Many school personnel are concerned that HIV may be spread through contact with blood and other body fluids when an accident occurs in school.
HIV, as noted earlier, has been found in significant concentrations in blood, semen, vaginal secretions, and breast milk. Other body fluids, such as feces, urine, vomit, nasal secretions, tears, sputum, sweat, and saliva do not transmit HIV unless they contain visible blood. However, these body fluids do contain potentially infectious germs from diseases other than AIDS. If you have contact with any of these body fluids, you are at risk of infection from these germs. It should be remembered that the risk of transmission of these germs depends on many factors, including the type of fluid contacted, the type of contact made, and the duration of the contact. Also, specifically related to HIV, there has never been a reported case of HIV transmission in a school (or similar setting), even when contact with blood and body fluids has occurred.
Very simply, it is good hygiene policy to treat all spills of body fluids as infectious in order to protect personnel from becoming infected with any germs and viruses. The procedures outlined below offer protection from all types of infection, and should be followed routinely.
How Should Blood and Body Fluid Spills be Handled?
Whenever possible wear disposable, waterproof gloves when you expect to come into direct hand contact with body fluids (when treating bloody noses, handling clothes soiled by incontinence, or cleaning small spills by hand). Gloves used for this purpose should be put in a plastic bag or lined trash can, secured, and disposed of daily. Hands should always be washed after gloves are removed, even if the gloves appear to be intact.
If you have unexpected contact with body fluids or if gloves are not available (for example, when wiping a runny nose, applying pressure to a bleeding injury outside the classroom, or helping a student in the bathroom), you should wash your hands and other affected skin for at least 10 seconds with soap and water after the direct contact has ended. This precaution is recommended to prevent exposure to other pathogens, not just HIV. As has been discussed, blood, semen, vaginal secretions, and blood-contaminated body fluids transmit HIV. Wiping a runny nose, saliva, or vomit does not pose a risk for HIV transmission.
Most schools already have standard procedures in place for removing body fluids such as vomit. These policies should be reviewed regularly by appropriate personnel to determine whether appropriate cleaning and disinfection steps have been included.
Handwashing
Proper handwashing requires the use of soap and warm water and vigorous washing under a stream of running water for at least 10 seconds. If hands remain visibly soiled, more washing is required. Scrubbing hands with soap will suspend easily removable soil and microorganisms, allowing them to be washed off. Running water is necessary to carry away dirt and debris. Rinse your hands under running water and dry them thoroughly with paper towels or a blow dryer. When hand-washing facilities are not available, use a waterless antiseptic cleanser, following the manufacturer’s directions for use.
Disinfectants
An EPA approved germicide or a solution of 99 parts water to 1 part household bleach (or ¼ cup bleach to one gallon of water) will inactivate HIV, and should be used to clean all body fluid spills. Higher concentrations of bleach can be corrosive, and are unnecessary. Surfaces should be cleaned thoroughly prior to dis-infection.
Disinfecting Hard Surfaces and Caring for Equipment
Although hard surfaces have not been found to be a means of transmitting HIV, it is good hygiene policy to clean any soiled hard surfaces thoroughly. To do this, scrub the surface to remove any soil and apply a germicide (like the bleach/water solution described above) to the equipment used. Mops should be soaked in this solution after use and rinsed thoroughly with warm water. The solution should be promptly disposed of down a drain pipe. Remove gloves and discard them in appropriate receptacles, and wash hands as described above.
Laundry Instructions for Clothing Soiled with Body Fluids
It is important to remember that laundry has never been implicated in the transmission of HIV. To ensure safety from transmission of other germs, contaminated clothes must be laundered with soap and water to eliminate potentially infectious agents. The addition of bleach will further reduce the number of potentially infectious agents. Clothing soaked with body fluids may be washed separately from other items. Pre-soaking may be required for heavily soiled clothing. Otherwise, wash and dry as usual, following the directions provided by the manufacturer of the laundry detergent. If the material can be bleached, add ½ cup of household bleach to the wash cycle. If the material is not colorfast, add ½ cup of non-chlorine bleach to the wash cycle.
It is good hygiene to treat all bodily fluids as infectious.
NOTE: Information for the above section based on the following:
“Guidelines for Handling Body Fluids in the School Setting,” National Association of School Nurses, 1988. Used with permission.
Centers for Disease Control. Recommendations for prevention of HIV transmissions in health-care settings. MMWR 1987; 36 (suppl. no. 2S)
Centers for Disease Control. Update: Universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health care settings. MMWR 1988; 37:377 – 382, 387.
