Occupational Safety And Health Administration
- Standard Number: 1910.1030
OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA’s interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA’s website at .
Dear :
This is in response to your letter of January 9, addressed to the Occupational Safety and Health Administration concerning the potential for the transmission of the human immunodeficiency virus from contact with urine specimens during handling and transport.
Under section 1910.1030, OSHA requires that “specimens of blood or other potentially infectious materials shall be placed in a container which prevents leakage during collection, handling, processing, storage, transport, or shipment.” Therefore, if test tubes are used to transport blood, then the test tubes must be capable of preventing leakage during transport. Urine that does not contain visible blood would not be regulated under this standard and would not be required to be placed in containers that prevent leakage.
Sincerely,
Performance Characteristics Of The Calypte Biomedical Test For Hiv
A study in support of licensure for the Calypte HIV-1 Urine EIA compared the frequency of the occurrence of antibodies to HIV-1 in paired urine and serum specimens that were obtained from subjects at multiple geographic sites representative of US populations. EIA RR specimens were confirmed by WB assays for IgG antibodies. This survey extends that reported previously but differs in that 552 high-risk individuals were added to the original cohort . Data are recorded according to risk groups.
Results are summarized in . As reported previously , the sensitivity of the urine test was 98.73%. Ten serum samples matched to WB urine-positive subjects were serum EIA nonreactive. Therefore, the sensitivity of the serum tests was calculated at 99.15%. The combined use of urine and serum EIA tests detected a higher frequency HIV-1 antibody-positive subjects than either test alone.
The data in bring out several interesting points: of the 11 896 subjects tested, 29 were UPSN, a result consistent with the compartmentalization of the immune response to HIV-1 infection the preponderance of UPSN reactivities were in the high-risk cohort and 14 of 1111 of the known HIV-1-positive cohort subjects were either urine negative/indeterminate or urine negative/serum positive . As noted below, we carried out a systematic study of the factors contributory to ID.
How Could You Get Hiv From Contact With Blood
The risk of HIV transmission through blood comes when the person has a detectable viral load and their blood enters another persons body or comes into contact with a mucous membrane. These are parts of the body with wet, absorbent skin such as the:
- eyes
- inside of the anus
- mouth.
Theres also a risk if blood from a person who has a detectable viral load comes into contact with a cut or broken skin, giving HIV a way through the skin and into someones bloodstream. If blood gets onto skin that isnt broken, there is no risk.
In a medical setting, its possible for HIV to be transmitted by someone accidentally cutting themselves with a blade or needle they have used to treat a person living with HIV.
This is called a needlestick injury. The risk of being infected in this way is very low. However, if someone thinks they have been exposed to HIV through a needlestick injury, post-exposure prophylaxis may be an option.
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Ethics Approval And Consent To Participate
Ethical clearance was obtained from the institutional review board of Hawassa University College of medicine and health science. Then support letter were obtained from the hospital administration. Written informed consents were obtained from each study participants. All methods were carried out in accordance with relevant guidelines and regulation as mentioned by Declaration of Helsinki.
Isnt Hiv Only A Risk For Certain Groups Of People
Like most illnesses, HIV doesnt discriminate between types of people and the infection can be passed on to anyone via one of the ways mentioned above.
Some people are more vulnerable to HIV infection if they engage regularly in certain activities that are more likely to transmit the virus. However, its a common misunderstanding that HIV only affects certain groups.
While not everyone has the same level of HIV risk, everyone can reduce their risk of infection.
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What Are The Signs & Symptoms Of Hiv And Aids
When first infected with HIV, a person may have:
- increased number of infections
- infections that are more severe than is typical
Without treatment, HIV can lead to a very weakened immune system and progress to AIDS. Illnesses that happen in AIDS are called “AIDS-defining conditions.”
AIDS-defining conditions include:
- a lung infection called pneumocystis pneumonia
- Kaposi sarcoma
- lymphoma
Can Herbal Medicine Cure Hiv
No. Some people choose to take alternative forms of medicine, such as herbal medicines, as a natural way of treating HIV. However, herbal remedies do not work.
Taking herbal medicines can be dangerous as they will not protect your immune system from infection. They may also interact poorly with antiretrovirals if you are taking them alongside treatment. The only way you can stay healthy when living with HIV is to take antiretroviral treatment as prescribed by your doctor or healthcare professional, and to attend viral load monitoring appointments to make sure your treatment is working.
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Hiv Transmission Through Other Sexual Activities
HIV is also sometimes transmitted during oral sex . It may occasionally be passed from an HIV-positive person to someone sucking their penis.
“Not every act of unprotected sex with an HIV-positive person results in HIV transmission.”
Oral sex is much less risky than vaginal or anal sex, but it is not risk free. The risk depends on the viral load of the person with HIV, the dental health of the person performing oral sex and untreated sexually transmitted infections.
HIV can be transmitted by sharing sex toys such as dildos or butt plugs. They should be covered with condoms or disinfected between use by different people.
Is Hiv Transmitted Through Feces
Ask the Experts
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Management Of Infected Health
Health-care workers with impaired immune systems resulting from HIV infection or other causes are at increased risk of acquiring or experiencing serious complications of infectious disease. Of particular concern is the risk of severe infection following exposure to patients with infectious diseases that are easily transmitted if appropriate precautions are not taken . Any health-care worker with an impaired immune system should be counseled about the potential risk associated with taking care of patients with any transmissible infection and should continue to follow existing recommendations for infection control to minimize risk of exposure to other infectious agents. Recommendations of the Immunization Practices Advisory Committee and institutional policies concerning requirements for vaccinating health-care workers with live-virus vaccines should also be considered.
The question of whether workers infected with HIVespecially those who perform invasive procedurescan adequately and safely be allowed to perform patient-care duties or whether their work assignments should be changed must be determined on an individual basis. These decisions should be made by the health-care worker’s personal physician in conjunction with the medical directors and personnel health service staff of the employing institution or hospital.
Urine Testing Proves An Accurate Measure In Hiv Screening
HIV-1 testing by using urine samples is an accurate, safe and more acceptable way to screen for the disease, according to collaborative researchers at Makerere University, Kampala, Uganda, Columbia University, and the Johns Hopkins School of Public Health. The study, which compared the results of blood and urine samples from study participants, appears in the November issue of the Sexually Transmitted Diseases.
Senior author Ronald Gray, MD, MSc, professor, Population and Family Health Sciences, Johns Hopkins School of Public Health, said, “Screening for HIV in populations is critical for public health and using urine samples has advantages over blood testing because it does not require the use of needles. Also, urine collection is a safer alternative because urine does not contain the infectious HIV virus which can be inadvertently transmitted to health workers through the handling of blood. The disposal of urine samples is also cheaper and simpler than the disposal of potentially infected blood specimens.”
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Principles Of The Urine Test Procedures
Samples that are initially reactive are retested in duplicate using the original specimen. If, after repeat testing, one or both of the duplicate tests are reactive, the specimen is considered EIA RR. Before a determination of HIV-1 status can be made, subjects that test EIA RR are confirmed for HIV-1 antibody using only the additional, more specific Calypte Biomedical HIV-1 urine WB kit.
How Are Hiv And Aids Treated
Medicines can help people with HIV stay healthy. They can also prevent HIV from progressing to AIDS.
Health care providers prescribe a combination of different medicines for people with HIV and AIDS. They must be taken exactly as prescribed or they wont work. These medicines:
- help keep the number of CD4 cells high
- reduce the viral load of HIV
Regular blood tests will check the number of CD4 cells in the body and the viral load.
If an HIV-positive persons CD4 count gets low, doctors prescribe daily antibiotics. This prevents pneumocystis pneumonia, which happens in people with weakened immune systems.
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Can You Get Hiv Through Oral Sex
The risk of HIV from oral sex is very small unless you or your partner have large open sores on the genital area or bleeding gums/sores in your mouth.
There is only a slightly increased risk if a woman being given oral sex is HIV-positive and is menstruating. However, you can always use a dental dam to eliminate these risks.
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Can You Get Hiv From A Blood Transfusion
Receiving a blood transfusion or other products made from blood is safe in the UK as all blood products have been screened for infections such as HIV since 1985.
In countries that dont have strict checks on the safety of their blood supply, receiving contaminated blood can pass the virus on. This can also happen in countries that dont screen other blood products, organs or sperm.
Giving blood has never been a risk.
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Does Hiv Viral Load Affect Getting Or Transmitting Hiv
Yes. Viral load is the amount of HIV in the blood of someone who has HIV. Taking HIV medicine daily as prescribed can make the viral load very lowso low that a test cant detect it .
People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
HIV medicine is a powerful tool for preventing sexual transmission of HIV. But it works only as long as the HIV-positive partner gets and keeps an undetectable viral load. Not everyone taking HIV medicine has an undetectable viral load. To stay undetectable, people with HIV must take HIV medicine every day as prescribed and visit their healthcare provider regularly to get a viral load test. Learn more.
Leukocyte In Urine Without Nitrite
If the leukocyte esterase test is positive and nitrite is negative, it can still mean an infection. Such cases can be attributed to poor hygiene or incorrect technique used while collecting the urine sample. It can lead to false results such as the presence of bacteria in the urine without them being actually present in the urinary tract.
To avoid a false positive result, the area around the urethral opening should be rinsed with clean water before collecting the sample. Men should hold back the foreskin and women should hold the genital labia aside. Urine should be collected halfway since the initial amount of urine may be contaminated.
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Do Condoms Stop Hiv Being Passed On
Yes.Using a condom correctly prevents contact with semen or vaginal secretions , stopping HIV from being passed on. The virus cannot pass through the latex of the condom.
Condoms should only be used with a water-based lubricant as oil-based lube weakens them.
People with HIV who are on effective treatment and have an undetectable viral load cannot pass on HIV through any of their body fluids.
Its also important to remember that if you have sex without a condom other sexually transmitted infections can be passed on.
Sex without a condom can also result in pregnancy if other contraception is not being used.
What Should I Do If I Need To Clean Up Blood
HIV does not usually survive long outside of the body, but contact with blood should be avoided.
Hepatitis C can survive in dried blood at room temperature for several weeks, and hepatitis B can survive in dried blood for around a week outside the body.
To clean up blood that has been spilled, wear rubber gloves and mop up the liquid using bleach and warm water . Use warm, soapy water to clean away blood spilled on someones body.
Put the waste, used gloves and bloodied clothes in a plastic bag, seal and throw away.
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Ways Hiv Cannot Be Spread
HIV is not spread by:
- Air or water
- Mosquitoes, ticks or other insects
- Saliva, tears, or sweat that is not mixed with the blood of a person with HIV
- Shaking hands hugging sharing toilets sharing dishes, silverware, or drinking glasses or engaging in closed-mouth or social kissing with a person with HIV
- Drinking fountains
Whats The Risk For Types Of Oral Sex
Oral sex ranks very low on the list of ways HIV can be transmitted. Its more likely to transmit HIV through anal or vaginal sex. Its also possible to transmit the virus by sharing needles or syringes used for injecting drugs or tattooing.
However, the risk of contracting HIV through oral sex is not zero. The truth is, you can in theory still contract HIV this way. Theres just been from years of research to show that it has happened.
Why is it hard to get data?
Its difficult to know the absolute risk of transmitting HIV during oral sex acts. Thats because many sex partners who engage in oral sex of any type also engage in vaginal or anal sex. It may be difficult to know where the transmission occurred.
Fellatio carries some risk, but its low.
- If youre giving a blowjob. Receptive oral sex with a male partner who has HIV is considered exceptionally low-risk. In fact, a 2002 study found that the risk for HIV transmission through receptive oral sex was statistically zero.
- If youre receiving a blowjob. Insertive oral sex is an unlikely method of transmission, too. Enzymes in the saliva neutralize many viral particles. This may be true even if the saliva contains blood.
There are no documented cases of HIV being transmitted between partners through cunnilingus .
Anilingus , or rimming, has some risk, but it is negligible. Its especially low for receptive partners. In fact, the lifetime risk of transmitting HIV during rimming is
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Genetic Analysis Of Hiv
Studies of genetic abnormalities in veterans with Persian Gulf War syndrome led to analogous investigation of the patient described above who had no known risk factors for HIV-1 infection. Our central interest based on reactivity of urine to HIV-1 gp160 was in the HIV-1vau env nucleotide sequence. Basically, a mosaic analysis involved the determination of signature segment homologies to known human chromosomal sequences. Mosaic analysis of the HIV-1vau env sequence was carried out using the Advance Blast program described in Materials and Methods. shows that signature segments of HIV-1vau env had homologies with 14 different human chromosomes. Segments from chromosome 7 predominated. Of these, six segments had homologies with 7q31. This is of interest because 7q31 is a fragile chromosomal site involved in mutations and recombinations. Mutations in 7q31 have been implicated in several human malignancies . In addition, a 37mer segment of African green monkey simian immunodeficiency virus env was found.
Saliva Sweat Tears Urine Or Feces
HIV cannot be spread by sharing drinking glasses or by casual kissing. The risk of spreading the virus through deep kissing in which large amounts of saliva are exchanged is extremely low. Only one unproven case has ever been reported.
No cases of HIV spread have ever been reported after a person has come in contact with the sweat, tears, urine, or feces of an HIV-infected person.
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