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C UNIVERSAL PRECAUTIONS (BSI) E patient at the time, rather than on the DIAGNOSIS of the patieint which is the cornerstone of the traditional isolation systems. Another reason for this change from a traditional "diagnosis -driven" isolation system to the new "interaction -driven" Body Substance Precautions System is that for virtually all infectious diseases, the diagnosed cases represent only the tip of the iceberg. This certainly is true for HIV infection and for HBV infection. Focusing on isolation precautions only on diagnosed cases of AIDS and hepatitis 8 musses the vast majority of persons who have the infectious agents, in their blood. Because the status of all patient's blood cannot be known for these or other infectious diseases, it makes far more sense to treat ALL blood and body substances as potentially infectous rather than to focus precautions only on the patients diagnosed with infectious diseases. Human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), and hepatitis B virus (HBV) is transmitted through sexual contact and exposure to infected blood or blood components and perinatally froim mother to neonate. HIV has been isolated from blood, semen, vaginal secretions, saliva, tears, breast milk, cerebrospinal fluid, amniotic fluid, and urine and is likely to be isolated from other body fluids, secretions, and excretions. However, epideniologic evidence has implicated only blood, semen, vaginal secreations, and possibly breast milk in transnission.(1) Despite the similarities in the modes of transmission, the risk of HBV infection in the health care setting far exceeds that for- HIV infection. Following puncture with a needle contaminated by an HBV carrier, the number of infections ranges from 6% to 0% as compared to a 1% risk of acquiring HIV infection under similar circ stnces.(2) The increasi�g prevalence of HIV increases the.risk that health-care workers will be exposed to blood from patients infected with HIV, expecially when blood and body -fluid precautions are not followed for all patients. Thus., this document again emphasizes the need for health-care workers to consider all patients as potentially infected with HIV/HBV and/or other blood-borne pathogens and to adhere rigorously to infection control precautions for minimizing the risk of exposure to blood and body fluids of all patients. In addition, colonized body substances are major reservoirs for multi -drug resistant organisms that can be easily transmitted from patient to patient on the hands of personnel. The Body Substance Isolation System also reduces the risks of such transmissions by the consistent use of barriers whenever any body substances are likely to be in contact with the care giver's hands. Body Substance Isolation provides a consistent approach to managing body substances from ALL patients and is essential to prevent transmission of potentially infectious agents.