Infection Control & Hygiene

Infection control is a fundamental professional responsibility for massage therapists. Maintaining a clean, hygienic environment protects clients, the therapist, and the public from communicable diseases.

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Standard Precautions (Universal Precautions)

Standard precautions are infection control practices that assume all blood and body fluids are potentially infectious, regardless of the client's apparent health status.

Key Standard Precautions

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Hand Hygiene

Hand hygiene is the single most effective method of preventing the spread of infection.

Proper Handwashing Procedure

1. Wet hands with warm running water
2. Apply soap (liquid soap preferred over bar soap)
3. Rub hands together vigorously for at least 20 seconds
4. Clean all surfaces: palms, backs of hands, between fingers, under nails, wrists
5. Rinse thoroughly under running water
6. Dry with a clean paper towel or air dryer
7. Use the paper towel to turn off the faucet (avoid recontamination)

When to Wash Hands

• Before each client session
• After each client session
• After removing gloves
• After contact with blood, body fluids, or contaminated surfaces
• After using the restroom
• After coughing, sneezing, or blowing your nose
• Before and after eating

Hand Sanitizer

• Alcohol-based hand sanitizer (at least 60% alcohol) can be used when soap and water are not immediately available
• Hand sanitizer is NOT a substitute for handwashing when hands are visibly dirty or contaminated with blood/body fluids
• Allow hands to air dry after applying sanitizer — do not wipe off

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The Chain of Infection

Infection transmission requires all six links in the chain. Breaking any link prevents transmission:

Breaking the Chain

Massage therapists can break the chain at multiple points:

• Remove the infectious agent: Disinfect surfaces, launder linens properly
• Block the portal of exit: Cover wounds, use barriers
• Interrupt transmission: Hand hygiene, clean linens, disinfected equipment
• Block the portal of entry: Wear gloves, cover any breaks in the therapist's skin
• Protect the susceptible host: Do not work with clients who have active infections (contraindication), maintain own health

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Sanitation, Disinfection & Sterilization

Three levels of microbial control:

Between-Client Protocol

1. Remove used linens — place in closed laundry container
2. Clean table surface — wipe with soap and water to remove debris
3. Disinfect table surface — spray with EPA-registered disinfectant, allow proper contact time
4. Disinfect face cradle — clean and disinfect the face rest and cradle
5. Apply fresh linens — clean sheet, face cradle cover, blanket if needed
6. Wash hands — before preparing for the next client

Laundry Standards

• Wash linens in hot water (at least 160F / 71C) with detergent
• Use bleach when appropriate (check fabric compatibility)
• Dry on high heat to kill remaining pathogens
• Store clean linens in a closed cabinet — away from dirty linens
• Never reuse linens between clients, even for a "short session"

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Bloodborne Pathogens

Key Bloodborne Pathogens

Exposure Incident Protocol

If a therapist is exposed to blood or body fluids:

1. Stop immediately — remove gloves if wearing them
2. Wash the exposed area — with soap and water for at least 20 seconds
3. Flush eyes/mucous membranes — with clean water if exposed
4. Report the incident — to your supervisor (if employed) and document it
5. Seek medical evaluation — visit a physician or emergency department within 2 hours
6. Get tested — for HIV, HBV, HCV (baseline and follow-up)
7. Document everything — incident report, medical visits, test results