OSHA
requires, at a minimum, dental offices to follow the concept of universal precautions to control occupational exposure to bloodborne pathogens (BBPs), while the Centers for Disease Control and Prevention (CDC) recommends the adherence to standard precautions. The term universal precautions refers to the concept that all blood and bloody body fluids should be treated as infectious because patients with bloodborne infections can
be asymptomatic or unaware they are infected. In 1996, the CDC expanded the concept and changed the term to standard precautions, which integrated and expanded the elements of universal precautions to include contact with all body fluids (except sweat), regardless of whether blood is present. In dentistry, standard precautions would include controlling exposure to saliva as well as blood, since those are the only two bodily fluids potentially encountered during dental treatments. Since
OSHA has always considered saliva as “other potentially infectious material” (OPIM) in dental infection control, no operational difference exists in clinical dental practice between universal precautions and standard precautions. Standard precautions must be used in the care of all patients, regardless of their infection status. Since 1992, OSHA Review, Inc. has provided dental professionals with comprehensive
programs to support regulatory compliance and infection control. We are a registered continuing education provider in the state of California, specializing in Dental Practice Act, infection control, and OSHA training. OSHA ReviewThere are 5 major components to routine practices. They are risk assessment, hand hygiene, personal protective equipment, environmental and administrative controls. Risk Assessment Before any task is performed, conduct a risk assessment to evaluate the risk of disease transmission. The risk assessment should take into account the following:
Appropriate strategies such as hand hygiene, waste management, and the use of personal protective equipment are then selected to reduce the risk of exposure and disease transmission. The Ontario Ministry of Health and Long-Term Care suggest the following questions for healthcare providers to ask while assessing the risk: 1. What task am I going to perform? 2. What is the risk of exposure to:
3. How competent/experienced am I in performing this task? 4. Will the patient be cooperative while I perform the task? Hand HygieneHand hygiene is the act of removing or destroying microorganisms on the hands while maintaining good hand integrity (keeping the skin healthy). Hand hygiene can be performed with an alcohol-based hand sanitizer (when hands are not visibly soiled) or with soap and water (especially when hands are visibly soiled). In healthcare settings, alcohol-based hand sanitizer is preferred when hands are not visibly soiled. For healthcare providers, using sanitizer is said to take less time than hand washing, and the mechanical rubbing action is important to kill transient bacteria. The sanitizer is also less drying to the skin when hands are cleaned repetitively. The sanitizer should contain between 70 and 90% alcohol. Please see the OSH Answers document for more information about general hand washing. Personal Protective Equipment (PPE)PPE includes gloves, gowns, lab coats, shoe covers, goggles, glasses with side shields, masks, and resuscitation bags. PPE is particularly needed when disease transmission may occur through touching, spraying, aerosolization, or splashing of blood, bodily fluids, mucous membranes, non-intact skin, body tissues, and contaminated equipment and surfaces. PPE can help create a barrier between the exposed worker and the source of microorganisms. GlovesGloves are for single-patient and single-procedure use only. Only disposable gloves should be used in the prevention of disease transmission. Gloves must be removed and replaced when they become heavily soiled and when working between patients and between dirty and clean tasks. Gloves should always be removed using a glove-to-glove or skin-to-skin technique which will prevent contaminating the hands. The use of gloves does not replace the need for hand hygiene. Gloves often create a moist environment that facilitates the growth of microorganisms. Hands should be properly washed before the gloves are put on and after the gloves are removed. Hand hygiene is also needed before and after the replacement of gloves during a procedure or in between tasks. GownsGowns can be either reusable or disposable. These steps of gown donning and removal should be followed: Gown Donning
Gown Removal
Face ProtectionFace protection can provide an effective barrier to protect a worker’s eyes, nose or mouth from coming into contact with sprays or aerosolized body fluids. There are different types and combinations of face protection, such as a mask with safety glasses, goggles, face shield (with safety glasses or goggles), or a mask with an attached visor (and safety glasses or goggles). Steps to remove PPEThe proper steps when removing PPE are critical to prevent contamination of the worker with soiled PPE. The removal of PPE should be performed in the following order:
Environmental ControlsEnvironmental control refers to controlling and minimizing the level of microorganisms in the environment. Environmental control measures include:
Administrative ControlsAdministrative controls include employee training, supervisory competency, immunization, cough etiquette, workplace policies and procedures that are strictly enforced, and sufficient staffing. Administrative controls are critical to ensure that the principles of routine practices are effectively and properly executed in the workplace. What are standard precautions for blood and body fluids?Wear protective clothing that covers skin and personal clothing during procedures or activities where contact with blood, saliva, or OPIM is anticipated. Wear mouth, nose, and eye protection during procedures that are likely to generate splashes or spattering of blood or other body fluids.
What are the proper precautions for handling bodily fluids?How can you reduce your risk of exposure to blood and body fluids?. Always wear gloves for handling items or surfaces soiled with blood or body fluids.. Wear gloves if you have scraped, cut, or chapped skin on your hands.. Change your gloves after each use.. Wash your hands immediately after removing your gloves.. Which standard precautions should be used to prevent exposures to body substances?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.
What are the 3 standard precautions for infection control?Standard precautions consist of the following practices: hand hygiene before and after all patient contact. the use of personal protective equipment, which may include gloves, impermeable gowns, plastic aprons, masks, face shields and eye protection. the safe use and disposal of sharps.
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What is the one standard precaution that must be taken after any contact with bodily fluids other than sweat )?
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