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Universal Precautions and Workplace Safety

Though not all harm reduction organizations or programs are in need of universal precautions or OSHA considerations, most are. It’s important when setting up a harm reduction space to take into consideration the important and real risks of harm reduction work. This includes the potential for entry and exposure to blood-borne pathogens as well as airborne pathogens.

Important Definitions

Airborne pathogen—Pathogenic microorganisms present in the human mouth, lungs, or throat that can cause disease in humans through wide airborne dispersal. These pathogens include, but are not limited to, measles morbillivirus, chickenpox virus, mycobacterium tuberculosis, influenza virus, enterovirus, norovirus, and less commonly coronavirus, adenovirus, and possibly respiratory syncytial virus.

Bloodborne pathogen—Pathogenic microorganisms present in human blood that can cause disease in humans. These pathogens include but are not limited to the ones that harm reduction workers are most at risk from, including hepatitis C virus (HCV), hepatitis B virus (HBV), human immunodeficiency virus (HIV), as well as those that pose lesser risk such as tetanus and syphilis.

Droplet borne pathogen—Pathogenic microorganisms present in respiratory droplets, generated by coughing, sneezing, or talking. Respiratory droplet transmission is the most common route for respiratory infections. Transmission can occur when respiratory droplets reach susceptible mucosal surfaces, such as in the eyes, nose, or mouth. This can also happen indirectly via contact with used surfaces when hands touch droplets and then touch the face. Respiratory droplets are large, cannot remain suspended in the air for long, and are usually dispersed over short distances. Viruses spread by droplet transmission include influenza virus, rhinovirus, respiratory syncytial virus, enterovirus, norovirus, measles morbillivirus, and coronaviruses such as SARS coronavirus (SARS-CoV-1), and SARS-CoV-2, which causes COVID-19.

Un-used supplies—Unused harm reduction or safer sex materials still in their original packaging or containers which are not subject to potential contamination such as bagged supplies. Examples include packed or bagged syringes and supplies, cases or boxes of materials and so on.

Exposed supplies—Unused harm reduction or safer sex materials no longer in their original packaging or containers which are subject to potential contamination or substantial risk of passive or indirect exposure. Examples include unpacked syringes, un-boxed cookers, un-bagged cottons, and so on.

Used supplies—Harm reduction or safer sex supplies which are used and subject to potential contamination or a substantial risk for cross-contamination. Examples include used syringes, cookers, cottons, tourniquets, and so on.

Sharps—Any object whose primary purpose is to pierce the skin such as syringes, needles, lancets, autoinjectors, infusion sets, IVs, scalpels, etc.

Bio-waste or sharps container—Hard-sided containers marked with a biowaste symbol used to dispose of all materials that might be contaminated with hazardous or biological waste. For harm reduction, this includes syringes, tourniquets, cottons, cookers, wound care supplies, and so on.

Cross-contamination—The process by which pathogens are unintentionally transferred from one substance or object to another. Examples include touching surfaces or used sharps or supplies and then touching one’s mouth or an open wound.

Exposure control plan (ECP)—The official workplace exposure control plan for a workplace under OSHA guidelines based on OSHA standard 29 CFR 1910.1030.

Personal protective equipment (PPE)—Equipment worn to minimize exposure to hazards that can cause workplace injuries and illnesses. For bloodborne pathogen control, PPE can also include lab coats and gowns, splash guards, gloves, and goggles. For air- or droplet-borne pathogens, PPE includes gloves, face masks, and goggles.

Featured Hacks

These featured hacks highlight creative, practical solutions from harm reduction leaders on the ground. From DIY tools to clever workarounds, each one reflects the ingenuity, care, and real-world experience that keeps this movement alive. 

Though not all harm reduction organizations or programs are in need of universal precautions or OSHA considerations, most are. It’s important when setting up a harm reduction space to take into consideration the important and real risks of harm reduction work. This includes the potential for entry and exposure to blood-borne pathogens as well as airborne pathogens.
The concept of “consent culture” emerged from the sex positive movement of the 1980s and 90s. It was a response to the concept of “rape culture”, a term that had been coined to describe the experience that many people—especially women, queer and trans people—have of sexual violence and harassment.