Working Safely with Blood and Body Fluids - Guidelines

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1.0 Purpose and Scope

This guideline supports The University of Queensland’s (UQ) Health, Safety and Wellness Policy principle of empowering staff and students to take personal responsibility for their own wellbeing and the safety of others. It provides advice to UQ workers who handle, or may be exposed to human or animal blood and body fluids as part of their workplace activities at UQ or other locations.

For the purposes of this guideline, the definition of UQ workers is broad – including staff, students, visitors, volunteers and contractors – and is intended to ensure UQ meets its responsibilities under the Work Health and Safety Act 2011 (WHS Act). The definition of UQ workers is provided in the appendix.

2.0 Risk Assessment and Training

All blood and body fluids should be handled as if they are potentially infectious. This recognises that some blood borne infections do not have a vaccine available to prevent transmission of disease.

Organisational Units are responsible for managing the safety of UQ workers by maintaining an ongoing and appropriate risk identification and management process and applying safe work instructions and standard operating procedures to minimise risks associated with working with blood and body fluids. Areas with increased risk of exposure to blood-borne pathogens include, but are not limited to:

• laboratories in which blood and body fluids are handled and stored;
• clinical settings in which blood and body fluids are handled and exposure prone procedures are performed; and
• veterinary practices and field and laboratory research working with animals and animal derivatives.

Organisational Units are responsible for informing UQ workers who are working with blood and body fluids of the:

• possible routes of pathogen transmission and signs and symptoms associated with an infection for the specific pathogens likely to be carried in blood or body fluids;
• risks associated with occupational exposure to infectious pathogens that could adversely affect foetal development or maternal health during pregnancy (see Reproductive Hazard Guideline).

UQ workers are responsible for completing health and safety training and induction and other training associated with the role (e.g. UQ workers in a biological facility need to complete UQ Biosafety Training).

UQ workers that are unsure about the potential risks associated with working with blood and body fluids, or that have concerns about how to safely proceed with any tasks or activities related to their work, should seek advice from their supervisor, a UQ Biosafety Advisor or the Health, Safety and Wellness Division.

3.0 Vaccinations and screen for blood borne viruses

UQ workers handling blood and body fluids at UQ should refer to their Organisational Unit’s immunisation requirements and the Vaccinations and Immunisation Procedure and Guidelines for information on preventing the risk of vaccine-preventable disease transmission. For example: UQ workers potentially exposed to human blood, body fluids or tissue must provide evidence of immunity to hepatitis B; UQ workers who perform exposure prone procedures as a requirement of their job or placement must also be screened for hepatitis B, C and HIV infection at enrolment (dentistry students must repeat the screening in the third and fifth year of the course).

4.0 Exposure and infection control

4.1 Healthcare and clinical safety

UQ workers performing duties or placements in Queensland Health or clinical facilities where patient contact or sample handling is involved should refer to the:

Australian Guidelines for the Prevention and Control of Infection in Healthcare published by the National Health and Medical Research Council; and

Management of occupational exposure to blood and body fluids published by Queensland Health for post exposure information.

4.2 Laboratory safety

UQ workers that work with blood and body fluids in a laboratory at UQ should refer to the following guidelines outlining laboratory safety rules, including use of personal protective equipment (PPE):

Working Safely in the Laboratory Guideline;
Occupational Health and Safety in the Laboratory Guideline; and
Eye Protection Guidelines.

4.2.1 Emergency plans

Organisational Units should prepare emergency plans in consultation with the Health, Safety and Wellness Division, and with reference to UQ’s emergency procedures.

4.2.2 Safe work instructions

Organisational Units should provide safe work instructions or standard operating procedures to UQ workers in their area that includes information on the following matters.

(1) Containment of aerosols and definition of tasks required to be undertaken in biological safety cabinets and centrifuges, including: 

(a) Use of biological safety cabinets suitable for the procedures being performed.
(b) Establishment of maintenance and testing procedures for biological safety cabinets and ventilation systems, with testing and servicing at intervals of not more than one year.
(c) Use of sealed closed or sealed rotor centrifuge tubes for potentially contaminated material.

(2) Requirements for transporting biological material that is either infectious or diagnostic (contact UQ’s Biosafety Advisors and refer to Transport of Biological Materials Procedures).

(3) Personal laboratory hygiene standards including hand, hair and skin hygiene.

(4) Safe use, decontamination and sterilisation of equipment.

(5) Safe and correct disposal of contaminated items.

(6) Safe and correct disinfection and management of spills.

(7) Instrument decontamination, repair and transport.

(8) Contact details for UQ’s Biosafety Advisors and the Health, Safety and Wellness Division.

4.3 Biological hazards

UQ workers should consult a UQ Biosafety Advisor and refer to the Working with Potentially Hazardous Biologicals Procedure before working with:

• human tissue or body fluids that are known to contain microorganisms classified as risk group 2, 3 or 4 in AS-NZS 2243-3: Safety in laboratories – Microbiological safety and containment or that have not been screened for infectious disease; or
• animal tissue or body fluids that may contain zoonotic disease or have not been screened for zoonotic disease.

4.4 Health examinations and monitoring

UQ workers that work with blood or body fluids may be required to undergo initial and periodic health examinations and ongoing health monitoring, including provision of a baseline serum sample. This requirement will be dependent on outcomes of the risk assessment and facility containment level associated with the work being undertaken. UQ workers should consult a UQ Biosafety Advisor and refer to the Working in a PC3 Facility Procedure to determine requirements.

5.0 First Aid

When working with blood and body fluids, a prompt response to wounds is critical, especially cuts and needle stick injuries. Immediate referral should be made to an infectious disease specialist if the injury is high risk for HIV infection. First aid instructions should include clear contact details for professional medical practitioners and the following information:

• Bleeding should be encouraged but squeezing and rubbing the affected site should be avoided.
• Puncture wounds or cuts should be washed with soap and water.
• Splashes into the eye should be flushed using an eye wash fountain or saline with eye open for at least 30 seconds.
• If splashing to the face occurs then gentle washing and rinsing several times with water should be used for the skin, nose and mouth.

Immediately following an incident or injury, staff and students should report the incident to their supervisor and in UQSafe Incident.

6.0 Appendix

6.1 Definitions

Blood and body fluids – blood, blood products, tissue, body fluids and any derivatives that harbour the potential to transmit human or zoonotic disease.

Exposure prone procedures – any situation where there is a potentially high risk of transmission of blood borne disease from health care workers to patients during medical or dental procedures. These are usually characterised by the potential for direct contact between the skin (usually fingers and thumb) of the health care workers and sharp surgical instruments, needles, or sharp tissues (spicules of bone or teeth) in body cavities or in poorly visualised or confined body sites, including the mouth.

Invasive surgical procedure – any surgical entry into tissue, body cavities or organs, or repair of traumatic injury.

Organisational Unit – a formal grouping of staff established to conduct a discrete set of activities within a functional area of UQ.

UQ workers – for the purposes of this procedure includes:

• staff - continuing, fixed-term, research (contingent funded) and casual staff;
• contractors, subcontractors and consultants;
• visiting academics and researchers;
• affiliates - academic title holders, visiting academics, emeritus professors, adjunct and honorary title holders, industry fellows and conjoint appointments;
• higher degree by research students; and
• volunteers and students undertaking work experience.

Zoonotic disease – an infectious disease that can be passed between animals and humans.

Director, Health, Safety and Wellness Mr Jim Carmichael
Director, Health, Safety and Wellness Mr Jim Carmichael