GUIDE

Bodily Fluids Exposure
December 2005

2005-0043

crude oil. natural gas liquids. John’s. Newfoundland Canada A1C 1B6 Tel (709) 724-4200 Fax (709) 724-4225 Email: communication@capp. 235 Water Street St. While it is believed that the information contained herein is reliable under the conditions and subject to the limitations set out.capp. Calgary. Together.The Canadian Association of Petroleum Producers (CAPP) represents 150 companies that explore for. and elemental sulphur throughout Canada.ca Website: www. CAPP and the contributors do not guarantee its accuracy. Alberta Canada T2P 3N9 Tel (403) 267-1100 Fax (403) 261-4622 403.W. 2100. Review by July 2008 Disclaimer This publication was prepared for the Canadian Association of Petroleum Producers (CAPP) by industry representatives and Lost Time Solutions. CAPP member companies produce more than 98 per cent of Canada’s natural gas and crude oil. The use of this report or any information contained will be at the user’s sole risk. regardless of any fault or negligence of the contributors. CAPP also has 125 associate members that provide a wide range of services that support the upstream crude oil and natural gas industry. oil sands. these members and associate members are an important part of a $90-billion-a-year national industry that affects the livelihoods of more than half a million Canadians. 350 – 7th Ave. develop and produce natural gas. CAPP or its contributors.ca . S.

December 2005 CAPP Guide . This may also include the cleanup/disposal of contaminated equipment/supplies that may occur as a result of the above-mentioned activities.Overview • • • • To provide a resource to assist member companies to develop their own code of practice and safe work practices for management of bodily fluids (BF) To limit occupational exposure to BF through the use of Universal Precautions and by appropriate waste management disposal To decrease the risk of occupationally acquired infection from BF This guide is not intended as a safe operating procedure nor does it relieve employers of the responsibility to develop their own site-specific safe operating procedures Project Scope Applies to all business activities and personnel where first aid and/or life support practices as well as cleanup/disposal of spilled body fluids is an expected role.Bodily Fluid Exposure Page i .

................................................................................................................4 5..................... Eye Protection .................4 5...........................................i 1 Program Layout......................1......................7 5 Engineering Controls .......4 Personal Protective Equipment..............5 Disposal Practices ......................................1 Gloves ...........................................1............................................................................5 5............................................................................................................................2 2 2.........................................................5 5...........1 5.......................................1 7...................................................................................................................3..........6 6.........................................................................5 5..................................................................................................3 Control...............1 Housekeeping ..Bodily Fluid Exposure Page ii ................................................................................................................................................................................................i Project Scope..1 1.......................................1 4...........................................................................................2 5..........................................1 2...................................3 3 4 Regulatory Requirements.........................................................3.....................................................................3.......2 Risk Management........................................2 Employee...............1 1..2 Masks....................................2 Responsibilities ..........................3................................2 Bodily Fluid Waste Disposal..................4 Incident Management..................................6 Post Exposure Follow-up ....3 Work Practices ............................................................3 Assessment.4 5..........2.................................................2 4.................1 Sharps Use and Disposal.....................................................3 6 7 8 Post Exposure Management ...................Contents Overview .........................................2...3 4.......................1 Training Content...............3 Identification .............................3 Contaminated Laundry.............5 Post Exposure Reporting...................................................................................................................................................7 Program Evaluation.............................................2 2..................................................................................................................................................................................................................................................5 5.4 5...............................................................................................2 Record Keeping...............................2 Contractor...........1 Post Exposure Testing....................1 Employer ....................7 July 2005 CAPP Guide ...........2 Care and Maintenance of Equipment...........................................................................................................................................................................4 5......................................................................................

and the names and job titles of all persons attending the training session The training record will be maintained according to regulatory and/or specific company requirements • • December 2005 CAPP Guide . transmission modes. immunization considerations.1 Program Layout 1.Bodily Fluids Exposure Page 1 . • • • • The training content is considered a CAPP recommendation as a due diligence obligation for all employees. appropriate engineering controls. the name and qualifications of the individual conducting the sessions.1 Regulatory Requirements • • 1. waste management and disposal and information on post-exposure protocol and follow-up Employer will maintain records of all training sessions. students and contractors Training should be provided by a qualified agency that meets local regulatory requirements Contractors will comply with these standards and train employees as part of their contractual obligations Training should include a general explanation of epidemiology and symptoms of blood borne diseases.2 Companies should be aware of federal. the contents or summary of training sessions. provincial and territorial regulations/ recommendations pertaining to BF handling in their specific area of operations Refer to Appendix “A” for examples of regulations Training Content Training is an integral component of risk management and the following should be considered when implementing a training program. practices and personal protective equipment.

Ensuring that appropriate protective equipment is supplied. available and maintained commensurate with the potential risks Ensuring that employees are aware of the need and procedures for obtaining immediate first aid/medical attention and for reporting incidents of exposure to blood and body fluids Investigating exposure incidents with follow-up to prevent similar incidents from occurring Providing for the care and maintenance of equipment Program Evaluation Record Keeping Employee The employee is responsible for: • • • • • • Identifying the risks associated with the potential for exposure to BF Knowing how to access immediate first aid and medical attention Knowing and implementing procedures for reporting exposure incidents Applying appropriate clean-up and disposal procedure as per safe work practices Participating in all training programs Practicing universal precautions.e. December 2005 CAPP Guide .Bodily Fluids Exposure Page 2 . requirements for documentation and record keeping will vary according to operating site location.1 Employer The employer is responsible for: • • • • • • • • • 2.2 Responsibilities 2. 3 Record Keeping Employers must comply with federal. including the use of personal protective equipment 2. retention and confidentiality of personal health care records.2 Offering all employees the opportunity to participate in the BF Program Identifying employees who are required to be included in the BF Program i. (those who have first aid responsibilities as a designated part of their job) Scheduling and delivery of BF Training Program. provincial or territorial regulations specific to content. As a result. training records and equipment maintenance records.3 Contractor The contractor is responsible for: • Implementing a guideline that is aligned with applicable regulations.

Bodily Fluids Exposure Page 3 . mouth and/or nose − Contact with non-intact skin. personal protective equipment and disposal practices December 2005 CAPP Guide .3 Control Prevention is a key component to any program in order to minimize or eliminate risks to the company or its employees. hepatitis B virus (HBV). chapped or abraded skin.2 Assessment First Aid administration procedures which may include: • • • • Suppression and containment of bleeding Artificial Respiration (AR mouth to mouth) Cardiopulmonary Resuscitation (CPR) Automatic External Defibrillators (AED) 4. laceration or puncture − Exposure with contaminated material that can occur during procedure administration and / or waste disposal 4. • • • Universal precautions are designed to prevent transmission of human immunodeficiency virus (HIV). open dermatitis or eczema − Contact from a needle stick. hepatitis C virus (HCV) and other bloodborne pathogens Universal precautions treat all blood and body fluids as potentially infectious Engineering controls should include work practices.4 Risk Management 4.1 Identification • • Identify all procedures where workplace exposure to BF is anticipated. Exposure types include: − Contact with mucous membranes such as a splash in the eye.

or as soon as feasible. vehicles etc. or other potentially infectious materials Appropriate disinfectants shall be used for cleaning All receptacles which are intended for reuse shall be inspected and decontaminated on a regularly scheduled basis.1 Work Practices 5. inspection. or breached gloves shall be disposed of in the specified manner Gloves must be changed after contact with each individual (remove gloves pulling from top and turning inside out) Hands must be washed immediately after gloves are removed • • • • December 2005 CAPP Guide .2 Personal Protective Equipment Personal protective equipment should be placed in areas where exposure to BF is anticipated (First Aid stations. and non-intact skin. etc.) used for picking up contaminated or potentially contaminated materials shall be properly disinfected or disposed of after use A quality assurance program that includes regular maintenance.2. upon visible contamination Broken glassware shall not be picked up directly with the hands. Cleanup materials (brush.1 Gloves • Disposable impermeable gloves must be worn for all procedures where it can be reasonably anticipated that there will be contact with blood. or forceps. and when touching contaminated items or surfaces Gloves shall be replaced when contaminated.1 Housekeeping • • • • • All equipment and working surfaces shall be cleaned and decontaminated after contact with blood. It shall be cleaned up using mechanical means. torn.1. or punctured. forceps. Equipment must be cleaned and maintained according to manufacturer instructions 5.) 5. mucous membranes. other potentially infectious materials.1. storage and cleaning along with documentation must be in place. tongs. such as brush and dustpans. or when their ability to function as a barrier is compromised Contaminated. Supplies must be inspected and changed on a regular basis.Bodily Fluids Exposure Page 4 .2 Care and Maintenance of Equipment • 5. body fluids.5 Engineering Controls 5. used.

2. nose.3 Disposal Practices 5. and local regulations Should be handled as little as possible with a minimum of shaking Should be tagged.3. or mouth contamination may be anticipated 5. splatter.1 Sharps Use and Disposal • Containers for contaminated sharps shall be easily accessible to personnel and located as close as possible to the immediate area where sharps are used. transport and dispose of wastes according to federal.5. leak-proof sharps container Store.4 Incident Management Incident with loss of blood/body fluid: • • • Close off the area to prevent traffic moving through Put on personal protective equipment (minimum is disposable gloves) Clean area/work surfaces and/or equipment then disinfect with the recommended disinfectant December 2005 CAPP Guide . or droplets of blood or other potentially infectious materials may be generated and eye.3.2 Masks. The container will be maintained upright throughout use 5. provincial.2 Bodily Fluid Waste Disposal Using appropriate Personal Protection Equipment (PPE): • • • • Place all contaminated products in double garbage bags clearly marked with either a bio-hazard label or in a bio-hazard disposal bag Handle garbage as little as possible Place all sharps in a bio-hazardous labeled.Bodily Fluids Exposure Page 5 . bagged or containerized at the location where used and shall not be sorted or rinsed Should be transported in a highly visible labeled bag and cleaned by professional service provider using approved method of disinfection 5. spray.3 Contaminated Laundry • • • 5.3. such as goggles or glasses with side shields. Eye Protection • Disposable surgical masks. in combination with eye protection.3. should be worn whenever splash.

hc-sc.ca/ for post-exposure testing schedule Refer to http://www.e.pdf for post-exposure guidelines Post Exposure Reporting Employee • • Report exposure immediately to Supervisor Complete an incident investigation report form ensuring the following information is captured: − Incident description − Specific equipment involved i.6 Post Exposure Management For workers exposed to blood and body fluids • • • 6.e.gc. etc) − Eye(s) − Nose − Mouth − Personal protection used (i.gc.) − Initial treatment − Disposition Supervisor • Report exposure immediately to a qualified health professional Qualified Health Professional • Implement follow up protocol which shall have post exposure testing and post exposure follow-up December 2005 CAPP Guide .e. needle − Body surface exposed − Condition of the skin: Is the skin intact or broken? (i. gloves. cut(s). disposal surgical mask etc. needle prick. gown.Bodily Fluids Exposure Page 6 .phac-aspc.ca//publicat/ccdr-rmtc/95pdf/cdr2119e.1 Post exposure follow-up will be initiated as soon as possible after the exposure has occurred Refer to http://www.

provincial and/or federal requirements Keep records for each individual with occupational exposure as per company.7 Post Exposure Testing To be performed by qualified health professional • • • • • • • Review completed incident investigation report Obtain consent from source individual and exposed individual(s) for blood testing Document if no signed consent is received Collect all employee’s blood as soon as feasible after consent is obtained Provide results of source individual’s tests to the exposed individual(s). this may include consultation with an infection control specialist File confidential documentation in exposed individual’s health record Immediately following a report of an exposure incident. local. Anti-HBC − Hepatitis C screen – Anti HCV − HIV testing Frequency of the above tests will be determined by local. with the appropriate signed consents Inform the exposed individual about confidentiality laws in order to protect the source individual’s privacy rights Laboratory testing should include but not be limited to: − Hepatitis B screen – HbsAg. provincial and federal regulations Assess each exposure to determine prevention strategies • • • 7. the exposed individual will be given a confidential health evaluation and followup Supportive psychological counseling by a qualified professional may be required Schedule of follow-up blood testing will be dependent upon initial exposure results and shall follow local. provincial and/or federal requirements Review results and develop subsequent treatment plan.1 Post Exposure Follow-up • • • • • 8 Program Evaluation • • • • Review of overall program content Effectiveness of education and training ensuring all components are covered Data analysis to review frequency trends Safe work practices established December 2005 CAPP Guide .Bodily Fluids Exposure Page 7 .

on.htm December 2005 CAPP Guide .ca Saskatchewan: Saskatchewan Labour Health and Safety Protecting Emergency Response Workers from Infectious Diseases http://www.ipc.mb.ca/labour/ Ontario: Ontario Occupational Health and Safety Act HIV/AIDS in the Workplace http://www.ca British Columbia: Worker’s Compensation Board of British Columbia HIV/AIDS AND HEPATITIS B AND C Preventing Exposure at Work http://www.labour.sk.ccohs.ca Quebec: Act Respecting Occupational Health and Safety Regulation respecting the Quality of the Work Environment http://www.ca/safety/infectious-diseases/introduction. Canada Occupational Safety and Health Regulations Alberta: Alberta Human Resources and Employment Statutes and Regulations Workplace Health & Safety Bulletins AIDS and the Workplace Universal Precautions for Workers Who May Be Exposed to HIV Alberta First Aid Regulations http://www.worksafebc.gov.com Manitoba: Workplace Safety and Health Division Managing Exposure to Human Blood/Body Fluids Work Safe Bulletin http://www.ab.Appendix A Canada: Resources Canada Labour Code.gov.Bodily Fluids Exposure Page 8 .gov.

ns.ca/ Nunavut: The Nunavut Act states that all laws of the Northwest Territories will apply in Nunavut. and Regulatory Mechanisms Part 4 – Occupational Health and Safety Policy.nf.pe.nt.gov.php3 Yukon Occupational Health and Safety Act http://www.html Nova Scotia: Nova Scotia Offshore Petroleum Occupational Health and Safety Requirements – Draft Element 1 – Rights.yk. some will access the Occupational and Safety Act for that province. General Safety Regulations http://www. Program and Management System http://www.ca/index.ca/acts/acts/o-00-2.gov.gov.gov.htm Northwest Territories Safety Act. Prince Edward Island: Occupational Health and Safety Act http://www. Newfoundland: Occupational Health and Safety Act http://www.ca/hss/index.gov.The following websites will take you to the province’s government site.ca/labour/ New Brunswick: Occupational Health and Safety Act General Regulation http://www. Responsibilities.ca/ December 2005 CAPP Guide .cnsopb.Bodily Fluids Exposure Page 9 .nb.

and blouses) not intended to function as protection against a hazard are not considered to be Personal Protective Equipment. These pathogens include. Means human blood. A situation in which mucous membranes or the skin barrier is pierced. exposes individual to potentially infectious BF.. Any contaminated object that can penetrate the skin. broken capillary tubes. Exposure Refers to an event which. through an event such as a needle stick. Includes all bodily fluids in situations where it is difficult or impossible to differentiate between bodily fluids. that isolate or remove the blood-borne pathogen hazard from the workplace. Hepatitis B Virus Hepatitis C Virus Human Immunodeficiency Virus HBV HCV HIV Personal Protection Specialized disposable clothing or equipment worn by an Equipment individual for protection against a hazard. Pathogenic microorganisms present in humans. Any bodily fluids visibly contaminated with blood. infected BF. and abrasion. self sheathing needles).g. General work clothes (e. Hepatitis B Virus (HBV). including. but not limited to: needles. saliva. Blood Bloodborne Pathogens Broken Skin Contaminated Contaminated Sharps Engineering Controls Exposed Individual An individual. but are not limited to. pants. pleural fluid. cerebrospinal fluid. human blood components. during the course of an individual’s duties. who in the course of his/her daily duties has been exposed to potentially. shirts.Bodily Fluids Exposure Page 10 . human bite. Controls (e. but are not limited to. amniotic fluid and pus. uniforms.Appendix B Bodily Fluid (BF) Glossary Includes.. scalpels. sharps disposal containers. Describes the presence or the reasonably anticipated presence of BF on an item or surface. Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV). synovial fluid.g. broken glass. and exposed ends of dental wires. seminal secretions. and products made from human blood. vaginal secretions. cut. December 2005 CAPP Guide .

HCV.Bodily Fluids Exposure Page 11 . and other blood-borne pathogens. Universal Precautions Work Practice Controls December 2005 CAPP Guide . HIV. Controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e. prohibiting the recapping of needles).Source Individual Any individual. all blood and bodily fluids are treated as if known to be infectious for HBV. According to the concept of Universal Precautions. whose blood or other potentially infectious materials may be a source of occupational exposure to other individuals.g. An approach to infection control.. living or dead.

Blood and Body Fluid – Post Exposure Guidelines.. Quality Management Plan for Compliance with First Aid Regulation. An Integrated Protocol to Manage Health Care Workers Exposed to Bloodborne Pathogens.ca/directives/ohs/first-aid.gov.show_document?p_table=STANDARDS&p_ id=10051 Last Update: 2001-01-18 8. Canadian Center for Occupational Health and Safety. Occupational Safety and Health Administration.calgaryhealthregion. May 1997 Last Modified: 2005-09-21 7. AIDS and the Workplace.ca/oshanswers/prevention/ppe/universa. Standards – 29 CFR Bloodborne Pathogens 1910 – 1030. Administrative Manual 1998 Refer to: www. Blood and Body Fluid Post Exposure Management Standard. First Aid Regulation. http://www.gov. Alberta Occupational Health and Safety.pao.calgaryhealthregion. Calgary Regional Health Authority.Appendix C Bibliography 1. Universal Precautions for Workers Who May Be Exposed to HIV. Universal Precautions.ab.ccohs. 23S3.pdf 4. PanCanadian Petroleum Ltd.pdf 2000 2.ca/hre/whs/publications/pdf/bh003.S.worksafebc. Draft 2000 9. 2000 www3. 2000 Refer to: www.ab. Preventing Exposure at Work WorkSafe 1998 www. (AR48/2000). Health Canada. U. 1996. HIV / AIDS and Hepatitis B and C.com/publications/health_and_safety_information/by_topic/assets/pdf/hi v_aids. 1997 www. 2000 Last Update: March 2003 December 2005 CAPP Guide . Bloodborne Pathogen Exposure Standard.ca/policydb/ShowPolicy?policy_id=1478 www. Safety Bulletin BH003.gov/pls/oshaweb/owadisp.ca/policydb/ShowPolicy?policy_id=1465 5.Bodily Fluids Exposure Page 12 .html Last Updated: 2002-04-02 6. Alberta Workplace Health & Safety Bulletins. Workplace Health and Safety. Canadian Communicable Disease Report Supplement Vol. British Columbia Worker’s Compensation Board.osha.htm 3. Department of Labor.