INTRODUCTION

Hepatitis B virus (HBV), human immunodeficiency virus (HIV), and other pathogenic microorganisms may be present in human tissues. Because these microorganism can be transmitted through human blood, body fluids, or tissues, laboratory workers improperly handling these materials are at risk of becoming infected and developing disease. These procedures, drawn from the most recent recommendations from the U.S. Department of Health and Human Services, are intended to minimize exposure to human blood and body fluids and prevent infection of laboratory workers. The references cited provide additional information which may be useful.

UNIVERSAL PRECAUTIONS

Work practices should be developed on the assumption that blood and certain other body fluids(cerebrospinal fluid, vaginal fluid, peritoneal fluid, pleural fluid, synovial fluid, amniotic fluid, pericardial fluid) from any person may be infective for HIV, HBV, or other blood-borne pathogens. Universal precautions do not apply to saliva and other body fluids including nasal secretions, sputum, sweat, tears, urine, and vomitus unless they are contaminated with blood.

HEPATITIS B VACCINATION

Hepatitis B vaccination is recommended for all laboratory workers whose jobs involve handling blood or other body fluids to which universal precautions apply. This vaccination is available from University Health Services (UHS). For more information, please contact the Occupational Health Nurse at UHS or the Biological Safety Officer at EH&S.

RECOMMENDED PROCEDURES

BSL 2 standards, containment and special practices, containment equipment, and facilities, as described in the CDC-NIH publication, Biosafety in Microbiological and Biomedical Laboratories are recommended for activities involving all clinical specimens and human serum and other blood products that are used as control regimens. The documented occupational risks of HIV and HBV infection are associated with parenteral and mucous membrane exposure to potentially infectious blood and body fluids. Attempts should be made to prevent these exposures.

1. Needle and sharps disposal - Hypodermic needles should be used only when necessary. Extreme care must be taken to avoid accidental injuries from hypodermic needles, scalpel blades and other sharp objects which have been contaminated with blood or other body fluids. To prevent needlestick injuries, needles should not be recapped, bent, removed from disposable syringes, or otherwise manipulated by hand. After they are used they should be placed in a puncture-proof container that is located in the work area. Sharps containers (available from EH&S) should be disposed of through EH&S.
2. Disposable gloves should be worn when body fluid samples are handled. This is particularly important for workers with cuts or abrasions on their hands. Disposable gloves should be work for direct contact with mucous membranes or nonintact skin of subjects. Gloves should be removed when they become contaminated so that clean surfaces are not contaminated. Workers who have exudative lesions or weeping dermatitis should refrain from all direct subject contact.
3. Handwashing - Hands should be washed with soap or disinfectant after work with blood, body fluids, or contaminated items (after gloves are removed). Hands should also be washed immediately if a spill occurs and they become contaminated with blood, etc. Waterless antiseptic should be used when handwashing facilities are not available.
4. Safety glasses or face shields should be worn to protect skin and mucous membranes of eyes, nose, and mouth.
5. Lab coats or gowns should be worn to protect skin and prevent clothing from being contaminated. Contaminated lab coats should be removed when leaving the laboratory.
6. Work surfaces should be routinely decontaminated with an approved disinfectant. When spills occur, they should be immediately decontaminated and cleaned up.
7. Mechanical pipeting devices are required for the manipulation of liquids in the laboratory. Mouth pipeting shall not be used.
8. Aerosols droplets, and splashes should be minimized in all procedures. A biological safety cabinet should be used for manipulations involving aerosols (e.g. vortexing, centrifugation, and vigorous pipeting).
9. Materials transported from one laboratory to another should be packaged in secondary containers. All visible contamination should be removed from the outside of the specimen container before placing in the secondary container.
10. Storage and Disposal of Waste - Biohazardous waste should be stored in leakproof, covered containers and labeled with a biohazard symbol. Blood and body fluids may be carefully poured into a drain that connects to a sanitary sewer. All potentially contaminated items should be decontaminated before disposal or disposed of by incineration (See Waste Management at UMASS).
11. Equipment contaminated with blood or body fluids should be decontaminated and cleaned before being repaired or moved from the laboratory.
12. Additional information about procedures, safety equipment, disinfection, and disposal of infectious waste is available from Environmental Health and Safety at 545-2682.

References

Biosafety in Microbiological and Biomedical Laboratories, U.S. Department of Health and Human Services. 1998.

1988 Agent Summary Statement for Human Immunodeficiency Virus, Morbidity and Mortality - Weekly Reports, 37: #S-4, April 1, 1988.

Guidelines for Prevention of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Health-Care and Public Safety Workers, U.S. Department of Health and Human Services, February 1989.