OSHA also requires that this plan include a schedule and method of implementation for the various requirements of the standard. The following complies with this requirement.
(A) Compliance methods.
(1) Universal precautions will be observed at the city in order to prevent contact with blood or other potentially infectious materials. All blood or other potentially infectious material will be considered infectious regardless of the perceived status of the source individual.
(2) Engineering and work practice controls will be utilized to eliminate or minimize exposure to employees at the city. Where occupational exposure remains after institution of these controls, personal protective equipment shall also be utilized. The above controls will be examined and maintained or replaced on a regular schedule by the Safety Committee Chairperson for each department. Hand washing facilities are also available to the employees who incur exposure to blood or other potentially infectious materials. OSHA requires that these facilities be readily accessible after incurring exposure. Public and private restroom facilities are located in each department. When hand washing facilities are not feasible, the city is required to provide either an antiseptic cleanser in conjunction with a clean cloth/paper towels or antiseptic towelettes. These supplies will be provided by the Safety Committee Chairperson for each department.
(3) If these alternatives are used, then the hands are to be washed with soap and running water as soon as feasible. Alternatives to readily accessible hand washing facilities include public services while in city vehicles. The Safety Committee Chairperson for each department is responsible to ensure maintenance and accessibility of these alternatives.
(4) After removal of personal protective gloves, employees shall wash hands and any other potentially contaminated skin area immediately or as soon as feasible with soap and water. If employees incur exposure to their skin or mucous membranes, then those areas shall be washed or flushed with water as appropriate as soon as feasible following contact.
(B) Needles. Contaminated needles and other contaminated sharps will not be bent, recapped, removed sheared or purposely broken.
(C) Containers for reusable sharps. Contaminated sharps that are reusable are to be placed immediately or as soon as possible after use into appropriate sharps containers.
(D) Work area restrictions. In work areas where there is a reasonable likelihood of exposure to blood or other potentially infectious materials, employees are not to eat, drink, apply cosmetics or lip balm, smoke, or handle contact lenses. Food and beverages are not to be kept in refrigerators, freezers, shelves, cabinets, or on counter tops or bench tops where blood or other potentially infectious materials are present. Mouth pipetting/suctioning of blood or other potentially infectious materials is prohibited. All procedures will be conducted in a manner that will minimize splashing, spraying, splattering, and generation of droplets of blood or other potentially infectious materials.
(E) Contaminated equipment. Equipment which has become contaminated with blood or other potentially infectious materials shall be examined prior to servicing or shipping and shall be decontaminated as necessary unless the decontamination of the equipment is not feasible.
(F) Personal protective equipment.
(1) All personal protective equipment used by city employees will be provided without cost to employees. Personal protective equipment will be chosen based on the anticipated exposure to blood or other potentially infectious materials. The protective equipment will be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employees' clothing, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used.
(2) Protective clothing will be provided to employees by the Safety Chairperson of each department. A personal protective equipment assessment will be completed for employees.
(3) All personal protective equipment will be cleaned, laundered, or disposed of by the city at no cost to employees. All repairs and replacements will be made by the City of Bedford at no cost to employees. All garments which are penetrated by blood shall be removed immediately or as soon as feasible. All personal protective equipment will be removed prior to leaving the work area. All contaminated personal protective equipment will be bagged in biohazard bags and scheduled for laundry or disposal upon leaving the work area.
(4) Gloves shall be worn where it is reasonably anticipated that employees will have hand contact with blood, other potentially infectious materials, non-intact skin, and mucous membranes. Gloves will be available from the Safety Committee Chairperson for each department. Disposable gloves used at this facility are not to be washed or decontaminated for re-use and are to be replaced as soon as practical when they become contaminated or as soon as feasible if they are torn, punctured, or when their ability to function as a barrier is compromised. Utility gloves may be decontaminated for re-use provided that the integrity of the glove is not compromised. Utility gloves will be discarded if they are cracked, peeling, torn, punctured, or exhibit other signs of deterioration or when their ability to function as a barrier is compromised.
(5) Masks in combination with eye protection devices, such as goggles or glasses with solid side shield, or chin length face shields, are required to be worn whenever splashes, spray, splatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose or mouth contamination can reasonably be anticipated.
(6) Decontamination will be accomplished by utilizing the following materials:
(a) 10% (minimum) solution of chlorine bleach.
(b) Lysol or other EPA-registered disinfectant.
(7) All contaminated work surfaces will be decontaminated after completion of procedures and immediately or as soon as feasible after any spill of blood or other potentially infectious materials, as well as the end of the work shift if the surface may have become contaminated since the last cleaning.
(8) All bins, pails, cans, and similar receptacles shall be inspected and decontaminated on a regularly scheduled basis by the custodian of the building.
(9) Any broken glassware, which may be contaminated, will not be picked up directly with the hands. Sweep or brush material into a dustpan.
(G) Regulated waste disposal. Regulated waste shall be placed in appropriate containers.
(H) Laundry procedures.
(1) Laundry contaminated with blood or other potentially infectious materials will be handled as little as possible. Such laundry will be placed in appropriately marked bags at the location where it was used. Such laundry will not be sorted or rinsed in the area of use.
(2) All employees who handle contaminated laundry will utilize personal protective equipment to prevent contact with blood or other potentially infectious materials. Laundry will be sent off-site for cleaning. The laundry service accepting the laundry is to be notified, in accordance with section (d) of the standard.
(I) Hepatitis B vaccine.
(1) All employees who have been identified as having exposure to blood or other potentially infectious materials will be offered the Hepatitis B vaccine, at no cost to the employee. The vaccine will be offered within ten working days of their initial assignment to work involving the potential for occupational exposure to blood or other potentially infectious materials unless the employee has previously had the vaccine or wishes to submit to antibody testing which shows the employee to have sufficient immunity.
(2) Employees who decline the Hepatitis B vaccine will sign a waiver, which uses the wording in Appendix A of the OSHA standard. Employees who initially decline the vaccine but who later wish to have it may then have the vaccine provided at no cost. The Office of Administrative Services has responsibility for assuring that the vaccine is offered, the waivers are signed, etc. as part of the new hire procedure.
(J) Post-exposure evaluations and follow-up. When the employee incurs an exposure incident, it should be reported to the Safety Committee Chairperson for that department who will report to the Director of Administrative Services. All employees who incur an exposure incident will be offered post-exposure evaluation and follow-up will include the following:
(1) Documentation of the route of exposure and the circumstances related to the incident.
(2) If possible, the identification of the source individual and, if possible, the status of the source individual should be noted. The blood of the source individual will be tested (after consent is obtained) for the HIV/HBV infectivity.
(3) Results of testing of the source individual will be made available to the exposed employee with the exposed employee informed about the applicable laws and regulations concerning disclosure of the identity and infectivity of the source individual.
(4) The employee will be offered the option of having their blood collected for testing of the employee's HIV/HBV serological status. The blood sample will be preserved for up to 90 days to allow the employee to decide if the blood should be tested for HIV serological status. However, if the employee decides prior to that time that testing will or will not be concluded, then the appropriate action can be taken and the blood sample discarded.
(5) The employee will be offered post-exposure prophylaxis in accordance with the current recommendations of the U.S. Public Health Service.
(6) The employee will be given appropriate counseling concerning precautions to take during the period after the exposure incident. The employee will also be given information on what potential illnesses to be alert for and to report any related experiences to appropriate personnel.
(7) The Director of Administrative Services has been designated to assure that the policy outlined here is effectively carried out as well as to maintain records related to this policy.
(K) Interaction with health care professionals.
(1) A written opinion shall be obtained from the health care professional who evaluates employees of the city. Written opinions will be obtained in the following instances:
(a) When the employee is sent to obtain the Hepatitis B vaccine.
(b) Whenever the employee is sent to a health care professional following an exposure incident.
(2) Health care professionals shall be instructed to limit their opinions to:
(a) Whether the Hepatitis B vaccine is indicated and if the employee has received the vaccine or for evaluation following an incident.
(b) That the employee has been informed of the results of the evaluation.
(c) That the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials. (Note that the written opinion to the employer is not to reference any personal medical information.)
(L) Training. Training for all employees will be conducted prior to initial assignment to tasks where occupational exposure may occur. Training will be conducted in the following manner and include the following:
(1) An explanation of the OSHA Standard for Bloodborne Pathogens;
(2) Epidemiology and symptomatology of bloodborne diseases;
(3) Modes of transmission of bloodborne pathogens;
(4) This Exposure Control Plan, i.e. points of the plan, lines of responsibility, how the plan will be implemented, etc.;
(5) Procedures which might cause exposure to blood or other potentially infectious materials at the city;
(6) Control methods which will be used at the city to control exposure to blood or other potentially infectious materials;
(7) Personal protective equipment available at the city and contact person for PPE will be the Safety Committee Chairperson for each department;
(8) Signs and labels used at the city;
(9) Hepatitis B vaccine program at the city;
(M) Record keeping.
(1) All records required by the OSHA standard will be maintained by the Director of Administrative Services.
(2) Any employer who is required to maintain a log of occupational injuries and illnesses under 29 CFR 1904 shall maintain a sharps injury log recording all per cutaneous injuries from contaminated sharps. This log shall be maintained in a manner to protect the confidentially of the injured employee.
(N) Dates.
(1) All provisions required by the standard will be implemented by July 1, 2005.
(2) Training will be conducted using Bloodborne Pathogen videotape presented by the Safety Committee Chairperson.
(3) All employees will receive annual refresher training. (Note that this training is to be conducted within one year of the employee's previous training.)
(Ord. 19-2005, passed 5-10-05)