• Section 1910.1030 requires universal precautions, which refers to treating all blood and OPIM as though it’s infectious.
• Two alternative infection control methods, BSI and standard precautions, are stricter than universal precautions and thus acceptable to OSHA.

Universal precautions is an approach to infection control under which all human blood and other potentially infectious materials (OPIM) are treated as if known to be infectious for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and other bloodborne pathogens.

Universal precautions treat all people in the workplace the same way, removing any reason to speculate about anyone’s infection or risk status. If an employer has a policy of treating the blood or OPIM of some patients as potentially infectious and the blood or OPIM of others (e.g., the elderly or children) as not infectious, this is an Occupational Safety and Health Administration (OSHA) violation.

Universal precautions are to be observed in all situations where there is a potential for contact with blood or OPIM, whether or not this contact arises as part of a job duty. This is similar to an approach that is followed in hospitals and other healthcare facilities. If it’s difficult or impossible to differentiate between body fluid types, all body fluids are to be considered potentially infectious, and universal precautions must be observed.

Two alternative concepts in infection control, body substance isolation (BSI) and standard precautions, are discussed below. These concepts are acceptable alternatives to universal precautions, provided that facilities using them fulfill all other requirements of the Bloodborne Pathogens Standard.

Implementing universal precautions

Paragraph (d) of the Bloodborne Pathogens Standard sets forth the method by which employers must protect their employees from the hazards of bloodborne pathogens and comply with 1910.1030 through the use of universal precautions, engineering controls, work practice controls, personal protective equipment (PPE), proper housekeeping, and handling of regulated waste.

Body substance isolation

One alternative to universal precautions is called body substance isolation (BSI). This is an infection control method that defines all body fluids and substances as infectious, not just blood and OPIM as in the Bloodborne Pathogens Standard.

BSI is an acceptable alternative to universal precautions as long as facilities adhere to all other provisions of 1910.1030.

Standard precautions

Another alternative to universal precautions is known as standard precautions. This term refers to the minimum infection prevention measures that apply to all patient care, regardless of the suspected or confirmed infection status of a patient, in any setting where healthcare is delivered.

Standard precautions include:

• Hand hygiene,
• PPE,
• Respiratory hygiene and cough etiquette,
• Safe injection practices, and
• Safe handling of potentially contaminated equipment or surfaces.

For the Centers for Disease Control and Prevention (CDC), standard precautions have replaced earlier guidance relating to universal precautions and BSI. Standard precautions are more stringent than universal precautions and are therefore acceptable to OSHA. However, OSHA currently only requires universal precautions.