osha medical dental with bloodborne pathogens 2014
TRANSCRIPT
Lisa Smith CMA,RMA,CHWE
*Breaks – 10:15 / 2:30 ‘ish’
*Lunch – 12:20 – 1:30 ‘ish’
*Home – 3:55 ‘ish’
*Goals for Goals for TodayToday*Discuss coverage of the OSH Act and the regulations (standards) implementing it.
*Comply with the Bloodborne Pathogen Standard.
*Comply with Needlestick Prevention and PPE.
*Follow the requirements of the Right-to-know /Hazardous Chemicals (HAZCOM) Standard.
*Training Requirements
*X-Ray / Nitrous Oxide
*Develop fire prevention and emergency action plans.
*Coordinate exit route responsibilities.
*Workplace Violence Plans
*OSHA inspection protocol
*Quick Quick QuizQuiz
1. A Safety Data Sheet (SDS) gives information about:a. Hazardous chemicals.b. Injuries in the workplace.c. Medical examinations.d. Machinery maintenance.
2. A “SESIP” is:a. an engineering control.b. A non-needle sharp or a needle device used for withdrawing body fluids, accessing avein or artery, or administering medications or other fluids, with a built-in safetyfeature or mechanism that effectively reduces the risk of an exposure incident.c. Sharps with engineered sharps injury protections.d. All of the above.
3. Because OSHA is an administrative agency, a compliance officer does not need to have a search warrant to inspect a property.a. True.b. False.
4. Medical records of an employee’s exposure incident must be retained for:a. the length of the worker’s employment plus 30 years.b. 30 years.c. 5 years.d. 3 years.
5. If you were looking for the OSHA regulations dealing with bloodborne pathogens you would look in:a. 29 CFR 1910.1030.b. 29 CFR 1904.c. 29 CFR 1926.1030.d. 29 CFR 1910.1020.
*Quick Quick QuizQuiz6. Bloodborne Pathogens for OSHA purposes means pathogenic microorganisms that are present in:
a. all blood.b. human blood.c. animal (non-human) blood.d. “b.” and “c.”
7. The hepatitis B vaccination is a(n):a. noninfectious, yeast-based vaccine.b. potentially infectious, yeast-based vaccine.c. noninfectious, yeast-based vaccine that is used for both hepatitis B and C.d. a direct derivative of gamma globulin.
8. An employer does not have to keep and maintain a Sharps Injury Log if:a. it employs no licensed medical professionals.b. reviews SESIPs annually.c. it is exempt from OSHA recordkeeping under 29 CFR 1904.d. None of the above.
9. Employers have to pay for a titer for employees who have responsibility for ongoing direct patient care.a. True.b. False.
10. Nasal secretions and tearsa. are not generally considered to be OPIM.b. are considered to be OPIM.c. are considered to be OPIM if they are mixed with visible blood.d. “a” and “c.”.
Who is An Who is An EmployerEmployer??DOL defines and ‘employer’ as “any person
acting directly or indirectly in the interest of an employer in relation to an employee.”
29 USC §203 (d).
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Penalties can be assessed against the employer or a ‘person acting on behalf of
an employer.’
2011-2013 – the courts re-defined ‘employer ‘ in
all employment law issues. States also followed.
*Covered EmployersCovered Employers
Occupational Safety and Health Occupational Safety and Health Act Act
of of
1970 (OSHA)1970 (OSHA)29 CFR 1975.4(a)
General.General. Any employer employing one or more employees would be an "employer engaged in a business affecting commerce who has employees" and, therefore, he is covered by the Act as such.
*General Duty ClauseGeneral Duty Clause
29 CFR 1975.29 CFR 1975.5 Duties5 Duties
(a)Each employer -- (1) shall furnish to each of his employees
employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees;
(2) shall comply with occupational safety and health standards promulgated under this Act.
(b) Each employee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct.
FOUR Main Personality Types
Colorful Connections – Rob and Mary Hambleton
Direct Red
Dynamic Yellow
Caring Green
Detail Blue15
I am the ___________________ in my peer group.
*Mother
*Father
*Child
*Organizer
*Student
*Teacher
*Nurse/Doctor
*Patient
*Counselor……………..
DIRECT RED
Do it Now!Direct and Guarded
Dynamic YellowDo it Together!
Direct and Open
Detail Blue Do it Right!
Indirect and Guarded
Caring Green Do it in a Caring Way!
Indirect and Open
Which Personality am I?Which Personality am I?
I am the Resource Person in my peer group.
*Mother
*Father
*Child
*Organizer
*Student
*Teacher
*Nurse/Doctor
*Patient
*Counselor……………..
Which Personality am I?Which Personality am I?
*The StandardsThe Standards
““The Law”The Law”
* The OSH Act regulations are called, “standards.” Standards may require conditions, or the adoption or use of one or more practices, means, methods or processes reasonably necessary and appropriate to protect workers on the job.
* The standards can be found at: www.osha.gov * The standards most applicable to medical are 29 CFR 1910
and 29 CFR 1904. * Standards are “performance based” – the employer is
instructed on what to do, but not how. * It is the responsibility of employers to become familiar with
standards applicable to their establishments and to ensure that employees have and use personal protective equipment when required for safety.
*CatastropCatastrophehe
*3+ employees hospitalized--same incident
*Death on the job
*Must ReportsMust Reports
*Report fatal heart attack occurring at work
*Work related death that occurs regardless of time between injury and death or length of illness.
29 CFR 1904 Subpart B
Specific SICs – Medical/DentalSpecific SICs – Medical/Dental
*OSHA HOTLINE OSHA HOTLINE
1-800-321-6742
Hot Tip!
Follow Your Chain
of Command.
Workplace Violence Workplace Violence
Bloodborne PathogensBloodborne Pathogens
Hazard CommunicationHazard Communication
Three Major Concerns Three Major Concerns
Inspection-Secure
Your Practice! What will the inspectors
find swimming in your waters?
Have you caught your fish?
OSHA Inspection-Secure ChecklistOSHA Inspection-Secure Checklist1.Reasonable Basis File
* Regulations
* Desk References/Software/Templates
* Consultant/Attorney/OSHA advice in writing
2.Plans, Programs, and Procedures* Step by step guidance for each process
* Reference your Reasonable Basis / Regulations
* Must contain update and revision dates
3.Training Records* Initial training records
* Refresher or Annual training when mandatory
4.Employee Handbook – Policies/Procedures* Must reflect federal and state laws
* Must include specific company policies when law is silent
* Must include documentation of review and updates annually
5. Job Descriptions* Not optional
* List Essential Functions and BFOQs
* Review annually – minimum – document
6.Self-Inspection Documentation* Annual inspection documentation for each area
* Must include corrective action / remediation plan and outcome
*KEY*
OSHA’s Workplace Violence Prevention
Program
What Is Workplace Violence?
Any physical assault, threatening behavior, or verbal abuse occurring in the workplace.
The workplace may be any location either permanent or temporary where an employee performs any work-related duty.
Establishments Affected by Workplace Violence
According to the Bureau of Labor Statistics, the highest number of homicides occur in night retail establishments.
The highest number of nonfatal assaults occur in the health care and social service sectors.
Types of Serious Injuries and Deaths from Workplace Violence
• Physical assaults
• Beatings/stabbings
• Shootings
• Rapes
• Attempting to cause physical harm, i.e.., striking, pushing, or other aggressive acts against another person
Acts of Aggression Which May Indicate Risk
• Disorderly conduct, such as shouting, pushing or throwing objects, punching walls, or slamming doors;
• Verbal threats to inflict bodily harm including vague or overt threats;
• Fascination with guns or other weapons, demonstrated by discussions or bringing weapons to workplace;
Acts of Aggression Which May Indicate Risks (Continued)
• Obscene phone calls;
• Intimidating presence; and
• Harassment of any nature.
Types of Workplace Violence Incidents
• Based upon the relationship between the
assailant/worker/workplace, violent incidents can be
divided into categories:
– Violence by strangers
– Violence by customers/clients/patients
– Violence by co-workers
– Violence by personal relationship
Domestic Violence and the Workplace
• 1 in 3 women will be abused by an intimate partner.
• 1 in 4 of these women will tell someone.
• 2-5% of men will be abused by their female partner.
• Race has no bearing on the statistics.
• 74% of working women in abusive relationships will be
confronted at work on some level.
• DV causes Americans to miss 175,000 workdays each year.
• DV costs employers $5.8 billion annually
• A woman is battered every 9 seconds in America
Domestic Violence and the Workplace
Domestic Violence and the Workplace
Domestic Violence and the Workplace
How to recognize signs of abuse:
– Coming in late or very early– Crying– Excuses– Strange calls or visits– Incessant calls or texts– Odd ways of thinking – child-like– Defensiveness– Easy to startle– Court dates– Extreme concern regarding errands for partner
Occupational Safety and Health Act
The OSH Act of 1970 mandates that, in addition to compliance with hazard-specific standards, all employers have a general duty to provide their
employees with a workplace free from recognized hazards likely to cause death or serious physical harm. This includes the prevention and control of
the hazard of workplace violence.
OSHA will rely on Section 5 (a) (1) of the OSH Act (the “General Duty Clause”)
for enforcement authority.
Overview of the Guidelines
The guidelines are:
• Not a new standard or regulation
• Advisory in nature and informational in content• Intended for use by employers who are seeking
to provide a safe and healthful workplace through effective workplace violence prevention programs.
Six Components of Guidelines
• Management Commitment
• Employee Involvement
• Worksite Analysis
• Hazard Prevention and Control
• Written Program
• Training and Education
*Bloodborne PathogensBloodborne Pathogens
• Human blood, human blood components, and products made from human blood.
• Bloodborne Pathogens: pathogenic microorganisms that are present in human blood and can cause disease in humans including, but are not limited to, HBV and HIV.
*Other Potentially Infectious Materials (OPIM)1. The following human body fluids: semen, vaginal
secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids;
2. Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and
3. HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organ, or other tissues from experimental animals infected with HIV or HBV.
Note: Even if a human bodily fluid is not listed above, Note: Even if a human bodily fluid is not listed above, employers should train workers to use universal employers should train workers to use universal precautions when dealing with any bodily fluid. precautions when dealing with any bodily fluid.
*Parenteral Exposure
*Literally, entry into the body by any other route than the mouth/digestive system; typically, this takes the form of needlesticks, cuts, abrasions and dried blood.
*Includes human bites that break the skin, which are most likely to occur in dental practices or violent situations, e.g., prison and law enforcement personnel, psychiatric ward workers.
*Who must we protect and train?
*All employees who could be “reasonably anticipated”, as the result of performing their job duties, to face contact with human blood and other potentially infectious materials.
*“Good Samaritan” acts such as assisting a co-worker with a nosebleed would not be considered occupational exposure.
*BBP Training Requirements*Copy of the standard
*Site-specific exposure control plan
*Modes of transmission
*Signs/Symptoms/Stats
*Hazard recognition
*Use of engineering controls
*Work practice controls
*PPE
*Live question and answer session
*Human Immunodeficiency Virus – leads Human Immunodeficiency Virus – leads to AIDSto AIDS
*Hepatitis BHepatitis B
*Hepatitis CHepatitis C
Human Immunodeficiency Virus – leads to AIDSHuman Immunodeficiency Virus – leads to AIDS
Approximately:Approximately:*1.1 million people in U.S. have HIV – 20% do not know!1.1 million people in U.S. have HIV – 20% do not know!*42,000 new diagnosis each year42,000 new diagnosis each year*16,000 deaths from AIDS each year16,000 deaths from AIDS each year*26,000 person increase each year in overall population26,000 person increase each year in overall population*Northeast U.S. has the HIGHEST increase in new diagnosisNortheast U.S. has the HIGHEST increase in new diagnosis*Methamphetamine use is a growing riskMethamphetamine use is a growing risk
*CDC.gov has FAQs and information of CDC.gov has FAQs and information of prevention/treatmentprevention/treatment
Attacks immune systemDestroys white blood cells (CD4+ T cells)Leaves patient immune suppressed & susceptible to infections/tumors
Many people show no symptoms for a long time (10 years)
May eventually lead to development of AIDS
*(Acquired Immune Deficiency Syndrome)
* Early symptoms very similar to flu:
*Fever
*Headache
*Tiredness
*Enlarged lymph nodes
* Treatment focuses on ways to lower blood levels of virus
* HIV is killed by digestive enzymes – saliva, digestive tract.
* Many workers view this as a license for carelessness.
Occupational Exposure – 3/1000 are Occupational Exposure – 3/1000 are PositivePositiveRisk for HIV transmission after:
Percutaneous injury – 0.3% Mucous membrane exposure – 0.09% Non-intact skin exposure – low risk (< 0.09%)
In 2011*57 documented occupational infections in U.S. (139 possible infections)
*84% resulted from percutaneous exposure!
No cure – eventually fatal without No cure – eventually fatal without
treatment/compliancetreatment/compliance
NO VACCINENO VACCINE
Some HIV strains resistant to therapySome HIV strains resistant to therapy
Post-exposure therapy costly & has side effects.Post-exposure therapy costly & has side effects.
Cocktails of three or more antiretroviral drugs given Cocktails of three or more antiretroviral drugs given
Ryan White Foundation covers most costs Ryan White Foundation covers most costs
Spread through direct contact with infected body fluids More transmissible than Hep C virus and HIV Infection may be acute or chronic
1/250 Americans carry HepB Virus 5-10 % of adults will develop chronic infection; ~1.2 million
people with chronic HBV 15-25% develop cirrhosis , liver failure, or liver cancer (~ 3000
deaths/year)
Many people (~50%) are asymptomatic; if symptoms occur they include:
Occupational Exposure
HepB: 30% or 300 people per 1000 needle sticks, if unvaccinated
Can be transmitted by surface contact with dried blood or OPIM!
HBV can remain infective in dried blood @ room temperature for 1 week +
Many people have no idea how they became infected
Risk of infection from blood/OPIM splash onto non-intact skin or mucous membranes… greater risk than other BBPsgreater risk than other BBPs
Transmitted primarily through contact with Transmitted primarily through contact with infected bloodinfected blood
Many people asymptomatic Many people asymptomatic
(symptoms similar to HepB) (symptoms similar to HepB)
2 % of Americans have been infected with 2 % of Americans have been infected with HepC, 3.2 million chronically infectedHepC, 3.2 million chronically infected ~ 12,000 deaths/year~ 12,000 deaths/year 20 people per 1000 needle sticks20 people per 1000 needle sticks
Leading indication for liver transplant in Leading indication for liver transplant in U.S.U.S.
No treatment available – Rest, nutrition, No treatment available – Rest, nutrition, fluidsfluids
15-25% of infected will clear virus naturally15-25% of infected will clear virus naturally
Occupational ExposureOccupational Exposure
Percutaneous injury, esp. with deep punctures or extensive blood exposures
~2% develop infection
Mucosal/non-intact skin exposures rarely documented Proper cleaning/disinfection of surfaces important
HCV in dried blood samples remains infective for at least 16 hours
There is no vaccine !!!There is no vaccine !!!
*Identifies jobs and tasks where occupational exposure to blood or other potentially infectious material occurs.
Some of these jobs or tasks might be:_____________________
*Describes how the employer will:
*Use engineering and work practice controls
*Ensure use of personal protective equipment
*Provide training
*Provide medical surveillance
*Provide hepatitis B vaccinations
*Use signs and labels
*Written plan required
*Plan must be reviewed at least annually to reflect changes in:
*tasks, procedures, or assignments which affect exposure
*technology that will eliminate or reduce exposure
*Annual review must document employer’s consideration and implementation of safer medical devices
*Must solicit input from potentially exposed non-management employees in the identification, evaluation and selection of engineering and work practice controls
*Plan must be accessible to employees
*Treat all human blood and certain body fluids as if they are infectious.
*Must be observed in all situations where there is a potential for contact with blood or other potentially infectious materials.
These controls reduce employee exposure by either removing the hazard or isolating the worker.
Examples:
*Sharps disposal containers
*Self-sheathing needles
*Safer medical devices
*Needleless systems
*Sharps with engineered sharps injury protections
•Do Place needles directly into the Sharps Box
•Close & replace Sharps Box when it is ¾ full • Do not overfill the sharps box.
•Never attempt to re-open a closed Sharps Box
Needle Safety: NEVER RECAP NEEDLES USING BOTH HANDS
When possible retract tissue with another instrument (mouth mirror)
Recapping Needles
•Use a scoop technique
•Use a cap holder if supplied on the tray
Needle Safety:
**Never leave a needle uncapped anywhere in your operating field.
**Know where your needles and other sharps are—AT ALL TIMES!!!!!!!
Never use two hands when recapping - use the one-handed scoop method.
*Work Practice Work Practice ControlsControls
*Wash hands after removing gloves and as soon as possible after exposure
*Do not bend or break sharps
*No food or smoking in work areas
*Proper Use of Bio-hazard Waste Bags
These controls reduce the likelihood of exposure by altering how a task is performed.
Examples:
Recent Outbreaks – April /May/August 2014
MERS (Middle Eastern Respiratory Syndrome) - Arabian Peninsula
Polio - Guinea, Cameroon, Somalia, Syria
Ebola – Widespread across West Africa 2473+
Cholera – Cuba *Mainly Hand Hygiene*
Avian Flu (H7N9) – China
CDC Recommends :•Post visual alerts asking patients to report respiratory symptoms immediately
•Cover your cough flyer – CDC.gov
•Cover your mouth and nose with a tissue when coughing or sneezing;
•Use in the nearest waste receptacle to dispose of the tissue after use;
•Perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic hand-wash) after having contact with respiratory secretions and contaminated objects/materials.
Indications for Hand Hygiene When hands are visibly dirty, contaminated
or soiled, wash with non-antimicrobial or anti-microbial soap and water. Should be washed for at least 20 seconds and
dried thoroughly before donning gloves. Pay attention to areas between fingers and around nails.
Use an alcohol based hand sanitizer for routinely decontaminating hands. Use enough sanitizer to moisten all surfaces of the
hands and rub until dry.
Note residue around cuticles & under watchband after thorough hand washing (using “Glo-Germ” )
*Personal Protective Personal Protective EquipmentEquipment
*Specialized clothing or equipment worn by an employee for protection against infectious materials.
*Must be properly cleaned, laundered, repaired, and disposed of at no cost to employees.
*Must be removed when leaving area or upon contamination.
*Examples of PPEExamples of PPE
*Gloves
*Gowns
*Face shields
*Eye protection
*Mouthpieces and resuscitation devices
According to the CDC, the correct order for donning personal protective equipment is:
1.Cover gown• Fully cover torso from neck to knees , arms to end of wrist
2.Mask• Fit flexible band to nose bridge• Fit snug to face and over chin, covering nose
3.Goggles, safety glasses with side shield or face shield
4.Gloves• Extend to cover wrist of cover gown
According to the CDC, the correct order for removing personal protective equipment is:
1.Gloves• Outside of glove is contaminated!• When removing, grasp outside of glove with opposite gloved hand and peel
off
2.Goggles, safety glasses with side shield or face shield• Outside of goggles is contaminated!• Remove by grasping ear piece
3.Cover gown• Gown front and sleeves are contaminated!• Unfasten ties• Pull away from neck and shoulders, touching inside of gown only• Turn gown inside out and roll into a ball then discard
4.Mask• Front of mask is contaminated – DO NOT TOUCH!• Grasp bottom, then elastics and remove
Pay attention to how you remove your gloves
Grasp the top or wrist of one glove, being careful not to touch anything but the glove. Pull the glove off, turning it inside out. Continue holding the glove. Go under the cuff of the other glove, being careful not to touch its outside surface. Pull the glove off, turning it inside out and pulling it over the first glove. Both gloves should now be inside out, one inside the other. Discard both gloves into an approved waste container.Then wash hands or use hand sanitizer!
Respiratory Protection for Healthcare Workers*Minimum level N95 air-filtering disposable face piece
*Fit testing is performed upon initial assignment/annually
*More frequent fit testing may be determined by:1) dental changes of the wearer,
2) a change in facial features of the wearer,
3) medical condition that would affect respiratory function,
4) weight gain of wearer,
5) a change in the model or size of the assigned respirator.
*For situations in which the risk for exposure to TB is especially high because of cough-inducing and aerosol-generating procedures, more protective respirators might be needed. N99, N100, Powered air-purifying respirators (PAPR)
*General PPE General PPE PrecautionsPrecautions* Wash Wash hands immediately hands immediately or or as soon as feasibleas soon as feasible after removal of gloves or other after removal of gloves or other personal protective equipment. personal protective equipment.
* Remove protective equipment Remove protective equipment before leaving the work area before leaving the work area and after a garment and after a garment becomes contaminated. becomes contaminated.
* Place used protective equipment in appropriately designated areas or containers Place used protective equipment in appropriately designated areas or containers being stored, washed, decontaminated, or discarded. being stored, washed, decontaminated, or discarded.
* Wear appropriate gloves when it can be Wear appropriate gloves when it can be reasonably anticipated reasonably anticipated that you may that you may have contact with blood or other potentially infectious materials and when have contact with blood or other potentially infectious materials and when handling or touching contaminated items or surfaces.handling or touching contaminated items or surfaces.
* Replace gloves Replace gloves if torn, punctured, contaminated, or if their ability to function as a if torn, punctured, contaminated, or if their ability to function as a barrier is compromised. barrier is compromised.
* Following any contact of body areas with blood or any other infectious materials, Following any contact of body areas with blood or any other infectious materials, you must you must wash your hands and any other exposed skin wash your hands and any other exposed skin with soap and water as with soap and water as soon as possible. Employees must also flush exposed mucous membranes (eyes, soon as possible. Employees must also flush exposed mucous membranes (eyes, mouth, etc) with water. mouth, etc) with water.
* Never wash or decontaminate Never wash or decontaminate disposable gloves for reuse or before disposal. disposable gloves for reuse or before disposal.
* Wear appropriate face and eye protection such as a mask with glasses with solid Wear appropriate face and eye protection such as a mask with glasses with solid side shields or a chin-length face shield when side shields or a chin-length face shield when splashes, sprays, splatters, or splashes, sprays, splatters, or dropletsdroplets of blood or other potentially infectious materials pose a hazard to the of blood or other potentially infectious materials pose a hazard to the eye, nose, or mouth. eye, nose, or mouth.
* If a garment is penetrated by blood and other potentially infectious materials, the If a garment is penetrated by blood and other potentially infectious materials, the garment(s) garment(s) must be removed immediately must be removed immediately or as soon as feasible. or as soon as feasible.
*Location within the facility
*Type of surface to be cleaned
*Type of soil present
*Tasks or procedures being performed
Must develop a written schedule for cleaning and decontamination at the work site based on the:
*After completion of procedures *When surfaces are contaminated
*At the end of the work shift
*Use the 4x Rule
*20 minutes set time for bleach
*Do NOT use ethanol – Alcohol Products
Work surfaces must be decontaminated with an appropriate disinfectant (bleach 1:10, Cavicide, SaniWipes, etc):
*Regulated WasteRegulated Waste
Must be placed in:
•Closeable containers •Leak-proof containers •Built to contain all contents during handling, storing, transporting or shipping •Be appropriately labeled or color-coded.
*LaundryLaundry*Handle contaminated laundry as little as possible and use PPE
*Must be bagged or containerized at location where used
*No sorting or rinsing at location where used
*Must be placed and transported in labeled or color-coded containers
Warning labels required on:*Containers of regulated waste
*Refrigerators and freezers containing blood and other potentially infectious materials
*Other containers used to store, transport, or ship blood or other potentially infectious materials
*Red bags or containers may be substituted for labels.
*Hepatitis B Hepatitis B VaccinationVaccination Employer Employer RequirementsRequirements*Must make available, free of charge
at a reasonable time and place, to all employees at risk of exposure within 10 working days of initial assignment unless:
*employee has had the vaccination
*antibody testing reveals immunity
*The vaccination must be performed by a licensed healthcare professional
*HBV Declination HBV Declination StatementStatementApp A 1910.1030App A 1910.1030
I understand that due to my occupational exposure to blood or other potentially infectious materials, I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine, at no charge to myself. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease. If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me.
Employee Signature __________________________Date ___________
Basic Steps to Take If An Exposure Occurs
Wash the area very thoroughly with soap & water: flush Wash the area very thoroughly with soap & water: flush mucous membranes for 15 minutesmucous membranes for 15 minutes
Notify supervisor/facultyNotify supervisor/faculty
Get immediate medical attention (1-2 hr max)Get immediate medical attention (1-2 hr max)
Allow Medical to follow up with the appropriate testing & Allow Medical to follow up with the appropriate testing & the required written opinionthe required written opinion
*Document routes of exposure and how exposure occurred.
*Record injuries from contaminated sharps in a sharps injury log.
*Obtain consent from the source individual and the exposed employee and test blood as soon as possible after the exposure incident.
*Provide risk counseling and offer post-exposure protective treatment for disease when medically indicated in accordance with current U.S. Public Health Service guidelines.
*Provide written opinion of findings to employer and copy to employee within 15 days of the evaluation.
*Post-exposure follow up must be offered by the employer, confidential, & offered at no cost to the employee.
CDC Guidelines are found here:http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm
HIV – PEP Cocktail – effective within 72 hours max
HBV – HepB vaccination started within 24 hours
HCV – No PEP available which has been proven effective
29 C.F.R. 1910 1200*Written Plan
*Hazard Assessment - Annually
*MSDS/SDS
*Labeling
*Training
*Hazardous Chemical Inventory Listing
*Must be in English and include information regarding the specific chemical identity and common names.
*Must provide information about the:
*Physical and chemical characteristics
*Health effects
*Exposure limits
*Carcinogenicity (cancer-causing)
*Identification (name, address, and telephone number) of the organization responsible for preparing the sheet
*Must be readily accessible to employees in their work area.
As of June 1, 2015, the Global Harmonizing System (GHS), will require:
pictograms, a signal word, hazard and precautionary statements, the product identifier, supplier identification
Chemical Identity Hazard Warning Manufacturer’s Information
*At the time of initial assignment
*Annually Refresher
*Whenever a new hazard is introduced into their work area
Training is required for all employees regarding new SDS guidelines NLT Dec. 1, 2013 and employees who are exposed to hazardous chemicals in their work area:
*Explanation of the HazCom program, including information on labels, SDSs, and how to obtain and use available hazard information
*Hazards of chemicals
*Protective measures such as engineering controls, work practices, and the use of PPE
*How to detect the presence or release of a hazardous chemical (using monitoring devices, observation, or smell)
*Ionizing Radiation at the Ionizing Radiation at the Cellular LevelCellular LevelExposure
*Employer cannot allow an employee to be exposed to sources of ionizing radiation in any way that will cause them to be exposed to 1.4 rems per calendar quarter to their head and trunk, active blood-forming organs, lens of eyes or gonads.
*For exposure to strictly the hands and forearms or feet and ankles, the limit is 18.75 rems per quarter. Exposure to the skin of the whole body is limited to 7.5 rems per quarter.
Signs
*Radiation Area - Such areas must be conspicuously marked with a sign in the conventional radiation caution colors (magenta or purple on yellow) and the words "Caution Radiation Area."
*High-radiation area - Such areas must be marked with a sign bearing the words "Caution High Radiation Area."
*Fire Prevention Fire Prevention PlanPlan
The Plan Must Include:The Plan Must Include: *A list of the major fire hazards and handling, storage, and control procedures.
*Names or job titles of persons responsible for maintenance of equipment and systems to prevent or control ignitions or fires.
*Names or job titles of persons responsible for control of fuel source hazards.
*Training for all employees who have responsibilities in the plan.
*Fire Prevention PlanFire Prevention Plan
NOTE: An employer must:
*Inform employees upon initial assignment to a job of the fire hazards to which they are exposed.
*Review with each employee those parts of the fire prevention plan necessary for self-protection.
*Portable Fire ExtinguisherPortable Fire ExtinguisherTraining and EducationTraining and Education*Where portable fire extinguishers have been provided for employee use in the workplace, employees must be provided with an educational program on the:
*General principles of fire extinguisher use
*Hazards of incipient (beginning) stage fire fighting
*Employees designated to use extinguishers must receive instruction and hands-on practice in the operation of equipment.
*P-A-S-S TechniqueP-A-S-S Technique
*Pull…
*Aim…
*Squeeze…
*Sweep…*Stand Back 5-6 Feet!
*Emergency Action Emergency Action PlanPlan
*Describes actions that must be taken to ensure employee safety in emergencies
*Includes floor plans or maps which show emergency escape routes
*Tells employees what actions to take in emergency situations
*Covers reasonably expected emergencies, such as fires, explosions, toxic chemical releases, hurricanes, tornadoes, blizzards, and floods
*Exit Doors Must Be Exit Doors Must Be UnlockedUnlocked*Must be able to open from the inside at all times without keys, tools, or special knowledge.
*Device such as a panic bar that locks only from the outside is permitted.
*Must be free of any device or alarm that could restrict emergency use if the device or alarm fails.
*May be locked from the inside only in mental, penal, or correctional facilities where there is constant supervision.
Locked and blocked exit
*Exit Marking Exit Marking (cont’d)(cont’d)
Each doorway or passage along an exit access that could be mistaken for an exit must be marked “Not an Exit” or similar designation, or be identified by a sign indicating its actual use (e.g., closet).
*Walking/Working Walking/Working SurfacesSurfaces
What You Should Do• If you drop it, pick it up.• If you spill it, wipe it up.• Look where you are going, and• Go where you are looking.
*Office ErgonomicsOffice Ergonomics
*Workplace InspectionsWorkplace Inspections*Every establishment covered by the OSH Act is subject to inspection by OSHA compliance safety and health officers (CSHO's)
*Most inspections are conducted without advance notice
*Priorities
*Imminent Danger
*Catastrophes & Fatal Accidents
*Complaints
*Programmed High Hazard
*Follow-up Inspections
*Inspection ProcessInspection Process
*CSHO displays official CSHO displays official credentialscredentials
*Opening conferenceOpening conference
*Walk-around inspectionWalk-around inspection
*Closing conferenceClosing conference
*Violations and PenaltiesViolations and Penalties
Types of Types of PenaltiesPenalties*Other-than-
serious
*Serious
*Willful
*Repeated
*Failure to Abate
Employers may be assessed Employers may be assessed penalties for:penalties for:*Violating posting requirements (can bring
a civil penalty up to $7,000)
*Falsifying records, reports, or applications (can bring a criminal fine of $10,000 or up to 6 months in jail, or both)
*Assaulting a compliance officer or otherwise resisting, opposing, intimidating or interfering with his/her duties (can bring a criminal fine up to $5,000 and up to 3 years in jail)
*Base Penalty AdjustmentsBase Penalty AdjustmentsSize Adjustment
60% 1 - 25 employees40% 26 - 100 employees20% 101 - 250 employees-0-% 250+ employees
Good Faith Adjustment 25%
History Adjustment 10% if no Serious, Willful or Repeat citations for past
3 years
OSHA Inspection-Secure ChecklistOSHA Inspection-Secure Checklist1.Reasonable Basis File
* Regulations
* Desk References/Software/Templates
* Consultant/Attorney/OSHA advice in writing
2.Plans, Programs, and Procedures* Step by step guidance for each process
* Reference your Reasonable Basis / Regulations
* Must contain update and revision dates
3.Training Records* Initial training records
* Refresher or Annual training when mandatory
4.Employee Handbook – Policies/Procedures* Must reflect federal and state laws
* Must include specific company policies when law is silent
* Must include documentation of review and updates annually
5. Job Descriptions* Not optional
* List Essential Functions and BFOQs
* Review annually – minimum – document
6.Self-Inspection Documentation* Annual inspection documentation for each area
* Must include corrective action / remediation plan and outcome
*KEY*
Big Boss
Me
2 Years Later!
