Assessment of blood-splash exposures of medical-waste treatment workers

The authors estimate that more than 10,000 workers process more than 3.5 mi llion tons of medical waste in the United States each year, both on site at health care establishments and off site at commercial treatment facilities . As part of a study recently conducted to assess engineering controls and to define bioaerosol, chemical, and safety hazards to workers, this report discusses potential exposure to bloodborne pathogens from blood splashes. P otential exposure to blood splashes was assessed during the manual dumping of medical waste at three commercial facilities where waste is handled exte nsively. At each facility, tubs of biohazardous waste 32 gallons or smaller were man ually dumped into larger containers for subsequent treatment. All workers i nvolved in dumping containers of loose and bagged waste wore cotton pads in special holders pinned to the front and back of the upper torso. At the en d of each shift the pads were visually assessed, A sensitive and rapid dete ction method, performed on site, was used to test for hemoglobin, At two of the facilities, wipes were also taken of face shields or goggles, as well as of various surfaces with which workers typically would come into contact . Samples were extracted in sterile buffer and were tested for hemoglobin. This method yielded semiquantitative results. Splashes were evaluated over two days at each facility Blood splashes were confirmed on 11 of 128 upper-torso samples (eight percent), four of 18 eye or face protectors (22 percent), and 61 of 96 process area surfaces (64 per cent). The authors stress the importance of adherence to all requirements o f the OSHA Bloodborne Pathogens Standard, engineering controls to minimize manual waste dumping, and enforcement of the use of proper protective cloth ing and face shields.