CLINICAL LAB SCIENEC

120
ESSENTIALS OF CLINICAL LABORATORY SCIENCE
with the majority of infections by bloodborne pathogens are given a status that
requires specific training for health care personnel. It bears repeating that while
the emphasis is on only two bloodborne organisms—HIV and HBV —focusing
attention on other pathogenic (disease-causing) organisms among humans cannot
be neglected. Hepatitis A virus , which is chiefly transmitted through water
and food, is an important pathogen that can now be prevented through immunization,
and the hepatitis C virus , which is blood borne or sexually transmitted in
most cases, is becoming increasingly important (sometimes dual immunization
occurs for both hepatitis B and hepatitis C during a single immunization).
At this time, hepatitis A and C are not treated in OSHA guidelines as “covered
organisms” requiring periodic training of the health care worker. Exposure
to biohazards is inherent in some tasks and in those who perform them. Not
only health care professionals but also other personnel who may come in contact
with bloodborne pathogens or other body fluids may contract and spread organisms
by virtue of their professions. Table 6-2 contains a list of most professionals
who are at risk.
Blood is an extremely good bacterial medium, and viruses are intracellular
organisms, meaning that they may grow well inside blood cells . Another organism
that grows in blood cells is the malaria organism, of which there are four
major strains capable of infecting humans. The strains of malaria organisms,
called protozoa, that infect humans are not prevalent in North America currently
but are rampant in other parts of the world. There are strains of malaria in
the United States that infect birds, but humans fortunately have natural immunity
against these strains.
This immunity of humans to certain animal pathogens seems to have been
breached recently with certain organisms previously unknown to have infected
humans. An example seen in outbreaks in Asia is severe acute respiratory syndrome
(SARS) caused by organisms normally found only in chickens, turkeys,
ducks, and migratory fowl. Exposure to the blood of animals is currently
a topic for research, as diseases harbored by mammals and birds to which
humans are currently immune may eventually find an avenue to directly infect
humans.
Table 6-2 Workers Who May Be at Risk for Exposure to
Bloodborne Pathogens*
Physicians
Nurses
Pathologists
Phlebotomists
Dialysis personnel
Some laundry workers
Medical examiners
Paramedics
* Exclusion of a job category here does not denote lack of risk.
Dentists and other dental workers
Laboratory and blood bank technologists
Medical technologists
Research laboratory scientists
Emergency medical technicians
Morticians
Some maintenance personnel
Some housekeeping personnel
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