Around one out of ten health care workers (HCWs) worldwide experience percutaneous bloodborne pathogen exposure, as published by the World Health Organization. The top three bloodborne viruses (BBV) they’re exposed to include hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). Even in high-income countries that follow preventive interventions, HCWs remain at risk of occupational bloodborne viruses.
Besides HIV, watch out for other less-common bloodborne pathogens such as syphilis, malaria, leptospirosis, viral hemorrhagic fever, hepatitis delta (HDV), and arboviral infections. It is vital then to define where and how HCWs can be at risk of BBV infection. It’s equally important to follow protocols and imposed safety measures as HCWs treat patients.
Risks Of Bloodborne Pathogens
Risk Of Transmission In The Workplace
HCWs in urban and tertiary-care hospitals have increased exposure to patient populations with a relatively high prevalence of BBV infection. Urban and tertiary-care hospitals have more patients who are at high risk of getting infected. The risk of occupational infection for HCWs in this setting can be higher than those serving in rural and community hospitals.
It is crucial for employers to implement preventive measures. Bloodborne Pathogens Training can be crucial especially for HCWs with a higher possibility of exposure to BBVs in the workplace setting.
Risk In Handling
The probability of BBV transmission post-exposure depends on several factors. First is the concentration of infectious virions in the body fluid. Second is the volume of BBV transferred. High titers of BBV have been noted in blood and serous fluids. Moderate titers of BBV are believed to be found in saliva, semen, and vaginal secretions. Meanwhile, low levels of BBV are in urine and feces, unless contaminated by blood.
The third factor considered in the probability of transmission postexposure is the route of inoculation. While the National Center for Biotechnology Information noted that three out of four cases of occupational exposure is percutaneous, one of four cases is mucosal-cutaneous.
BBVs can be transmitted via sexual and blood-to-blood contact. But, among the most common modes of BBV transmission in the healthcare setting is through drug injection. This is the unintentional injury from a needle contaminated with the blood of an infected patient. An accidental puncture may also occur from contaminated sharp objects resulting in the transmission of bloodborne pathogens.
Risk Of Transmission While Caring For Patient
The risk of patient-to-HCW transmission can also depend on the patient population where the HCW works. In particular, patients who tested positive with BBV (acute or chronic) can be potential sources of infection.
Now, why is it vital to avoid contact with the blood and body fluids of all patients? Acutely infected patients may not be easily recognized as they are often asymptomatic. Further, it is not rare for people to be carriers of more than one of the main BBVs, especially since these pathogens spread via similar routes.
This is the more dangerous part—traveling also paves the way for rare diseases to travel globally. In this case, HCWs abroad should be aware of the possibilities of risk of exposure to rare diseases. For instance, Hepatitis C (HCV) is more prevalent in some countries.
Safety Measures In Handling Bloodborne Pathogens
- Safety With PPE
The use of personal protective equipment (PPE) has been emphasized globally. PPE use can also prevent BBV transmission as they provide filters or barriers between the HCW and the hazard (setting or individual). Though PPE cannot prevent needle-stick injuries, the use of eye goggles, masks, gowns, and gloves can prevent exposures to bodily fluids.
- Safety By Eliminating Hazards
BBV transmission is preventable in the workplace, especially when handling possibly contaminated objects and caring for patients. Elimination of unnecessary or used sharp tools and injections are some ways to prevent accidental transmission. And, when possible, remove sharps and needles. Needle-less intravenous systems and jet injectors are ideal as substitutes for sharps.
When removal of hazards is not feasible, isolation may be implemented. An example is utilizing disposal containers. Also, the use of sharps protection devices and needles that blunt or retract immediately after use, is necessary.
- Safety Though Good Workplace Practice
Health care institution administrations can implement policies that limit HCW’s exposure to hazard. This could include consistent training of HCWs on the use of safety devices. Creating a plan to control exposure can also include a needle-stick injury prevention committee.
Further, the administration should see to it that HCWs follow safety protocols such as ‘no needle recapping’ safe handling and safe disposal of sharp devices. Hospital administration should further urge HCWs to report exposures. This is especially vital as exposures may be underreported. Post-exposure evaluation should also be a common practice. Finally, management should ensure proper housekeeping such as cleaning and decontaminating infected surfaces.
Understanding Laws Concerning Bloodborne Pathogens
Brush up on the OSHA Bloodborne Pathogens Standard, a federal law passed in 1992 and continues to be updated as needed. Employers are required by federal law to implement an updated exposure control plan along with universal precautions, work practice controls, vaccinations, PPE, and hazard signs.
Moreover, 22 states have enacted state legislation towards improving HCW safety when using needle sticks. State legislation may fill in gaps in the federal OSHA Bloodborne Pathogen Standard. Further coverage of public employees that are not regulated by OSHA may also be addressed in state laws.
Enumerated above are just some of the risks and safety measures healthcare workers and laboratories must observe in handling bloodborne pathogens. Exposure to the latter can cause grave effects to the healthcare workers handling them. Thus, it’s crucial to prevent exposure by observing safety measures and following state laws, as the case may be.