Cleaning workers may also be exposed to biological agents from blood and body fluids [21] [47]. The
cleaning groups most at risk are cleaners in hospitals, nursing homes, clinics and laboratories, as the
most dangerous biological risk factors for cleaners’ health are blood-borne viruses such as hepatitis C
(HCV) and B (HBV), and Human Immunodeficiency Virus (HIV), both HIV-1 and HIV-2 [45]. The
International Agency of Research on Cancer (IARC) has classified HCV, HBV and HIV-1 as
carcinogenic to humans (group 1) and HIV-2 as possibly carcinogenic to humans (group 2B).
Contamination with blood-born pathogens may occur when infected blood or body fluid enters the body
for example through wounded skin, through the mucous membrane that lines body cavities - for
instance the nose and eyes - or enters immediately into the bloodstream, for example if a needlestick
injury occurs or small patters of blood or body liquid come into the eyes or other mucous membranes [9]
[45]. Since the HIV epidemic continues to grow, every time cleaning workers come upon a situation
where they might be in contact with blood, it is more likely that the HIV and other infectious viruses are
present and the risk of exposure is greater than in the past. Since the transmission route of HIV is
blood, cleaners who have to handle medical wastes, possibly contaminated needles and sharps,
workers cleaning public toilets and sinks, or who have to clean blood are at risk and should wear rubber
gloves and ensure splash protection [45]. An additional preventive measure would also be vaccination
against blood-borne viruses such as Hepatitis B. On 17 July 2009, the EU social partners HOSPEEM
(European Hospital and Healthcare Employers' Association) and EPSU (European Public Services
Union) signed a “framework agreement on prevention from sharp injuries in the hospital and health care
sector” which applies to all workers “in hospital and healthcare sector-directly related services and
activities”, thus including cleaning workers in this sector [48]. A lot of practical information material on
how to prevent needlestick injuries and how to handle sharps is available from the Agency’s website18