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Massage therapists Cosmetologists and Aestheticians are not at great risk for occupational exposure to blood borne pathogens. Because of our work with the human body it is important that the basics of the Blood borne Pathogen standard and Universal precautions as set forth by the Center for Disease Control and the Occupational and Safety Health Administration are reviewed and understood.

Common blood borne pathogens include hepatitis B, hepatitis C, syphilis, malaria, and human immunodeficiency virus (HIV). Blood borne pathogens are very small , so small you can’t see them without a microscope. Blood borne viruses live in certain body fluids like blood, semen, vaginal fluids. You can only get these diseases if you get someone’s infected body fluids into your body. Things can get into your body through cuts, scrapes, your eyes, nose and mouth and sexual intercourse. You can’t tell by looking at people if they have an infectious virus or not, so it is best to assume that anyone could have it.

Since routine testing, medical history, and examination cannot reliably identify individuals who are infected with blood borne pathogens (bbp), it is imperative that consistent controls be in place to prevent the spread of blood borne infections. Based on recommendations from the CDC and OSHA regulations, clinicians should adapt to the following Universal Precaution guidelines, as applicable to the job guidelines.

The basic Principles of Universal Precautions include:

  1. Assume that all individuals you have contact with as a result of job responsibilities, are potential carriers for blood born pathogens (BBP).
  2. Assume that all blood and other potentially infectious material (OPIM: human blood , semen, vaginal secretions, wound drainage, fluids visibly contaminated with blood, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, unfixed tissue or organs, and any body fluids in situations where it is difficult or impossible to differentiate between body fluids are infectious for bbp and must be treated as infectious.
  3. Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomitus unless they contain visible blood. Universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictable
  4. Vomit, feces, urine, saliva, and tears can not transmit bloodborne pathogens. They may contain other infectious agents. To be safe, treat with basic infection control and body substance isolation. Body Substance Isolation is similar to universal precautions except that it involves all body fluids.
  5. Avoid contact whenever possible with a client’s blood, body fluid or any areas of local infection.
  6. Do not eat, drink, smoke, handle contact lenses, or apply make-up without washing hands first.
  7. A group of approaches (Universal Precautions) is more effective than any one approach to preventing the spread of bbp.
  8. Gloves: Non sterile disposable vinyl or latex gloves shall be worn and changed when: (a) handling any items (e.g. laundry, dressings, clothing) that are contaminated with another person’s blood or OPIM. (b) Providing care involving potential contact with blood, OPIM, mucous membranes or non-intact skin. (c) Providing care involving potential contact with all body fluids (Note: this is basic infection control and body substance isolation, not universal precautions).
  9. Practitioners should keep open wounds or inflamed dermatitis covered whenever possible while working. Gloves should be worn by bodyworker’s who have sores, cuts, or a rash on their hands and are providing care to individuals. Vinyl gloves are preferred because of the high rate of allergies to latex products and because oils break down latex gloves very quickly making them permeable. Clients should be encouraged to keep wounds or inflamed dermatitis covered.
  10. Handwashing: Routinely and effectively was hands at least before and after glove use; at the start and end of the work shift; before and after use of bathrooms; after any personal hygiene; before and after every session; and after touching any objects that are likely to be contaminated. Handwashing and skin washing should be done immediately if blood or OPIM gets on intact or broken skin. Proper handwashing includes warm running water, soap, friction, proper nail care and proper technique. Hand sanitizers can be used as an intermittent substitute for proper handwashing but they do not completely replace it.
  11. Vacination for Hepatitis B: Hepatitis B Vaccination is a relatively risk free means of greatly reducing the potential for infection with the hepatitis B virus. The Vaccination is given as a series of three injections over a six-month period. People at risk for exposure to hepatitis B should consult with their health care provider about receiving the hepatitis B vaccination. Most bodyworkers will be considered low risk for potential exposure to the hepatitis B virus. The hepatitis B vaccination does not offer immunity to other hepatitis viruses such as hepatitis A or hepatitis C.
  12. Laundry: All potentially contaminated laundry should be handled minimally. It should not be sorted or rinsed as these activities increase the risk of exposure. Linens and towels must be changed between each client. Dirty linens should be stored in a separate, closed container away from clean linens until washed. Machine washing & drying with soap and hot water will clean laundry. Do not let oily sheets sit for long period. Oils and some lotions will go rancid on sheets and make them smell. Stored oily sheets have also been known to spontaneously combust.
  13. Housekeeping: (a) sharp items (needles, lancets, glass, etc.) should be treated as if infected. Disposable sharps should be placed in a puncture resistant, labeled container. (b) Keep a clean work environment. (c) broken glass should never be handled by hand. Use a mechanical device such as a dustpan and broom or tongs. (d) When environmental work surfaces become contaminated with blood or OPIM immediately secure the area, disinfect the area, and clean the area. (Bleach and water is considered the most universal disinfectant, otherwise read labels., 1 part Bleach to 9 parts water, mixed as needed, do not store overnight.) (e) Double bag and label any contaminated waste before proper disposal. (f) Clean and disinfect all equipment: massage table, mechanical massage devices, face cradles, bolsters, oil/lotion bottles, etc. between clients. (g) Use germicidal cleaners, diluted beach, rubbing alcohol for routine disinfecting of equipment.
  14. Personal Protective Equipment (PPE): (a) When there is anticipated potential of exposure to blood/OPIM PPE must be used. The most common piece of PPE is gloves. Other types of PPE may include gowns, goggles, face shield, masks, and CPR Micro shields. (b) The rule of thumb for PPE is dress for the occasion. Use the right equipment for the right potential situation. Massage therapists and bodyworkers should always have gloves (vinyl or latex) and CPR micro shields available in their work area for potential emergencies.
  15. Post Exposure: Anytime someone else’s blood or OPIM gets into your body (puncture, mucous membranes, open areas, etc.) in a work situation, report and follow the procedure of the employer and seek medical follow up immediately.


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