3. Controlling sources of bloodborne infection
Transmission of bloodborne viruses (BBVs) to workers or the public is very unlikely through everyday social contact with BBV-infected individuals. Transmission happens through direct exposure to blood or body fluids, delivered through the protective skin barrier.
In workplaces, this is most likely to result from a penetrating injury with a contaminated sharp instrument, such as a needle, broken glass or contaminated machinery or vehicles. More rarely, it can be caused by contamination of broken skin or mucous membranes.
Effective control of BBVs starts with the ability to accurately recognise the potential sources of infection during work activities.
All blood and body fluids should be treated as potentially infected with BBVs, particularly in a healthcare setting.
If sources of BBVs are not recognised and the right precautions are not put in place, they can pose a health threat to workers where they could be potentially exposed to infection.
Needlestick or sharps injuries
Medical sharps can cause BBV infection through needlestick injuries. These injuries can be reduced by:
- avoiding the unnecessary use of sharps
- use of safer sharps
- safe and secure disposal of sharps
- increased awareness of the risks and preventive measures through education and training
Use of suitable equipment, for example safer needle technology, can reduce the amount of needlestick injuries. Such devices and systems include:
- blood lancets
- retractable or shielded syringes
- blood collection systems
- needle-free devices or blunt needles
- safety cannulae
There is more information on the use of sharps in the workplace in our health services sharps injuries guidance page. This places a duty on employers, contractors and workers in the healthcare sector to use and dispose of medical sharps safely.
You can also find general guidance on avoiding needlestick or sharps injuries.
Infected cadavers
HSE has guidance on managing infection risks when handling the deceased in the mortuary, post-mortem room and funeral premises, and during exhumation.
Medical equipment
Medical, dental, laboratory or other reusable equipment that has been in contact with blood or body fluids can risk infection for workers and patients if it has not been adequately decontaminated.
Reusable devices must therefore be decontaminated between uses on different individuals.
If an item of equipment is to be sent for examination or repair, it should be decontaminated before despatch. In some instances, for example when items have delicate electrical components, you should choose a method of decontamination that doesn’t damage the equipment.
Contaminated objects
Any article contaminated with blood or blood products from an infected person must be regarded as a potential source of BBV infection for those handling it, if there is a way the virus can be delivered into the body.
Examples include sharp objects but also 'soft' waste, such as discarded dressings, contaminated clothing, linen and furnishings.
For situations such as those described above, it must be assumed that there is a risk of infection, unless the item concerned has been decontaminated by effective means.
Environmental contamination
Blood and body fluids may contaminate the site of industrial and road-traffic accidents, playgrounds and sporting events.
Discarded needles in the environment are a potential source of contamination and workers may have to deal with them. Care should be taken to safely retrieve and dispose of these in a manner that avoids sharps-related injuries.
Provided there is no direct contact, there is no risk for those in the area. However, BBVs may remain a risk on surfaces for extended periods, depending on environmental conditions.
The use of simple personal protective measures, avoiding needlestick or sharps injuries, and appropriate decontamination will minimise the risk for those dealing with the contamination. After cleaning up, it is essential to dispose of contaminated waste safely.
There is more guidance on:
Vehicles
Vehicles involved in traffic and rail accidents are often contaminated with blood and human tissue. Sharp metal and broken glass at an accident scene present an added sharps risk for those first attending the trauma scene.
There is guidance on managing potential risk in emergency workers (on GOV.UK).
Vehicle recovery and repair work may potentially involve contact with contaminated surfaces.
Discarded hypodermic needles could be found in upholstery and glove compartments in cars sent for repair and servicing. Employers should make workers aware of this risk, even during routine maintenance work, and precautions are essential in all cases, for example:
- avoiding contact
- using tongs for removal
- arrangements for the safe disposal of any discarded needles
However, the risk of transmission of a BBV from a discarded needle in the community is extremely low, unless it was known to have been used by a known individual with a BBV or in a high-risk group for infection with one of these viruses.