4 Sharps Safety and Exposure Response

Understand the risk

Sharps such as needles, lancets, scalpels, and broken contaminated glass can cause punctures or cuts that expose workers to bloodborne pathogens, including hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV. Prevention depends on safer devices and safe work practices; if an exposure occurs, prompt care and reporting are essential.

Prevent sharps injuries

Employers must use engineering and work-practice controls to eliminate or minimize exposure. Where appropriate, these include needleless systems and sharps with built-in safety features. Follow device instructions and activate the safety feature immediately after use.

Wear appropriate gloves and other protective equipment based on the task and anticipated exposure. Personal protective equipment (PPE) supplements engineering and work-practice controls; it does not replace them.

Handle and discard sharps safely

Handle sharps deliberately: keep the sharp pointed away from yourself and others, minimize hand-to-hand passing, and never reach blindly into a container or bag. Do not bend, break, shear, or remove contaminated needles by hand.

Avoid recapping needles. If recapping is medically necessary, use a mechanical device or a one-handed technique. Place used sharps directly into an appropriate sharps container at the point of use. Do not carry them across a room, leave them on a tray, put them in regular trash, or force them into a container.

Use sharps containers correctly

A sharps container must be closable, puncture-resistant, and leakproof on its sides and bottom. It must be labeled or color-coded as required, accessible to workers, and kept upright. Replace it routinely so that it does not become overfilled.

Close and dispose of the container according to workplace procedures and applicable requirements. Do not reopen it, empty it, or manually sort its contents. If a sharp is found outside a container, do not pick it up with bare hands; use an appropriate tool, such as forceps or a brush and dustpan, and follow the site’s exposure-control procedures.

Respond immediately to an exposure

An occupational exposure may happen through a puncture or cut, or when blood or other potentially infectious material contacts the eyes, mouth, another mucous membrane, or nonintact skin. Take these steps promptly:

1. Provide immediate first aid. Wash a puncture or cut with soap and water. Flush splashes to the nose, mouth, or skin with water. Irrigate eyes with clean water, saline, or sterile irrigant. Do not apply bleach or other caustic agents, and do not delay care to investigate the source.

2. Report the incident immediately. Notify the supervisor or designated workplace contact, even if the injury seems minor.

3. Obtain urgent medical evaluation. Do not wait for test results before seeking evaluation.

Get medical evaluation and follow-up

The employer must make a confidential post-exposure medical evaluation and follow-up available promptly. A qualified clinician assesses the exposure, documents relevant details, and determines indicated testing, treatment, and follow-up. Provide information about the route and circumstances of exposure and, when available and legally permitted, the source individual’s testing.

If HIV post-exposure prophylaxis (PEP) is indicated, it should be started as soon as possible; CDC guidance says no later than 72 hours after exposure. HBV vaccination or other preventive measures may also be indicated. There is no recommended PEP medication for HCV, although follow-up testing may be needed. Follow the clinician’s instructions for testing and follow-up.

Meet workplace requirements

OSHA’s Bloodborne Pathogens standard, 29 CFR 1910.1030, applies to covered workplaces where employees have reasonably anticipated occupational exposure to blood or other potentially infectious materials. It requires an exposure control plan, appropriate engineering and work-practice controls, training, and confidential post-exposure evaluation and follow-up.

When identifying and evaluating safer medical devices, employers must solicit input from non-managerial employees with direct patient-care duties. Employers covered by OSHA recordkeeping rules must record work-related needlestick injuries and cuts from contaminated sharps on the OSHA 300 Log, subject to privacy protections. Certain employers must also maintain a separate Sharps Injury Log.

The employer must document exposure incidents and review their circumstances to identify improvements to prevention. Follow the employer’s reporting process even when an incident does not appear to require medical treatment.