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Work practice controls are designed to change the way in which a task is performed to reduce the likelihood of exposure to bloodborne pathogens. The most important work practice control is implementation of "universal precautions" which are a set of precautions recommended by the CDC which are designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens when providing first aid or health care. Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious for HIV, HBV and other bloodborne pathogens.

Universal precautions took the place of and eliminated the need for the isolation category "Blood and Body Fluid Precautions" in the 1983 CDC Guidelines for Isolation Precautions in Hospitals. In 1996, CDC published new guidelines which coined the term "standard precautions" for isolation precautions in hospitals. Standard Precautions synthesize the major features of Body Substance Isolation (BSI) and Universal Precautions to prevent transmission of a variety of organisms and requires the use of appropriate barrier precautions based upon the anticipated degree of exposure to blood and body fluids by the Health Care Provider.

Body Fluids requiring the use of Universal Precautions

Universal precautions apply to blood, other body fluids containing visible blood, vaginal secretions and semen. Universal precautions also apply to tissues and to the following fluids: cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids. Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomitus unless they contain visible blood. Universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictable.

General infection control practices are used to further minimize the already minute risk for salivary transmission of HIV. These infection control practices include the use of gloves for digital examination of mucous membranes and endotracheal suctioning, handwashing after exposure to saliva, and minimizing the need for emergency mouth-to-mouth resuscitation by making mouthpieces and other ventilation devices available for use in areas where the need for resuscitation is predictable.
Although universal precautions do not apply to human breast milk, gloves may be worn by health care workers in situations where exposures to breast milk might be frequent, e.g., in breast milk banking.
Universal precautions involve the use of protective barriers such as gloves, gowns, aprons, masks, or protective eyewear and the following work practices to prevent needlestick injuries:

• needles should not be recapped by hand, purposely bent or broken by hand, removed from disposable syringes, or otherwise manipulated by hand.

• After they are used, disposable syringes and needles, scalpel blades, and other sharp items should be immediately placed in puncture-resistant containers for disposal. The puncture-resistant containers should be located as close as practical to the use area.

• All reusable needles should be placed in a puncture-resistant container for transport to the reprocessing area.

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