Violation Detail
Standard Cited: 5A0001 OSH Act General Duty Paragraph
Inspection Nr: 103039228
Citation: 01001
Citation Type: Serious
Abatement Date: 06/21/1992 X
Initial Penalty: $750.00
Current Penalty: $375.00
Issuance Date: 12/18/1991
Nr Instances: 1
Nr Exposed: 7
Related Event Code (REC):
Gravity: 01
Report ID: 0522500
Contest Date:
Final Order:
Emphasis:
| Type | Latest Event | Event Date | Penalty | Abatement Due Date | Citation Type | Failure to Abate Inspection |
|---|---|---|---|---|---|---|
| Penalty | I: Informal Settlement | 01/06/1992 | $375.00 | 06/21/1992 | Serious | |
| Penalty | Z: Issued | 12/18/1991 | $750.00 | 01/21/1992 | Serious |
Text For Citation: 01 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. Health care workers such as Direct Care Staff at 7 Brian Cliff Drive, Cambridge, Ohio were exposed to the hazard of being infected by HBV and/or HIV through possible direct contact with blood or other body fluids. Feasible and useful abatement methods for reducing this hazard are: 1. Hepatitis B Vaccination. The facility's IC policy regarding hepatitis B vaccinations shall address all circumstances warranting such vaccinations and shall identify employees at substantial risk of directly contactig body fluids. All such employees shall be offered hepatitis B vaccinations free of charge in amounts and at times presribed by standard medical practices. 2. Linen. The IC program shall have identified all laundry operations involving substantial risk of direct exposure to body fluids. Linen soiled with 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 rinced in the patient-care areas. Soiled linen shall be placed and transported in bags that prevent leakage. 3. Bagging the Articles. Objects that are contaminated with potentially infectious materials shall be placed in an impervious bag. If outside contamination of the bag is likely, a second bag shall be added. 4. Handwashing. After removing gloves, hands or other skin surfaces shall be washed thoroughly and immediately after contact with body fluids. 5. Follow-up Procedures After Possible Exposure To HIV or HBV: a. If a health care worker has a percitaneous (cut) or mucous membrane (splash to eye, nasal mucous, or mouth) exposure to body fluids has a cutaneous exposure to bood when the workers 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. b. If patient consent is refused or if the source patient tests positive, the health care worker shall be evaluated clinically and 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 six weeks post-exposure and on a periodic basis thereafter (12 weeks and six months after exposure). c. Follow-up procedures shall be taken for health care workers exposed or potentially exposed to HBV. The types of procedures depends on the immunization status of the worker (i.e., whether HBV vaccinatin 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 postex- posure prophylais in table format in June 7, 1985, Morbidity and Mortality Weekly Report. d. 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. 6. Training and Education Of Health Care Workers. The employer's training program shall be evaluated in accordance with Appendix C. a. All high risk health care workers such as those listed in H.1 shall receive education on precautionary measures, epidemiology, modes of transmission and prevention of HIV/HBV. Health care workers shall be counseled regarding possible risks to the fetus from HIV/HBV and other associated infectious agents. b. In addition, such high risk workers must receive training regarding the location and proper use of personal protective equipment. They shall be trained concerning proper work practices and, if the facility has implemented them, shall understand the concept of "universal precautions" as it applies to their work practices. They shall be trained about the meaning of color coding or other methods (except tags) used to designate contaminated articles or infectious waste. Where tags are used, training about tags and precautions to be used in handling contaminated articles or infectious waste is governed by 29 CFR 1910.145(f). (see section M.4.) Workers shall receive training about procedures to be used if they are exposed to body fluids.
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