A bloodborne pathogen (BBP) is a type of bacteria or virus that is spread by contact with an infected individual's blood or other potentially infectious body fluids. Examples of diseases caused by bloodborne pathogens include human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV).
The most common ways a person can be exposed to a bloodborne pathogen include receiving contaminated blood or blood products, sharing needles (includes needles used during tattooing or body piercing), or having unprotected sexual intercourse. In a healthcare or residential setting, exposure may also occur as a result of unsafe injection practices or through contact with contaminated equipment such as blood glucose monitoring devices, podiatry equipment, or any other device that has not been properly cleaned and disinfected.
Estimated burden of bloodborne infections in healthcare facilities in the United States:
- Between 1998 and 2008, there were 40 outbreaks of HBV or HCV in healthcare settings
- 33 of these outbreaks occurred in non-hospital healthcare settings (15 in long-term care facilities, 12 in outpatient clinics, and 6 in hemodialysis centers), resulting in 448 persons acquiring HBV or HCV infection. (citation)
- An additional 11 outbreaks of healthcare-associated HBV or HCV occurred in 10 states between July 2008 and June 2009, resulting in at least 120 persons acquiring HBV or HCV infection. (citation)
- 9 of these outbreaks occurred in non-hospital healthcare settings.
- In the last 10 years, there have been at least 15 outbreaks of HBV infection associated with providers failing to follow standard principles of infection control when assisting with blood glucose monitoring. (citation)
- Transmission of HIV to patients while in healthcare settings is rare. Most exposures do not result in infection.
- The risk of HIV transmission to a healthcare worker after percutaneous exposure to HIV-infected blood is considerably lower than the risk of HBV transmission after percutaneous exposure to blood that is positive for HBV (0.3% versus approximately 30%). (citation)
- Between 1981 and 2010, 57 healthcare personnel had documented seroconversion to HIV following occupational exposure.
- Bloodborne pathogen transmission events often result in facility closures and large public health notifications of hundreds or thousands of potentially exposed patients.
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Prevention Strategies for Healthcare Providers
- The best way to prevent contracting a bloodborne infection in a healthcare facility is to avoid exposure to blood or other potentially infectious bodily fluids by following standard and transmission-based precautions, including proper hand hygiene and wearing appropriate personal protective equipment such as gloves, gowns, and face protection.
- Follow safe injection practices:
- Use aseptic technique to prevent contamination of sterile injection equipment.
- Do not administer medications from a single syringe to multiple residents. Changing the needle is not sufficient.
- Use fluid infusion and administration sets (i.e., intravenous bags, tubing, and connectors) for one resident only, and discard immediately after use.
- Use single-dose vials for injectible medications whenever possible.
- If multi-dose vials must be used, store and use them in accordance with the manufacturer’s instructions.
- Medical procedures such as injections and blood glucose monitoring should be conducted with equipment (such as fingerstick devices, blood glucose meters) that has been cleaned and disinfected appropriately.
- Vaccines, if available and indicated, should be administered to susceptible individuals to prevent infection in the case of an accidental exposure.
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Tools and Resources
Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard – federal regulation that states what employers must do to protect workers who may be occupationally exposed to blood or other potentially infectious materials.
National Healthcare Safety Network (NHSN) Healthcare Safety Personnel module – contains a blood/body fluids exposure module to help healthcare facilities track information about occupational exposures to blood and body fluids and their management.
The One & Only Campaign - a public health campaign, led by the Centers for Disease Control and Prevention (CDC) and the Safe Injection Practices Coalition (SIPC), to raise awareness among patients and healthcare providers about safe injection practices. The campaign aims to eradicate outbreaks resulting from unsafe injection practices.
General BBP Fact Sheet
BBP Fact Sheet for Assisted Living Facilities and Nursing Homes
BBP In-Service for Assisted Living Facilities (but can be customized to other settings)
For additional prevention materials on safe injection practices and blood glucose monitoring such as posters, policy templates, or sample in-services for healthcare or residential facilities, please see Safe Injection Practices.
For more information about hepatitis in healthcare settings, go to the CDC hepatitis website.
For more information about HIV in healthcare settings, go to the CDC HIV website.
For more patient resources, please see Consumer and Public Information.
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Thompson ND, Perz JF, Moorman AC, and Holmberg SD. Nonhospital Health Care-Associated Hepatitis B and C Virus Transmission: United States, 1998-2008. Annals of Internal Medicine. 2009;150:33-39.
Citation: A review of hepatitis B and C virus infection outbreaks in healthcare settings, 2008-2009: Opening our eyes to viral hepatitis as a healthcare-associated infection
March 20, 2010
SHEA Fifth Decennial International Conference on Healthcare-Associated Infections
Nicola D. Thompson, Melissa Schaefer, Umid Sharapov, Priti Patel, Joseph F. Perz