The three bloodborne pathogens that are the most commonly involved in occupational exposures in healthcare workers are hepatitis B, hepatitis C, and HIV (Weber, Rutala, Eron, 2013; Deuffic-Burbank, Delaroccque-Astagneau, Abitedoul, 2011).

Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) are three of the most common bloodborne pathogens from which health care workers are at risk.

For a bloodborne pathogen to be spread, the bodily fluids of an infected person must enter into the bloodstream of another person. The most common cause of transmission in the workplace is when an infected person’s blood enters another person’s bloodstream through an open wound.

Because OSHA considers HBV infection one of the most important protections that a health care worker can have, the OSHA regulations require the employee to sign a waiver if vaccination is refused. If you change your mind in the future, the employer does have to pay to vaccinate you then.

Potentially infectious blood and body fluids include

• fluids containing visible blood.
• semen.
• vaginal secretions.
• cerebrospinal fluid.
• synovial fluid, pleural fluid.
• peritoneal fluid.
• pericardial fluid.
• amniotic fluid.

A short list of bodily fluids includes:

• Blood. Blood plays a major role in the body’s defense against infection by carrying waste away from our cells and flushing them out of the body in urine, feces, and sweat.
• Saliva.
• Semen.
• Vaginal fluids.
• Mucus.
• Urine.

Feces, nasal secretions, saliva, sputum, sweat, tears, urine, and vomitus are not considered potentially infectious unless they are visibly bloody.

Only some body fluids have the potential to be infectious. In someone not taking HIV treatment (ART), these include: Sexual fluids (semen and vaginal fluid).

The four humors, or fluid substances, of the body were blood, yellow bile, black bile, and phlegm.

Examples of diseases spread through blood or other body fluids:

• hepatitis B – blood, saliva, semen and vaginal fluids.
• hepatitis C – blood.
• human immunodeficiency virus (HIV) infection – blood, semen and vaginal fluids, breastmilk.
• cytomegalovirus (CMV) infection – saliva, semen and vaginal fluids, urine, etc.

Wash the area with warm water and soap. If you are splashed with blood or body fluids and your skin has an open wound, healing sore, or scratch, wash the area well with soap and water. If you are splashed in the eyes, nose or mouth, rinse well with water. If you have been bitten, wash the wound with soap and water.

How can you reduce your risk of exposure to blood and body fluids?

• Always wear gloves for handling items or surfaces soiled with blood or body fluids.
• Wear gloves if you have scraped, cut, or chapped skin on your hands.
• Change your gloves after each use.
• Wash your hands immediately after removing your gloves.

What should you do if you’re exposed?

1. Wash needlesticks and cuts with soap and water.
2. Flush splashes to nose, mouth, or skin with water.
3. Irrigate eyes with clean water, saline, or sterile wash.
4. Report all exposures promptly to ensure that you receive appropriate followup care.

You should be tested for HCV antibody and liver enzyme levels (alanine amino- transferase or ALT) as soon as possible after the exposure (baseline) and at 4-6 months after the exposure. To check for infection earlier, you can be tested for the virus (HCV RNA) 4-6 weeks after the exposure.

The risk of acquiring HBV from an occupational needle stick injury when the source is hepatitis B surface antigen (HBsAg)-positive ranges from 2% to 40%, depending on the source’s level of viremia (2). HBV can survive for up to one week under optimal conditions, and has been detected in discarded needles (6,18).

Blood-borne diseases that could be transmitted by a needlestick injury include human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV).

Hepatitis C virus can survive in syringes for up to 63 days.