Universal Precautions

(in full, Universal Blood and Body Fluid Precautions). A set of procedural directives and guidelines published in August 1987 by the Centers for Disease Control and Prevention (CDC) (as Recommendations for Prevention of HIV Transmission in Health-Care Settings) to prevent parenteral, mucous membrane, and nonintact skin exposures of health care workers to bloodborne pathogens. In December 1991 the Occupational Safety and Health Administration (OSHA) promulgated its Occupational Exposure to Bloodborne Pathogens Standard, incorporating u. and imposing detailed requirements on employers of health care workers, including engineering controls, provision of protective barrier devices, standardized labeling of biohazards, mandatory training of employees in U., management of accidental parenteral exposure incidents, and availability to employees of immunization against hepatitis B.The principle underlying u. is that the blood and certain other body fluids of all patients are to be considered potentially infected with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens. Universal precautions apply to blood, unfixed tissues (except intact skin), cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, amniotic fluid, semen, and vaginal secretions, but not to feces, nasal secretions, sputum, sweat, tears, urine, or vomitus unless these materials contain visible blood. Specific precautions are prescribed with respect to mouth-to-mouth resuscitation, surgery, invasive diagnostic procedures, obstetrics, renal dialysis, dentistry, clinical laboratories, morgues, and morticians' services. Barrier devices such as gloves, gowns, waterproof aprons, masks, and protective eyewear are required in certain settings, to prevent exposure to blood and other biologically hazardous materials. The OSHA standard requires glove wear for phlebotomy and intraoral examinations and manipulations. Standards are also imposed for laundry, cleaning of surfaces, and disposal of contaminated wastes. Special precautions are advised for handling needles, scalpels, and other sharp instruments or devices after use. Immunization with HBV vaccine is recommended as an important adjunct to u. for health care workers exposed to blood. Universal precautions are intended to supplement, not replace, recommendations for routine infection control, such as handwashing and using gloves to prevent gross contamination of the hands. Implementation of u. does not eliminate the need for other category- or disease-specific isolation precautions, such as enteric precautions for infectious diarrhea or isolation for pulmonary tuberculosis.

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a group of measures formerly recommended for protection of noninfected individuals against bloodborne infections such as hepatitis B virus and human immunodeficiency virus, now replaced by the measures called standard precautions.