Text For Citation: 01 Item/Group: 002 Hazard: BLOODBORNE

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees were exposed to infectious bloodborne diseases: a) Employees such as, but not limited to, the dental assistants performing and assisting with dental surgeries and routine procedures while working throughout the dental practice are exposed to the hazard of being infected with HBV and/or HIV through possible direct contact with blood or body fluids: Center for Disease Control (CDC) recommended universal precautions are not being followed for all situations where blood and body fluids are/or may be encountered. 1) The Hepatitis B vaccine was not offered to employees who are at substantial risk of contacting blood and/or body fluids. 2) Appropriate follow-up procedures after a possible exposure to HIV/HBV were not developed nor implemented. 3) Training for high risk health care workers was inadequate in that employees had no knowledge of: all aspects of personal protective equipment, "universal precautions", color coding, other methods used in designating contaminated waste, precautions used in handling contaminated articles or infectious waste, and procedures used when exposed to a needlestick or to body fluids. Some feasible and acceptable abatement methods among others to correct these hazards are: 1) Provide training and education on the Universal Precaution system. This training would be based on the fact that all patients would be treated as infectious meaning all employees would be mandated to use personal protective equipment for all procedures where potential exposure to blood, body lfuids, and/or gingiral fluid would occur (i.e., eye protection, surgical masks, gloves, etc..,). 2) Provide a policy that addresses all circumstances warranting Hepatitis B vaccinations and identify employees at substantial risk of direct contact with body fluids. Offer employees Hepatitis B vaccinations in amounts and at times prescribed by standard medical practice. 3) Follow CDC guidelines (Appendix B) "recommendations for prevention of HIV Transmission in Health-Care Settings"; Management of exposures for follow-up procedures after possible exposure to HIV/HBV. 4) Provide training and education on precautionary measures, epidemiology, modes of transmission and prevention of HIV/HBV. Provide counseling regarding possible risks of transmission to the fetus of HIV/HBV and other infectious agents. Training and education will also include providing information on personal protective equipment, color coding, handling of infectious waste, and procedures after exposure. ABATEMENT NORMALLY WILL BE MULTI-STEP AS FOLLOWS: STEP 1: Provide and ensure use of protective equipment to exposed employees. STEP 2: Submit to the Area Director a written detailed plan of abatement outlining a schedule for the implementation of engineering and/ or administrative measures to control employee exposures to hazardous substances referenced in this citation. The plan shall include, at a minimum, target dates for the following actions which should be consistent with the dates required by this citation. a) Evaluation of engineering/administrative control options; b) Selection of optimum control methods and completion of design; c) Procurement, installation and operation of selected control measures; d) Testing and acceptance or modification/redesign of controls. All proposed control measures shall be evaluated for each particular use by a competent Industrial Hygienist or other technically qualified person. Thirty (30) day progress reports are required during the abatement period. STEP 3: Abatement shall have been completed by the implementation of feasible engineering and/or administrative controls and upon verification of their effectiveness of achieving compliance.