Student Exposure to Infectious and Environmental Hazards Policy

Formerly known as Universal Precautions or Body Substance Isolation.

Standard Precautions

  • Consider blood, body fluids and tissue from ALL PATIENTS to be potentially infectious.
  • Perform hand hygiene before/after all patient contacts.
  • Wear gloves when exposure to blood and body fluids may occur, e.g., during phlebotomy. Change your gloves and perform hand hygiene after each procedure and before contact with another patient.
  • Wear a gown, mask and goggles when blood or body fluids splashes may occur, e.g., during surgery, placing nasogastric tubes, etc.
  • Report immediately all incidents of blood and body fluid exposure of the following types:
    • Parenteral: needle stick, puncture or cut.
    • Mucous membrane: splash to eyes, nose, mouth.
    • Cutaneous: contact with blood and body fluids on ungloved hands or other skin surfaces that may be cut, chapped, abraded, or affected by active dermatitis.

Exposure Risk

High Risk Exposure

  • Needle stick, especially hollow-bore needles and/or deep injury
  • Other percutaneous injuries such as cuts
  • Source patient with known untreated or poorly controlled infection with HIV/HBV/HCV

Lower Risk Exposure

  • Mucous membrane splash
  • Non-intact skin splash
  • Human bite with blood exposure

Exposure Management

Possible Hepatitis B, Hepatitis C, HIV exposure.

Immediate Response

  • Clean wounds or punctures with soap and water
  • Flush mucous membranes or skin copiously with water or saline
  • DO NOT “force bleed” the wound
  • DO NOT apply caustics (eg, bleach, organic solvents, hard surface disinfectants, etc.)

After First Aid

  • Prompt medical evaluation is important to ensure adequate treatment.
  • Inform the supervising house officer or attending physician of any exposures and report, as soon as possible, to the Emergency Department or Employee Health Service at the institution where the exposure occurred. If the student is at a facility without either of the above, report to the UB Student Health Center on the Main Street Campus or the emergency department of an affiliated hospital.
  • When HIV post–exposure prophylaxis (PEP) is indicated, early treatment (within hours) is recommended.
  • Carefully note the type of exposure, type of fluid/tissue involved and appropriate information about the source patient (risk factors, lab data)

Laboratory Data For Proper Management

  • On the EXPOSED health care worker:
    • Hepatitis B & C antibody tests
    • HIV test (4th generation)
    • If HIV PEP will be used: CBC, electrolytes, BUN/creat, LFTs, pregnancy test
  • On the SOURCE patient:
    • Hepatitis B surface antigen
    • Hepatitis C RNA test
    • HIV test (4th generation)


General management

  • Tetanus toxoid (if needed)
  • No specific treatment if HCV (+) source

Hepatitis B specific management

  • Hepatitis B vaccine (if not immune)
  • Hepatitis B Immune Globulin (HBIG) if not immune and known Hepatitis B surface antigen (+) source


  • May be indicated – prescribed according to CDC guidelines based on severity of injury & risk of source patient (see More Information)


More Information

Students will be excused from all learning activities to address the potential risks or effects of infectious or environmental disease or disability. Students will also meet with the Senior Associate Dean for Student and Academic Affairs to discuss the impact on their education and/or graduation date.

Reason For Policy

LCME Element 12.8 Student Exposure Policies/Procedures

A medical school has policies in place that effectively address medical student exposure to infectious and environmental hazards, including the following:

  • The education of medical students about methods of prevention
  • The procedures for care and treatment after exposure, including a definition of financial responsibility
  • The effects of infectious and environmental disease or disability on medical student learning activities

Reviewed by Curriculum Committee: 11/30/18
Passed by Curriculum Committee: 12/21/18
Policy Implementation: Course/Clerkship Directors, Senior Associate Dean for Student and Academic Affairs
Policy Contact: Senior Associate Dean for Student and Academic Affairs