NIOSH Safety and Health Topic:

Bloodborne Infectious Diseases
HIV/AIDS, Hepatitis B Virus, and Hepatitis C Virus

Exposures to blood and other body fluids occur across a wide variety of occupations. Health care workers, emergency response and public safety personnel, and other workers can be exposed to blood through needlestick and other sharps injuries, mucous membrane, and skin exposures. The pathogens of primary concern are the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Workers and employers are urged to take advantage of available engineering controls and work practices to prevent exposure to blood and other body fluids.

If you experienced a needlestick injury or are managing occupational exposures, click here

General Resources

OSHA Regulations (Standards - 29 CFR) Bloodborne Pathogens. - 1910.1030
Provides information on OSHA standards, hazard recognition, post-exposure evaluation, more.
External Link: http://www.osha.gov/SLTC/bloodbornepathogens/index.html

Exposure to Blood: What Healthcare Personnel Need to Know
Focuses on human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV).

Overview of State Needle Safety Legislation
Listing of state laws aimed at adding additional safeguards for health care workers at the state level.

Universal Precautions for Prevention of Transmission of HIV and Other Bloodborne Infections

Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis
MMWR, June 29, 2001/50 (RR-11)
Updates previous U.S. Public Health Service recommendations for the management of health-care personnel who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV).

PDF 333KB (67 pages)

Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures, MMWR, July 12, 1991/40(RR08);1-9
MMWR 40(RR08) July 12, 1991
Updates recommendations for prevention of transmission of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) in the health-care setting.

HIV Resources

Strategies Preventing Occupational HIV Transmission to Health Care Workers
To prevent transmission of HIV to healthcare personnel in the workplace, the Centers for Disease Control and Prevention (CDC) offers the following recommendations.

FDA Approves New Rapid HIV Test Kit (November 7, 2002)
Press release announcing the U.S. Food and Drug Administration has approved a new rapid HIV diagnostic test kit that provides results with 99.6 percent accuracy in as little as 20 minutes.
http://www.fda.gov/bbs/topics/NEWS/2002/NEW00852.html

Hepatitis B Virus Resource

Viral Hepatitis B - Frequently Asked Questions
FAQ's from CDC's National Center for Infectious Diseases.

En Espanol

Hepatitis C Virus Resources

Viral Hepatitis C - Frequently Asked Questions
CDC Viral Hepatitis C Safety and Prevention Topic Page.

Viral Hepatitis C - What Clinicians and Other Health Professionals Need to Know
A CDC web-based training course.

Preventing Needlesticks and Sharps Injuries

Sharps Safety
A workbook for designing, implementing, and evaluating a sharps injury prevention program.
http://www.cdc.gov/sharpssafety/

Preventing Needlestick Injuries in Health Care Settings: NIOSH ALERT
DHHS (NIOSH) Publication No. 2000-108, 1999
This booklet describes the risk of needlestick injury and prevention strategies.

En Espanol

How to Protect Yourself From Needlestick Injuries
DHHS (NIOSH) Publication No. 2000-135
This pamphlet describes needlestick protection strategies.

En Espanol

OSHA Needlestick Injuries Information
OSHA Needlestick Prevention Topic Page.
http://www.osha-slc.gov/SLTC/needlestick/index.html#Record

GAO Report (GAO-01-60R)
Occupational Safety: Selected Cost and Benefit Implications of Needlestick Prevention. Devices for Hospitals GAO Report (GAO-01-60R), November 17, 2000.
PDF 203KB (18 pages)

International Health Care Worker Safety Center
The University of Virginia's International Health Care Worker Safety Center is dedicated to identifying effective measures for reducing occupational exposures to and transmission of bloodborne pathogens to health care workers worldwide.
External Link: http://www.healthsystem.virginia.edu/internet/epinet/

Training for Development of Innovative Control Technologies Project
TDICT, based at San Francisco General Hospital, is a collaborative effort of frontline healthcare workers, product designers, and industrial hygienists dedicated to preventing exposure to blood through better design and evaluation of medical devices and equipment.
External Link: http://www.tdict.org/

California Department of Health Services Sharps Injury Control Program
The Sharps Injury Control Program was established by Senate Bill 2005 to study sharps injuries in hospitals, skilled nursing facilities, and home health agencies in California.
External Link: http://www.dhs.ca.gov/ohb/sharps/

Safer Needle Device Listings

Needle-free Injection Technology
This page provides background information, scientific bibliography, history, and links to news reports, policy sources, device manufacturers, and related sites about needle-free injection technology.

The National Alliance for the Primary Prevention of Sharps Injuries (NAPPSI)
NAPPSI is a group of health organizations, medical device manufacturers, healthcare professionals, and others working cooperatively to reduce sharps injuries by reducing the number of sharps in the workplace.
External Link: http://www.nappsi.org/

List of Devices Designed to Prevent Percutaneous Injury and Exposures to Bloodborne Pathogens in the Health Care Setting
Developed by the University of Virginia's International Health Care Worker Safety Center.
External Link: http://www.healthsystem.virginia.edu/internet/epinet/

The California List of Needleless Systems and Needles With Engineered Sharps Injury Protection Developed in accordance with California Labor Code section 144.7 by the California Department of Health Services (DHS) and the Division of Occupational Safety and Health (Cal/OSHA).
External Link: http://www.dhs.ca.gov/ohb/SHARPS/disclaim.htm

Needlestick-Prevention Device Selection Guide
Sponsored by ECRI, an independent nonprofit health services research agency.
External Link: http://www.ecri.org/

Sustainable Hospitals
Provides technical support for selecting products and work practices that reduce hazards.
External Link: http://www.sustainablehospitals.org/cgi-bin/DB_Index.cgi

TDICT: A user-based performance standard for the design, evaluation, and selection of medical devices
External Link: http://www.tdict.org/performance.html

TDICT: Evaluation Tools
Evaluation tools for evaluating medical devices.
External Link: http://www.tdict.org/evaluation2.html

Other Engineering Controls

Glass Capillary Tubes: Joint Safety Advisory About Potential Risks, February 1999
Recommended steps that can minimize the potential risk of injury and/or infection from bloodborne pathogens due to accidental breakage of glass capillary tubes.

Selecting, Evaluating, and Using Sharps Disposal Containers
DHHS (NIOSH) Publication No. 97-111, January 1998
This document presents a comprehensive framework for selecting sharps disposal containers and evaluating their efficacy as part of an overall needlestick injury prevention plan.

Management and Treatment Guidelines

National HIV/AIDS Clinicians' Consultation Center (PEPline)
Provides health care professionals with up-to-the-minute HIV clinical information and individualized, expert case consultation.
External Link: http://www.ucsf.edu/hivcntr/

Download PEPline poster:

PDF 158KB (1 page)

Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis
Updates previous U.S. Public Health Service recommendations for the management of health-care personnel who have occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV).

PDF 333KB (67 pages)

Immunization of Health-Care Workers: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee(HICPAC)
MMWR 46(RR-18), 1997
This report summarizes recommendations of the Advisory Committee on Immunization Practices (ACIP) concerning the use of certain immunizing agents in health-care workers (HCWs) in the United States.

Surveillance

Sharps Injuries among Hospital Workers in Massachusetts, 2002 (June 2004)
Findings from the Massachusetts Sharps Injury Surveillance System
Massachusetts Department of Public Health
External Link: http://www.mass.gov/dph/bhsre/ohsp/sharps/injuries_hospital.doc

Surveillance of Health Care Personnel with HIV/AIDS
CDC Fact Sheet provides current information on adult employees in the health care setting with reported AIDS cases.

HIV/AIDS Surveillance Report
The HIV/AIDS Surveillance Report contains information about U.S. AIDS and HIV case reports, including data by state, metropolitan statistical area, mode of exposure to HIV, sex, race/ethnicity, age group, vital status, and case definition category.

National Surveillance System for Health Care Workers
The Centers for Disease Control and Prevention developed the National Surveillance System for Health Care Workers (NaSH) and collaborates with healthcare facilities to systematically collect information important to prevent occupational exposures and infections among healthcare workers.

Exposure Prevention Information Network (EPINet)
EPINet was developed to provide standardized methods for recording percutaneous injuries and blood and body fluid contacts, in order to assist hospitals in complying with the OSHA recordkeeping requirements of the December 1991 Bloodborne Pathogens Standard.
External Link: http://www.healthsystem.virginia.edu/internet/epinet/

Latex Gloves

NIOSH Safety and Health Topic: Latex Alergy

Preventing Allergic Reactions to Natural Rubber Latex in the Workplace
DHHS (NIOSH) Alert NIOSH Publication Number 97-135 (June 1997)
Describes six case reports of workers who developed latex allergy and presents NIOSH recommendations for minimizing latex-related health problems.

En Espanol

Latex Allergy—A Prevention Guide
DHHS (NIOSH) Publication Number 98-113 (February 1999)
Latex gloves have proved effective in preventing transmission of many infectious diseases to health care workers, but for some workers exposures to latex may result in allergic reactions.

Latex Allergy—Fact Sheet
DHHS (NIOSH) Publication Number 705006 (June 1997)
Rcommendations for selecting products and implementing work practices that reduce the risk of allergic reactions.

En Espanol

Dental Infection Control

Dental Infection Control
Including fact sheets, FAQ's, Publications, and Guidelines from CDC.

OSHA: Safety and Health Topics for Dentistry
Includes information on hazard identification, compliance, and more.
External Link: http://www.osha.gov/SLTC/dentistry/index.html

USAF Dental Investigation Service
Provides evaluations for dental products and information on infection control.
External Link: http://www.brooks.af.mil/dis

NIOSHTIC-2 Search

NIOSHTIC-2 search results on Bloodborne Infectious Disease

is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.