CLINICAL LAB SCIENEC

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ESSENTIALS OF CLINICAL LABORATORY SCIENCE
including health care providers who may transmit organisms to them. Laboratory
workers should always wear disposable gloves when handling blood and
other body fluids, secretions, and excretions. However, only blood, semen, vaginal
fluids, and bloody body fluids are known to enable transmission of the HIV
organism. Note that sweat is the only fluid not included in Standard Precautions
guidelines issued by the CDC. Tears and urine may also contain the viruses, but
no transmission has been made through these body fluids to date.
After contact with any body fluid, the hands should be washed as soon as
possible. There is no substitute for ordinary hand soap, warm water, and friction
in washing all parts of the hands, including the cuticles. Although disposable latex
gloves are necessary to prevent contamination when performing ordinary laboratory
work, reusable gloves that are sturdier and more impenetrable should be
used for cleaning spills of body fluids and sharp objects such as broken glass. The
work practice control of washing the hands is the easiest method for preventing
contamination of oneself as well as others with whom the medical worker comes
in contact. Even if gloves have been worn, the hands should be washed thoroughly
and vigorously with running water and soap for at least 30 seconds after
removing the gloves, ensuring that the webbing between the fingers is scrubbed.
Remove rings and other jewelry to do a more thorough job of washing of the
hands and arms. Particular care should be taken to wash around the cuticles of
the nails, with vigorous rubbing together of the hands to produce friction .
Remember, handwashing (Figure 6-7) is indicated before donning gloves
and after removing them. The area where procedures are performed should be
cleaned before removing one’s gloves.
Limiting the Spread of Hepatitis B Virus
Hepatitis B is the second important bloodborne pathogen that is considered a
“covered” disease. The causative organism is HBV , which is spread much in
the same manner as HIV, through sexual practices and exchanges of body fluids.
However, unlike HIV, immunization is available for this organism and it is
required in many health care facilities unless the worker declines vaccination.
Although 10% of those who contract an infection with HBV become chronically
infected and can still transmit the disease even when asymptomatic, the remaining
90% recover spontaneously after varying periods of time.
The symptoms for HBV are similar to those of HIV with the exception, in
part, of nausea and jaundice (yellowing chiefly of the skin and eyes). Anorexia
(loss of appetite), tiredness, nausea, and vomiting, often accompanied by arthralgia
(joint pain ), and sometimes a rash are often but not always present. Jaundice
is most often present in adults but is ordinarily not found in young children.
Symptoms will vary widely from person to person, with some patients having
almost no symptoms at all, while others become seriously ill. Again, a person
with HBV may exhibit almost no signs, yet be capable of infecting another via
the exchange of body fluids through sexual activities and the sharing of needles
and contaminated blood products.
HBV is found throughout the world, and the disease is rampant in many
areas where medical care and immunization are not readily available. The only
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