Text For Citation: 02 Item/Group: 001 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: a) The hazards to employees working with blood and body fluids thus causing or likely to cause employee exposure to and contraction of Hepatitis B Virus (HBV) and/or Human Immunodeficiency Virus (HIV). Health Care workers exposed include physicians, nurses, nursing assistants, phlebotomists, medical technologists, technicians, housekeeping and maintenance personnel on or about 7/26/89. Feasible abatement methods for reducing this hazard, include but are not limited to: TRAINING AND EDUCATION Training and Education of Health Care Workers such as but not limited to physicians, pathologists, dentists, dental technicians, decay technicians, phlebotomists, emergency room, intensive care and operating nurses and technicians, laboratory and blood bank technicians housekeeping personnel, laundry workers, orderlines, morticians, research laboratory workers, paramedics and medical examiners. Such training and education shall be at the time of initial employment and at least annually thereafter. The training materials used shall be appropriate in content and vocabulary to educational level, literacy, and language background of the employees being trained. The Training and Education Program shall contain as a minimum the following elements: I) A general explanation of the modes of transmission of bloodborne pathogens; II) An explanation of the employer's Infection Control Program; III) An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood or body fluids and other potentially infectious materials; IV) An explanation of the use and limitations of work practices that will prevent or reduce employee exposure, including appropriate engineering controls, work practices, and personal protective equipment; V) An explanation of the basis for selection of personal protective equipment; VI) Information on the Hepatitis B vaccination, including information on its efficacy, safety and the benefits of being vaccianted; VII) Information on the appropriate actions to be taken and the person to contact in an emergency; VIII)An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available; IX) An explanation of the signs and labels and/or color coding used in the wokrplace; X) A copy of the Center for Disease Control (CDC) Guidelines. WRITTEN INFECTION CONTROL PROGRAM The employer shall design and implement a written Infection Control Program to minimize or eliminate employee exposure. This Infection Control Program shall be reviewed and updated as necessary to reflect significant changes in tasks or procedures. This program shall contain as a minimum the following: I) A determination of the exposure potential of all employees; II) The schedule and method of implementation of the Infection Control Program. The written Infection Control Program shall be made available to all employees during the training program. HEPATITIS B VACCINATION The facility's infection control policy regarding Hepatits B vaccinations shall address all circumstances warranting such vaccinations and shall identify employees at substantial risk of directly contacting body fluids. All such employees shall be offered Hepatitis B vaccinations in amounts and at times prescribed by standard medical practice. FOLLOW-UP PROCEDURES AFTER POSSIBLE EXPOSURE TO HIV/HBV: I) If a health care worker has a percutaneous (needlestick) or cut or mucous membrane (splash to eve, nasal mucosa, or mouth) exposure to body fluids or has a cutaneous exposure to blood or body fluids when the worker's skin is chapped, abraded, or otherwise nonintact, the source patient shall be informaed of the incident and tested for HIV and HBV infections, after consent is obtained. II) If patient consent is refused or if the source patient tests positive, the health care worker shall be evaluated clincially by HIV antibody testing as soon as possible and advised to report and seek medical evaluation of any acute febrile illness that occurs within 12 weeks after exposure. HIV seronegative workers shall be be retested 6 weeks post-exposure and on a periodic basis thereafter (12 weeks and 6 months after exposure). III) Follow-up procedures shall be taken for health care workers exposed or potentially exposed to HBV. The type of procedures depends on the immunization status of the worker (i.e., whether HBV vaccination has been received an antibody response is adequate) and the HBV serologic status of the source patient. The CDC Immunization Practices Advisory Committee has published its recommendations regarding HBV post-exposure prophylaxis in table format in the June 5, 1985, Morbidity and Mortality Weekly Report. IV) If an employee refuses to submit to the procedures in (b) or (c) above, when such procedures are medically indicated, no adverse action can be taken on that ground alone since the procedures are designed for the benefit of the exposed employee. HANDLING OF LINEN The Infection Control Program shall have identified all laundry operations involving substantial risk of direct exposure to blood or body fluids. Linen spoiled with blood or body fluids shall be handled as little as possible and with minimum agitation to prevent contamination of the person handling the linen. All soiled linen shall be bagged at the location where it was used; it shall not be sorted or rinsed in patient-care areas. Soiled linen shall be placed and transported in bags that prevent leakage.