Protecting School Employees
Against HIV Infection
What steps should the Department of Education be taking to protect school employees against exposure to HIV?
The Bloodborne Pathogen Standard adopted by the federal Occupational Safety
and Health Administration in December 1991 requires that every employer develop
a plan to prevent or reduce workers’ exposure to bloodborne pathogens
(germs) including HIV and the hepatitis B and C viruses.
For Department of Education
employees, the Bloodborne Pathogen Standard is enforced by the New York State
Department of Labor through PESH, the Public Employee Safety and Health Program.
The OSHA/PESH Bloodborne Pathogen Standard was adopted after strong pressure
by the UFT, the American Federation of Teachers and many other unions throughout
the country.
What does PESH require for bloodborne pathogen control?
Every public employer must:
• Identify all employees whose work can be reasonably anticipated to
involve contact with blood and other potentially infectious bodily fluids.
• Provide those employees with annual training in safe work practices,
all necessary personal protective equipment (such as disposable gloves) and
the opportunity to take the hepatitis B vaccine at employer expense.
• Provide for confidential medical counseling and testing for any employee
who sustains a significant exposure to blood or body fluids at work, as well
as treatment to prevent hepatitis B, if appropriate.
Has the Department of Education implemented the PESH requirements for bloodborne pathogen control?
Unfortunately, as of this printing (July 1995), the DOE has not yet
developed its exposure control plan, which should have been completed by
November 1992. Bloodborne pathogen control was placed on the back burner
while the DOE dealt with asbestos and lead and developed a tuberculosis
control plan.
At UFT insistence, however, the DOE began the planning process for bloodborne
pathogen control late in 1994 and has identified the categories of school
employees who face routine exposure to blood. Designated employees include
those who administer first aid; work with students who need medical care;
work with students who need bathroom care; work in medical or dental offices;
perform custodial duties that involve cleaning blood or body fluids; function
as peace officers; and those who handle regulated waste. Only these routinely
exposed staff will be offered the hepatitis B vaccine, but the DOE plans
to provide training and personal protective equipment for every school
employee since any staff member could be exposed to blood through an accident
or incident involving a blood spill.
At press time, no schedule had been established for implementing this program.
What is the UFT doing to address the DOE ’s failure to implement an exposure control plan for bloodborne pathogens?
As a result of steady pressure by the UFT, the DOE has finally begun
the planning process, but that is not enough. To ensure full compliance with
the PESH standard, the UFT has filed a formal PESH complaint with the New
York State Department of Labor. At press time, the Labor Department had informed
the union that it intended to cite the DOE for non-compliance.
In addition, the union has been providing its own workshops in self-protection
for employees whose jobs entail routine exposure to blood. Contact your UFT
district representative if you are interested in such training.
What can I do to protect myself without waiting for the Department of Education to act?
The best way to protect yourself against exposure to the HIV virus and
other bloodborne pathogens like hepatitis B is to follow the “universal
precautions” described below.
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Universal precautions involve:
1) Treating ALL blood and potentially infectious body fluids (semen and vaginal
secretions) as if they are contaminanted with the HIV virus or other bloodborne
pathogens.
It is necessary to assume that all blood and body fluids are contaminated because
there is no way to tell by looking at a child or adult whether he or she is infected
with the HIV virus or other bloodborne pathogens. Many people infected with HIV
have no symptoms and may not themselves know that they are infected.
2) Following the safety procedures listed here whenever there is a risk of exposure
to blood or other body fluids:
• Wear disposable gloves and other protective equipment when performing
routine tasks that involve risk of exposure. Principals must make gloves available
to all staff.
• In an accident or situation where no gloves are available, place another
barrier (such as a paper towel or article of clothing) between yourself and the
blood or body fluid.
• Notify the custodian if there is a blood spill. Custodial staff should
use a hospital disinfectant or a solution of one part bleach and 10 parts water
to clean up blood spills and disinfect potentially contaminated surfaces.
• Pick up potentially contaminated sharp objects—such as needles,
knives, razor blades, box cutters and broken glass—with a tool such as
a pliers or tweezers. Never pick up such objects with your hands.
• Discard any articles contaminated with blood or body fluids in a leak-resistant
container such as a plastic bag sealed inside another plastic bag. If possible,
put sharp objects in a puncture-proof container, before double-bagging them,
so they won’t injure anyone handling the waste bag. (When the DOE implements
the Bloodborne Pathogen Standard it should supply special containers for blood-contaminated
waste and establish appropriate disposal procedures.)
• When you are ready to remove your gloves, turn them inside out as you
do so to avoid contact with blood. Discard gloves in a leak-resistant container,
such as a double plastic bag.
• Use soap and warm water to thoroughly wash hands and any skin that may
have been contaminated. Flush with water any mucous membranes (eyes, nose, mouth)
that may have come in contact with blood or body fluids.
• School nurses should follow special procedures mandated in the OSHA/PESH
Bloodborne Pathogen Standard for giving injections and handling needles.
First you told me the risk of exposure to HIV at school was very low. Then you scared me by telling me to follow these special procedures. I’m confused.
The risk of contracting HIV is low, even when there is a major blood spill. But there is no reason to take any risks. Universal precautions are easy to follow and will provide an extra margin of safety against HIV as well as hepatitis B which is much more contagious than HIV.
How can I get more information about universal precautions?
If you have questions about the procedures described here, you can call the UFT’s HIV/AIDS resource specialists.
The American Federation of Teachers, the UFT’s national affiliate, has
a video called It’s Up to You that is designed for school staff—particularly
those working with children with special needs. It shows how to handle everything
from blood spills to toileting and diapering. If you want to see the video, ask
your UFT district representative to borrow a copy for you from the UFT borough
office.
Is there anything else I should do if I am involved in a situation where I have had direct contact with someone else’s blood?
Yes. If you have sustained a significant exposure to blood or body fluids
you should have a single injection of HBIG (hepatitis B immunoglobulin) as soon
as possible after exposure unless you are pregnant or nursing. It can provide
temporary immunity to hepatitis B. HBIG treatment usually is not necessary if
you have previously received the hepatitis B vaccine. (For more information about
the hepatitis B vaccine and the circumstances in which you should get an HBIG
shot, see Viral Hepatitis: Straight Talk from the UFT.)
After any exposure to blood or body fluids you also should file an official incident
report in the principal’s office. Keep a copy of the report for your own
records so you can document workplace exposure if you subsequently develop HIV
or another bloodborne infection.
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