Most accidental exposures to human blood and body fluid are avoidable.
People who work with human blood and body fluids in combination with needles, syringes and other sharp instruments are known to be at increased risk of exposure to blood borne viruses such hepatitis B, hepatitis C and HIV. Treatment of these infections is not always successful and hence emphasis must remain on PREVENTION. This can be achieved by the use of suitable engineering controls i.e. appropriate safety cabinets, operating a no sharps policy and /or by adhering to the following safe working practices:
A vaccine is available to protect against Hepatitis B infection but there are no vaccines available to protect against infection with either Hepatitis C or HIV. Hence the importance that every effort is made by staff and managers to avoid accidental exposures.
3.1 An accidental exposure is defined as:
Puncture or break of the skin with a sharp object such a needle or a blade which has been contaminated by blood or other body fluid such plasma or cerebrospinal fluid
Splash into the eye, mouth or on to broken skin with blood or other body fluid such plasma or cerebrospinal fluid
3.2 The recipient is defined as:
The person who has had an accidental exposure
3.3 The donor is defined as:
The person whose blood or body fluid is the source of the accidental exposure
The blood sample/vial which is the source of the accidental exposure
3.4 Infectivity status of the donor
This is defined as whether the donor sample is known to be infected with Hepatitis B, Hepatitis C and/or HIV or not.
3.5 Immune status of the recipient
This is defined as whether the recipient is known to have been successfully immunised against Hepatitis B i.e. antibody levels against Hepatitis B have been measured as greater than 100 IU/L following a course of immunisation with Hepatitis B vaccine and a vaccination booster has been given within the last 5 years.
4.1 Immediate first aid
If the skin has been scratched or punctured then squeeze the wound to make it bleed and wash under running water.
DO NOT SUCK THE WOUND
If a person has had a splash into the eye then the eye should be irrigated with water as soon as possible and for several minutes.
If a person has a splash into the mouth then they should rinse their mouth out with water several times and spit it out. Do not swallow the water.
4.2 Report incident to manager
If the person is working alone or their manager/ DSO is not available then this step can be done at a later stage.
4.3 Obtain donor details
Details and the known infectivity status of the donor blood or body fluid should be noted. As stated in 3.4 above, this is defined as whether the donor sample is known to be infected with Hepatitis B, Hepatitis C and/or HIV or not. I.e. is the infectivity status of the sample unknown or known.
4.4 Attend for a risk assessment of the exposure as soon as possible:
Upon arriving at the A&E department make it clear to the triage nurse that you have had an accidental exposure to human blood or body fluids at UCL. Make it clear to the nurse whether it has been a sharps injury or a splash exposure into the eye, mouth or on to broken skin.
A&E staff will perform a risk assessment of the exposure and advise accordingly.
How the incident is managed will depend upon 3 factors:
1. The severity of the exposure
2. The immune status of the recipient
3. The infectivity status of the donor
Everyone who has sustained an accidental exposure to human blood or body fluid MUST make an appointment with UCL Occupational Health as soon as possible after the initial assessment.
The Occupational Health Adviser will then organise the appropriate follow up for the recipient.
UCL Accident and Incident report form available here.