Biohazard - Use Universal Precautions Sign.
It is important to use universal precautions whenever there is a potential for exposure to bloodborne pathogens or OPIM.

Exposure Control Methods

Universal Precautions

The recommended infection-control concept called "universal precautions" advocates everyone's blood and body fluids be considered potentially infectious. It is an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens. This eliminates the difficulty in determining risk individually.

Bloodborne Pathogen Standard 29 CFR 1910.1030(d)(1) requires:

  • Employees to observe Universal Precautions to prevent contact with blood or other potentially infectious materials (OPIM).
  • Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.
  • Treat all blood and other potentially infectious materials with appropriate precautions such as:
    • Use gloves, masks, and gowns if blood or OPIM exposure is anticipated.
    • Use engineering and work practice controls to limit exposure.

1. Which of the following infection-control concepts advocates that everyone's blood is considered potentially infectious?

a. Engineering practices
b. Administrative controls
c. Universal precautions
d. Employee involvement

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Methods To Control Hazards and Exposure

In the previous section we learned that two essential strategies OSHA specifically requires to eliminate or reduce injuries due to exposure to bloodborne pathogens are: changing hazards and changing behaviors.

Each of the two basic strategies include unique control methods, and together they form the Hierarchy of Controls.

In healthcare, engineering, work practice, and PPE controls are generally the most widely used methods to protect healthcare employees from exposure, so those methods are in bold type.

  1. To eliminate or reduce exposure by changing hazards, use the following methods:
    1. Elimination. Remove the hazard.
    2. Substitution. Replace the hazard.
    3. Engineering Controls. Design equipment to isolate the hazard.
  2. To eliminate or reduce exposure by changing behaviors, use the following methods:
  3. SHARPS Container
    Control methods work together to protect workers.
    1. Administrative Controls. Develop policies, programs, and procedures to reduce exposure.
    2. Work Practice Controls. Using safe techniques and practices to reduce exposure.
    3. Personal Protective Equipment (PPE). Set up a personal barrier to reduce exposure.

The image to the right is a good example of how engineering, work practice, and PPE control methods work together to protect healthcare workers.

  1. The sharps container is the engineering control;
  2. Using the sharps container is a safe work practice; and
  3. Wearing gloves is a PPE control.

2. Engineering controls minimize exposure by _____.

a. classifying hazardous conditions
b. designing equipment
c. lean manufacturing
d. importing approved materials

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Engineering Controls

Engineering controls minimize exposure in the workplace either by designing equipment to physically isolate the hazard from the worker, such as:

  • sharps container for needles,
  • splash guards,
  • red bags for contaminated materials, and
  • mechanical pipetting devices.

Work Practice Controls

Gloved hand providing first aid for a cut finger.
Always use PPE when providing first aid care.

Work practice controls focus on behaviors: the way tasks are performed. Each of the following is an example of a safe work practice control:

  • using disposable gloves when performing emergency care;
  • performing all actions involving OPIM in a way as to minimize splattering, splashing, and spraying;
  • properly handling and disposing needles or sharps in sharps containers;
  • disposing contaminated bandages, gauze, or linens in proper containers; and
  • eliminating eating, drinking, smoking, applying make-up or lip balm, or handling contact lenses in locations with potential exposure to OPIM.

Work practice controls are all about how tasks are performed to minimize exposure.

In healthcare facilities, employees are prohibited from wearing artificial nails. Food and drink must not be kept in a refrigerator, freezer, shelf, or in the general area of where blood or other potentially infectious materials are kept.

3. Which of the following is a good example of a work practice control?

a. Disposable gloves
b. Eliminating the need to use gloves during first aid
c. Using disposable gloves as required
d. Replacing disposable gloves with reusable gloves

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Methods To Control Hazards and Exposure (Continued)

Wash your hands!

Washing hands.
After any exposure, you should wash your hands to reduce your risk of infection.

Hand washing after an exposure can reduce your risk of infection.

Your employer must provide readily accessible hand-washing facilities or antiseptic hand cleanser or wipes if hand-washing facilities are not available.

Perform hand washing immediately after any exposure, even if you were wearing gloves. Vigorous scrubbing with soap or alcohol-based foam or gel and warm water is considered the most effective technique. This will further reduce your risk of infection resulting from an exposure.

Prohibited Practices

Practices that are completely prohibited in the workplace include: bending, recapping, and removing contaminated needles, shearing or breaking needles, and mouth pipetting or suctioning of potentially infectious material.

These practices significantly increase the risk of exposure. As a result, they should never be performed by employees.

4. Which of the following can reduce your risk of infection after exposure to a bloodborne pathogen?

a. Putting on a new pair of gloves
b. Wiping hands with a towel
c. Using hand lotion
d. Thoroughly washing hands

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Antiseptic hand cleaner.

Methods To Control Hazards and Exposure (Continued)

Alternatives

Antiseptic hand cleaner in conjunction with clean cloth/paper towels or antiseptic towelettes are examples of acceptable alternatives to running water.

However, when these types of alternatives are used, employees must wash their hands (or other affected areas) with soap and running water as soon as feasible.

This alternative would only be acceptable at worksites where soap and running water are not feasible.

5. What is important to remember if you have used antiseptic hand cleaner to clean your hands?

a. Be sure to wipe your hands with a paper towel
b. Do not eat food for at least 15 minutes
c. Use soap and water as soon as possible
d. Rinse with plain water

Check your Work

Read the material in each section to find the correct answer to each quiz question. After answering all the questions, click on the "Check Quiz Answers" button to grade your quiz and see your score. You will receive a message if you forgot to answer one of the questions. After clicking the button, the questions you missed will be listed below. You can correct any missed questions and check your answers again.

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Scenario

Dr. Kramer owns and operates a small dental clinic in San Francisco, CA. As part of her exposure control plan, she requires her employees to wash their hands before and after working with any patients. She also requires new gloves be used with every patient.

Is this an example of engineering controls or work practice controls?

Work practice controls.

Dr. Kramer is requiring her employees to do something to reduce the risk of occupational exposure. Work practice controls focus on the actions taken to minimize exposure.

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