An exposure incident involves contact with potentially infectious materials, carrying the risk of transmitting diseases such as Hepatitis B (HBV), Hepatitis C (HCV), or Human Immunodeficiency Virus (HIV). These incidents are most commonly associated with occupational settings, including healthcare, laboratory work, and first-response professions. Understanding the definition and proper procedural response is necessary for mitigating health risks and ensuring compliance with safety standards. Immediate action following an incident can significantly reduce the potential for infection.
Defining an Exposure Incident
An exposure incident is defined by occupational safety standards as specific contact with blood or other potentially infectious materials (OPIM) during the performance of an employee’s duties. This definition is regulated by the Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogens standard. For an event to qualify, the contact must involve a specific route of entry.
The routes of entry include mucous membranes (eyes, nose, or mouth) where a splash may occur. Contact with non-intact skin also qualifies, including abrasions, cuts, or any break in the skin barrier. The third type is parenteral contact, which means piercing the skin barrier, such as through a needlestick or a cut from a contaminated sharp object.
The materials involved are human blood and OPIM. OPIM includes body fluids such as:
- Semen
- Vaginal secretions
- Cerebrospinal fluid
- Synovial fluid
- Pleural fluid
- Amniotic fluid
Any body fluid visibly contaminated with blood is also classified as OPIM. Fluids such as sweat or tears are generally not considered OPIM unless they contain visible blood.
Immediate Actions Following an Incident
The first step following any potential exposure is to provide immediate care to the affected site to reduce the amount of infectious material present. This physical first aid must be performed before seeking formal medical consultation or completing any paperwork.
If the exposure involves a needlestick or a cut, the wound must be thoroughly washed with soap and water. The exposed person should not squeeze the injury site, as this may force infectious material deeper into the tissue.
For splashes to the eyes, nose, or mouth, the affected area should be flushed continuously with clean water, saline, or sterile irrigants. Flushing of the mucous membranes should be sustained, ideally for at least 15 to 20 minutes. These washing and flushing procedures remove the contamination and focus solely on decontamination before moving to the next phase of the response.
Post-Incident Evaluation and Follow-Up
Once immediate first aid is completed, the next steps involve formal reporting and medical evaluation. The exposed individual must promptly report the incident to their supervisor or a designated safety officer. Timely reporting is necessary to initiate the administrative process and effective medical intervention.
A confidential medical evaluation must be made available to the exposed person at no cost. This evaluation, performed by a licensed healthcare professional, includes an assessment of the exposure risk and counseling. The provider will also evaluate the infection status of the source individual, if known and if consent is obtainable, by testing for HBV, HCV, and HIV.
Based on the risk assessment, the professional determines the need for post-exposure prophylaxis (PEP). For HIV exposure, PEP involves a regimen of antiretroviral drugs and must be initiated as soon as possible, preferably within one to two hours of the incident. The follow-up process includes baseline blood testing of the exposed person and repeat testing over months to monitor for seroconversion. The employer must provide the employee with a copy of the healthcare professional’s written opinion within 15 days of the evaluation.