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What Protects Healthcare Workers From Bloodborne Pathogens?

What Protects Healthcare Workers From Bloodborne Pathogens
Comparing the universal precautions of OSHA’s Bloodborne Pathogens standard to the standard precautions and the transmission-based precautions used by healthcare practitioners for infection control – CDC/ Amanda Mills The Bloodborne Pathogens standard (29 CFR 1910.1030) and CDC’s recommended standard precautions both include personal protective equipment, such as gloves, gowns, masks, eye protection (e.g., goggles), and face shields, to protect workers from exposure to infectious diseases.

OSHA standards for bloodborne pathogens (BBP, 29 CFR 1910.1030 ) and personal protective equipment (PPE, 29 CFR 1910 Subpart I ) require employers to protect workers from occupational exposure to infectious agents. The BBP standard applies when workers have occupational exposure to human blood or other potentially infectious materials (OPIM), as defined in paragraphs (a) and (b) of the BBP standard, and requires the use of universal precautions to prevent contact with these materials.1 Adhering to standard and transmission-based precautions in healthcare settings is recommended by Centers for Disease Control and Prevention (CDC), and protects workers from a wider range of infectious disease hazards than the BBP standard.

Employers and workers should be familiar with several key approaches to infection control, including universal precautions, standard precautions and transmission-based precautions.

  • Universal precautions (UP), originally recommended by the CDC in the 1980s, was introduced as an approach to infection control to protect workers from HIV, HBV, and other bloodborne pathogens in human blood and certain other body fluids, regardless of a patients’ infection status.2 UP is an approach to infection control in which all human blood and certain human body fluids are treated as if they are known to be infectious. Although the BBP standard incorporates UP, the infection control community no longer uses UP on its own.
  • Standard precautions (SP), introduced in 1996 in the CDC/Healthcare Infection Control and Prevention Advisory Committee’s “1996 Guideline for Isolation Precautions in Hospitals,” added additional infection prevention elements to UP in order to protect healthcare workers not only from pathogens in human blood and certain other body fluids, but also pathogens present in body fluids to which UP does not apply. SP includes hand hygiene; the use of certain types of PPE based on anticipated exposure; safe injection practices; and safe management of contaminated equipment and other items in the patient environment. SP is applied to all patients even when they are not known or suspected to be infectious.
  • Transmission-based precautions (TBP) for contact-, droplet-, and airborne-transmissible diseases augment SP with additional controls to interrupt the route(s) of transmission that may not be completely interrupted using SP alone.3 The different types of TBP are applied based on what is known or suspected about a patient’s infection.

The BBP standard requires the use of UP, and extends UP to protect workers against pathogens found in saliva during dental procedures and body fluids in situations where it is difficult or impossible to differentiate between body fluids (e.g., vomit mixed with blood).

During recent outbreaks of emerging infectious diseases, other body fluids to which UP and the BBP standard do not apply have been identified as potential sources of worker exposures and infections. For example, the CDC identified contact with urine, saliva, feces, vomit, and breast milk as potential sources of Ebola virus exposure.4, 5 Studies also found that urine of individuals with Zika can contain high concentrations of infectious virus that could persist in urine longer than it is detectable in serum, a component of blood.6, 7 (Note that exposure to urine has not been a recognized cause of Zika transmission.) By using SP in healthcare settings, additional protection is provided by expanding UP to protect workers where UP and the BBP standard do not apply.

For example, SP applies, without limitation, to urine, feces, nasal secretions, sputum, vomit, and other body fluids that may be potential sources of worker exposure to infectious agents. SP assumes that every person is potentially infected or colonized with an organism that could be transmitted in the healthcare setting.

  1. Since SP was developed to integrate principles of UP and body substance isolation, 8 the infection prevention and control methods used under SP encompass what employers should already be implementing to protect workers against exposures under the BBP standard and its requirements for use of UP.
  2. Other OSHA requirements, such as the PPE standards (see 29 CFR 1910 Subpart I ) and Section 5(a)(1), the General Duty Clause, of the Occupational Safety and Health Act, 29 USC 654, also may apply.9 The following tables highlight key distinctions among UP as originally written, the BBP standard (which incorporates UP), and SP.

Table 1 outlines the body fluids and other materials to which each applies. Table 1. Body fluids to which UP, the BBP standard, and SP apply

Exposure to Covered by
UP (as originally defined) BBP SP
Blood
Semen 2
Vaginal secretions 2
Cerebrospinal fluid 2
Synovial fluid 2
Pleural fluid 2
Pericardial fluid 2
Peritoneal fluid 2
Amniotic fluid 2
Saliva in dental procedures 2
Any body fluid that is visibly contaminated with blood 2
All body fluids in situations where it is difficult or impossible to differentiate between body fluids 2 10
Urine 6, 11
Feces 11
Nasal secretion 11
Sputum 11
Vomit 11
Breast milk 11
Saliva, other than in dental procedures 11

Table 2 compares selected controls, actions and other measures for the protection of workers against exposure to blood and OPIM and for the protection of workers against exposure to material that is not blood or OPIM. Note that Table 2 discusses only selected provisions of the BBP standard, as well as only selected elements of SP and TBP, and is not intended to describe all provisions with which employers may need to comply.

Control, action or other measure To protect workers against exposure to.
Blood and OPIM 1 Material that is not blood or OPIM, including body fluids not covered under OPIM (e.g., urine 6 and feces)
Blood and body fluid precautions for all patients, regardless of infection status BBP, SP SP
Exposure control plan and required elements thereof 12 BBP
Patient isolation/placement TBP TBP
Hand hygiene BBP, SP SP
Safe injection practices BBP, SP SP
Safe sharps management/disposal BBP, SP SP
Prohibiting eating, drinking, smoking, or application of cosmetics or lip balm and handling of contact lenses in areas where there is a reasonable likelihood of occupational exposure 13 BBP
Separating food and drink from areas where blood and OPIM are present 13 BBP
Prohibiting mouth pipetting and suctioning of blood or OPIM 13 BBP
Safe specimen storage, packaging, shipment 13 BBP
PPE – Gloves, gowns, masks, eye protection (e.g., goggles), face shields BBP, 14 SP, TBP SP, TBP
PPE – Aprons and other protective body clothing BBP, TBP TBP
PPE – Surgical caps BBP, TBP TBP
PPE – Shoe/boot covers BBP, TBP TBP
PPE – N95 or higher respirators for aerosol-generating procedures on patients with suspected or proven infections transmitted by respiratory aerosols SP, TBP SP, TBP
PPE – Any additional appropriate equipment to prevent blood or other potentially infectious materials to pass through to or reach the employee’s work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used. See 29 CFR 1910.1030(d)(3)(i). BBP
PPE – Any additional appropriate equipment (i.e., not specifically listed already) to protect workers against transmission of infectious agents TBP TBP
Housekeeping and environmental control procedures BBP, SP SP

Safe waste management 13

BBP

Safe laundry management

BBP, SP SP

Soiled patient-care equipment management

BBP, SP SP
Post exposure evaluation and follow-up after occupational exposure to a bloodborne pathogen(s) 15 BBP
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How can we protect employees from bloodborne pathogens?

Wear disposable gloves whenever providing care, particularly if you may come into contact ■ with blood or body fluids. Also wear protective coverings, such as a mask, eyewear and a gown, if blood or other body fluids can splash.

What OSHA standards cover bloodborne pathogens?

OSHA’s Bloodborne Pathogens Standard ( 29 CFR 1910.1030 ) as amended pursuant to the 2000 Needlestick Safety and Prevention Act, is a regulation that prescribes safeguards to protect workers against health hazards related to bloodborne pathogens.

How can employees become infected by bloodborne pathogens?

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.

What is the most important method in preventing transmission of a bloodborne pathogen?

Bloodborne Pathogens: How To Protect Yourself One of the most effective ways to protect yourself from exposure is by following the principle of Standard Precautions also referred to as Universal Precautions. Standard Precautions assume that all human blood and all human body fluids are infectious and should be handled with appropriate protective measures.

  • Healthcare-Associated Infections (HAI) Guidelines and Recommendations are available at this site.
  • Included in the HAI guidelines are the use of personal protective equipment (PPE), work practices, and engineering controls to ensure safety in all situations where exposure to blood or body fluids is possible.
  • Personal Protective Equipment (PPE)

Always wear PPE (e.g. gloves, eye protection) when there is a potential for exposure to blood or body fluids. This is proven to be the single most effective precaution to avoid exposure. PPE should be readily accessible. If some PPE that you feel is necessary for your protection is not available to you, contact your supervisor.

Gloves as PPE Gloves may be made of latex, nitrile, rubber, or other impervious materials. If glove material is thin or flimsy, double gloving may provide additional protection. If you have cuts or sores on your hands, you should cover these with a bandage as additional protection before putting on gloves.

Inspect gloves before putting them on to check for tears or punctures and replace them at that point if they are damaged. Remove gloves carefully, trying not to touch the outside of the gloves with bare skin. The established method for removing gloves without contaminating hands is illustrated here: After removal, discard contaminated gloves in the medical waste box.

Always wash hands thoroughly as the final step. A Word about Latex Allergy Although latex gloves have proven effective in preventing transmission of infectious diseases, for some individuals, repeated exposures to latex may result in allergic reactions. These reactions result from exposure to certain proteins in the latex rubber.

Symptoms may include flushing, skin rashes, hives, runny nose, sneezing, itchy eyes, scratchy throat and wheezing. Rarely and over time, with repeated exposures, symptoms may escalate to anaphylactic shock. However, the response would unlikely be the first indication of a person’s adverse reaction to latex.

  • Use non-latex gloves for activities involving contact with infectious materials.
  • When using latex gloves, use powder-free gloves with reduced protein content.
  • When wearing latex gloves, do not use oil-based creams or lotions.
  • After removing latex gloves, wash hands with mild soap and dry thoroughly.
  • Frequently clean areas and equipment contaminated with latex-containing dust.
  1. Other PPE that may be needed:
  2. Goggles
  3. Because bloodborne pathogens can be transmitted through the mucous membranes of the eyes, it is very important to protect them by using chemical splash goggles if there is a potential for splash or spray to occur in the course of your work.
  4. Face shields
  5. Face shields may also be worn in addition to goggles to provide additional face protection against splashes to the mouth and nose.
  6. Gowns or Lab Coats
  7. Wear gowns or lab coats to protect clothing and to keep blood or OPIM from soaking through to the skin.
  8. Contaminated Clothing

Personal clothing that becomes contaminated with blood should be removed as soon as possible to avoid fluids from seeping through and coming in contact with skin. Contaminated laundry should be handled as little as possible and placed in a red biohazard bag until it is decontaminated, disposed of, or laundered.

  • Always wear PPE in potential exposure situations
  • Remove and replace PPE that is torn, punctured, or otherwise no longer acting as a barrier to infectious materials.
  • Remove PPE before leaving the work area.
  • Dispose of PPE in the proper biohazard waste receptacle.

: Bloodborne Pathogens: How To Protect Yourself

What are the 3 major bloodborne pathogens of concern in healthcare?

The pathogens of primary concern are the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Workers and employers should take advantage of available engineering controls and work practices to prevent exposure to blood and other body fluids.

What PPE is needed for bloodborne pathogens?

Comparing the universal precautions of OSHA’s Bloodborne Pathogens standard to the standard precautions and the transmission-based precautions used by healthcare practitioners for infection control – CDC/ Amanda Mills The Bloodborne Pathogens standard (29 CFR 1910.1030) and CDC’s recommended standard precautions both include personal protective equipment, such as gloves, gowns, masks, eye protection (e.g., goggles), and face shields, to protect workers from exposure to infectious diseases.

OSHA standards for bloodborne pathogens (BBP, 29 CFR 1910.1030 ) and personal protective equipment (PPE, 29 CFR 1910 Subpart I ) require employers to protect workers from occupational exposure to infectious agents. The BBP standard applies when workers have occupational exposure to human blood or other potentially infectious materials (OPIM), as defined in paragraphs (a) and (b) of the BBP standard, and requires the use of universal precautions to prevent contact with these materials.1 Adhering to standard and transmission-based precautions in healthcare settings is recommended by Centers for Disease Control and Prevention (CDC), and protects workers from a wider range of infectious disease hazards than the BBP standard.

Employers and workers should be familiar with several key approaches to infection control, including universal precautions, standard precautions and transmission-based precautions.

  • Universal precautions (UP), originally recommended by the CDC in the 1980s, was introduced as an approach to infection control to protect workers from HIV, HBV, and other bloodborne pathogens in human blood and certain other body fluids, regardless of a patients’ infection status.2 UP is an approach to infection control in which all human blood and certain human body fluids are treated as if they are known to be infectious. Although the BBP standard incorporates UP, the infection control community no longer uses UP on its own.
  • Standard precautions (SP), introduced in 1996 in the CDC/Healthcare Infection Control and Prevention Advisory Committee’s “1996 Guideline for Isolation Precautions in Hospitals,” added additional infection prevention elements to UP in order to protect healthcare workers not only from pathogens in human blood and certain other body fluids, but also pathogens present in body fluids to which UP does not apply. SP includes hand hygiene; the use of certain types of PPE based on anticipated exposure; safe injection practices; and safe management of contaminated equipment and other items in the patient environment. SP is applied to all patients even when they are not known or suspected to be infectious.
  • Transmission-based precautions (TBP) for contact-, droplet-, and airborne-transmissible diseases augment SP with additional controls to interrupt the route(s) of transmission that may not be completely interrupted using SP alone.3 The different types of TBP are applied based on what is known or suspected about a patient’s infection.
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The BBP standard requires the use of UP, and extends UP to protect workers against pathogens found in saliva during dental procedures and body fluids in situations where it is difficult or impossible to differentiate between body fluids (e.g., vomit mixed with blood).

During recent outbreaks of emerging infectious diseases, other body fluids to which UP and the BBP standard do not apply have been identified as potential sources of worker exposures and infections. For example, the CDC identified contact with urine, saliva, feces, vomit, and breast milk as potential sources of Ebola virus exposure.4, 5 Studies also found that urine of individuals with Zika can contain high concentrations of infectious virus that could persist in urine longer than it is detectable in serum, a component of blood.6, 7 (Note that exposure to urine has not been a recognized cause of Zika transmission.) By using SP in healthcare settings, additional protection is provided by expanding UP to protect workers where UP and the BBP standard do not apply.

For example, SP applies, without limitation, to urine, feces, nasal secretions, sputum, vomit, and other body fluids that may be potential sources of worker exposure to infectious agents. SP assumes that every person is potentially infected or colonized with an organism that could be transmitted in the healthcare setting.

  1. Since SP was developed to integrate principles of UP and body substance isolation, 8 the infection prevention and control methods used under SP encompass what employers should already be implementing to protect workers against exposures under the BBP standard and its requirements for use of UP.
  2. Other OSHA requirements, such as the PPE standards (see 29 CFR 1910 Subpart I ) and Section 5(a)(1), the General Duty Clause, of the Occupational Safety and Health Act, 29 USC 654, also may apply.9 The following tables highlight key distinctions among UP as originally written, the BBP standard (which incorporates UP), and SP.

Table 1 outlines the body fluids and other materials to which each applies. Table 1. Body fluids to which UP, the BBP standard, and SP apply

Exposure to Covered by
UP (as originally defined) BBP SP
Blood
Semen 2
Vaginal secretions 2
Cerebrospinal fluid 2
Synovial fluid 2
Pleural fluid 2
Pericardial fluid 2
Peritoneal fluid 2
Amniotic fluid 2
Saliva in dental procedures 2
Any body fluid that is visibly contaminated with blood 2
All body fluids in situations where it is difficult or impossible to differentiate between body fluids 2 10
Urine 6, 11
Feces 11
Nasal secretion 11
Sputum 11
Vomit 11
Breast milk 11
Saliva, other than in dental procedures 11

Table 2 compares selected controls, actions and other measures for the protection of workers against exposure to blood and OPIM and for the protection of workers against exposure to material that is not blood or OPIM. Note that Table 2 discusses only selected provisions of the BBP standard, as well as only selected elements of SP and TBP, and is not intended to describe all provisions with which employers may need to comply.

Control, action or other measure To protect workers against exposure to.
Blood and OPIM 1 Material that is not blood or OPIM, including body fluids not covered under OPIM (e.g., urine 6 and feces)
Blood and body fluid precautions for all patients, regardless of infection status BBP, SP SP
Exposure control plan and required elements thereof 12 BBP
Patient isolation/placement TBP TBP
Hand hygiene BBP, SP SP
Safe injection practices BBP, SP SP
Safe sharps management/disposal BBP, SP SP
Prohibiting eating, drinking, smoking, or application of cosmetics or lip balm and handling of contact lenses in areas where there is a reasonable likelihood of occupational exposure 13 BBP
Separating food and drink from areas where blood and OPIM are present 13 BBP
Prohibiting mouth pipetting and suctioning of blood or OPIM 13 BBP
Safe specimen storage, packaging, shipment 13 BBP
PPE – Gloves, gowns, masks, eye protection (e.g., goggles), face shields BBP, 14 SP, TBP SP, TBP
PPE – Aprons and other protective body clothing BBP, TBP TBP
PPE – Surgical caps BBP, TBP TBP
PPE – Shoe/boot covers BBP, TBP TBP
PPE – N95 or higher respirators for aerosol-generating procedures on patients with suspected or proven infections transmitted by respiratory aerosols SP, TBP SP, TBP
PPE – Any additional appropriate equipment to prevent blood or other potentially infectious materials to pass through to or reach the employee’s work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used. See 29 CFR 1910.1030(d)(3)(i). BBP
PPE – Any additional appropriate equipment (i.e., not specifically listed already) to protect workers against transmission of infectious agents TBP TBP
Housekeeping and environmental control procedures BBP, SP SP

Safe waste management 13

BBP

Safe laundry management

BBP, SP SP

Soiled patient-care equipment management

BBP, SP SP
Post exposure evaluation and follow-up after occupational exposure to a bloodborne pathogen(s) 15 BBP

What is the most common risk of exposure to bloodborne pathogens for healthcare workers?

STOP STICKS CAMPAIGN 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. However, bloodborne pathogens are implicated in the transmissions of more than 20 other pathogens ().

A percutaneous injury in which a health care worker is injured by a sharps object A mucocutaneous exposure incident with contact of a mucous membrane or non-intact skin with blood, tissue, or other potentially infectious bodily fluids

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When personal protective equipment is not readily available or accessible, employees are less likely to wear it. This puts them at risk of exposure to blood and body fluids and vulnerability to bloodborne pathogens. Human immunodeficiency virus (HIV) disables the body’s immune system until it is no longer capable of fighting infection.

What are standard precautions in healthcare?

– PPE includes items such as gloves, gowns, masks, respirators, and eyewear used to create barriers that protect skin, clothing, mucous membranes, and the respiratory tract from infectious agents. PPE is used as a last resort when work practices and engineering controls alone cannot eliminate worker exposure.

  1. The items selected for use depend on the type of interaction a public health worker will have with a client and the likely modes of disease transmission.
  2. Wear gloves when touching blood, body fluids, non-intact skin, mucous membranes, and contaminated items.
  3. Gloves must always be worn during activities involving vascular access, such as performing phlebotomies.

Wear a surgical mask and goggles or face shield if there is a reasonable chance that a splash or spray of blood or body fluids may occur to the eyes, mouth, or nose. Wear a gown if skin or clothing is likely to be exposed to blood or body fluids. Remove PPE immediately after use and wash hands.

It is important to remove PPE in the proper order to prevent contamination of skin or clothing. The CDC has suggested steps for correctly Donning and Removing PPE, If PPE or other disposable items are saturated with blood or body fluids such that fluid may be poured, squeezed, or dripped from the item, discard into a biohazard bag.

PPE that is not saturated may be placed directly in the trash. Saturated waste generated from the home should be placed in sealable leak-proof plastic bags before placing in regular trash bags for disposal. The OSHA PPE Standards 1910.132 and 1910.133 require employers to provide PPE for employees with hazard exposure in the workplace, train employees on the proper use of PPE, and properly maintain, store, and dispose of PPE.

What are work practice controls?

Work Practice Controls means controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g., prohibiting recapping of needles by a two-handed technique).

How can you prevent blood borne viruses?

Preventing Infection – The following precautions can help to reduce the risk of infection:

Avoid all contact with blood or body fluids where possible. Cover breaks in exposed skin by means of waterproof dressings and/or gloves.Treat all blood or blood products as if it were infectious.Use engineering controls e.g. needle safe systems.Use safe work practices e.g. have documented safe practices for handling and disposing of contaminated sharps, handling specimens, handling contaminated laundry, items and surfaces etc.Wear appropriate Personal Protective Equipment (PPE) to avoid contamination e.g. gloves, goggles or visor, disposable clothing protection such as aprons.Make hepatitis B vaccinations available to those at risk.Ensure emergency procedures and post-exposure plans are in place for those who experience an exposure incident e.g. needlestick injury.Follow good basic hygiene practices such as hand washing before and after glove use and avoid hand to mouth or eye contact.

What kills bloodborne pathogens?

Blood Spills in Pools – What Protects Healthcare Workers From Bloodborne Pathogens For blood in the pool, there is no action required other than attending to the injured individual and making sure the blood does not contaminate anywhere else. A properly maintained pool contains enough chlorine to kill any bloodborne pathogens. From the CDC: Germs found in blood (for example, Hepatitis B virus or HIV) are spread when infected blood or certain body fluids get into the body and bloodstream (for example, by sharing needles or by sexual contact).

  • Does chlorine kill the germs in blood? Yes. These germs do not survive long when diluted into properly chlorinated pool water.
  • Swimmers want something to be done after a blood spill. Should the pool be closed for a short period of time? There is no public health reason to recommend closing the pool after a blood spill. However, some pools choose to do so temporarily to satisfy patrons.

What is the only way an employee can be exposed to a bloodborne pathogen?

Occupational exposures can occur through needlesticks or cuts from other sharp instruments contaminated with an infected patient’s blood (including blood contaminated saliva) or through contact of the eye, nose, mouth, or skin with a patient’s blood.

What is bloodborne pathogens training for employees?

Designed for those who are at risk for on the job exposure to blood and other bodily fluids in the workplace. The course teaches staff how bloodborne pathogens are spread, how to avoid exposure and what to do if exposed to infectious material. This course is one of the requirements of the OSHA Bloodborne Pathogens Standard.

  • After taking this course, students should talk with their employer about their workplaces specific policies and procedures.
  • Those who complete the training receive a Bloodborne Pathogens Training certification valid for one year.The 2021 Bloodborne Pathogens online course is designed for those who are at risk for on the job exposure to blood and other bodily fluids in the workplace.

The course teaches staff how bloodborne pathogens are spread, how to avoid exposure and what to do if exposed to infectious material. Allow approximately 60 minutes to complete the course. More Details Provider American Red Cross Class Setting online Class Setting: online Work At Your Own Pace And Schedule, Interactive And Customizable Courses, Unlimited Course Access For Two Years, Start Taking Your Course Immediately Designed for those who are at risk for on the job exposure to blood and other bodily fluids in the workplace.

  1. The course teaches staff how bloodborne pathogens are spread, how to avoid exposure and what to do if exposed to infectious material.
  2. This course is one of the requirements of the OSHA Bloodborne Pathogens Standard.
  3. After taking this course, students should talk with their employer about their workplaces specific policies and procedures.

Those who complete the training receive a Bloodborne Pathogens Training certification valid for one year.The 2021 Bloodborne Pathogens online course is designed for those who are at risk for on the job exposure to blood and other bodily fluids in the workplace.

Work at your own pace Engaging and Interactive courses Start taking your course immediately Course access after completion

The content of this review regarding the quality and value of this course is based on data collected across all American Red Cross classes and does not reflect ratings of the specific provider.

What are the main bloodborne pathogens of concern in the workplace?

The pathogens of primary concern are the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Workers and employers should take advantage of available engineering controls and work practices to prevent exposure to blood and other body fluids.

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