• Implement the use of universal precautions(treating all human blood and OPIM as if knownto be infectious for bloodborne pathogens).

• Identify and use engineering controls. Theseare devices that isolate or remove the blood-borne pathogens hazard from the workplace.They include sharps disposal containers, self-sheathing needles, and safer medical devices,such as sharps with engineered sharps-injuryprotection and needleless systems.

• Identify and ensure the use of work practicecontrols. These are practices that reduce thepossibility of exposure by changing the way atask is performed, such as appropriate practicesfor handling and disposing of contaminatedsharps, handling specimens, handling laundry,and cleaning contaminated surfaces and items.

• Provide personal protective equipment (PPE),such as gloves, gowns, eye protection, andmasks. Employers must clean, repair, andreplace this equipment as needed. Provision,maintenance, repair and replacement are at nocost to the worker.

• Make available hepatitis B vaccinations to allworkers with occupational exposure. This vac-cination must be offered after the worker hasreceived the required bloodborne pathogenstraining and within 10 days of initial assignmentto a job with occupational exposure.

• Make available post-exposure evaluation andfollow-up to any occupationally exposed work-er who experiences an exposure incident. Anexposure incident is a specific eye, mouth,other mucous membrane, non-intact skin, orparenteral contact with blood or OPIM. Thisevaluation and follow-up must be at no cost tothe worker and includes documenting theroute(s) of exposure and the circumstances

Protections Provided by OSHA’sBloodborne Pathogens StandardAll of the requirements of OSHA’s BloodbornePathogens standard can be found in Title 29 of theCode of Federal Regulations at 29 CFR 1910.1030.The standard’s requirements state what employ-ers must do to protect workers who are occupa-tionally exposed to blood or other potentiallyinfectious materials (OPIM), as defined in the stan-dard. That is, the standard protects workers whocan reasonably be anticipated to come into con-tact with blood or OPIM as a result of doing theirjob duties.

In general, the standard requires employers to:

• Establish an exposure control plan. This is awritten plan to eliminate or minimize occupa-tional exposures. The employer must preparean exposure determination that contains a listof job classifications in which all workers haveoccupational exposure and a list of job classifi-cations in which some workers have occupa-tional exposure, along with a list of the tasksand procedures performed by those workersthat result in their exposure.

• Employers must update the plan annually toreflect changes in tasks, procedures, and posi-tions that affect occupational exposure, andalso technological changes that eliminate orreduce occupational exposure. In addition,employers must annually document in the planthat they have considered and begun usingappropriate, commercially-available effectivesafer medical devices designed to eliminate orminimize occupational exposure. Employersmust also document that they have solicitedinput from frontline workers in identifying, eval-uating, and selecting effective engineering andwork practice controls.

FactSheetOSHA’s Bloodborne Pathogens StandardBloodborne pathogens are infectious microorganisms present in blood that cancause disease in humans. These pathogens include, but are not limited to, hepatitis Bvirus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV), thevirus that causes AIDS. Workers exposed to bloodborne pathogens are at risk forserious or life-threatening illnesses.

This is one in a series of informational fact sheets highlighting OSHA programs, policies or standards. It does not impose any new compliance requirements. For a comprehensive list of compliance requirements of OSHA standards or regulations, refer to Title 29 of the Code of FederalRegulations. This information will be made available to sensory-impaired individuals upon request.The voice phone is (202) 693-1999; the teletypewriter (TTY) number is (877) 889-5627.

under which the exposure incident occurred;identifying and testing the source individual forHBV and HIV infectivity, if the source individualconsents or the law does not require consent;collecting and testing the exposed worker’sblood, if the worker consents; offering post-exposure prophylaxis; offering counseling; andevaluating reported illnesses. The healthcareprofessional will provide a limited written opin-ion to the employer and all diagnoses mustremain confidential.

• Use labels and signs to communicate hazards.Warning labels must be affixed to containers of regulated waste; containers of contaminatedreusable sharps; refrigerators and freezers containing blood or OPIM; other containersused to store, transport, or ship blood or OPIM;contaminated equipment that is being shippedor serviced; and bags or containers of con-taminated laundry, except as provided in thestandard. Facilities may use red bags or redcontainers instead of labels. In HIV and HBVresearch laboratories and production facilities,signs must be posted at all access doors whenOPIM or infected animals are present in thework area or containment module.

• Provide information and training to workers.Employers must ensure that their workersreceive regular training that covers all elementsof the standard including, but not limited to:information on bloodborne pathogens and dis-eases, methods used to control occupational

exposure, hepatitis B vaccine, and medical eval-uation and post-exposure follow-up procedures.Employers must offer this training on initialassignment, at least annually thereafter, andwhen new or modified tasks or proceduresaffect a worker’s occupational exposure. Also,HIV and HBV laboratory and production facilityworkers must receive specialized initial training,in addition to the training provided to all work-ers with occupational exposure. Workers musthave the opportunity to ask the trainer ques-tions. Also, training must be presented at aneducational level and in a language that work-ers understand.

• Maintain worker medical and training records.The employer also must maintain a sharpsinjury log, unless it is exempt under Part 1904 --Recording and Reporting Occupational Injuriesand Illnesses, in Title 29 of the Code of FederalRegulations.

Additional InformationFor more information, go to OSHA’s BloodbornePathogens and Needlestick Prevention Safety andHealth Topics web page at: https://www.osha.gov/SLTC/bloodbornepathogens/index.html.

To file a complaint by phone, report an emergency,or get OSHA advice, assistance, or products, con-tact your nearest OSHA office under the “U.S.Department of Labor” listing in your phone book, orcall us toll-free at (800) 321-OSHA (6742).

Occupational Safetyand Health Administrationwww.osha.gov 1-800-321-6742

For assistance, contact us. We can help. It’s confidential.

DSG 1/2011

Medical Evaluation and Follow-upWhen a worker experiences an exposure incident,the employer must make immediate confidentialmedical evaluation and follow-up available to theworker. This evaluation and follow-up must be:made available at no cost to the worker and at areasonable time and place; performed by or underthe supervision of a licensed physician or otherlicensed healthcare professional; and providedaccording to the recommendations of the U.S.Public Health Service (USPHS) current at the timethe procedures take place. In addition, laboratorytests must be conducted by an accredited labora-tory and also must be at no cost to the worker. Aworker who participates in post-exposure evalua-tion and follow-up may consent to have his or herblood drawn for determination of a baseline infec-tion status, but has the option to withhold consentfor HIV testing at that time. In this instance, theemployer must ensure that the worker's bloodsample is preserved for at least 90 days in casethe worker changes his or her mind about HIVtesting.

Post-exposure prophylaxis for HIV, HBV, and HCV,when medically indicated, must be offered to theexposed worker according to the current recom-mendations of the U.S. Public Health Service. Thepost-exposure follow-up must include counselingthe worker about the possible implications of theexposure and his or her infection status, includingthe results and interpretation of all tests and howto protect personal contacts. The follow-up mustalso include evaluation of reported illnesses thatmay be related to the exposure.

Reporting an Exposure IncidentExposure incidents should be reported immedi-ately to the employer since they can lead to infec-tion with hepatitis B virus (HBV), hepatitis C virus(HCV), human immunodeficiency virus (HIV), orother bloodborne pathogens. When a workerreports an exposure incident right away, thereport permits the employer to arrange for imme-diate medical evaluation of the worker. Earlyreporting is crucial for beginning immediate inter-vention to address possible infection of the work-er and can also help the worker avoid spreadingbloodborne infections to others. Furthermore, theemployer is required to perform a timely evalua-tion of the circumstances surrounding the expo-sure incident to find ways of preventing such asituation from occurring again.

Reporting is also important because part of thefollow-up includes identifying the source individ-ual, unless the employer can establish that identi-fication is infeasible or prohibited by state or locallaw, and determining the source’s HBV and HIVinfectivity status. If the status of the source indi-vidual is not already known, the employer isrequired to test the source’s blood as soon as fea-sible, provided the source individual consents. Ifthe individual does not consent, the employermust establish that legally required consent can-not be obtained. If state or local law allows testingwithout the source individual’s consent, theemployer must test the individual’s blood, if it isavailable. The results of these tests must be madeavailable to the exposed worker and the workermust be informed of the laws and regulationsabout disclosing the source’s identity and infec-tious status.

FactSheetBloodborne Pathogen Exposure Incidents OSHA’s Bloodborne Pathogens standard (29 CFR 1910.1030) requires employers tomake immediate confidential medical evaluation and follow-up available for workerswho have an exposure incident, such as a needlestick. An exposure incident is a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contactwith blood or other potentially infectious materials (OPIM), as defined in the standardthat results from the performance of a worker’s duties.

This is one in a series of informational fact sheets highlighting OSHA programs, policies or standards. It does not impose any new compliance requirements. For a comprehensive list of compliance requirements of OSHA standards or regulations, refer to Title 29 of the Code of FederalRegulations. This information will be made available to sensory-impaired individuals upon request.The voice phone is (202) 693-1999; teletypewriter (TTY) number: (877) 889-5627.

Written OpinionThe employer must obtain and provide the worker with a copy of the evaluating healthcareprofessional’s written opinion within 15 days ofcompletion of the evaluation. According toOSHA’s standard, the written opinion should only include: whether hepatitis B vaccination wasrecommended for the exposed worker; whetheror not the worker received the vaccination, andthat the healthcare provider informed the workerof the results of the evaluation and any medicalconditions resulting from exposure to blood orOPIM which require further evaluation or treatment.Any findings other than these are not to be includedin the written report.

Additional InformationFor more information, go to OSHA’s BloodbornePathogens and Needlestick Prevention Safety andHealth Topics web page at: https://www.osha.gov/SLTC/bloodbornepathogens/index.html.

To file a complaint by phone, report an emergency,or get OSHA advice, assistance, or products, contact your nearest OSHA office under the “U.S.Department of Labor” listing in your phone book, or call us toll-free at (800) 321-OSHA (6742).

Occupational Safetyand Health Administrationwww.osha.gov 1-800-321-6742

For assistance, contact us. We can help. It’s confidential.

DSG 1/2011

as psychiatric patients or children, from accessingthe sharps. Containers also must be availablewherever sharps may be found, such as in laundries.

Contaminated sharps must never be sheared orbroken. Recapping, bending, or removing needlesis permissible only if there is no feasible alterna-tive or if such actions are required for a specificmedical or dental procedure. If recapping, bend-ing, or removal is necessary, employers mustensure that workers use either a mechanicaldevice or a one-handed technique. The cap mustnot be held in one hand while guiding the sharpinto it or placing it over the sharp. A one-handed"scoop" technique uses the needle itself to pick upthe cap, and then the cap is pushed against a hardsurface to ensure a tight fit onto the device. Also,the cap may be held with tongs or forceps andplaced over the needle. Contaminated brokenglass must not be picked up by hand, but must be cleaned up using mechanical means, such as a brush and dust pan, tongs, or forceps.

Sharps ContainersContainers for contaminated sharps must bepuncture-resistant. The sides and the bottommust be leakproof. They must be appropriatelylabeled or color-coded red to warn everyone thatthe contents are hazardous. Containers for dispos-able sharps must be closable (that is, have a lid,flap, door, or other means of closing the container),and they must be kept upright to keep the sharpsand any liquids from spilling out of the container.

The containers must be replaced routinely and not be overfilled, which can increase the risk ofneedlesticks or cuts. Sharps disposal containersthat are reusable must not be opened, emptied,

A needlestick or a cut from a contaminated sharpcan result in a worker being infected with humanimmunodeficiency virus (HIV), hepatitis B virus(HBV), hepatitis C virus (HCV), and other blood-borne pathogens. The standard specifies measuresto reduce these types of injuries and the risk ofinfection.

Careful handling of contaminated sharps can prevent injury and reduce the risk of infection.Employers must ensure that workers follow thesework practices to decrease the workers’ chancesof contracting bloodborne diseases.

Safer Medical DevicesEmployers are required to consider and use safer medical devices, wherever possible. Thesedevices include those that are needleless or have built-in protection to guard workers againstcontact with the contaminated sharp. In addition,employers must ask non-managerial patient careworkers who could be exposed to contaminatedsharps injuries for their input in identifying, evaluating and selecting effective work practiceand engineering controls, including safer medicaldevices. The employer must document considera-tion and implementation of these devices, and thesolicitation of worker input, in the ExposureControl Plan.

Prompt DisposalEmployers must also ensure that contaminatedsharps are disposed of in sharps disposal contain-ers immediately or as soon as feasible after use.Sharps disposal containers must be readily acces-sible and located as close as feasible to the areawhere sharps will be used. In some cases, theymay be placed on carts to prevent patients, such

FactSheetProtecting Yourself When HandlingContaminated SharpsSharps are objects that can penetrate a worker’s skin, such as needles, scalpels, broken glass, capillary tubes and the exposed ends of dental wires. If blood or other potentially infectious materials (OPIM), as defined in the OSHA BloodbornePathogens standard (29 CFR 1910.1030), are present or may be present on the sharp,it is a contaminated sharp and appropriate personal protective equipment must beworn.

This is one in a series of informational fact sheets highlighting OSHA programs, policies or standards. It does not impose any new compliance requirements. For a comprehensive list of compliance requirements of OSHA standards or regulations, refer to Title 29 of the Code of FederalRegulations. This information will be made available to sensory-impaired individuals upon request.The voice phone is (202) 693-1999; teletypewriter (TTY) number: (877) 889-5627.

or cleaned manually or in any other manner thatwould expose workers to the risk of sharps injury.Employers also must ensure that reusable sharpsthat are contaminated are not stored or processedin a manner that requires workers to reach byhand into the containers where these sharps havebeen placed.

Handling ContainersBefore sharps disposal containers are removed orreplaced, they must be closed to prevent spillingthe contents. If there is a chance of leakage fromthe disposal container, the employer must ensurethat it is placed in a secondary container that isclosable, appropriately labeled or color-coded red, and constructed to contain all contents andprevent leakage during handling, storage, transport,or shipping.

Additional InformationFor more information, go to OSHA’s BloodbornePathogens and Needlestick Prevention Safety andHealth Topics web page at: https://www.osha.gov/SLTC/bloodbornepathogens/index.html.

To file a complaint by phone, report an emergency,or get OSHA advice, assistance, or products, con-tact your nearest OSHA office under the “U.S.Department of Labor” listing in your phone book, orcall us toll-free at (800) 321-OSHA (6742).

Occupational Safetyand Health Administrationwww.osha.gov 1-800-321-6742

For assistance, contact us. We can help. It’s confidential.

DSG 1/2011

You must also train workers who are required towear personal protective equipment on how todo the following:• Use protective equipment properly,• Be aware of when personal protective equip-ment is necessary,

• Know what kind of protective equipment isnecessary,

• Understand the limitations of personal protec-tive equipment in protecting workers frominjury,

• Put on, adjust, wear, and take off personal pro-tective equipment, and

• Maintain protective equipment properly.

Protection from Head InjuriesHard hats can protect your workers from headimpact, penetration injuries, and electricalinjuries such as those caused by falling orflying objects, fixed objects, or contact withelectrical conductors. Also, OSHA regulationsrequire employers to ensure that workerscover and protect long hair to prevent it fromgetting caught in machine parts such as beltsand chains.

Protection from Foot and Leg InjuriesIn addition to foot guards and safety shoes,leggings (e.g., leather, aluminized rayon, orotherappropriate material) can help preventinjuries by protecting workers from hazardssuch as falling or rolling objects, sharp objects,wet and slippery surfaces, molten metals, hotsurfaces, and electrical hazards.

Protection from Eye and Face InjuriesBesides spectacles and goggles, personalprotective equipment such as special helmetsor shields, spectacles with side shields, andfaceshields can protect workers from the haz-ards of flying fragments, large chips, hot sparks,

Employer ResponsibilitiesOSHA’s primary personal protective equip-ment standards are in Title 29 of the Code ofFederal Regulations (CFR), Part 1910 Subpart I,and equivalent regulations in states with OSHA-approved state plans, but you can find protec-tive equipment requirements elsewhere in theGeneral Industry Standards. For example, 29CFR 1910.156, OSHA’s Fire Brigades Standard,has requirements for firefighting gear. In addi-tion, 29 CFR 1926.95-106 covers the construc-tion industry. OSHA’s general personal protec-tive equipment requirements mandate thatemployers conduct a hazard assessment oftheir workplaces to determine what hazardsare present that require the use of protectiveequipment, provide workers with appropriateprotective equipment, and require them to useand maintain it in sanitary and reliable condition.

Using personal protective equipment is oftenessential, but it is generally the last line ofdefense after engineering controls, work prac-tices, and administrative controls. Engineeringcontrols involve physically changing a machineor work environment. Administrative controlsinvolve changing how or when workers dotheir jobs, such as scheduling work and rotat-ing workers to reduce exposures. Work prac-tices involve training workers how to performtasks in ways that reduce their exposure toworkplace hazards.

As an employer, you must assess your work-place to determine if hazards are presentthat require the use of personal protectiveequipment. If such hazards are present, youmust select protective equipment and requireworkers to use it, communicate your protectiveequipment selection decisions to your workers,and select personal protective equipment thatproperly fits your workers.

FactSheetPersonal Protective EquipmentPersonal protective equipment, or PPE, is designed to protect workers from serious

workplace injuries or illnesses resulting from contact with chemical, radiological, physi-

cal, electrical, mechanical, or other workplace hazards. Besides face shields, safety

glasses, hard hats, and safety shoes, protective equipment includes a variety of devices

and garments such as goggles,coveralls, gloves, vests, earplugs, and respirators.

This is one in a series of informational fact sheets highlighting OSHA programs, policies orstandards. It does not impose any new compliance requirements. For a comprehensive list ofcompliance requirements of OSHA standards or regulations, refer toTitle 29 of the Code of FederalRegulations. This information will be made available to sensory impaired individuals upon request.The voice phone is (202) 693-1999; teletypewriter (TTY) number: (877) 889-5627.

U.S. Department of Laborwww.osha.gov(800) 321-OSHA

For more complete information:

DOC 4/2006

optical radiation, splashes from molten metals,as well as objects, particles, sand, dirt, mists,dusts, and glare.

Protection from Hearing LossWearing earplugs or earmuffs can help preventdamage to hearing. Exposure to high noiselevels can cause irreversible hearing loss orimpairment as well as physical and psychologi-cal stress. Earplugs made from foam, waxedcotton, or fiberglass wool are self-forming andusually fit well. A professional should fit yourworkers individually for molded or preformedearplugs. Clean earplugs regularly, and replacethose you cannot clean.

Protection from Hand InjuriesWorkers exposed to harmful substances throughskin absorption, severe cuts or lacerations,severe abrasions, chemical burns, thermalburns, and harmful temperatureextremes willbenefit from hand protection.

Protection from Body InjuryIn some cases workers must shield most or allof their bodies against hazards in the work-place, such as exposure to heat and radiation aswell as hot metals, scalding liquids, body fluids,hazardous materials or waste, and other haz-ards. In addition to fire-retardant wool and fir-eretardant cotton, materials used in whole-bodypersonal protective equipment include rubber,leather, synthetics, and plastic.

When to Wear Respiratory ProtectionWhen engineering controls are not feasible,workers must use appropriate respirators toprotect against adverse health effects caused bybreathing air contaminated with harmful dusts,fogs, fumes, mists, gases, smokes, sprays, orvapors. Respirators generally cover the noseand mouth or the entire face or head and helpprevent illness and injury. A proper fit is essen-tial, however, for respirators to be effective.Required respirators must be NIOSH-approvedand medical evaluation and training must beprovided before use.

Additional InformationFor additional information concerning protec-tive equipment view the publication, Assessingthe Need for Personal Protective Equipment: AGuide for Small Business Employers (OSHA3151) available on OSHA’s web site at www.osha. gov. For more information about personalprotective equipment in the construction indus-try, visit www.osha-slc.gov/SLTC/construc-tionppe/ index.html.

Contacting OSHATo report an emergency, file a complaint or seekOSHA advice, assistance or products, call (800)321-OSHA or contact your nearest OSHAregional or area office.