Office of Environmental Health and
Bloodborne Pathogen Training for High Risk Personnel
Revised: September 4, 2018
This training module must be taken during normal working hours so
you have ready access to Taylor Kriete, Biological Safety Officer. He
is available at (504) 952-1337
to answer any questions you have related
to this training.
- Exposure Control Plan
- Types of BBPs and Modes of Transmission
- Risk Determination
- Hepatitis B Vaccine
- Exposure Response
- Work Practices
- The State of Louisiana Office of Risk Management requires that
Bloodborne Pathogen (BBP) training be provided to personnel who can
reasonably anticipate having contact with blood and other potentially
infectious materials in the course of their duties.
- The U. S. Occupational Safety and Health Administration (OSHA)
requires all personnel with occupational exposure to participate in a
- This training includes hyperlinks(indicated
by gold bold text)
to provide you with additional information.
- Click here to view the OSHA standard.
You should read the LSUHSC Exposure Control Plan (ECP), which
designed to eliminate of minimize occupational exposure to BBPs. Its
- Exposure Determinations.
- Engineering and Work Practice Controls.
- Availability of the Hepatitis B Vaccination Series.
- Post-Exposure Actions.
School of Dentistry personnel should also be familiar with the
additional guidance provided by the School of Dentistry ECP.
- Blood includes
human blood, human
blood components, and products made from human blood.
- Bloodborne Pathogens are
pathogenic microorganisms present in human blood and other body fluids
that can cause disease in humans, including hepatitis B virus (HBV),
hepatitis C virus (HCV), and human immunodeficiency virus (HIV).
- Occupational Exposure is
reasonably anticipated skin, eye, mucous membrane, or parenteral
contact with blood or OPIM that may result from the performance of the
- Other Potentially Infectious
Materials (OPIM) are materials other than human blood that can
contain bloodborne pathogens and may potentially be infectious. OPIM
HIV-containing cell or tissue cultures or organ cultures and HIV- or
HBV-containing culture medium or other solutions.
- Source Individual is any
individual, living or dead, whose blood or other potentially infectious
materials may be a source of occupational exposure.
- Standard Precautions is
the use of personal protective equipment (PPE) to prevent exposure to
both bloodborne and airborne pathogens.
- Universal Precautions is
an approach to infection control in which all human blood and certain
human body fluids are treated as if known to be infectious for HIV,
HBV, and other bloodborne pathogens.
Cerebrospinal, synovial, pleural,
amniotic, pericardial, and peritoneal fluids; semen; vaginal secretions.
Any material fluid contaminated with blood; saliva in dental
Bodily fluids in emergency situations that cannot be recognized.
Unfixed human tissues or organs.
Unfixed tissues or organs from HIV- or
HIV or HBV cell cultures or culture medium.
II. Types of BBPs and Modes of Transmission
- AIDS is Acquired
Syndrome, a fatal disease that diminishes the body's ability to fight
infection; it is caused by the Human Immunodeficiency Virus (HIV).
- During the incubation period, which may last many years, there
may be no signs an individual is infected with HIV; the person can,
however, still pass the virus on to others.
- As the disease progresses, there may be flu-like illness,
depressed immunity, and enhanced susceptibility to opportunistic
- 682,668 infected in U.S.; an estimated 185 occupationally
transmitted cases since 1981.
- Risk of HIV infection after a single positive needle stick is
0.3%. Currently no vaccine is available.
Hepatitis B Virus
- Hepatitis B is an
caused by the Hepatitis B Virus (HBV) which causes inflammation of the
liver, liver infection,
cirrhosis, and liver cancer.
- Hepatitis B is far more common than HIV
and is present in very high concentrations in the blood of infected
- Symptoms include flu-like illness, jaundice, dark urine, extreme
fatigue, nausea, abdominal and joint pain, and rash.
- In 2007, overall incidence of reported acute HBV infection was
1.5 per 100,000 population.
- The risk of HBV infection after a single positive needle stick is
6% - 30%. A vaccination is available
for Hepatitis B.
Hepatitis C Virus
- Hepatitis C is an
affecting the liver caused by the Hepatitis C Virus (HCV). Infection is
often asymptomatic, but once established chronic infection can lead to
liver fibrosis, cirrhosis, liver failure, and liver cancer.
- Early signs and symptoms include fatigue, fever, headaches,
vomiting, loss of appetite, abdominal pain, jaundice, dark-colored
urine, clay-colored stools.
- Estimated 3-4 million new HCV carriers, 175,000 documented cases,
and 1,120 occupationally transmitted cases in U.S. annually.
Risk of HCV infection after single positive needle stick is 3-10%. No
HCV vaccine is available.
- Transmission can be via direct and indirect contact.
- Transmission can occur through:
- Accidental punctures from sharp objects (i.e., needles,
broken glass, or other contaminated sharps).
- Contact between broken or damaged skin and infected body
fluids (e.g., open sores, cuts, abrasions, acne, or any sort of damaged
or broken skin such as blisters).
- Exposure to mucous membranes, eyes, nose, or mouth.
- BBPs are not known to be transmitted across intact skin.
- Understand which routes are viable means of transmission for the
BBPs in your work area and which are not.
III. Risk Determination
Exposure Risk Determination
Personnel are classified as high
risk if they:
- Perform direct patient care activities likely to result in
direct or indirect exposure to blood or body fluids.
- Process or handle human blood, body fluids, tissues or organs.
- Process or handle equipment, materials or waste that may be
contaminated with human blood, body fluids or OPIMs.
- Routinely administer first aid.
- Have potential to be exposed to blood, body fluids or
OPIM in their job duties.
- Examples: Physicians, dentists, laboratory workers,
healthcare workers, animal care technicians, plumbers and custodial staff, shelter workers,
child welfare workers, police officers and others who carry weapons,
first responders, firefighters, kitchen staff (that may handle sharp
equipment), and public safety workers.
risk personnel do not perform any activity listed above (e.g.,
clerical, administrative staff, IT).
Employee Risk Determination
- The Office of Compliance initially assigns risk levels
and associated training for all employees based on job title and
- Each supervisor will validate the assigned risk level by
reviewing tasks and procedures associated with the employee’s exposure
to human blood, body fluids, or OPIMs.
- If the employee’s risk level changes due to supervisory
review or the assignment of new tasks, notify the Biological
Safety Officer so that the correct training module can
Student Risk Determination
- Students enrolled in the Schools of Medicine, Nursing, Dentistry,
and Allied Health Professions are classified as high risk and are
required to be vaccinated for Hepatitis B.
- Students enrolled in the Schools of Public Health and
Graduate Studies are initially classified as low risk.
- If, due to the nature of their work, a student in School of
Health or Graduate Studies has potential exposure to human blood, body
fluids or OPIM, that student will obtain the Hepatitis B vaccination
form or complete the
Hepatitis B Consent/Declination form(appendix
A to the
ECP) indicating that they decline the vaccination. Provide the
immunization record or signed appendix Consent/Declination form to
Student Health. That student will also have their classification
changed to “high risk.”
IV. Hepatitis B Vaccine
- The hepatitis B vaccination series is available at no cost to all
high risk employees.
- Vaccination is encouraged unless documentation exists that the
employee has previously received the series, antibody testing reveals
that the employee is immune, or medical evaluation shows that
vaccination is contraindicated.
- The Centers for Disease Control and Prevention offers information
on the hepatitis B vaccine’s efficacy, safety, method of
administration, and the benefits of being vaccinated on their website.
- Employees may decline the hepatitis B vaccination, but must
complete the Hepatitis B Consent/Declination form (Appendix A of
Exposure Control Plan) indicating that they decline the vaccine. Note
that employees who decline the vaccine may request the vaccine at a
later date at no cost.
- The School of Nursing administers the Hepatitis B vaccine on a
- High risk employees should complete the Hepatitis B
Consent/Declination form (Appendix A of Exposure Control Plan) and
contact their supervisor/business manager, who will work with them to
schedule an appointment.
- If you have any questions regarding the vaccine, contact Dr.
Stephanie Pierce at Spierc@lsuhsc.edu or 568-4217.
V. Exposure Response
Exposure Incident: a
specific eye, mouth, other mucous membrane, non-intact skin, or a
puncture contact with blood or other potentially infectious materials
that results from the performance of a person's duties.
- Needlesticks or scrapes and cuts with contaminated
- Contact with broken skin through cuts or rashes.
- Splashes to the eyes, nose or mouth.
If you’re not sure if you’ve had an exposure, check for punctures in
your glove. If the glove is broken, assume an exposure has occurred.
The following actions should be taken immediately after
- Administer first aid. Wash the needlestick or cut with soap
and water. Notify your supervisor as soon as feasible.
- If exposure is by splashes of infectious materials to the
nose, mouth or eyes, the affected area should be flushed extensively
with water, saline or sterile irrigating solution.
- Document the routes of exposure, the biological material of
exposure, and how the incident occurred.
- Seek medical attention as soon as possible. HIV prophylaxis
is most effective if started within two hours of exposure.
After initial treatment is complete, make an appointment with
your healthcare provider as soon as possible for appropriate follow-up.
For more information on exposure response actions, see Section 9
of the Exposure Control Plan .
Following an exposure incident, the supervisor must report the
incident and complete the appropriate reporting form(s) as outlined in
the Incident and Accident Reporting and Investigation Policy.
Counseling for employees and students is available through the
Campus Assistance Program (568-8888). The Student Health Clinic can
provide access to the Expert Review Panel on behalf of students.
VI. Work Practices
Universal Precautions and Biological Safety
- Universal precautions is the practice of treating all blood and
OPIM as if they are contaminated or infectious.
- Biosafety while working with humans is the consistent application
of safety measures to minimize or prevent exposure to the person, the
lab and building occupants, and the community andenvironment.
- All employees will use standard precautions while handling any
type of human blood, human blood components, and materials made from
human blood, or OPIM.
- These materials are to be handled as if known to be infected with
HIV, HBV, or other bloodborne pathogens.
- All research involving the use of human blood, body fluids, and
OPIM is carried out using Biological Safety Level BSL-2 practices, because it is unknown if
these materials contain bloodborne diseases such as HIV, HBV, or HCV.
- For more information on Universal Precautions, visit the NIH/CDC
Work practice controls are modifications of work procedures to
reduce the likelihood of exposure to blood or OPIM. Use these work
- Personal Protective Equipment (PPE).
- Hand Washing.
- Engineering Controls.
- Work Area Restrictions.
- Safe Specimen Handling and Transport.
- Disinfection, Decontamination, and Autoclaves.
- Biological Waste Disposal and Spill Response.
- PPE shall be provided at no cost to all employees at risk of
occupational exposure to BBPs.
- Soiled PPE must not be taken home to launder. All garments that
are penetrated by blood shall be removed and discarded immediately.
- PPE shall be chosen based on the anticipated exposure to blood
- PPE is appropriate only if it does not permit blood or OPIM to
pass through or reach clothing, skin, eyes, mouth, or other mucous
membranes under normal conditions of use.
- Wear appropriate gloves when there is reasonable anticipation
of hand contact with blood or OPIM and when handling contaminated items.
- Never wash or decontaminate disposable gloves for reuse.
- Inspect gloves and replace if torn, contaminated, or if ability
to function as a barrier is compromised.
- Gloves should be made of latex, nitrile, rubber, or other water
- Remove contaminated gloves carefully, avoiding touching the
outside of the gloves with bare skin.
- Dispose of contaminated gloves in a proper container.
- Lotions and chemicals may break down gloves.
- Wear appropriate face and eye protection when splashes, sprays,
or droplets of blood or OPIM pose a hazard to eyes, nose, or mouth.
- Safety glasses are minimum eye protection that should be worn
when in laboratory and there is a potential for minor splash hazards
with small amounts of liquid.
- Goggles offer eyes splash protection and should be used when
handling corrosives, biological liquids, and large volumes of hazardous
substance (i.e., more than one liter).
- Masks and face shields offer additional protection and must be
used in combination with suitable eye protection (i.e., goggles and
- Refer to the LSUHSC PPE Policy for more information.
- All laboratories are required to have a sink available for hand
- Wash hands for 15 seconds using warm water and mild (preferably
- Rinse with warm running water.
- Dry with disposable paper towel.
- Alcohol-based hand sanitizers are an alternative to hand washing.
- Sanitizers are effective against common clinical microbes, but
have not been tested against laboratory pathogens.
- Hand washing is preferred.
Engineering controls are physical controls that isolate or remove
BBP hazards from the workplace. Examples include:
- Biological Safety Cabinets.
- Sharps Disposal Containers.
- Sharps with Engineered Sharps Injury Protection (SESIPs) and
- Splash Guards and Plastic Backed Absorbent Pads.
- Sealed Rotor Heads and Centrifuge Cups.
- Mechanical Pipetting Devices.
Biological Safety Cabinets
- Biological safety cabinets are a primary means of containment
developed for working safely with infectious microorganisms.
- Provide containment of infectious aerosols, isolate the operator
from the agent, and protect other personnel in the room.
- Must be certified annually, whenever moved, or after repair work
has been performed.
- Contact EH&S for assistance with cabinet selection,
certification and decontamination procedures, and proper placement in
(Click or tap image for expanded view)
- Sharps containers must be used for disposing of all needles,
scalpels and other sharps.
- Sharps must be placed in an appropriate sharps container
immediately following usage and shall be placed as close to the
procedure area as possible.
- Sharps containers must be non-breakable, puncture resistant, leak
proof, sealable/closeable and labeled with the universal biohazard
- Sharps containers must be properly maintained and disposed of
when ¾ full.
- Sharps with Engineered Sharps Injury Protections (SESIPs) and
needleless systems are recommended for work involving blood and OPIMs.
- Examples include syringes with protective shield, syringes with
retractable needles, and blunt-tip blood drawing needles.
- Syringes which re-sheathe the needle, needleless systems, and
other safety devices must be used whenever appropriate.
(Click or tap image for expanded view)
- Used disposable needles must not be bent, altered, broken,
recapped, removed from disposable syringes, or otherwise modified.
- Always dispose of contaminated sharps in an approved,
puncture-resistant sharps container.
- Dispose of container when it is ¾ full by sealing the container
and placing in a biological waste box.
- An SOP for the safe use and disposal of sharps is
the Biological Safety page of the EH&S website.
- Splash guards and plastic backed absorbent pads must be used to
contain the spread of blood and OPIM in the laboratory.
- Contaminated plastic backed absorbent pads shall be removed
immediately or as soon as feasible after any spill of blood or OPIM as
well as at the end of the workday.
Centrifuging and Pipetting
- Use sealed rotor heads and centrifuge cups to avoid accidental
spills while performing routine centrifuge operations with material
that potentially contains bloodborne pathogens.
- Mechanical pipetting devices must be used. Mouth pipetting is
Work Area Restrictions
- Do not eat, drink, apply cosmetics or lip balm, or handle contact
lenses in laboratories.
- Do not keep food and beverages in refrigerators, freezers,
shelves, cabinets, or on counter tops or bench tops in laboratories.
- All procedures will be conducted in a manner that will minimize
splashing, spraying, splattering, and generation of aerosol droplets of
blood or OPIM.
Handling and Transport
- Blood or OPIM must be placed in a container that prevents leakage
during the collection, handling, processing, storage, and transport of
- The container used for this purpose will be labeled or color
coded in accordance with 29 CFR 1910.1030 requirements and closed prior
- Any specimens that could puncture a primary container will be
placed within a puncture-resistant secondary container.
- Personnel who pack and/or ship blood or OPIM off campus or
clinical site must complete LSUHSC EH&S On-line Training for
Shipping Biological Materials or have a current International Air
Transport Association (IATA) certificate.
- Disinfection is the process of reducing a contaminant load.
- Can be accomplished in the laboratory using a 70% solution of
ethanol (EtOH) or a 10% solution of bleach (sodium hypochlorite).
- All works surfaces and materials should be disinfected before and
- SOP for Laboratory Disinfection is available on
the EH&S website
Decontamination is the process of removing biohazardous agents.
- Can be accomplished by physical or chemical means.
- Is typically done using an autoclave, utilizing high temperature
- Aqueous solutions such as blood, urine, or microbial cultures
must be autoclaved prior to disposal.
- An SOP for the safe use of autoclaves is available on
the EH&S website.
- Place items in a secondary container made of stainless steel or
- Most pathogens and recombinant molecules are sensitive to
temperatures above 121ºC for 20 or more minutes.
- Larger loads require more time and should be arranged in a way
that allows for steam penetration (i.e., not too densely packed).
- Do not cap vessels or add excessive liquid to the load.
- Use caution when opening autoclave at the end of the cycle –
steam is usually still in the chamber.
Biological Waste Disposal
- Use bioboxes with red biohazard liners to dispose of
- Use a sealable, leak-proof sharps container for all contaminated
sharps (e.g., needle, scalpel, glass).
- Don’t overfill bioboxes (<¾) or make too heavy for transport.
- Seal sharps containers when ¾ full. Place sealed sharps
container in biobox.
- Label bioboxes with supervisor’s name, building, room number, and
contact phone number prior to placing in hallway for pickup.
- Bioboxes are available on the 2nd Floor MEB, 1st Floor CSRB, and
Loading Dock area at the School of Dentistry. Sharps containers are
available from Medical Stores.
- NEVER place chemicals, chemical bottles, radioactive materials,
or other trash in biowaste containers.
Should a incident or spill occur involving blood or
OPIM, do not attempt to clean it up without appropriate PPE. For
major spills, contact University Police immediately, and
notify Environmental Health and Safety to assist in cleaning up the
- Secure the area, keeping all personnel clear of spill.
- Place paper towels, soaked in disinfectant, directly on spilled
materials to prevent spread of contamination. To ensure adequate
contact, surround the spill with appropriate disinfectant.
- Wash your hands thoroughly with soap and water immediately after
the clean-up is complete.
- Refer to the Biological Spill Response Policy for additional spill
If you have questions or comments, please contact Taylor Kriete,
Biological Safety Officer at (504) 952-1337 or email@example.com.