1.2 Bloodborne Pathogens & Emergency Spill Procedures

1.2 Bloodborne Pathogens & Emergency Spill Procedures

Cosmetologists are exposed to physical contact with clients on a daily basis. While cosmetologists do not intentionally perform invasive procedures, accidental cuts, nicks, and abrasions can occur during haircuts, shaves, manicures, and waxings. In these moments, understanding how to manage bloodborne pathogens and executing the correct emergency spill protocol is vital for public safety.

Understanding Bloodborne Pathogens

Bloodborne pathogens are disease-causing microorganisms carried in the body by blood or body fluids.

• Primary Pathogens of Concern: These include Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV).
• Transmission: In a salon, transmission can occur through direct skin-to-skin contact, needle sticks, or cuts from contaminated shears, razors, or nail implements.
• Survival of Viruses: Hepatitis viruses are highly resilient. For instance, Hepatitis B can survive on dry surfaces at room temperature for at least 7 days, making rigorous sanitation and emergency procedures essential.

---

Step-by-Step Blood Exposure Protocol

When an accidental cut or nick occurs, the cosmetologist must immediately stop the service and perform the Blood Exposure Incident Protocol. This procedure must be executed precisely depending on who is injured.

Scenario A: The Cosmetologist is Injured

If you cut yourself during a service:

1. Stop the Service: Immediately halt the service and inform the client. Remain calm.
2. Clean the Wound: Wash the cut area with soap and warm water. Apply gentle pressure with a sterile gauze pad to stop the bleeding.
3. Sanitize Your Hands: Clean your hands thoroughly with soap and water or an alcohol-based hand sanitizer.
4. Apply Antiseptic and Bandage: Apply an antiseptic cream or liquid to the wound, and cover it completely with a sterile bandage to prevent further exposure.
5. Protect Your Hands: Wear disposable gloves (nitrile or vinyl) over the bandaged hand before resuming any work or cleaning.
6. Clean and Disinfect the Workstation: Wipe down any surfaces contaminated with blood using an EPA-registered hospital-grade disinfectant that is specifically tuberculocidal or labeled as effective against HIV/HBV.
7. Discard Contaminated Single-Use Items: Dispose of all single-use contaminated items (gauze, wipes, cotton) following the double-bagging protocol.
8. Clean and Disinfect Implements: Clean and disinfect any reusable tools (shears, combs) that were exposed to blood.
9. Remove Gloves and Wash Hands: Properly peel off the gloves, discard them, and wash hands with soap and warm water.

Scenario B: The Client is Injured

If the client is cut during the service:

1. Stop the Service: Immediately halt the service. Do not panic or show distress to the client.
2. Put on Gloves: Put on disposable gloves immediately. Never touch open wounds or blood with bare hands.
3. Address the Wound: Clean the injured area with a sterile gauze pad. Apply pressure to control bleeding. Apply an antiseptic and cover the cut with a sterile adhesive bandage.
4. Clean and Disinfect: Clean the surrounding skin of any blood residue.
5. Double-Bag Contaminated Items: Place all contaminated disposable materials (such as gauze, cotton pads, or tissues) into a plastic bag, seal it, and place it into a second plastic bag (double-bagging) before disposal.
6. Disinfect the Area: Clean and disinfect your workstation, styling chair, and floor if blood spilled, using an EPA-registered disinfectant.
7. Disinfect Tools: Submerge any contaminated reusable implements in an EPA-registered hospital disinfectant for the full contact time.
8. Post-Exposure Care: Remove your gloves by turning them inside out, discard them in the double-bagged waste container, and immediately wash your hands with soap and water.

---

Double-Bagging and Biohazard Labeling

Any material that has come into contact with blood or body fluids is considered infectious waste or biohazardous material. To prevent accidental contact by sanitation workers or other staff, the salon must use the double-bagging method.

How to Double-Bag

1. Primary Bag: Place all contaminated disposable items (gloves, cotton pads, neck strips, wooden spatulas, bandages) into a small plastic trash bag.
2. Seal: Securely tie or seal the primary bag.
3. Secondary Bag: Place the sealed primary bag inside a second, heavy-duty trash bag.
4. Labeling: According to OSHA and standard infection control guidelines, if the waste contains liquid or semi-liquid blood that could release pathogens when compressed, the outer bag must be labeled with the universal Biohazard Symbol or placed in a red biohazard bag. For minor cuts where blood is contained on a bandage or gauze, double-bagging and placing it in a closed trash receptacle is standard, but check local ordinances as some jurisdictions require all blood-contaminated waste to be treated as biohazard waste.

---

Workstation and Implement Disinfection After a Spill

When a blood spill occurs, the entire area must be treated as a contamination zone.

• Immediate Action: Keep clients and other staff away from the area until disinfection is complete.
• Pre-Cleaning: Wipe up the blood spill using disposable towels. The surface must be cleaned with soap and water first, as organic matter (like blood) can deactivate chemical disinfectants.
• Disinfectant Application: Apply an EPA-registered hospital-grade disinfectant to the surface.
• Dwell Time: For blood spills, the disinfectant must remain wet on the surface for the full time recommended for bloodborne pathogens (typically 10 minutes, or as indicated on the label for HIV/HBV efficacy).
• Bleach Solution Alternative: A freshly mixed solution of 10% household bleach (1 part bleach to 9 parts water) can be used to disinfect surfaces after a blood spill. This solution must sit for 10 minutes.

---

Handwashing and Post-Incident Actions

The Handwashing Protocol

Handwashing is the single most effective way to prevent the spread of pathogens. In a blood exposure incident, handwashing must follow clinical standards:

1. Wet: Wet hands with clean, running water (warm is preferred).
2. Lather: Apply liquid soap and rub hands together to create a lather.
3. Scrub: Scrub all surfaces of the hands, including the backs of the hands, between the fingers, and under the fingernails. This scrubbing must last for at least 20 seconds (the time it takes to sing "Happy Birthday" twice).
4. Rinse: Rinse hands thoroughly under clean, running water, pointing fingers downward to flush pathogens away from the wrists.
5. Dry: Dry hands completely using a clean paper towel or air dryer.
6. Turn Off Faucet: Use the paper towel to turn off the faucet and open the restroom door to avoid re-contaminating clean hands.

Standard hand sanitizers (alcohol-based rubs) are excellent for quick sanitation between clients but are not effective when hands are visibly soiled with blood, dirt, or grease. In any exposure incident, mechanical handwashing with soap and water is mandatory.

• Log the Incident: Many salons and state regulations recommend keeping an incident report log. Record the date, time, client name, description of the incident, actions taken, and materials used.
• Monitor for Infection: Advise the injured individual (whether client or cosmetologist) to monitor the wound for signs of infection, such as redness, swelling, heat, or throbbing pain. If symptoms persist, seek medical attention.