Occupational Health, Bloodborne Pathogens, and Healthcare Worker Safety
Occupational health and bloodborne pathogen questions test OSHA requirements, exposure management, and work restrictions. Expect the Bloodborne Pathogens Standard, hepatitis B vaccination, post-exposure prophylaxis, sharps safety, respirator fit testing, and TB screening.
Core rules
- OSHA 29 CFR 1910.1030 requires a written exposure control plan, reviewed annually; engineering controls (safer sharps, sharps containers); work practice controls; PPE; hepatitis B vaccination offered within 10 working days of assignment at no cost; post-exposure evaluation and follow-up; labels; training at initial assignment and annually; and recordkeeping.
- Exposure control plan must list job classifications and tasks with exposure risk, and describe procedures for exposure incidents.
- Post-exposure: wash needlestick/sharps site with soap and water; flush mucous membranes; report immediately; source patient testing with consent per law; HIV PEP started as soon as possible, ideally within hours, for high-risk exposures; hepatitis B immune globulin and vaccine if nonimmune; HCV baseline and follow-up.
- Sharps: do not recap, bend, or break needles; use safety-engineered devices; activate safety feature; dispose immediately in puncture-resistant container at point of use.
- PPE: gloves, gowns, masks, eye protection; remove without contaminating skin; perform hand hygiene.
- Respirator: fit test annually and whenever facial changes; medical evaluation before use; N95 for TB/airborne.
- TB screening: baseline and annual for healthcare workers with risk; symptom screening; IGRA or TST.
- Work restrictions: exclude staff with active TB, varicella, measles, mumps, rubella, pertussis, and certain diarrheal illnesses; follow employee health.
Worked example
A nurse sustains a needlestick from a patient with unknown HIV status. The nurse washes the site with soap and water, reports within minutes, and employee health evaluates. Source testing is requested under state law. HIV PEP is most effective when started within hours and no later than 72 hours; the regimen is chosen with an HIV specialist. Baseline HIV testing is done, and follow-up testing is scheduled. The exposure is logged and the device is evaluated for sharps safety.
Traps
Do not squeeze or scrub a needlestick. Do not delay HIV PEP while waiting for all results. Do not assume hepatitis B vaccination guarantees immunity-check titers for high-risk staff. Do not confuse respirator fit testing with user seal check.