608 Dental Office Safety

Bloodborne Pathogens

The Bloodborne Pathogens Standard (29 CFR 1910.1030) is the most frequently requested and referenced OSHA standard affecting medical and dental offices. Some basic requirements of this standard include:

• a written exposure control plan, to be updated annually
• use of universal precautions
• consideration, implementation, and use of safer, engineered needles and sharps
• use of engineering and work practice controls and appropriate personal protective equipment (gloves, face and eye protection, gowns)
• Hepatitis B vaccine provided to exposed employees at no cost
• medical follow-up in the event of an "exposure incident"
• use of labels or color-coding for items such as sharps disposal boxes and containers for regulated waste, contaminated laundry, and certain specimens
• employee training
• proper containment of all regulated waste

Occupational Exposure to Bloodborne Pathogens

An exposure can be defined as a percutaneous injury (needlestick or cut with a sharp object) or contact of mucous membrane or nonintact skin (exposed skin that is chapped, abraded, or with dermatitis) with blood, saliva, tissue, or other body fluids that are potentially infectious.

Exposure incidents might place dental health care personnel at risk for hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) infection, and therefore should be evaluated immediately following treatment of the exposure site by a qualified health care professional.

When evaluating occupational exposures to fluids that might contain HBV, HCV, or HIV, health care workers should consider that all blood, body fluids, secretions, and excretions except sweat, may contain transmissible infectious agents. Blood contains the greatest proportion of infectious bloodborne virus particle titers of all body fluids and is the most critical transmission vehicle in the health-care setting.

During dental procedures, it is predictable that saliva will become contaminated with blood. If blood is not visible, it is still likely that very small quantities of blood are present, but the risk for transmitting HBV, HCV, or HIV is extremely small. Despite this small transmission risk, a qualified health care professional should evaluate any occupational exposure to saliva in dental settings, regardless of visible blood.

For more information on bloodborne pathogens in a healthcare setting, please take a look at OSHAcademy course 656 Bloodborne Pathogens in the Healthcare Setting.

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