Universal Precautions for the professional cleaner

The Center for Disease Control (CDC) sets standards for "Universal blood and body-fluid precautions" or "universal precautions." It does so to help prevent human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens in health-care settings. Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious for HIV, HBV and other bloodborne pathogens.

Because these standards are expected to work in the healthcare environment, we use them in the trauma cleanup environment.

When thinking about “universal,” think that it includes ANYTHING which might contain human blood. Among ANYTHING are blood, cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids. Semen and vaginal secretions belong to the list of ANYTHING that might contain blood. In trauma cleaning, expect that these fluids will be present while working on a death scene. If the scene is moist, consider that it is deadly dangerous. Getting stuck, splashed, or splattered on the eyes, nose, mouth, or open wounds is an “exposure.”

Treat an exposure as an emergency. Stop everything and go to an emergency room. This is part of the protocol for Universal Precautions.

How dangerous is an exposure to the eyes, nose, mouth, or open wounds?

It would be irresponsible to try to quantify a level of hazard for such exposures. Every person, every situation is different. What I can say is that these types of exposures pale in comparison to needle stick incidents.

So visible blood is dangerous in this way of thinking. Whether blood or body fluids, treat it like it is a pathogen.

What is the most dangerous of all while cleaning?

Needle stick is the most deadly injury known for transferring pathogens; Hollow-core needles used for injecting medication and drugs have the highest known incidence of causing illness. Needless to say, when working a death scene where needles may be found, work slowly. Needless to say, professional cleaners are at less risk than nurses, doctors, and other medical personnel.

Still, injecting pathogens might also occur from broken glass, bed springs, and other pointed, sharp objects, which professional cleaners work around every day on the job.

Not all secretions require universal precautions, unless they contain visible blood:

Feces
Nasal secretions
Sputum
Sweat
Tears
Urine
Vomitus

Visible blood in anything requires the use of protective barriers. These barriers include gloves, gowns, aprons, masks or protective eye-wear. They must reduce the risk of an exposure.

Gloves should be worn for touching blood and body fluids. If blood might come into contact with your mucous membranes, or non-intact skin (open sores or scabs), wear gloves and bandages. A full-body protection suite with gloves and full-face respirator is often required. We call this PPE for “personal protective equipment.”

Gloves should be changed often and disposed of as bio-waste when they have had contact with blood. If they have been used to clean a bloody scene, but have had no blood contact, dispose of them as solid waste.

Hands should be washed immediately after gloves are removed.

For information about the Occupational Safety and Health Administration (OSHA) proposed rule on occupational exposure to bloodborne pathogens, call 202-523-7157. The last time I called this number it did not work. It is all that I have at this writing.