Universal Precautions

What are Universal Precautions?

Universal precautions are a standard set of guidelines that were first developed in the mid-1980's by the Center's for Disease Control and Prevention (CDC) to protect healthcare workers in response to the growing human immunodeficiency virus (HIV) epidemic. Since the 1980's, they have expanded to include all bloodborne pathogens (BBP) and other potentially infectious materials (OPIM) and protection is broadly applied to all individuals in a workplace that may encounter these materials. The principle behind universal precautions is that all tissue, fluids and cells from humans and primates should be treated as it if is infectious, regardless of whether the source is known to be infected.  

Other potentially infectious materials as defined by OSHA and LSU includes: 

• Human and primate bodily fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva that is visibly contaminated with blood, and all body fluids in situations where it is difficult of impossible to differentiate between body fluids. 
• Any unfixed organ or tissue (other than intact skin) from a human or primate (living or dead).
• Human and primate cells lines used in biomedical research. 
• HIV containing cell or tissue cultures, organ cultures, and HIV- of hepatitis B (HBV)- containing culture medium or other solutions.
• Blood, organs, or other tissues from experimental animals infected with HIV of HBV. 

Universal precautions do not apply to sputum, feces, sweat, tears, vomit, urine, or nasal secretions UNLESS they are visibly contaminated with blood because the transmission of HBV and HIV is extremely low of non-existent.  If blood can be visualized in any of the aforementioned secretions or bodily secreta, universal precautions apply and appropriate work practice controls should be observed.

Universal Precautions Guidelines

• All work activities should be classified according to the potential for exposure. Tasks with a greater potential for exposure have a greater need to appropriate protective equipment.
• At a minimum, gloves, protective clothing, and eye protection should be worn at all times when there is a reasonable potential for exposure.
• A detailed work practice program should be developed that includes standard operating procedures (SOPs) for all activities having the potential for exposure.
• A worker education program should be implemented to assure familiarity with the work practices for potentially exposed workers.  No worker should engage in tasks of activities that put them at risk of exposure before receiving proper training pertaining to SOPs, work practices, and protective equipment required for that task.
• The employer should monitor workers to ensure that required work practices are observed and that protective clothing and equipment are provided and used properly.
• Training records should be maintained.
• Copies of all SOPs for tasks or activities involving predictable or unpredictable exposure to bloodborne pathogens or OPIM should be kept on file and easily accessible to employees. 

LSU Specific Requirements

The following list is a summary of LSU requirements for Universal Precautions for all individuals at risk for contact with bloodborne pathogens and other potentially infectious materials. 

Training Requirements

All individuals who work with BBP and/or OPIM are required (at a minimum) to complete the following online safety training annually:

• Blood Borne Pathogens (Biological Safety B004).
• Basic Biosafety (Biological Safety B002).
• Biological Risk Assessment (Biological Safety B006)

Practices and Procedures

To minimize potential exposures to pathogens and OPIM, use a combination of engineering controls, work practice control, and PPE.

Engineering Controls

• Use a biosafety cabinet for all aerosol generating procedures
• Use additional containment devices during procedures with high potential for generating aerosols (e.g. centrifugation, blending, mixing, homogenization). 
• Use safety sharps whenever possible. 
• Use HEPA filtered vacuum lines. 

Work Practice Controls

• Post a biohazard warning sign on doors and equipment where hazardous material is used. 
• Limit access to the lab while work is being conducted.  Only authorized users should be allowed.
• Properly dispose of cultures, stocks, and other regulated wastes. 
• Wash hands after completion or work and before leaving the laboratory.
• Decontaminate work spaces and equipment daily and after any spill. 
• Eating, drinking, applying cosmetics, lip balm, or contact lenses is not permitted in work areas. See the LSU policy on Food and Drink in Labs that contain rDNA and Biological Material for details. 
• No mouth pipetting
• The LSU Sharps Policy is observed

Personal Protective Equipment (PPE)

• Long pants, close-toed shoes, and a top that completely covers the abdomen are required.  Leggings, shorts, skirts, crop tops, sandals and low cut, v-neck style shirts are not permitted in the lab. 
• Lab coats and disposable gloves are required. 
• Safety glasses or goggles and/or face shields are required where the potential for splashes or sprays to the eyes and face are exist.