• Aims of the policy
• Introduction
• Definitions
• What the staff member should do
• Ring occupational health
• Complete incident form
• Summary

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Aims of the policy

• To protect people from infection from blood borne viruses during their work, as far as is possible.
• To enable UCL, through the reporting procedure, to establish the incidence and prevalence of accidental exposures to human blood and body fluid and to define what measures are required to reduce the risk of these incidents.

2.0 Introduction

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 high level of awareness of the risks involved with working with blood, body fluids and sharps
• A high level of awareness of how to prevent accidental exposures
  • handling of sharps must be kept to a minimum
  • sharps must not be passed directly from hand to hand
  • needles must not be bent or broken before use or before disposal
  • needles and syringes must not be separated before disposal
  • needles must not be recapped after use
  • suitable protective clothing must be worn), including eye and mouth protection if necessary, at all times when handling human blood and body fluids. This should supplement, not replace, protective equipment such as safety cabinets
  • exposed cuts or abrasions of the skin must be covered with a waterproof dressing or plaster
• Prompt first aid action in the event of an accidental exposure

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.

3.0 Definitions

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
or
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
or
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.

4.0 What the person should do if he/she has an accidental exposure to human blood or body fluids at work

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:

• Bloomsbury Campus - UCLH Accident and Emergency Department
• Hampstead Campus - Call ‘needle stick hotline’ on 020 7794 3301
• Archway Campus - Whittington Accident and Emergency Department
• Post Graduate Institutes at sites other than above - follow local NHS Trust Procedure

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

5.0 Ring UCL Occupational Health Service tel: 0207 679 2802 (internal 32802)

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.

6.0 Complete a UCL Accident and Incident report form as soon as possible after the accidental exposure and return it to UCL Safety Services.

UCL Accident and Incident report form available here.

7.0 SUMMARY of what a person should do following an accidental exposure to human blood or body fluids

1. FIRST AID
2. REPORT INCIDENT TO MANAGER (if available)
3. OBTAIN DONOR DETAILS: I.e. note whether the infectivity of the sample is KNOWN or UNKNOWN
4. ATTEND FOR IMMEDIATE ASSESSMENT OF EXPOSURE AS STATED IN POINT 4.4 ABOVE
5. RING OCCUPATIONAL HEALTH 0207 679 2802 (INTERNAL 32802) TO MAKE AN APPOINTMENT WITH AN OCCUPATIONAL HEALTH ADVISER
6. COMPLETE UCL ACCIDENT AND INCIDENT REPORT FORM

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