Text For Citation: 03 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 employee(s) were expsoed to the hazard of becoming infected with Hepatitis B virus (HBV) and/or Human Immunodeficiency Virus (HIV) through possible direct contact with blood or other body fluids. (a) Establishment - Housekeeping and Health Care Depts. On 11/20/91, Health care workers and housekeeping personnel were exposed to the hazard of being infected by HBV and/or HIV through possible direct contact with blood or other body fluids, while performing patient care and laundry sorting: (a) These employees were not offered Hepatitis B Vaccination. (b) The infection control Program did not include follow-up procedures after possible exposure to Hepatitis B Virus and/or Human Immunodeficiency Virus. ABATEMENT NOTES: Among other methods, one feasible abatement method to reduce this hazard, i s to establish and enforce adequate procedures regarding exposure to and handling of blood and body fluids, such as those stipulated by the Centers for Disease Control (CDC) Guidelines for prevention of transmission of Huma n Immunodeficiency Virus and Hepatitis B Virus to health care and public safety workers. HEPATITIS B VACCINATION The facility's infection control policy regarding Hepatitis B vaccinations shall address all circumstances warranting such vaccinations and shall identify employees of substant- ial risk of directly contacting blood and 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 percutane- ous (needle-stick or cut) or mucous membrane (splash to the eye, nasal mucosa, or mouth) exposure to blood or 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 informed 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 clinically 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 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 immuniza- tion status of the worker (i.e., whether HBV vaccination has been received and 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 (ii) or (iii) 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 soiled 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.