Bloodborne Risks in Child Care Settings
Early childhood professionals may not encounter bloodborne pathogens in the same capacity as health care workers, yet they still do on a frequent basis. Being in close contact with small children throughout the day when feeding, diapering, comforting, teaching, and playing with them provides a level of exposure risk to bloodborne pathogens. While it may not seem entirely risky to perform these daily duties, the potential for bloodborne pathogens to be present should always be considered and standard or universal precautions should be taken.
Being bitten is a real possibility for child care providers. It is important to note that biting is not a common way of transmitting HIV. In fact, there are numerous reports of bites that did not result in HIV infection. However, infection is possible when there is severe tissue tearing and damage combined with the presence of blood. The chance of transmitting HIV through a bite in a child care center, even when the skin is broken, is extremely unlikely and has never been reported.
As previously mentioned, certain events in child care settings are common and could present risk of exposure to bloodborne pathogens. Seemingly harmless situations such as a child losing a tooth, could potentially expose others to bloodborne pathogens. This is why employers are required to implement a “control plan” with details on how to protect employees and others from exposure.
According to OSHA “the plan must also describe how an employer will use engineering and work practice controls, personal protective clothing and equipment, employee training, medical surveillance, hepatitis B vaccinations, and other provisions as required by OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030).” This plan must be made available to all staff and should describe safe work practices, provide PPE (personal protective equipment) and protective clothing, provide annual training and review, signs, management and labels for infected materials, and hepatitis B vaccination information.
The Bloodborne Pathogens Standard was a result of the 2000 Needlestick Safety and Prevention Act which is a regulation that outlines certain precautions to protect workers against health hazards related to bloodborne pathogens. This standard includes exposure control plans, required training, vaccination information and requirements, recordkeeping, and engineering and work practice controls. This is important information for all staff members within a workplace to have and be well acquainted with.
For more information, employers should contact OSHA’s Small Business On-Site Consultation Services at https://www.osha.gov/dcsp/smallbusiness/consult.html
HIV & AIDS in Child Care Facilities
Child care facilities have a special responsibility to care for children with diverse needs. The ADA, which prevents discrimination against people with disabilities, also applies to child care facilities. The ADA specifies that children cannot be denied admission to child care facilities on the basis of their disability, including HIV status. The only exception applies to cases when the presence of the disability is a direct threat to the health or safety of others.
Child care facilities are required to make reasonable accommodations to care for children with all disabilities, including HIV. For example, if a child care facility has a general policy against administering medication to children, it may be necessary to make exceptions to this rule so that children with HIV can receive doses of medication on the prescribed schedule. Laws regarding requirements for specific accommodations may differ by state. Child care facilities cannot require HIV testing as a basis of admission. Parents and/or guardians are not required to report the HIV diagnosis to the child care facility.
However, it is generally recommended that the immunodeficiency, if not the HIV diagnosis, be shared with the child care facility and the child care provider to allow appropriate precautions to be taken. If information is disclosed, it can only be shared with those individuals who are approved by the guardian in writing. These individuals might or might not include the child care provider. Confidentiality laws require that child care facilities cannot share a child’s HIV status with guardians of other children in the program.
Since children and employees are not required to disclose their HIV status, child care providers may not be aware that the infection is present in the classroom. Therefore, universal precautions are necessary throughout the child care facility to ensure that the disease is not transmitted. Remember that HIV cannot be transmitted through casual contact. The virus is not spread through saliva, urine, mucus, or sweat.