice controls, personal protective equipment, hepatitis B vaccination, exposure response, medical follow-up, sharps safety, and recordkeeping.
California’s Bloodborne Pathogens Standard is contained in Title 8, California Code of Regulations, Section 5193. The standard applies to occupational exposure to blood or OPIM.
If You Are Exposed to Blood or OPIM
An exposure incident may include:
A needlestick or contaminated-sharps injury
A cut or puncture involving contaminated material
A splash to the eyes, nose, or mouth
Contact of blood or OPIM with non-intact skin
A human bite involving blood exposure
Other eye, mucous-membrane, non-intact-skin, or parenteral contact with blood or OPIM resulting from assigned work
Take These Steps Immediately
Stop the task when it is safe to do so.
Wash needlesticks, cuts, and exposed skin with soap and water.
Flush the eyes, nose, mouth, or other exposed mucous membranes with clean water.
Notify your supervisor immediately.
Obtain prompt occupational medical evaluation through the District’s established process.
Complete required District incident documentation.
Do not delay reporting or medical evaluation because the exposure appears minor.
Medical evaluation should not be delayed while incident paperwork or workplace investigation is being completed.
For a life-threatening emergency, call 911.
Post-Exposure Medical Evaluation and Follow-Up
Following a reported occupational exposure, the District provides a confidential medical evaluation and follow-up at no cost to the employee and at a reasonable time and place.
The evaluation includes, as applicable:
Documentation of the route of exposure and circumstances surrounding the incident
Identification and documentation of the source individual when feasible and legally permitted
Source-individual testing for HBV, HCV, and HIV when legally permitted
Communication of legally releasable source-test information to the exposed employee
Collection and testing of the employee’s blood, with consent, for HBV, HCV, and HIV status
Post-exposure prophylaxis when medically indicated
Counseling
Evaluation of illnesses reported following the exposure
Additional testing and follow-up as medically indicated
If baseline blood is collected but the employee does not initially consent to HIV testing, the sample must be preserved for at least 90 days. If the employee requests testing during that period, the testing must be completed as soon as feasible.
Information Provided to the Healthcare Professional
The District provides the evaluating healthcare professional with required information, including:
A copy of the applicable Bloodborne Pathogens regulation
A description of the employee’s duties related to the exposure
Documentation of the route and circumstances of exposure
Available source-individual test results
Relevant employee medical records, including hepatitis B vaccination status
Healthcare Professional Written Opinion
The District provides the employee with a copy of the evaluating healthcare professional’s written opinion within 15 days after completion of the evaluation.
The written opinion provided to the District is limited to information permitted by the Bloodborne Pathogens Standard. Other medical findings and diagnoses remain confidential.
Universal Precautions
Employees with occupational exposure must use Universal Precautions.
All human blood and applicable OPIM must be treated as though they are infectious for HBV, HCV, HIV, and other bloodborne pathogens.
When it is difficult or impossible to differentiate between body fluids, the material must be treated as potentially infectious.
Procedures involving blood or OPIM must be performed in a manner that minimizes splashing, spraying, splattering, and generation of droplets.
What Is OPIM?
Other Potentially Infectious Materials include certain human body fluids and materials identified by Cal/OSHA, including:
Semen
Vaginal secretions
Cerebrospinal fluid
Synovial fluid
Pleural fluid
Pericardial fluid
Peritoneal fluid
Amniotic fluid
Saliva in dental procedures
Body fluids visibly contaminated with blood
Body fluids when differentiation is difficult or impossible
Unfixed human tissue or organs other than intact skin
Certain cultures, tissues, solutions, and experimental-animal materials that may contain HBV, HCV, or HIV
Preventing Exposure
Engineering and work-practice controls are the primary means of eliminating or minimizing occupational exposure. Personal protective equipment supplements these controls but does not replace them.
Employees with occupational exposure must follow applicable procedures, including:
Wash hands immediately or as soon as feasible after removing gloves or other PPE.
Wash skin with soap and water following contact with blood or OPIM.
Flush exposed mucous membranes with water immediately or as soon as feasible.
Do not eat, drink, smoke, apply cosmetics or lip balm, or handle contact lenses in areas where occupational exposure is reasonably likely.
Do not store food or beverages where blood or OPIM are present.
Never mouth-pipette or suction blood or OPIM.
Use mechanical means to pick up contaminated broken glass.
Follow approved sharps-handling procedures.
Place specimens in appropriate closed containers that prevent leakage.
Use and maintain required engineering controls.
Personal Protective Equipment
When occupational exposure remains after engineering and work-practice controls are implemented, the District provides required PPE at no cost to the employee.
Depending on the task and anticipated exposure, PPE may include:
Disposable examination gloves
Reusable utility gloves
Gowns
Laboratory coats
Clinic jackets
Aprons
Masks
Face shields
Protective eyewear
Resuscitation bags
Pocket masks
Other ventilation devices
Shoe covers or other protection when gross contamination is reasonably anticipated
PPE is appropriate only when it prevents blood or OPIM from passing through to or reaching the employee’s work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use.
PPE Availability and Department Responsibilities
Affected departments and supervisors must ensure that:
Appropriate PPE is readily accessible.
PPE is available in appropriate sizes.
Employees are trained in when and how to use PPE.
Suitable alternatives are available for employees with glove sensitivities.
Required PPE is cleaned, laundered, repaired, replaced, or disposed of at no cost to employees.
PPE selection considers both biological hazards and chemical hazards associated with disinfectants or sterilants.
Removal of Contaminated PPE
Remove PPE before leaving the work area.
If blood or OPIM penetrates a garment, remove it immediately or as soon as feasible.
Place contaminated PPE in the designated area or container for storage, laundering, decontamination, or disposal.
Do not take contaminated District PPE home for cleaning or laundering.
Wash hands after removing gloves or other PPE.
Gloves
Gloves must be worn when hand contact with blood, OPIM, mucous membranes, non-intact skin, contaminated items, or contaminated surfaces can reasonably be anticipated.
Disposable Gloves
Replace disposable gloves as soon as practical when contaminated.
Replace them immediately when torn, punctured, or otherwise compromised.
Do not wash or decontaminate disposable gloves for reuse.
Reusable Utility Gloves
Reusable utility gloves may be decontaminated for reuse if their integrity is maintained.
Discard them if they are:
Cracked
Peeling
Torn
Punctured
Deteriorated
Otherwise unable to function as an effective barrier
Eye, Face, and Protective Clothing
Masks together with appropriate eye or face protection must be used whenever splashes, sprays, splatter, or droplets of blood or OPIM may reasonably be anticipated to contact the eyes, nose, or mouth.
Gowns, aprons, lab coats, clinic jackets, or other protective clothing must be selected based on the task and anticipated degree of exposure.
Cleaning and Decontamination
Cabrillo Community College District, through affected departments, will ensure that work areas involving blood or OPIM are maintained in a clean and sanitary condition.
Exact procedures depend upon departmental activities, work areas, equipment, and potential exposure hazards.
Affected departments must establish and implement appropriate written methods and schedules for cleaning and decontamination based on:
Location within the facility
Type of surface or equipment
Type of contamination present
Tasks or procedures performed in the area
These procedures must be followed and made accessible to affected employees. California expressly requires written cleaning and decontamination methods and schedules.
Contaminated Work Surfaces
Contaminated work surfaces must be cleaned and decontaminated with an appropriate disinfectant immediately or as soon as feasible:
When surfaces become visibly contaminated
After a spill of blood or OPIM
After procedures are completed
At the end of the work shift if contamination may have occurred since the last cleaning
Reusable Receptacles
Bins, pails, cans, and similar reusable receptacles that may become contaminated with blood or OPIM must:
Be inspected on a regular schedule
Be cleaned and decontaminated as necessary
Be cleaned and decontaminated immediately or as soon as feasible when visibly contaminated
Protective Coverings
Protective coverings such as plastic wrap, aluminum foil, or impervious-backed absorbent material must be removed and replaced:
As soon as feasible when contaminated
At the end of the work shift when they may have become contaminated
Contaminated Broken Glass
Broken glass that is or may be contaminated with blood or OPIM must not be picked up directly by hand.
Instead:
Use tongs, forceps, a brush and dustpan, or other mechanical means.
Place contaminated broken glass into an appropriate sharps container or other approved container.
Disinfectants
Disinfectants and other decontamination products must be selected and used according to:
Manufacturer labeling
EPA registration and intended use
Required contact time
Safety Data Sheet
Required PPE
Ventilation requirements
District Hazard Communication requirements
Applicable departmental procedures
Employees must not mix disinfectants or cleaning products unless specifically authorized by manufacturer instructions and an established written procedure.
Blood and OPIM Spill Cleanup
Only employees whose assigned duties include blood or OPIM cleanup and who have received appropriate training, controls, and PPE should perform cleanup.
For blood or OPIM spills:
Restrict access to the contaminated area as appropriate.
Wear required PPE.
Remove visible material using appropriate absorbent materials.
Clean and disinfect the affected surface using an approved product appropriate for the intended use.
Follow required dilution, application, and contact-time instructions.
Use mechanical means to collect contaminated broken glass or sharps.
Place cleanup materials into the appropriate waste container.
Remove PPE appropriately and wash hands.
Do not rely on a universal bleach dilution for every spill. The disinfectant and method must be appropriate to the product, surface, contamination, and departmental procedure. The District ECP requires disinfectants to be used according to their label, intended use, contact time, SDS, and departmental procedure.
Sharps Safety
Contaminated sharps must be handled in a manner that minimizes needlestick, cut, and other percutaneous injuries.
Handling Sharps
Do not shear or purposely break contaminated needles or sharps.
Do not bend, recap, or remove contaminated needles unless no alternative is feasible or the action is specifically required by a medical or dental procedure.
When an exception applies, use a mechanical device or one-handed technique.
Do not manipulate contaminated sharps unnecessarily by hand.
California also requires appropriate needleless systems and engineered sharps-injury protection where applicable and where regulatory exceptions do not apply.
Disposable Sharps
Dispose of contaminated sharps immediately or as soon as feasible in an approved sharps container.
Sharps containers must be:
Closable
Puncture resistant
Leak resistant on the sides and bottom
Appropriately labeled or color-coded
Maintained upright
Located as close as feasible to the point of use
Replaced routinely and before they become overfilled
Reusable Sharps
Reusable contaminated sharps must be placed immediately or as soon as feasible into appropriate containers until reprocessing.
Employees must not reach by hand into containers holding reusable contaminated sharps.
Sharps containers must not be opened, emptied, or manually cleaned in a manner that exposes employees to sharps injury.
Removing or Transporting Sharps Containers
Before removing a sharps container from the area of use:
Close the container.
Prevent spillage or protrusion of contents.
Use appropriate secondary containment when leakage is possible.
Keep required biohazard identification intact.
Sharps Injuries
A needlestick or other injury involving a contaminated sharp is an exposure incident and must be reported immediately.
The employee should:
Stop the task when safe.
Wash the affected area with soap and water.
Notify the supervisor immediately.
Obtain prompt occupational medical evaluation.
Complete required incident documentation.
Medical evaluation must not be delayed because the injury appears minor.
Sharps Injury Log
The District maintains a confidential Sharps Injury Log for each applicable exposure incident involving a sharp.
The log includes, when known or reasonably available:
Date and time of the incident
Type and brand of sharp
Employee job classification
Department or work area
Procedure being performed
How the incident occurred
Body part involved
Whether engineered sharps-injury protection was present
Whether the safety mechanism was activated
When the injury occurred in relation to activation
Employee input regarding whether an engineered device could have prevented the injury
Employee input regarding whether engineering, administrative, or work-practice controls could have prevented the injury
Each applicable exposure incident must be entered into the Sharps Injury Log within 14 working days after the incident is reported.
The log must be maintained in a manner that protects employee confidentiality.
The District uses this information, together with employee input and available device-use information, to evaluate injury trends, safer devices, and corrective actions.
Contaminated Laundry
Laundry contaminated with blood or OPIM must be handled as little as possible and with minimum agitation.
Bag or containerize contaminated laundry where it was used.
Do not sort or rinse contaminated laundry at the location of use.
Use appropriate labeling or color coding.
When laundry is wet and may soak through or leak, use bags or containers that prevent leakage.
Employees handling contaminated laundry must wear protective gloves and other appropriate PPE.
Do not take contaminated District laundry home.
When contaminated laundry is sent off-site, applicable contamination hazards and handling requirements must be communicated to the receiving facility.
Regulated Waste
Contaminated sharps and other regulated bloodborne-pathogen waste must be managed in accordance with applicable District medical-waste, sharps, and hazardous-waste procedures.
Other Regulated Waste
Regulated waste other than sharps must be placed in containers that are:
Closable
Leak resistant where required
Capable of containing the contents
Appropriately labeled or color-coded
Closed before removal from the work area
Use secondary containment when leakage or exterior contamination is possible.
Not every material with a small amount of dried blood is regulated medical waste. Departments must follow applicable District procedures for distinguishing regulated medical waste from ordinary trash, chemical waste, pharmaceutical waste, and other waste streams.
Do not treat, autoclave, chemically process, sewer-discharge, or place regulated waste into ordinary trash unless an applicable District procedure specifically authorizes that method.
Biohazard Labels and Color Coding
Biohazard labels or required red bags or containers are used to identify materials that present a bloodborne-pathogen hazard.
Labels are required where applicable for:
Regulated waste
Sharps containers
Refrigerators and freezers containing blood or OPIM
Containers used to store, transport, or ship blood or OPIM
Contaminated equipment
Contaminated laundry when applicable
Other materials identified by the Bloodborne Pathogens Standard
Required biohazard labels must be fluorescent orange or orange-red, or predominantly so, with contrasting lettering or symbols, and must be securely affixed. California also has specific labeling requirements for regulated medical and sharps waste.
Contaminated Equipment
Equipment that may be contaminated with blood or OPIM must be examined before servicing or shipment and decontaminated when feasible.
If full decontamination is not feasible:
Attach a readily observable biohazard label.
Identify which portions remain contaminated.
Communicate remaining contamination to affected employees, service representatives, or manufacturers before handling, servicing, or shipment.
Hepatitis B Vaccination
Employees with occupational exposure are provided hepatitis B vaccination in accordance with 8 CCR §5193 and District procedures.
For employees subject to the standard pre-exposure vaccination requirement, the vaccine is offered:
After required Bloodborne Pathogens training
Within 10 working days of initial assignment
At no cost to the employee
Vaccination is not required when the employee has already completed the vaccination series, has documented immunity, or vaccination is medically contraindicated.
Employees who decline vaccination must sign the regulatory declination statement. Employees who initially decline may later request vaccination at no cost while they remain covered.
California regulations contain a narrowly defined exception for certain collateral-duty first-aid providers, but that exception may be used only when all requirements of §5193 are implemented.
Who Is Covered?
The Bloodborne Pathogens Exposure Control Plan applies to District employees, including student employees, temporary employees, and other workers under District direction when occupational exposure is reasonably anticipated as part of assigned duties.
Potentially affected activities may include:
Student Health Services
Nursing, Dental Hygiene, Medical Assisting, Radiologic Technology, and other allied-health instruction
Custodial and certain Facilities activities
Athletics and aquatics
Designated first-aid or emergency-response duties
Children’s Center operations
Public Safety functions, when assigned
Laboratory activities involving human blood, unfixed human tissue, or OPIM
Student employment assignments involving blood or OPIM
Coverage is determined based on the employee’s assigned duties and exposure-producing tasks, without regard to the use of PPE.
Students
Students participating solely as students are generally not employees for purposes of the Cal/OSHA Bloodborne Pathogens Standard.
Instructional programs must nevertheless maintain appropriate infection-control procedures, supervision, and exposure-response processes.
Student employees whose assigned duties create occupational exposure are covered as employees.
Bloodborne Pathogens Training
Employees with occupational exposure receive Bloodborne Pathogens training at no cost and during working hours.
Training is required:
At initial assignment and before covered tasks are performed
At least annually, within one year of the previous training
Whenever changes in tasks, procedures, engineering controls, equipment, or assignments affect occupational exposure
Required Training Content
Training includes:
An accessible copy and explanation of 8 CCR §5193
Epidemiology, symptoms, and transmission of bloodborne diseases
The District Exposure Control Plan and how to access it
Department-specific exposure-producing tasks
Engineering and work-practice controls
PPE selection and use
PPE removal, handling, decontamination, and disposal
Hepatitis B vaccination
Emergency actions and contacts
Exposure-incident reporting
Post-exposure medical evaluation and follow-up
Sharps Injury Log procedures
Biohazard labels and color coding
Safer-device requirements and employee participation, where applicable
Chemical hazards of disinfectants and sterilants when applicable
An opportunity for interactive questions and answers with a knowledgeable person
Recordkeeping
The District maintains required Bloodborne Pathogens records in accordance with Cal/OSHA requirements.
Confidential Employee Medical Records
For each employee with occupational exposure, the required medical record includes:
Employee name and Social Security number
Hepatitis B vaccination status and vaccination dates
Relevant medical documentation concerning ability to receive vaccination
Results of required examinations, testing, and follow-up
The District’s copy of the healthcare professional’s written opinion
Required information provided to the healthcare professional
These records are confidential and may not be disclosed without the employee’s written consent except as permitted or required by law.
Medical records must be retained for the duration of employment plus 30 years.
Training Records
Training records include:
Training dates
Contents or a summary of the training
Names and qualifications of trainers
Names and job titles of employees attending
Training records are retained for 3 years.
Sharps Injury Log
The Sharps Injury Log is retained for 5 years from the date of the exposure incident.
Access to the Exposure Control Plan
The District Bloodborne Pathogens Exposure Control Plan is maintained so employees can readily access it during their work shift.
Access may be provided through:
The Environmental Health & Safety webpage
An established District electronic system
Designated departmental access
A paper or electronic copy upon request
The plan and applicable records are made available to employees, authorized representatives, and regulatory agencies as required by law.
Program Administration and Review
Environmental Health & Safety coordinates the District Bloodborne Pathogens Exposure Control Plan in collaboration with Human Resources, affected departments, supervisors, employees, and occupational-health resources.
The plan is reviewed at least annually and whenever necessary, including when there are changes in:
Tasks or procedures
Technology or equipment
Engineering controls
Job classifications
Occupational exposure
Exposure incidents or sharps injuries
Safer medical devices
Medical-provider arrangements
Waste procedures
Related District safety programs
The review also includes required employee involvement in evaluating workplace procedures and, where applicable, safer sharps devices.
For Bloodborne Pathogens program questions, contact:
Environmental Health & Safety
ehs@cabrillo.edu