Infection control is central to safe phlebotomy practice and is governed primarily by the Occupational Safety and Health Administration (OSHA) and the Bloodborne Pathogens Standard, codified as 29 CFR 1910.1030. This regulation requires employers to protect employees from occupational exposure to blood and other potentially infectious materials. The three primary bloodborne pathogens of concern in healthcare are Human Immunodeficiency Virus (HIV), Hepatitis B (HBV), and Hepatitis C (HCV). Standard Precautions, also historically called Universal Precautions, direct healthcare workers to treat all blood and body fluids as potentially infectious regardless of a patient's diagnosis. A written exposure control plan must be in place outlining the employer's strategy for minimizing employee exposure to these pathogens, and the Hepatitis B vaccine must be offered free of charge to all employees at risk of occupational exposure.
Personal Protective Equipment (PPE) is the first line of defense against exposure. For routine phlebotomy, this includes gloves at a minimum, with gowns, masks, and face shields added as needed based on the risk of splash or splatter. The correct order for removing, or doffing, PPE is gloves first, then gown, and finally mask and eye protection, followed by thorough hand hygiene. Hand hygiene itself must be performed before and after every patient contact to prevent the spread of infection between patients and healthcare workers, and the CDC recommends washing with soap and water for at least 20 seconds. Biohazardous waste is identified by orange or red bags and containers marked with the biohazard symbol.
Sharps, particularly needles, lancets, and glass capillary tubes, present one of the greatest occupational hazards in phlebotomy. Needles must never be recapped by hand, because this is a leading cause of accidental needlestick injury. If recapping is absolutely unavoidable, a one-handed scoop technique may be used. Used sharps must be discarded immediately into a puncture-resistant, leak-proof, labeled biohazard sharps container. These containers should be replaced when they reach approximately three-quarters full, as overfilled containers increase the risk of injury during disposal. After any needlestick or other potential exposure incident, the worker must immediately wash the affected area with soap and water, report the incident according to facility protocol, and seek prompt medical evaluation and follow-up.