Workplace Blood Incidents: OSHA Bloodborne Basics

Blood incidents happen in almost every kind of workplace: a warehouse injury, a fall in a retail store, a fight in a bar, a medical emergency in an office. Employers often discover after the fact that they are unsure who should clean up, what the rules are, and what to do if an employee was exposed. This guide summarizes the federal basics. It is general information, not legal advice, and some states run their own OSHA-approved plans with standards at least as effective as federal rules.

Who the standard covers

The Bloodborne Pathogens standard applies to employers with employees who have occupational exposure, meaning reasonably anticipated skin, eye, mucous membrane or parenteral contact with blood or other potentially infectious materials as a result of performing their duties. Healthcare is the obvious example, but OSHA also identifies first responders and some housekeeping staff among at-risk workers. Employers in other industries may have covered employees if part of someone's job is first aid response, cleanup of blood, or handling contaminated items.

Federal OSHA covers most private-sector employers and federal agencies. States with OSHA-approved plans cover their own state and local government employees and adopt standards at least as effective as the federal standard.

What covered employers must do

Written exposure control plan

Covered employers must have a written exposure control plan that identifies job classifications and tasks with exposure and describes how the employer protects workers. OSHA requires the plan to be reviewed and updated at least annually and when tasks or positions change.

Engineering and work practice controls

These reduce exposure at the source: sharps disposal containers, safer devices, handwashing facilities, and rules such as not eating or drinking in contaminated areas.

Personal protective equipment

Where exposure remains, the employer must provide appropriate PPE, such as gloves, gowns, face and eye protection, at no cost to the employee, and ensure it is used. See our guide on PPE in biohazard cleanup.

Hepatitis B vaccination

The vaccine must be made available at no cost to employees with occupational exposure, within 10 working days of initial assignment and after required training. Employees may decline, which must be documented.

Training

Covered employees must be trained at initial assignment to tasks with exposure, and at least annually after that.

Housekeeping and waste

Contaminated work surfaces must be decontaminated with an appropriate disinfectant. OSHA has pointed to EPA-registered tuberculocidal disinfectants and properly diluted household bleach as appropriate options. Items saturated with blood are regulated waste and must be contained, labeled or color-coded, and disposed of under applicable federal, state and local rules. See our guide on regulated medical waste.

Post-exposure evaluation and follow-up

If an employee has an exposure incident, the employer must provide a confidential medical evaluation and follow-up.

Records

Training and medical records must be kept, and employers who must keep OSHA injury logs must also keep a sharps injury log.

When a blood incident happens

1. Care for the injured person. Call 911 for serious injuries. Trained first aid responders should use gloves and other PPE.
2. Isolate the area. Block it off and keep employees and customers away.
3. Decide who cleans. Only employees covered by your exposure control plan, trained and equipped, should clean blood. Everyone else should stay clear.
4. Bring in a professional for larger incidents. Blood that soaked into carpet, furniture or ceiling tiles, spread across a large area, or resulted from a death or violent incident usually calls for a professional biohazard company.
5. Handle any exposure. If an employee contacted blood with broken skin, eyes, nose or mouth, or had a needlestick, they should wash or flush the area and the employer should start post-exposure evaluation right away.
6. Document. Record what happened, who was involved, how it was cleaned, and any exposures, keeping medical information confidential.

Using an outside cleanup company

When you hire a biohazard cleanup company, that company is the employer of its technicians and is responsible for its own bloodborne pathogens program. OSHA has stated that the standard applies to cleaning company employees who clean up blood after deaths and violent events. Ask vendors to confirm they maintain a program, carry appropriate insurance, and will provide a written scope and completion summary. Our guide on setting up a vendor in advance covers this.

Building a simple incident kit

Many workplaces keep a first aid kit but no way to deal with what is left after the injured person is cared for. A basic bodily fluid kit for trained staff usually includes disposable gloves in several sizes, eye and face protection, an absorbent, disposable towels, a scoop or scraper for broken glass, leak-resistant bags labeled or color-coded for regulated waste, an appropriate disinfectant, and a copy of your procedure. Keep kits where incidents are most likely, check them on a schedule, and replace used items right away. A kit is only useful for the small spills your plan covers; it does not replace professional cleanup for larger events.

Common gaps employers discover

• Janitorial staff expected to clean blood without being included in an exposure control plan
• No sharps containers in restrooms where needles have been found before
• First aid kits without gloves or with gloves that are too small
• No plan for after-hours incidents
• Blood-soaked materials put in regular dumpsters
• Exposures not reported because employees did not know they should

Workplace deaths and violent incidents

After a death or violent event at work, the area may be held by police. Cleanup can begin only after release. Employees who witnessed the event may need support; many employers offer an employee assistance program. Fatalities and certain serious injuries must also be reported to OSHA within set time frames.

When to call a professional

Call a professional when blood or bodily fluids go beyond a small, contained spill your trained staff can handle, when porous materials are involved, or after any death or violent incident. New Dawn Bio Restoration provides a written scope before work begins and a written summary when complete. Contact us or call 615-914-0790, and please confirm availability for your location.

Related services

• Blood cleanup

  Removal and disinfection of blood and the materials it has soaked into, whether the spill is small or large, recent or days old.

• Commercial and workplace biohazard cleanup

  Biohazard cleanup for offices, retail stores, restaurants, warehouses and other workplaces, planned around staff safety and operations.

Related guides

• Property Manager Guide: Setting Up a Biohazard Cleanup Vendor Before You Need One

  Setting up a biohazard cleanup vendor in advance means collecting the vendor's insurance certificates, W-9 and service agreement, agreeing on how scopes, pricin

• How Regulated Medical Waste Differs From Ordinary Trash

  Regulated medical waste is waste that may be contaminated with blood, bodily fluids or other potentially infectious material, such as blood-saturated materials

• What Personal Protective Equipment Do Biohazard Cleanup Professionals Use, and Why?

  Biohazard cleanup technicians typically wear disposable gloves, often doubled, fluid-resistant coveralls, shoe covers, eye and face protection, and a respirator