Safe working practices
The following steps will minimise the risk of exposure to blood products and any associated BBV, but not all will be necessary in all situations.
- Avoid contact with blood or body fluids.
- Take all necessary precautions to prevent puncture wounds, cuts and abrasions in the presence of blood and body fluids.
- Avoid use of, or exposure to, sharps (needles, glass, metal, etc) when possible, and discard sharps directly into the sharps container immediately after use, and at the point of use.
- Take particular care in handling and disposal if the use of sharps is unavoidable – 'one use only' contaminated sharps must be discarded into an approved sharps container (this is generally safer and more practical than attempting to recycle contaminated items). This must be constructed to BS 7320; 1990/ UM 3291, and used containers must be disposed of through a waste management company who will dispose of them safely as 'waste for incineration only'.
- Protect all breaks in exposed skin by means of waterproof dressings and/or gloves. Chain mail and armoured gloves are available to protect the hands when working with sharp instruments or exposed to bone splinters, etc.
- Protect the eyes and mouth by means of a visor or goggles/safety spectacles and a mask when splashing is a possibility (this will also protect against bone fragments in orthopaedic surgery and post-mortem examination).
- Avoid contamination of the person or clothing by use of waterproof/water resistant protective clothing, plastic apron, etc.
- Wear rubber boots or plastic disposable overshoes when the floor or ground is likely to be contaminated.
- Apply good, basic hygiene practices, including hand-washing, before and after glove use, and to avoid hand-to-mouth/eye contact. Disposable gloves should never be washed and reused, as they may deteriorate during use and in washing. If latex gloves are worn, powder-free, low-protein products should be chosen to help prevent latex allergy. Any disposable gloves should be CE marked for use with biological agents.
- Control surface contamination by blood and body fluids by containment and appropriate decontamination procedures.
- Dispose of all contaminated waste safely and refer to relevant guidance.
Safe working practices for healthcare workers
Employers should use a task-related approach to applying safe working practices. Levels of protection should be proportionate to the task, and the foreseeable degree of exposure to blood or body fluids. This means that the potential risk of exposure to blood-borne viruses is considered from a range of activities.
Some activities are specifically defined as exposure-prone procedures (EPP) and include major surgery, re obstetrics and gynaecology, cardiothoracic and trauma orthopaedic.
EPP are associated with a risk of disease transmission from patient to healthcare worker and vice-versa. Emphasis is placed on assessing the exposure-prone nature of procedures, the risk of penetrating injury and the scale of exposure, rather than on attempting to define the risk from any particular individual.
Other activities involve exposure to blood and body fluids but are much lower risk for disease transmission: such as arterial puncture; insertion/removal of intra-arterial lines; and the simple administration of injections. The principles described above are also applicable to other occupations.
- Guidance on safe working practices for healthcare workers has been published by the UK Health Departments.
Handling incidents/emergency planning
Employers are legally required to make arrangements that deal with emergencies. Emergency plans need to include:
- the foreseeable types of incidents, accidents or emergencies that might occur;
- the role, responsibilities and authority of individuals during an emergency;
- procedures for employees to follow - including regular safety drills and identifying the special needs of any disabled employees;
- the safety equipment and personal protection equipment to be used;
- arrangements for liaison with emergency services;
- first aid facilities, access to post-exposure prophylaxis and follow up through the occupational healthcare provider; and
- procedures for cleaning up and disposal of waste.