Issue link: https://www.massageandbodyworkdigital.com/i/1515580
58 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 24 Committee put out the first version of what we now call Standard Precautions. In its early days, the emphasis remained on limiting exposure to blood. The Occupational Safety and Health Administration (OSHA), a branch of the US Department of Labor, filled in some details of Standard Precautions with their identification of "other potentially infectious materials," or OPIM. According to OSHA, OPIMs include: • semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, amniotic fluid, saliva during dental procedures, and fluid visibly contaminated with blood, any fluid for which it is difficult to determine • unfixed tissue or organ (outside of intact skin) • HIV-containing tissue cultures or other solutions from humans or animals infected with HIV or HBV Interestingly, OPIMs don't include tears, sweat, saliva (unless it is blood-tinged), nasal secretions, vomit, feces, or urine. STANDARD PRECAUTIONS TODAY The main emphasis in Standard Precautions is still blood-borne infections. However, as we have learned more about disease transmission, the Centers What Does Standard Precautions Really Mean? Well, It Depends . . . By Ruth Werner I n massage therapy education and practice, we often throw around the term Standard Precautions like it means the same thing to all people. That turns out not to be true: Recommendations vary according to setting and risks, and no single list of rules or recommendations for massage therapy has ever been published by a government agency. A LITTLE HISTORY In 1985, the HIV/AIDS epidemic had already established a strong foothold in the US. At this time, US health agencies finally began to acknowledge that the infection was a real problem—specifically for health-care providers who were at risk for accidental exposure to the infection through needle sticks. This prompted the development of the first stringent and widely applied infection-control protocols for blood-borne pathogens. These were called Universal Precautions, and they were built mainly around trying to prevent the spread of HIV in health-care settings. It was quickly found that these recommendations were inadequate, so in 1987 the idea of Body Substance Isolation was introduced. The purpose of this guidance was to "avoid direct physical contact with all moist and potentially infectious body substances, even if blood is not visible." 1 Again, the focus was on blood-borne pathogens, especially HIV and varieties of hepatitis viruses, although the use of masks against airborne infections for nurses was also introduced at this time. Between 1987 and 1996, we learned much more about HIV, and hepatitis, along with the transmission mechanisms of other infections, and the Healthcare Infection Control Practices Advisory KEY POINT • Standard Precautions have changed over the years as agencies have attempted to limit exposure to pathogens.