HIV & AIDS Education

Because human immunodeficiency virus (HIV) and other bloodborne diseases is transmitted by blood and body fluids containing blood, preventing exposure to HIV on the job really means preventing exposure to these substances. It is the actual contact with blood on the job that puts you, the worker, at risk. Workers, especially health care workers, may come into contact with blood on the job by a blood splash to the eyes, mouth, or nose, or they may be one of the estimated one million health care workers stuck by a needle every year.

Fortunately when you practice universal precautions and work to make sure that the OSHA Bloodborne Pathogens Standard is enforced in your workplace, your risk of exposure to HIV and other bloodborne diseases decreases.

Bloodborne diseases like HIV and hepatitis B are caused by viruses. Viruses are transmitted by contact with blood, semen, vaginal secretions, and certain other body fluids. If any of these viruses get into a person's body, he or she may become infected with the virus and get sick.

Most workers have no risk of getting HIV from their job. However, HIV is transmitted by human blood, so those who have direct contact with blood, body fluids containing visible blood, or the virus itself at work may have some risk of getting HIV on the job. HIV is only one virus transmitted by blood. Others include hepatitis B virus (HBV) and hepatitis C virus (HCV). Direct contact with blood or body fluids containing visible blood and certain other body fluids on the job can occur when a worker:

• Gets stuck with a needle or a lancet;
• Gets cut with a sharp instrument, like a scalpel;
• Is splashed in the eyes, nose, or mouth with blood, body fluid, or the actual virus;
• Has an opening on the skin (like a cut or a rash).

Besides blood, HIV can be found in other fluids including:

• Semen;
• Vaginal or cervical fluids;
• Breast milk;
• Fluids surrounding the joints, lungs, heart, and abdomen;
• Fluids in childbirth, like amniotic fluid;
• Any other body fluids that contain visible blood;
• Other specific body fluids.

Workers exposed to any of these fluids at work should practice universal precautions. The following section outlines universal precautions.

Because it is impossible to know who is or is not infected with HIV, HBV, or HCV, workers must treat ALL blood and body fluids as if they are potentially infectious. This practice is called standard body isolation precautions and should be used by anyone exposed to any body fluids on the job. Standard body isolation precautions include the more specific precautions known as universal precautions. These precautions apply to blood and certain body fluids capable of transmitting bloodborne diseases like HIV, HBV, and HCV. For the purposes of this document, the term universal precautions will be used. Universal precautions also are a component of OSHA's Bloodborne Pathogens Standard.

Always use universal precautions whenever you come in contact with:

• blood or blood products like plasma;
• body fluids like semen, vaginal secretions, and amniotic fluid. (See page 4 for a list of some of these fluids);
• any body fluid in which blood is visible; or
• cuts, wounds, or other kinds of open skin or lesions.

Universal precautions include:

• hand-washing with soap and water: -between each patient and task, -after using the bathroom, and -after taking off your gloves.
• wearing appropriate gloves (e.g., vinyl, latex, or housekeeping) whenever you may have contact with blood or other body fluids;
• wearing a gown, mask, or eye protection (goggles or face shield) when you may be splashed with blood or other body fluids;
• disposing of needles and other sharp instruments by placing them in a puncture-resistant container, like a needle disposal box (do not re-cap needles);
• using resuscitation equipment, such as a mouthpiece or a resuscitation bag, when mouth-to-mouth resuscitation is needed;
• using leak-proof containers to store and transport patient specimens (the containers should have lids)
• using leakproof bags to store and transport soiled linen (bags that contain linens soiled with blood or body fluids should be color-coded [red] or labeled with the biohazard symbol).

All workers who come in contact with blood on the job should practice universal precautions, including:*

• Wear housekeeping utility (rubber) gloves when cleaning up blood or bodily fluids.
• First, contain blood spill with absorbent materials such as paper towels, then clean up spill with appropriate disinfectant.
• Never use your hands or feet to push down the trash in a bag — it could contain needles that could poke through your hands or shoes.
• Never hug bags of trash to your body. They could contain needles that could poke you or fluids that could leak on you.
• Throw away housekeeping gloves if they become cracked, split, or discolored.

• Put waste that has blood or body fluids in a special red plastic bag.
• Always put needles and other sharp objects in a needle disposal box or container.
• Never use your hands or feet to push down the trash in a bag — it could contain needles that could poke through your hands or shoes.
• Never hug bags of trash to your body. They could contain needles that could poke you or fluids that could leak on you.
• Follow disinfection procedures with a chemical germicide solution. One inexpensive, easy solution is bleach and water (1:100 dilution; e.g., 1/3 cup of bleach per 2 gallons of water). This solution should be made fresh daily and discarded within 24 hours.

• Wear gloves when sorting laundry.
• Never hug bags of laundry to your body. They could contain needles that could poke you or fluids that could leak on you.

• Wear gloves and an apron when preparing food. If you find a needle or any-thing else on a food tray that does not belong there, tell your supervisor.

* While the items in this list may be prudent practice, not all are required by the OSHA Bloodborne Pathogens Standard.

Use Universal Precautions Because:

• They are a CDC recommendation and OSHA regulation.
• They may save you from becoming infected.
• They also protect patients and clients.

When workers practice universal precautions, they don't need to know a patient's, client's, or student's diagnosis. Confidentiality laws often make it impossible to know someone's diagnosis anyway. Practicing universal precautions and treating all blood and body fluids as potentially infectious help ensure that the workers protect themselves while focusing on providing quality care to the patient or client. Practicing universal precautions — including the use of gloves, hand washing, etc.

— also protects the patient or client from any illnesses that the care providers may have. In short, following universal precautions is a solid foundation of prevention and infection control that is good for the worker and good for the patient or client.

Many workers also are exposed to saliva, sweat, urine, vomit, and feces. These fluids are not known to spread HIV. While very small amounts of HIV have been found in saliva and tears, there is no risk unless there is visible blood in these body fluids.

Remember, it's bloodborne pathogens that put workers at risk of exposure to hepatitis B, hepatitis C, or HIV.