Occupational Exposures, Body Fluid Exposures and Occupational Injuries

Overview/Rationale

At the medical center, we recognize our obligation to have policies and procedures in place to protect health professional students from infectious and environmental hazards, ensuring their safety and well-being. These procedures reduce anxiety and manage educational interruptions. They also promote best practices in infection control and provide access to necessary healthcare and follow-up. Additionally, such procedures model professional behavior and prepare students for safe clinical practice. 

VP&S seeks to prevent medical student exposure to infectious and environmental hazards through education and use of appropriate procedures and engineering controls and provides prophylaxis therapy if students are exposed to infectious agents. 

Medical students must receive education and training regarding the methods of prevention of exposure to infectious and environmental hazards. Instruction may also include the use of adequate barrier protection (gloves, safety glasses, mask, gown, etc.), sharps precautions, and hand washing/hygiene, as well as other relevant health care workers. 

Accreditation Standards:  

LCME Accreditation Standard: 12.8 Student Exposure Policies/Procedures 

Stakeholders

Graduate Students (Inclusive of Medical Students) on the Columbia University Irving Medical Center Campus 

Policy: (Includes definitions and procedures) 

Students, including visiting students, are instructed to first clean and decontaminate by washing wounds and contaminated skin with soap and water; rinse mouth, nose and eyes with water or saline.  

Occupational Exposures | Student Health on Haven 

Medical Services is available to treat all body fluid exposures and occupational injuries. Remember, body fluid exposures are a medical emergency.  

  • If you sustain an occupational exposure, contact Student Health on Haven immediately. If we are closed, contact the Student Health clinician on call at 212-305-3400 and go to the nearest emergency room.  

  • If prophylaxis is indicated, the goal is to start within 1-2 hours of the exposure.  

  • The first dose of post-exposure prophylaxis can be given at Student Health on Haven with no cost to the student, and a prescription will be sent to the pharmacy for the remainder of the treatment. 

  • You must also file an incident report at your clinical site for any body fluid exposure or injury.  

Blood-Borne Pathogen Exposures  

A blood-borne pathogen exposure is not JUST a needle stick, but the exposure of non-intact skin or any mucosal surface to blood or other potentially infectious body fluids (e.g., semen, vaginal secretions, breast milk,  Cerebrospinal fluid (CSF), peritoneal or pericardial fluid, saliva in dental procedures, or any fluid contaminated by blood).  

Follow these steps immediately for a blood-borne pathogen exposure:  

  • Cleanse the injury (soap and water).  

  • Notify your resident, preceptor or attending to arrange for prompt counseling and testing of the source patient for HIV, Hepatitis C and Hepatitis B. Getting the source patient tested can potentially save you a month of prophylaxis, drug side effects, and many months of anxiety.  

  • Seek medical attention immediately.  

  • Notify Student Health.  

Effects of infectious and/or environmental disease or disability on medical student learning activities 

As soon as possible students must Inform their supervisor(s). Students will not be excluded or discriminated against in any way due to infection of a potentially transmissible disease.  

  • Only a qualified, medically-based judgement can establish exclusion or restriction if the welfare of patients, other members of the patient-care community, or welfare of the individual is deemed to be at risk.  

  • Students who are infected with any potentially transmissible disease will not be excluded from participating in patient-care activities, or restricted in their access to patient-care services or facilities because of their health status, unless medically-based judgements in individual cases establish that exclusion or restriction is appropriate for the welfare of patients, the welfare of other members of the patient-care community, or the welfare of the individual. 

Insurance Considerations for Occupational Exposures  

As a preventive measure, all clinical students enrolled in the Columbia University Student Health Insurance Plan are enrolled in an annual supplemental plan to cover blood-borne pathogen exposures. The annual premium for this plan is $10, and the fee will be assessed during the fall semester. New incoming Spring or Summer students are billed $10 during their respective term of arrival.  

The supplemental insurance plan will minimize your out-of-pocket costs should you require treatment related to any blood-borne pathogen exposure in the course of your clinical experience.   

If you are planning to waive the Aetna Student Health Insurance Plan, please ensure you have adequate coverage in case of occupational exposure to blood-borne pathogens.    

For questions about reimbursements or procedures, please contact shsinsurance@cumc.columbia.edu(link sends e-mail).  

Environmental Safety: 

The following Environmental Health and Safety policies and procedures include guidelines, plans and written programs for hazardous waste at Columbia University. Review the Hazardous Chemical Waste Management Guidelines: Hazardous Chemical Waste Management Guidelines | Columbia | Research at this site.