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Universal Precautions in the Workplace
Now let's talk about universal precautions for the general workplace. Most of the time this is going to be because somebody got injured or ill in the workplace and we have blood or other potentially infectious materials in the environment that have to be cleaned up but no one specific employee is actually designated to do so. If they were designated to do that cleanup they would fall under the type A category under the bloodborne pathogens rule as the high risk employee that must be trained in blood borne pathogens before they actually get into an exposure incident. If an individual actually has that job description they no longer fall under the general universal precautions but then are a type A employee and should go through the full blood borne pathogens training program, like at probloodborne.com. Now for the general workplace or general employee who is volunteering or just happens to have to clean it up, this is for you. The most important thing to do is to protect yourself against exposure of the potentially infectious material. Now people have asked me a lot, how do I know if it's potentially infectious? That's a great question. You can't, unless you actually can identify under a microscope or through laboratory testing. So the best way to protect yourself is with gloves. Putting them on is not that big a deal. The biggest thing you want to do is make sure there are no holes. So just twisting them around themselves one time, checking for any air leaks is a great way to test them for little pin holes or some kind of cut or breakage in the glove. Then you just put them on like a normal glove. Now we can work with our solution. One part household bleach to nine parts water. What does this mean? If I were to make one cup just for the chlorine bleach and I fill that up to the one cup line and I put it into a pail, I would then pour in nine more additional cups with regular cold tap water. This would make the proper solution to be able to kill most hepatitis, HIV, and other infectious diseases. This bleach solution can then either be applied using a rag or it could be applied with a spray bottle. If I thought that I might become contaminated through any kind of after spray or splattering, I would want to put on goggles, a face mask and an apron that would protect me against those infectious diseases. But for the general purpose let's say we had blood on a tool. I could spray that tool down with the bleach solution, let it set for a bit and then wipe it down. Once I've wiped it all down and I can't see any more visible contamination, I throw that in the trash. I would then spray the tool one more time with a light mist of that bleach solution and let it air dry from wet to dry. That time is what it takes to disinfect the tool, and it could be a tool like this, it could be a regular fixed tool, it doesn't really matter. Or it could even be a work surface for that matter, like a floor, a workbench or a table. And then once I'm done cleaning up I can remove my gloves. Now removing the gloves is a little more tricky than donning them or putting them on. I remove them by touching glove on glove, untucking that hand, lining the contaminated glove up in the other gloved hand and then skin on skin. Be careful not to pop or flick the glove as this can nebulize blood or other potentially infectious material as it snaps or pops. Once this is all on the inside I throw this away into the trash can as well. Now I take the trash, I wad it up, and I throw it into the normal dumpster. As long as we cannot produce a lot of it, can't wring it out, can't flake it off, we probably don't need to put it into a special biohazard bag. However, if you had a biohazard bag I think it would be very, very good for communication to put it in a biohazard bag and then put it into the dumpster, so that if there was a spill then the waste management people would know that there's potentially infectious material in that bag. So I don't think it's a bad idea, it's just not legally required. So these are some simple steps to take in protecting yourself initially, but after you're done removing your personal protective equipment you still want to wash up at the sink with soap and water. So we're gonna wash our hands, we're gonna wash upper arms if there's any chance of splatter. If you think it's on your face we want to wash our face. And then after we're all done, we're going to report any potential exposures to our supervisor. Now unless you actually got it inside your body, like through eyes, nose, mouth, or into a cut or it was poked into your body, it's not a true exposure incident and does not need to be reported or followed up on. But if you did get a true exposure you would first decontaminate and then report to your supervisor immediately. And then they would follow the bloodborne pathogens rule for post exposure evaluation and follow-up.
This lesson deals with situations in which an injury or illness in the workplace leads to the presence of blood or other potentially infectious materials in the environment.
It should go without saying that the scene must be cleaned up. But who does the cleanup? And more importantly, how can it be done safely?
Often there are no specific employees who are designated to handle such cleanup jobs. But in other situations, there may be.
If an employee was so designated, he or she would fall under the Type A category of the bloodborne pathogens rule. Such employees need to undergo specific training in bloodborne pathogens before being allowed to clean up a potentially infectious scene – training like that which is provided at ProBloodborne.com.
However, for the general employee who volunteers (or not) to clean up the scene – or anyone with possible access, like first responders – this lesson is for you.
A fairly common question people have is, how do I know if the scene contains bloodborne pathogens or other types of infectious materials?
While that's an excellent question, the answer is likely to disappoint – Most of the time, you really don't know. The only way to know that if a scene contains pathogens is to get a sample into a laboratory and under a microscope. Assume the worst and be diligent, but most importantly …
Safety First
Pro Tip #1: What's the most important thing when it comes to a scene that you suspect to be infectious? Protect yourself. You must protect yourself against exposure to potentially infectious materials before engaging in any cleanup.
The best way to protect yourself is by wearing gloves. And while it may sound silly, it pays to inspect your gloves before putting them on.
Make sure there aren't any holes. Blow some air into a glove and hold the wrist end shut. Do you notice any air escaping through a leak? This is a great way to test for pinholes that you wouldn't be able to see.
Warning: Defective gloves DO NOT protect against infectious diseases as well as gloves that aren't defective. If that's the one thing standing between you and them, better to take that one thing (your gloves) seriously.
Solution Time
All you need is water and household bleach, but more specifically, 1 part bleach to 9 parts water. In other words, take your pale or bucket and fill it with 1 cup of bleach and 9 cups of cold tap water.
This is a simple solution but strong enough to kill most hepatitis, HIV, and other infectious pathogens.
Application Time
You can apply the bleach solution a couple of ways. Fill a spray bottle and spray the solution on contaminated surfaces and objects. Or dip a rag or towel into the solution and wipe those items down instead.
Pro Tip #2: Consider wearing goggles, a face mask, and an apron if there's a chance of getting hit with splatter or spray of possibly infectious materials while cleaning up the scene. Better safe than sorry.
An Example Situation
A worker has an accident that leaves blood on an electric saw. Follow the steps below to safely clean it.
- Spray the saw with the bleach solution.
- Let it sit for 30 seconds or so.
- Wipe the saw down.
- Throw the rag or towel in the trash. (At this point, you may not be able to see visible signs of contamination, but that doesn't mean you got it all after one go.)
- Spray the bleach solution on the saw again.
- Let the saw air dry.
Pro Tip #3: Letting the possibly contaminated saw air dry after the second go-around with the bleach solution is a great method of disinfecting it.
When You're Done
After you've cleaned all the tools and work surfaces that were affected, you'll want to properly dispose of your gloves, which involves taking them off without touching them.
Remove the first glove using only glove-on-glove contact, by grabbing the wrist part of one glove (the outer part) and peeling it off. Bunch up the glove you just took off and work it into your other hand and make a fist, with the glove inside.
Take one of your un-gloved fingers and using only skin-on-skin contact, push it under the wrist part of the glove and peel the second glove off.
Warning: Be careful when taking off your gloves that you don't accidentally snap the material and send possibly infectious substances into the air and around the scene. Remember that initially, you'll be removing these gloves in a pretty unfamiliar way; just something to be aware of.
Throw both gloves into the trash bin you've been using to dispose of your rags or towels, seal the bag up properly, and toss it into the nearest dumpster.
Pro Tip #4: For larger cleanup jobs, consider getting special biohazard bags. However, it may be a good idea for jobs of any size, no matter how small, as those bags are a great way to alert others of the potential hazards inside, like waste management personnel.