Section 1.6: Bloodborne Pathogens & Exposure Incidents

Bloodborne Pathogens and OSHA Standards

The Bloodborne Pathogens Standard (29 CFR 1910.1030) was established by OSHA to protect workers from health risks associated with exposure to blood and other potentially infectious materials (OPIM). Bloodborne pathogens are disease-causing microorganisms carried in the body by blood or body fluids. The primary pathogens of concern in a salon or spa are Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV).

Hepatitis is an inflammation of the liver caused by a bloodborne virus. HBV is extremely resilient; it can survive in dried blood on a surface for at least a week, making proper surface disinfection vital. HIV damages the body’s immune system, leading to AIDS, but is less resilient outside the body than Hepatitis. The standard requires employers to identify workers at risk of exposure, provide safety training, supply PPE, and offer the Hepatitis B vaccine at no cost to at-risk employees.

Defining an Exposure Incident

An exposure incident occurs when an employee contacts blood, body fluids, or other potentially infectious materials during their duties. In esthetics, exposure typically happens through non-intact skin (e.g., cuts, scrapes, dermatitis) or mucous membranes (eyes, nose, mouth). Common triggers include a lancet puncture, a comedone extractor slipping and breaking the skin, waxing over active acne, or performing extractions on open blemishes. Estheticians must treat all blood and body fluids as infectious under the principle of Standard Precautions, which assumes all human blood and body fluids are contaminated.

Step-by-Step Client Exposure Incident Protocol

If a client’s skin is cut or punctured during a service, the esthetician must execute the blood spill procedure in this exact sequence:

1. Stop the service immediately: Pause all work and explain the situation to the client to prevent panic.
2. Put on disposable gloves: Protect yourself before touching the client or any contaminated materials.
3. Clean the injured area: Wipe the wound with antiseptic or wash it with soap and water to clean the cut.
4. Bandage the wound: Apply sterile gauze and a bandage to stop the bleeding and protect the cut from contamination.
5. Clean and disinfect the area: Clean all contaminated surfaces and tools to remove organic matter, then disinfect them with an EPA-registered hospital-grade disinfectant that is tuberculocidal or active against HIV/HBV (or a 10% bleach solution) for the full contact time.
6. Double-bag contaminated items: Place all soiled single-use materials (cotton pads, gloves, bandages, wipes) in a plastic bag, seal it, place it in a second trash bag, and seal that bag as well.
7. Dispose of the double-bagged waste: Place the bag in a closed trash receptacle (or a biohazard waste container if required by state or local rules).
8. Remove gloves and wash hands: Safely peel off gloves (glove-to-glove, skin-to-skin), discard them in the trash, and wash hands with liquid soap and warm water for at least 20 seconds.
9. Resume the service: Once all steps are complete, put on fresh gloves and resume the treatment.

Step-by-Step Esthetician Exposure Incident Protocol

If the esthetician is cut or injured during a service, the protocol focuses on self-protection to avoid contaminating the client:

1. Stop the service immediately: Secure any active tools and step away from the client.
2. Clean and bandage the wound: Remove contaminated gloves, wash the cut, apply antiseptic, and cover it with a sterile bandage.
3. Put on a clean glove: Place a fresh glove over the bandaged hand to seal the wound and prevent fluid transfer.
4. Clean and disinfect: Clean and disinfect all tools and surfaces that contacted your blood using an EPA-registered hospital-grade disinfectant.
5. Double-bag waste: Gather all blood-soiled cotton, wipes, and contaminated gloves, double-bag them, and place them in the closed trash receptacle.
6. Wash hands: Wash hands thoroughly with soap and warm water before returning to the client.
7. Resume service: Wear fresh gloves on both hands and proceed.

The Mechanics of Double-Bagging

Double-bagging is a critical waste-disposal safety standard. It requires placing all blood-contaminated single-use items in a secure plastic bag, sealing it, placing that bag inside a second plastic bag, and sealing the outer bag. This process creates two layers of protection, preventing waste collectors and salon staff from contacting bloodborne pathogens during trash disposal. In California, double-bagged items can typically be placed in a standard closed trash bin unless local ordinances specify biohazard waste disposal.

State Board Exam Traps

• First Step Order: The exam often tests the sequence of the blood spill procedure. The first step is always Stop the service. Do not select applying antiseptic, putting on gloves, or cleaning tools as the first step.
• The Glove Removal Trap: You must wash your hands after removing contaminated gloves. Removing gloves does not leave hands sterile.
• Double-Bagging Waste: Blood-soiled items must never be thrown directly into the trash can without double-bagging. This is a severe safety violation that can result in immediate exam failure or state board fines.