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How Bloodborne Pathogens are Spread
You may be wondering, yourself, how does one get sick with a bloodborne pathogen? Well, bloodborne pathogens are microorganisms (such as viruses) that are present in human blood and can cause disease in humans. They include, but are not limited to, hepatitis B, hepatitis C and the human immunodeficiency virus we know as HIV. Infectious disease is a disease that enters into the body through various routes, that’s caused by microorganisms such as a bacteria, fungus, or virus. Infectious diseases can range from mild to life-threatening. For disease to be spread, it requires several conditions be present that we call The Chain of Infection. There must be: an adequate number of pathogens, or disease-causing organisms in the environment. There must be a reservoir or source that allows the pathogen to survive and multiply, like blood. A mode of transmission from the source to the host. And an entrance through which the pathogen may enter the host. A susceptible host is also required, which means, they don’t already have an immune system to that virus or bacteria. Infection control strategies serve to prevent disease transmission by interrupting one or more links in the chain of infection. The primary source of potential bloodborne pathogens is blood and specific bodily fluids, like semen and vaginal secretions. Other bodily fluids may contain bloodborne pathogens, especially those visibly contaminated with blood, such as: cerebrospinal fluid (which is found in the brain), synovial fluid (found in the joints), pleural fluid (in the lungs), and amniotic fluid (which is in the uterus and around the uterus), pericardial fluid (which is in the heart), and peritoneal fluid (which is found in the abdomen). Urine, feces, saliva and some other body fluids do not typically carry bloodborne pathogens. However, it can be difficult to identify a body fluid or know for sure whether or not it is contaminated with blood. In general you should really just treat all body fluids as potentially contaminated with blood with the potential of carrying a bloodborne pathogens disease. So how does a bloodborne pathogen or infectious disease get into your body? Well, there’s four basic modes of transmission. The first one is direct contact. Direct contact occurs when microorganisms are transferred from one infected person directly to another person. Examples would include: a body artist who has an open uncovered wound and blood from a client contacts that wound. There’s also parenteral exposure. Now this means that the infected blood is introduced directly into your body through piercing the skin. Examples include: a needle-stick injury or a cut with a sharp piece of material that’s been contaminated. Indirect contact means that it came from an object or a tool, then got onto the person’s open skin. So what is really important here is to make sure that we are decontaminating any of those objects that might actually have blood or blood product on them. Airborne transmission is another way to get it. This is when droplets or small particles containing the infectious agent remain, and they remain effective for some time, float around, and then are inhaled into the body. An example of this might be like tuberculosis. Most bloodborne pathogens do not fall into that category. So, what’s the most common way bloodborne pathogens are spread? Needlestick and sexual contact are our most potential risks. The highest potential risk while working with clients exists when a contaminated sharp object cuts or punctures the skin. An example would include: a needle stick, cut from broken glass, cut from a razor used on a client, etc. A medium potential risk exists when an infected body fluid gets into an open cut or mucous membrane, such as into the eyes, the mouth, the ears or the nose. The lowest potential risk is when a contaminated object touches inflamed skin, acne, or skin abrasion. In addition to knowing how bloodborne pathogens are spread, it is just as important to know how bloodborne pathogens are NOT spread: Intact skin is our first line of defense against disease. Bloodborne pathogens cannot "soak" through normal intact skin. The Centers for Disease Control (otherwise known as the CDC) states that there is no known risk from exposure to intact skin. Unlike some infectious diseases, bloodborne pathogens are not spread by casual contact such as handshakes, hugging, doorknobs, or use of the same equipment like toilets or water fountains.
In this lesson, we'll take a look at how one gets ill from a bloodborne pathogen or infectious disease. But first, how about a couple of definitions?
Bloodborne Pathogen – A bloodborne pathogen is a microorganism that's present in human blood and can cause disease in humans.
Infectious Disease – An infectious disease is a disease (also caused by microorganisms like bacteria, virus, fungus, etc.) that enters the body through various biological routes.
It's important to note that not all bloodborne pathogens and infectious diseases are created equally, as some can produce mild symptoms, while others can be life-threatening.
The Chain of Infection
For any disease to spread, several conditions must be present. This is known as the chain of infection. And if you recall from the last lesson, those conditions are as follows:
- There must be an adequate number of pathogens or disease-causing organisms in the environment.
- There needs to be a reservoir or source that allows the pathogen to survive and even multiply, such as blood.
- There must be a mode of transmission from source to host.
- There must be an entrance through which the pathogen enters the host.
- The host must be susceptible to that pathogen, as opposed to being immune to it.
Pro Tip #1: Infection control strategies help prevent disease transmission by interrupting one or more links in the chain of infection.
Sources of Bloodborne Pathogens
The primary source of potential bloodborne pathogens is blood and specific bodily fluids, like semen and vaginal secretions. However, there are other bodily fluids that may contain bloodborne pathogens, especially if they are visibly contaminated with blood. Those sources include:
- Cerebrospinal fluid in the brain
- Synovial fluid in the joints
- Pleural fluid in the lungs
- Amniotic fluid in and around the uterus
- Pericardial fluid around the heart
- Peritoneal fluid in the abdomen
Urine, feces, saliva, and a few other fluids don't typically carry bloodborne pathogens, however …
Pro Tip #2: Because it's so difficult to identify contaminated body fluids or know for sure if those fluids are contaminated with blood, it's important to treat ALL bodily fluids as potential threats that could include bloodborne pathogens.
How Bloodborne Pathogens and OPIM Get into the Body
There are four basic modes of transmission:
- Direct Contact – Direct contact transmission occurs when microorganisms are transferred from an infected person to another person. An example would be a tattoo artist with an open, uncovered cut or wound, in which blood from a client/source comes in contact with that wound.
- Parenteral Exposure – Parenteral exposure is when infected blood and/or bodily fluids are introduced into the body through piercing or puncturing the skin. An example would be getting stuck with a contaminated needle or being cut with a sharp object that's been contaminated.
- Indirect Contact – Indirect contact is when a contaminated object (tools, needles, etc.) contacts a person's skin or mucous membranes, like those found in the eyes, mouth, nose, and ears. Which is why it's so important to decontaminate any objects that have blood on them.
- Airborne Transmission – Airborne transmission occurs when droplets or small particles that contain an infectious agent remain active in the air and are then inhaled into the body. An example of this would be tuberculosis. While airborne transmission is possible, most cases of bloodborne pathogen infections do not fall into this category.
Some Risks are Higher than Others
While it's important to consider all blood and bodily fluids potential threats, there are some methods of transmission that are more common than others.
Highest Potential Risks
The most common ways bloodborne pathogens and OPIM are spread are:
- Getting stuck with an infected needle
- Sexual contact
Other than sexual contact, the highest potential risks are when a contaminated, sharp object punctures or cuts the skin, such as with an infected needle, a broken piece of contaminated glass, or getting cut by a razor that was also used by an infected person.
Pro Tip #3: Fans of the TV show Live PD will be familiar with police protocol before searching a person – a protocol that includes asking if that person has any sharp objects or needles that could poke, stab, or cut them. If you weren't sure why police officers do this, now you know.
Medium Potential Risks
Medium risks involve situations where blood and bodily fluids get into an open cut or are absorbed through a mucous membrane – eyes, nose, ears, mouth, etc. Like our tattoo artist example from above.
Lowest Potential Risks
The lowest potential risks include situations where contaminated objects come in contact with inflamed skin, acne, skin abrasions, etc. Which brings up a good point.
Pro Tip #4: Knowing how bloodborne pathogens and OPIM are spread is important to be sure. But so is knowing what prevents those microorganisms from spreading. And the number one line of defense is intact skin.
In fact, the CDC (Center for Disease Control) has stated that there is no known risk of exposure to bloodborne pathogens and infectious diseases through intact skin. Which means casual contact – like handshaking, hugging, touching doorknobs, etc. – are not considered threats in normal situations.