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Bloodborne Pathogens - Control and Compliance
Terms in this set (12)
Consider for a moment that if differentiation between body fluids is difficult or impossible to ascertain, then all body fluids must be considered potentially infectious. This is in fact an instructive stance to take in handling such materials. If and when there is known occupational exposure, the employer must provide at no cost to the employee appropriate personal protective equipment (PPE), and procedures must be in place for when exposure does occur. For instance, proper gloves must be worn whenever contact with a potentially infectious material is anticipated. Furthermore, all PPE must be removed before leaving the work area and placed in an appropriate designated area or container for storage, washing, decontamination or disposal.
Exposure Control Plan Requirements
All employers with employees who have had an occupational exposure to or potential occupational exposure to BBPs are required to establish a written exposure control plan (ECP) designed to minimize or eliminate employee exposure.
Written exposure control plans must contain the following elements:
1. An exposure determination
A list of all job classifications in which all employees in those job classifications have occupational exposure
A list of job classifications in which some employees have occupational exposure
A list of all tasks and procedures (or groups of closely related tasks and procedures) in which occupational exposure can occur when they are performed by employees in the listed job classifications
2. Methods of compliance
3. HIV and HBV research laboratories and production facilities (if applicable)
4. Hepatitis B vaccination and post-exposure evaluation and follow-up
5. Communication of hazards to employees
7. Procedures for evaluating circumstances surrounding exposure incidents
The ECP should be communicated in the following ways:
Made available for employees to review
Reviewed at least annually, and updated as necessary to reflect new or modified tasks and procedures affecting occupational exposure, and to reflect new or revised employee positions having occupational exposure to BBPs
Made available to OSHA upon request for examination and/or copying
Methods of Compliance
The first principle of methods of compliance is that universal precautions shall be observed to prevent contact with blood or other potentially infectious materials (OPIM). If differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.
Engineering controls, administrative controls, and work practices must be used to eliminate or minimize employee exposure. Where occupational exposure remains after the institution of these controls, personal protective equipment (PPE) shall also be used.
Any engineering controls used must be regularly maintained to ensure their effectiveness. In addition, hand washing facilities, or some other effective way for employees to disinfect their hands, must be readily accessible. It is the employer's responsibility to ensure that employees wash as soon as possible after they remove their gloves and personal protective equipment. Employers must also ensure that facilities are made available to flush mucous membranes, eyes, face, and the body after any contact with blood or other potentially infectious material(s).
Needles and Sharps
If contaminated needles or sharps must be recapped, bent, or removed, a one-handed technique or mechanical device must be used. Safety sharps (SESIPs or sharps with engineered sharps injury protection) must be used unless not feasible. If not feasible, a report must be written stating the reason and alternative protection methods.
As soon as possible after use, sharps must be disposed of in a proper container, the container must be:
Puncture resistant and closable
Labeled with the biological hazard placard or red colored
Leak proof on the bottoms and sides
Be constructed and placed to prevent employees, patients, and visitors from reaching into the container
Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of occupational exposure to BBPs.
Refrigerators used to store blood or other potentially infectious material shall not be used for food or beverages, and shall be so labeled.
Personal Protective Equipment
When there is occupational exposure, the employer shall provide, at no cost to the employee, appropriate personal protective equipment such as, but not limited to:
Fluid-resistant laboratory coats
Face shields or masks and eye protection
Pocket masks or other ventilation devices
Personal protective equipment will be considered "appropriate" only if it does not permit blood or other potentially infectious materials to pass through to, or reach, the employee's work clothes, street clothes, undergarments, 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.
If an employee exposure does occur, the employee should immediately:
Wash the skin with soap and water and flush mucous membranes with water.
Evaluate the exposure source and determine the risk of infection.
Seek medical evaluation per the facility's written BBP program
The employer shall ensure that the employee uses appropriate personal protective equipment unless the employer shows that the employee temporarily and briefly declined to use personal protective equipment when, under rare and extraordinary circumstances, it was the employee's professional judgment that in the specific instance its use would have:
Prevented the delivery of health care or public safety services
Posed an increased hazard to the safety of the worker or co-worker
When the employee makes this judgment, the circumstances shall be investigated and documented in order to determine whether changes can be instituted to prevent such occurrences in the future.
Accessibility of Gloves
The employer shall ensure that appropriate personal protective equipment, in the appropriate sizes, is readily accessible at the worksite or is issued to employees. Hypoallergenic gloves, glove liners, powderless gloves, non-latex, or other similar alternatives shall be readily accessible to those employees who are allergic to the gloves normally provided.
The employer must pay for any cleaning, or disposal of PPE, and shall repair or replace PPE as needed.
Proper gloves must be worn whenever contact with potentially infectious material is anticipated. Disposable (single use) gloves such as surgical or examination gloves must be replaced as soon as practical when contaminated or as soon as feasible if they are torn, punctured, or when their ability to function as a barrier is compromised. Utility gloves can be disinfected for reuse as long as they maintain their integrity.
If a garment(s) is penetrated by blood or other potentially infectious materials, the garment(s) shall be removed immediately or as soon as feasible. All personal protective equipment shall be removed prior to leaving the work area, and placed in an appropriately designated area or container for storage, washing, decontamination, or disposal.
Good housekeeping requires that employers ensure the worksite is maintained in a clean and sanitary condition. All equipment and environmental and working surfaces shall be cleaned and decontaminated after contact with blood or other potentially infectious materials. Broken glassware which could have been contaminated during an incident must be cleaned up using mechanical means, such as a brush and dustpan, tongs, or forceps.
During use, containers for contaminated sharps must be easily accessible, maintained upright, and not overfilled. Before moving, containers must be closed and labeled. If the sharps container is leaking, it must be placed in a leak-proof secondary container.
Contaminated laundry must be handled as little as possible with a minimum of agitation, and must be placed and transported in bags or containers which are labeled or color-coded. The employer must ensure that employees who have contact with contaminated laundry wear protective gloves and other appropriate personal protective equipment.
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