• The Bloodborne Pathogens Standard includes 28 terms in its key definitions.

Although the Bloodborne Pathogens Standard is far from new, it continues to confuse employers. The standard defines 28 terms in its definitions paragraph at 1910.1030(b), and the use of these terms can be challenging. Some of the definitions are explained in Occupational Safety and Health Administration (OSHA) directive CPL 02-02-069 for clarification.

Blood: Human blood, human blood components, and products made from human blood. Animal blood is not covered under this definition.

OSHA gives the following examples of human blood components:

• Plasma,
• Platelets,
• Serosanguineous fluids (containing both blood and blood serum),
• Immune globulins,
• Albumin (a protein found in blood serum), and
• Factors VIII and IX.

Bloodborne pathogens: Microorganisms that are present in human blood and can cause disease in humans. These include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

While HBV and HIV are specifically mentioned in the standard, the term includes any microorganism that is present in human blood and can cause disease in people who are exposed to blood containing the pathogen. CPL 02-02-069 lists 15 diseases related to bloodborne pathogens.

Contaminated: Having the presence or the reasonably anticipated presence of blood or other potentially infectious materials (OPIM) on an item or surface.

Contaminated items or surfaces can expose employees to blood or OPIM. If an employee has a cut or wound and the employee’s personal protective equipment (PPE) allows a contaminant to permeate through it or has even a pinhole, the bloodborne pathogen has a direct path into the body. Therefore, the goal is to keep contamination levels as low as possible.

Contaminated sharps: Any contaminated objects that can penetrate the skin, including but not limited to needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires.

When blades such as box cutters, razor blades, and knives are contaminated, these are also considered contaminated sharps.

An exposure incident: A specific eye, mouth, other mucous membrane, non-intact skin, or parenteral (piercing the skin or mucous membranes) contact with blood or other potentially infectious material (OPIM) that results from the performance of an employee’s duties.

Mucous membranes include the eye and inside the nose and mouth. Blood or OPIM that splatters into a worker’s eye, nose, or mouth is considered an exposure incident.

Non-intact skin includes skin with damage such as rashes, hangnails, cuts, abrasions, and chafing.

An exposure incident requires actual contact with blood and OPIM that results from the performance of an employee’s duties (as opposed to occupational exposure, which refers to reasonably anticipated contact). Examples of exposure incidents include

• A puncture from a contaminated sharp,
• An emergency responder getting blood or OPIM in a cut or in the mouth while administering first aid or cardiopulmonary resuscitation (CPR) to an injured employee, and
• Maintenance or janitorial personnel getting blood or OPIM in a cut or open sore while cleaning up a blood or OPIM spill.

Occupational exposure: Reasonably anticipated skin, eye, mucous membrane, or parenteral (piercing the skin or mucous membranes) contact with blood or other potentially infectious materials (OPIM) that may result from the performance of an employee’s duties.

An office worker wouldn’t reasonably anticipate having contact with blood or OPIM. However, if that worker is assigned to perform first aid involving blood-related injuries of coworkers, that counts as occupational exposure. Job duties don’t need to be healthcare-related to be covered. A good Samaritan who helps someone out of kindness rather than as a work duty doesn’t have occupational exposure.

Other potentially infectious materials (OPIM):

• Semen;
• Vaginal secretions;
• The fluids in and around the brain, spine, joints, lungs, heart, and abdominal organs;
• Amniotic fluid;
• Saliva, only in the context of dental procedures;
• Any body fluid that’s visibly contaminated with blood; and
• All body fluids when it’s difficult or not possible to tell them apart.

Only certain body fluids are considered OPIM. Others, like urine, vomit, feces, nasal secretions, phlegm, sweat, and tears, may be unpleasant to encounter in a work environment but aren’t efficient modes of transmission for bloodborne pathogens. However, if any body fluid is visibly contaminated with blood, it counts as OPIM.

OPIM also includes any “unfixed” tissue or organ (other than intact skin) from a human (living or dead). While OSHA does not define the term unfixed, it would be the opposite of fixed.

The term fixed is not OSHA-defined but generally understood as being rendered not potentially infectious for bloodborne pathogens. Often, but not always, a fixed status may be achieved by preserving the tissue or organ in a preservative substance, health sources say.

Any substance that contains HIV or HBV also counts as OPIM, including:

• Cell, tissue, and organ cultures;
• Culture medium or other solutions; and
• Blood, organs, and other tissues from experimental animals.

Parenteral contact: Piercing mucous membranes or the skin barrier, such as with needlesticks, cuts, abrasions, or human bites.

Regulated waste: Refers to the following five types of waste:

• Liquid or semi-liquid blood or other potentially infectious materials (OPIM),
• Contaminated items that would release liquid or semi-liquid blood or OPIM if compressed,
• Items that are caked with dried blood or OPIM and could release these materials during handling,
• Contaminated sharps, and
• Pathological and microbiological waste containing blood or OPIM.

If waste doesn’t fit into any of these categories, it’s not regulated waste. Some items only count as regulated waste if they can release OPIM, but under no circumstances should a bag of waste be squeezed or shaken to determine if it is regulated.

It’s not useful to specify an amount of blood as a determining factor because the same amount acts very differently depending on its location. Just as an example, 10 milliliters of blood on a bedsheet would appear as a spot (and not be regulated waste), while the same amount on a cotton ball would drip (and would be regulated waste).

In most cases, bandages, facial tissue, and feminine hygiene products would not be considered regulated waste. That’s because these are intended to absorb the blood, so it’s no longer in a liquid or semi-liquid state and wouldn’t be released.

While contaminated sharps are regulated waste, if a sharp is not contaminated with blood or OPIM, it is not regulated waste. Box cutter blades that are not contaminated are not regulated waste.