A blood-borne disease is a

disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that ar ...

that can be spread through contamination by blood and other

body fluid Body fluids, bodily fluids, or biofluids, sometimes body liquids, are liquids within the human body. In lean healthy adult men, the total body water is about 60% (60–67%) of the total body weight; it is usually slightly lower in women (52-55%). ...

s. Blood can contain pathogens of various types, chief among which are

microorganism A microorganism, or microbe,, ''mikros'', "small") and ''organism'' from the el, ὀργανισμός, ''organismós'', "organism"). It is usually written as a single word but is sometimes hyphenated (''micro-organism''), especially in olde ...

s, like bacteria and

parasites Parasitism is a close relationship between species, where one organism, the parasite, lives on or inside another organism, the host, causing it some harm, and is adapted structurally to this way of life. The entomologist E. O. Wilson has c ...

, and non-living infectious agents such as

virus A virus is a submicroscopic infectious agent that replicates only inside the living cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Since Dmitri Ivanovsky's ...

es. Three blood-borne pathogens in particular, all viruses, are cited as of primary concern to health workers by the CDC-NIOSH:

HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...

hepatitis B Hepatitis B is an infectious disease caused by the ''Hepatitis B virus'' (HBV) that affects the liver; it is a type of viral hepatitis. It can cause both acute and chronic infection. Many people have no symptoms during an initial infection. For ...

(HVB), &

hepatitis C Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. During the initial infection people often have mild or no symptoms. Occasionally a fever, dark urine, a ...

(HVC). Diseases that are not usually transmitted directly by blood contact, but rather by insect or other vector, are more usefully classified as

vector-borne disease In epidemiology, a disease vector is any living agent that carries and transmits an infectious pathogen to another living organism; agents regarded as vectors are organisms, such as parasites or microbes. The first major discovery of a disease ve ...

, even though the causative agent can be found in blood. Vector-borne diseases include

West Nile virus West Nile virus (WNV) is a single-stranded RNA virus that causes West Nile fever. It is a member of the family ''Flaviviridae'', from the genus ''Flavivirus'', which also contains the Zika virus, dengue virus, and yellow fever virus. The virus ...

zika fever Zika fever, also known as Zika virus disease or simply Zika, is an infectious disease caused by the Zika virus. Most cases have no symptoms, but when present they are usually mild and can resemble dengue fever. Symptoms may include fever, red ...

and

malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects humans and other animals. Malaria causes Signs and symptoms, symptoms that typically include fever, fatigue (medical), tiredness, vomiting, and headaches. In se ...

. Many blood-borne diseases can also be contracted by other means, including high-risk sexual behavior or intravenous drug use. These diseases have also been identified in

sports medicine Sports medicine is a branch of medicine that deals with physical fitness and the treatment and prevention of injuries related to sports and exercise. Although most sports teams have employed team physicians for many years, it is only since the ...

. Since it is difficult to determine what pathogens any given sample of blood contains, and some blood-borne diseases are lethal, standard medical practice regards all blood (and any body fluid) as potentially infectious. "Blood and body fluid precautions" are a type of

infection control Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe, infection prevention and control is expanded from ...

practice that seeks to minimize this sort of disease transmission.

Occupational exposure

Blood poses the greatest threat to health in a laboratory or clinical setting due to

needlestick injuries A needlestick injury is the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. Even though the acute physiological effects of a needlestick ...

(''e.g.'', lack of proper needle disposal techniques and/or

safety syringe A safety syringe is a syringe with a built-in safety mechanism to reduce the risk of needlestick injuries to healthcare workers and others. The needle on a safety syringe can be detachable or permanently attached. On some models, a sheath is pl ...

s). These risks are greatest among healthcare workers, including: nurses, surgeons, laboratory assistants, doctors,

phlebotomists Phlebotomy is the process of making a puncture in a vein, usually in the arm, with a cannula for the purpose of drawing blood. The procedure itself is known as a venipuncture, which is also used for intravenous therapy. A person who performs a ph ...

, and laboratory technicians.S. Deuffic-Burbana, E. Delarocque-Astagneauc, D. Abitebould, E. Bouvetd, Y. Yazdanpanah Blood-borne viruses in healthcare workers: Prevention and management.

Journal of Clinical Virology ''Journal of Clinical Virology'' is a scientific journal that covers the aspects of human virology that directly pertains to virus-induced clinical conditions. The journal is published by Elsevier. Abstracting and indexing The journal is abstrac ...

52(2011) 4–10 These roles often require the use of syringes for blood draws or to administer medications. The Occupational Safety and Health Administration (OSHA) prescribes 5 rules that are required for a healthcare facility to follow in order to reduce the risk of employee exposure to blood-borne pathogens. They are: * Written exposure control plan * Engineering controls (Sharps containers, detachable and retractable needles, syringe caps, etc.) * Safe work practices and safety devices *

Hepatitis B vaccine Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with poor immune function such as from HIV/AIDS and th ...

available to employees * Education and post-exposure follow up These controls, while general, serve to greatly reduce the incidence of blood-borne disease transmission in occupational settings of healthcare workers. There are 26 different viruses that have been shown to present in healthcare workers as a result of occupational exposure. The most common blood-borne diseases are

(HBV),

(HCV), and

human immunodeficiency virus The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...

(HIV).Annette Prüss-Üstün, Elisabetta Rapiti, and Yvan Hutin Estimation of the Global Burden of Disease Attributable to Contaminated Sharps Injuries Among Health-Care Workers.

American Journal of Industrial Medicine The ''American Journal of Industrial Medicine'' is a monthly peer-reviewed medical journal covering occupational safety and health, as well as environmental health. It was established in 1980 and is published by Wiley-Blackwell. The editor-in-chief ...

48:482–490 (2005) Exposure is possible through blood of an infected patient splashing onto mucous membranes; however, the greatest exposure risk was shown to occur during percutaneous injections performed for vascular access. These include blood draws, as well as catheter placement, as both typically use hollow bore needles. Preventive measures for occupational exposure include standard precautions (hand washing, sharp disposal containers), as well as additional education. Advancements in the design of safety engineered devices have played a significant role in decreasing rates of occupational exposure to blood-borne disease. According to the Massachusetts Sharps Injury Surveillance System, needle devices without safety features accounted for 53% of the 2010 reported sharps injuries. Safer sharps devices now have engineering controls, such as a protective shield over the needle, and sharps containers that have helped to decrease this statistic. These safer alternatives are highly effective in substantially reducing injuries. For instance, almost 83% of injuries from hollow bore needles can be prevented with the use of safer sharps devices.

Blood transfusions

Blood for

blood transfusion Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mo ...

is screened for many blood-borne diseases. Additionally, a technique that uses a combination of riboflavin and UV light to inhibit the replication of these pathogens by altering their

nucleic acid Nucleic acids are biopolymers, macromolecules, essential to all known forms of life. They are composed of nucleotides, which are the monomers made of three components: a 5-carbon sugar, a phosphate group and a nitrogenous base. The two main clas ...

s can be used to treat blood components prior to their transfusion, and can reduce the risk of disease transmission. A technology using the synthetic

psoralen Psoralen (also called psoralene) is the parent compound in a family of naturally occurring organic compounds known as the linear furanocoumarins. It is structurally related to coumarin by the addition of a fused furan ring, and may be considered a ...

(amotosalen HCl) and

UVA UVA most often refers to: * Ultraviolet A, a type of ultraviolet radiation * University of Virginia, a public research university in Charlottesville, Virginia, United States Uva or UVA may also refer to: Places * Uva, Missouri, an unincorpora ...

light (320–400 nm) has been implemented in European blood centers for the treatment of platelet and plasma components to prevent transmission of blood-borne diseases caused by bacteria, viruses and protozoa.

Needle exchange programs

Needle exchange programs (NEPs) are an attempt to reduce the spread of blood-borne diseases between intravenous drug users. They often also provide addiction counseling services, infectious disease testing, and in some cases mental health care and other case management. NEPs acquired their name as they were initially places where intravenous (IV) illicit substance users were provided with clean, unused needles in exchange for their used needles. This allows for proper disposal of the needles. Empirical studies confirm the benefits of NEPs. NEPs can affect behaviors that result in the transmission of HIV. These behaviors include decreased sharing of used syringes, which reduces contaminated syringes from circulation and replaces them with sterile ones, among other risk reductions.

Prevention

Follow standard precautions to help prevent the spread of blood-borne pathogens and other diseases whenever there is a risk of exposure to blood or other bodily fluids. Standard precautions include maintaining personal hygiene and using personal protective equipment (PPE), engineering controls, and work practice controls among others. Always avoid contact with blood and other bodily fluids. Wear disposable gloves when providing care, particularly if you may come into contact with blood or bodily fluids. Dispose of gloves properly and change gloves when providing care to a new patient. Use needles with safety devices to help prevent needlestick injury and exposure to blood-borne pathogens. A hierarchy of controls can help to prevent environmental and occupational exposures and subsequent diseases. These include: * Elimination: Physically remove hazards, including needles that lack a safety device. Additionally, eliminate the use of needle devices whenever safe and effective alternatives are available. * Substitution: Replace needles without safety devices with ones that have a safety feature built in. This has been shown to reduce blood-borne diseases transmitted via needlestick injuries. * Engineering controls: Isolate people from the hazard by providing sharps containers for workers to immediately place needles in after use, which means putting them within arm's reach of wherever patient treatment occurs, such as in every physician's exam room, every draw station in a medical lab, and every bedside in a hospital ward or wing. * Administrative controls: Change the way people work by creating a culture of safety such as avoiding recapping or bending needles that may be contaminated and promptly disposing of used needle devices and other sharps.

Personal protective equipment Personal protective equipment (PPE) is protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or infection. The hazards addressed by protective equipment include physical, ele ...

: Protect workers with PPE such as gloves and masks to avoid transmission of blood and other bodily fluids.

References

External links

Selected EPA-registered Disinfectants—U.S. Environmental Protection Agency

OSHA Bloodborne Pathogen Standard (BBPS)

Bloodborne Pathogens and Needlestick Prevention
from the

Occupational Safety and Health Administration The Occupational Safety and Health Administration'' (OSHA ) is a large regulatory agency of the United States Department of Labor that originally had federal visitorial powers to inspect and examine workplaces. Congress established the agenc ...

(OSHA)
OSHA Bloodborne Pathogens Workplace Safety Standards and Regulations

OSHA Bloodborne Pathogens Training

* ttp://www.vega.org.uk/video/programme/87 Professor Andrew Speilman, Entomologist, Harvard School of Hygiene and Public HealthFreeview Malaria video by the

Vega Science Trust The Vega Science Trust was a not-for-profit organisation which provided a platform from which scientists can communicate directly with the public on science by using moving image, sound and other related means. The Trust closed in 2012 but the web ...