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1.02 Bloodborne Pathogen Exposure Control Plan

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  • Section 1 | General
1.02 Bloodborne Pathogen Exposure Control Plan

This plan delineates specific rules and procedures relating to protecting employees of the Owasso School District from occupational exposure to bloodborne pathogens (e.g., Hepatitis B Virus (“HBV”), Human Immunodeficiency Virus (“HIV”), etc.) as required by Rule 380:40-1-2 of the Oklahoma Department of Labor, adopting 29 C.F.R. Subpart Z, Section 1910.1030, promulgated December 6, 1991, under the authority of the Occupational Safety and Health Act (OSHA).

Employees who are occupationally exposed to bloodborne pathogens include those who are reasonably anticipated to have skin, eye, mucous membrane or potential contact with blood or other potentially infectious materials during the performance of their duties. Other infectious materials include: (1) the following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid and any body fluid that is visibly contaminated with blood or where it is difficult or impossible to differentiate between body fluids; (2) any unfixed tissue or organ from a human, living or dead; (3) HIV-containing cell or tissue culture, organ culture and HIV- or HBV-containing culture medium or other solutions; and blood, organs or tissues from experimental animals infected with HIV or HBV. Any exposure to feces, nasal secretions, breast milk, sputum, sweat, tears, urine, vomitus or saliva, which is not visibly contaminated with blood, does not routinely constitute a risk of transmission of HBV or HIV. Saliva, if injected through a human bite, may pose a risk of HBV transmission.

This Exposure Control Plan delineates rules and procedures to be followed by employees to comply with the OSHA Bloodborne Pathogens Regulation previously cited. Appendix A defines the terms used throughout this Plan.

Employee Exposure Determination

The likelihood of exposure to bloodborne pathogens among employees of the School District varies among divisions and job classifications. Greatest exposure potential exists in school nurses. A much lesser risk potential exists in certain special education teachers and classroom assistants, secretaries, coaches and physical education instructors, administrators and custodial personnel. Most job classifications within the School District have no increased potential for occupational exposure to blood or potentially infectious materials as defined by the OSHA Bloodborne Pathogens Regulation.

Appendix B lists all School District employee exposures to bloodborne pathogens by job classification and specific groups of occupational tasks. All potential exposures to blood and potentially infectious materials listed in the tasks shown in Appendix A are based upon risks incurred without the use of personal protective equipment. The School District will review this Exposure Control Plan and the exposure potential for specific jobs and occupational tasks shown in Appendix A annually or when new or modified tasks or procedures for job positions within the School District alter potential occupational exposures.

Methods of Compliance with Regulation

Because some tasks present the potential for employee exposure to blood and other potentially infectious materials, a number of engineering and work-practice controls have been adopted to minimize such exposures. Universal precautions are observed throughout the School district to prevent contact with potentially infectious materials. Employees should consider all body fluids as potentially infectious because it is often difficult to differentiate between body fluid types. Where occupational exposure exists despite compliance with engineering and work practice controls, the use of appropriate personal protective equipment is required, which varies with the specific work tasks involved.

Engineering controls, including handwashing facilities, are maintained and replaced appropriately to insure their effectiveness. Any employee who observes an ineffective or malfunctioning control item or equipment should take immediate appropriate action to replace, discontinue use of and/or seek repair of the item or equipment.

Handwashing

Handwashing by all exposed employees is required. The importance of handwashing as the primary prevention of contamination cannot be overemphasized. It is the single most important means of preventing the spread of infection. Handwashing facilities are interspersed throughout each school building. All employees of the School District who have routine occupational exposure are provided with antiseptic hand cleaner for disinfection purposes when handwashing is not immediately feasible. However, hand cleaners are not provided with the intent of substituting for handwashing. Employees should wash hands with soap and water as soon as possible following use of such antiseptic hand cleaners. Employees are also required to wash their hands immediately after removing gloves or other personal protective equipment. Employees must insure that hands and any other skin which becomes contaminated with blood or other potentially infectious material are immediately washed with soap and water and that any mucous membrane exposed to blood or other potentially infectious material is flushed with water as soon as possible.

Protection of Food, Drink, Etc.

Eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses is prohibited in work areas of the School District where any risk of occupational exposure exists. The storage of food and drink in refrigerators, freezers or cabinets or on shelves, countertops or benchtops where blood or other potentially infectious materials are present is also prohibited.

Personal Protective Equipment

The School District provides appropriate personal protective equipment, including gloves, gowns and other appropriate devices, at no cost to any employee with occupational exposure. Appropriate personal protective equipment is that equipment which does not permit blood or other potentially infectious materials to pass through to the employee’s work clothes, street clothes, skin, eyes, mouth or other mucous membranes under normal use and for the duration of time the protective equipment is in use.

All occupationally exposed employees of the School District are required to use appropriate personal protective equipment. The only exception to this requirement allowed by the OSHA Bloodborne Pathogens Regulation might occur when the employee temporarily and briefly declines use of the equipment when “under rare and extraordinary circumstances, it [is] the employee’s professional judgment that in the specific instance its use would have prevented the delivery of health care or public safety service or would have posed an increased risk to the safety of the worker or co-worker.” When such a judgment is made, the circumstances will be investigated and documented to determine whether changes should be instituted to prevent future recurrence.

Personal protective equipment appropriate for the work tasks in each division are readily accessible at the work site for all employees. Cleaning and laundering of reusable personal protective equipment is provided by the School District through an outside vendor. Contaminated laundry is disposed of in the appropriate biohazard laundry containers provided by that vendor. Disposable personal protective equipment (e.g., disposable gloves) are discarded in sealed plastic bags.

If a garment becomes penetrated by blood or other potentially infectious materials during the course of its use, it should be removed immediately, or as soon as feasible, and disposed of appropriately. All personal protective equipment must be removed prior to leaving the work area.

Gloves

Latex or vinyl gloves will be worn when it is reasonably anticipated that the employee will have hand contact with blood or other potentially infectious materials, mucous membranes or non-intact skin and when touching contaminated items or surfaces. Disposable (single-use) gloves must be replaced as soon as practical when contaminated or when they are torn, punctured or their ability to function as a barrier is compromised. Disposable gloves are not to be washed or decontaminated for reuse.

Utility gloves, such as those used in housekeeping, sterilization, and clean-up activities, may be decontaminated for reuse if the integrity of the glove is not compromised, but they must be discarded if they are cracked, torn, punctured or exhibit signs of deterioration. Hypoallergenic gloves or glove liners or powderless gloves are provided to employees who are allergic to the gloves normally provided. Employees with contact dermatitis caused by gloves may find protective skin creams helpful in preventing further irritation.

Protective Body Clothing

Appropriate body clothing must be worn in occupational exposure situations. The types and characteristics of the protective clothing depend upon the task and degree of exposure anticipated. The need for protective body clothing will be rare in the school environment.

Masks, Eye Protection, and Face Shields

Because no employees engage in occupational activities in which splashes, spray, splatter or droplets of blood or other potentially infectious materials may be generated and eye, nose or mouth contamination can be reasonably anticipated, masks, eye protection and face shields are not provided.

Housekeeping

Worksites which are subject to contamination by blood and other potentially infectious materials are maintained in clean and sanitary condition by the staff who routinely work in the area and the custodial staff who have cleanup responsibility after the close of the work shift. Appendix C presents the written cleaning and decontamination schedules for the school nurse’s office or first aid sites.

All equipment, environmental and working surfaces are cleaned and decontaminated after contact with blood or other potentially infectious materials upon completion of procedures and immediately, or as soon as feasible, when surfaces are overtly contaminated or following any spill of blood or other potentially infectious materials. All work surfaces are cleaned and decontaminated at the end of each work shift if the surfaces have become contaminated since the last cleaning. One or more of the following solutions are to be used in disinfection of work surfaces, countertops and equipment: commercially-prepared germicidal disinfectants; commercially prepared disinfectants with an isopropyl alcohol content of 40% to 70%; commercially-prepared disinfectants with a hydrogen peroxide content of 3%; or an individually-prepared solution of one-part chlorine bleach to ten parts water. Cleaning and disinfection of floors and walls may be accomplished using commercial cleaning formulations containing quaternary ammonia.

Bins, pails, cans and other similar receptacles intended for re-use that have a potential for becoming contaminated with blood or other potentially infectious materials are inspected and decontaminated on a regular basis and immediately, or as soon as feasible, upon visible contamination.

Spill Cleanup

Spill cleanup requires the use of appropriate protective equipment including gloves, as appropriate. Spills are cleaned up by the individual responsible for the spill in most cases. Appendix D details specific procedures for biological spills cleaning and decontamination.

Broken glassware which may be contaminated is not picked up directly with the hands. Cleanup is affected using mechanical means such as a brush and dust pan. Contaminated broken glassware is discarded in sealed plastic bags.

Waste Disposal

Disposal of waste contaminated with blood or other potentially infectious materials is in sealed plastic bags with the School District’s other non-regulated waste.

Laundry

All contaminated laundry generated by exposed employees of the School District is bagged or containerized at the location where it is used in appropriately labeled containers. Heavily soiled laundry is bagged in leak-proof plastic bags before being placed in laundry containers, if appropriate. The School District contracts with an off-site commercial laundry company for laundry services. Laundry is not sorted, rinsed or processed in any other manner on site. Employees who have contact with contaminated laundry wear protective gloves and other appropriate personal protective equipment.

Hepatitis B Vaccination

Each School District employee who has occupational exposure is offered the Hepatitis B vaccine series within ten (10) days of initial work assignment and after he or she has received the required training unless the employee has previously received the vaccination series, antibody testing has revealed immunity or the vaccination is contraindicated for medical reasons. The School District will provide the health care professional responsible for the employee’s Hepatitis B vaccination with a copy of the OSHA Bloodborne Pathogens Regulation. Vaccinations are performed by or under the supervision of a licensed physician or by or under the supervision of another licensed health care professional in accordance with U.S. Public Health Service recommendations during normal working hours at a reasonable location and at no cost to the employee. Participation in a prescreening program is not a prerequisite for receiving the Hepatitis B vaccination. Employees who decline to accept the Hepatitis B vaccination are required to sign the declination statement included as Appendix E to this Plan.

Any employee who initially declines the Hepatitis B vaccination, but at a later date decides to accept the vaccination, is provided the vaccination at that time without cost. Any future recommended routine booster, does or doses of Hepatitis vaccine recommended by the U.S. Public Health Service will also be provided to exposed employees without cost.

The Hepatitis B vaccination record or signed declination statement is maintained in each employee’s confidential medical record in the office of the superintendent (see Recordkeeping-Medical Records).

Post-Exposure Evaluation and Follow-Up

All School District employees who experience an occupational exposure incident will complete the Incident Report attached as Exhibit F immediately after the exposure, or as soon thereafter as feasible.

Each exposed employee is provided a confidential medical evaluation and follow-up, including prophylaxis, at no cost to the employee, by a licensed health care professional of the School District’s choice. As part of the post-exposure evaluation and follow-up, the routes of exposure and the circumstances under which the incident occurred is documented, including identification and documentation of the source individual, unless infeasible or prohibited by law, and testing of the source individual’s blood and the exposed employee’s blood is completed, as soon as feasible and after consent is obtained. Completion of the Record of Occupational Exposure to Blood or Potentially Infectious Body Fluids included as Appendix G to this Plan satisfies the Regulation’s documentation requirements.

The School District will provide the licensed health care professional who evaluates the exposed employee with the following information: a cop of the OSHA Bloodborne Pathogens Regulation; a description of the exposed employee’s duties as they relate to the exposure incident; documentation of the route(s) of exposure and circumstances under which exposure occurred; results of the source individual’s blood testing, if available; and all medical records relevant to the appropriate treatment of the employee, including vaccination status, that are the School District’s responsibility to maintain.

The licensed health care professional’s written opinion of the post-exposure evaluation is to be provided to the employee within fifteen (15) days of completion of the evaluation and is to be limited to the following: whether Hepatitis B vaccination is indicated for the employee and if the employee has received such vaccination, that the employee has been informed of the results of the evaluation and that the employee has been told about any medical condition resulting from exposure to blood or other potentially infectious materials that require further evaluation or treatment. All other findings or diagnoses are to remain confidential and are not to be included in the written report.

Confidential medical records relating to post-exposure evaluation and follow-up are maintained in the office of the superintendent (see Recordkeeping – Medical Records).

Labels and Signs

To the extent required, the School District uses red color coding and/or fluorescent orange or orange-red biohazard labels to mark all hazardous items. The standard biohazard label and symbol, as shown below, is used for this purpose. Items contaminated with blood or other potentially infectious body fluids which are color coded or posted with biohazard labels include the following: contaminated laundry and sharps containers.

BIOHAZARD

Biohazard Logo

Medical Records

Confidential medical records are kept on all School District employees with occupational exposure to blood or other potentially infectious materials in the office of the superintendent. Each record includes the employee’s name, Social Security number, Hepatitis B vaccination record (or declination form), copies of all results of examinations, medical testing and follow-up procedures relating to any exposure incidents and a copy of the health care professional’s consultation and written opinion relating to any exposures.

All employee medical records are kept for the duration of employment plus thirty (30) years in accordance with the OSHA Bloodborne Pathogens Regulation.

Training Records

Records documenting the provision of information and training relating to occupational exposure to bloodborne pathogens are maintained for three (3) years from the date of training by the School District’s Training Coordinator. These records include the dates of training sessions, a summary of the training session, names and qualifications of the persons conducting the training sessions and the names and job titles of all persons attending the training sessions. An outline of the School District’s Bloodborne Pathogens Training Program is included as Appendix H to this Plan. A Training Record form is attached as Appendix I.

Information and Training 

Information and training pertaining to bloodborne pathogens is provided to all School District employees with occupational exposure without cost and during normal working hours. This training is provided within ten (10) days of initial assignment to tasks where occupational exposures occur and annually thereafter or whenever modifications of tasks or procedures or the institution of new tasks or procedures affect an employee’s occupational exposure to the extent that additional training is indicated and appropriate. Routine training of new employees is conducted on an as-needed basis through the School District’s Training Coordinator. Training is presented by qualified staff members.

Training material is appropriate in content and vocabulary to the educational level, literacy and language of employees. The training program is designed to fulfill the requirements for bloodborne pathogen training outlined in the OSHA Bloodborne Pathogens Regulation. A detailed outline of the training program is kept on file with the School District’s Training Coordinator.


APPENDIX A

DEFINITIONS OF TERMS

BIOSAFETY LEVEL (BL) Associated risks with microorganisms (e.g., BL1 minimal disease in healthy adults such as Bacillus subtilis, BL2 moderate risk associated with human diseases such as hepatitis B virus, BL3 microorganisms that may cause serious diseases such as Mycobacterium bacterium tuberculosis and BL4 microorganisms that are high risk and considered lethal such as Lassa fever virus).

BLOOD Human blood, human blood components and products made from human blood.

BLOODBORNE PATHOGENS Microorganisms that are present in human blood and that can cause disease in humans. These pathogens include hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

CONTAMINATED Marked by the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.

CONTAMINATED LAUNDRY Laundry that has been soiled with blood or other potentially infectious materials or that may contain sharps.

CONTAMINATED SHARPS Any contaminated object that can penetrate the skin, including, but not limited to, broken glass.

DECONTAMINATION The use of physical or chemical means to remove, inactivate or destroy bloodborne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use or disposal.

ENGINEERING CONTROLS Devices or equipment for isolating or removing hazards from the workplace.

EXPOSURE INCIDENT A specific eye, mouth, other mucous membrane, non-intact skin or potential contact with blood or other potentially infectious materials that results from an employee performing his or her duties.

HANDWASHING FACILITIES Locations that provide an adequate supply of running potable water, soap and single-use towels or hot-air drying machines.

HBV Hepatitis B Virus.

HIV Human Immunodeficiency Virus.

LICENSED HEALTH CARE PROFESSIONAL A person who’s legally permitted scope of practice allows him or her to independently perform the activities required for hepatitis B vaccination and post-Exposure evaluation and follow-up.

OCCUPATIONAL EXPOSURE Reasonably anticipated skin, eye, mucous membrane or potential contact with blood or other potentially infectious materials that may result from employees performing their duties.

OTHER POTENTIALLY INFECTIOUS MATERIALS

  1. The following body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures and any body fluid that is visibly contaminated with blood.
  2. Any unfixed tissue or organ (other than intact skin) from a human (living or dead).
  3. HIV-containing cell or tissue cultures, organ cultures and HIV- or HBV-contaminated culture media or other solutions; and blood, organs or other tissues from experimental animals infected with HIV or HBV.

PARENTERAL Exposure occurring as a result of piercing the skin barrier, (e.g., subcutaneous, intramuscular, intravenous routes) through such events as needle sticks, bites, cuts and abrasions.

PERSONAL PROTECTIVE EQUIPMENT Specialized clothing or equipment worn by an employee to protect against a hazard.

SHARPS Any object that can penetrate the skin, including, but not limited to, broken glass.

SOURCE INDIVIDUAL Any individual whose blood or other potentially infectious materials may be a source of occupational exposure to the employee.    

STERILIZE To use a physical or chemical procedure to destroy all microbial life, including highly resistant materials endospores.

UNIVERSAL PRECAUTIONS An approach to infection control in which all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV and other bloodborne pathogens.

WORK PRACTICE CONTROLS Mandated procedures or policies that reduce the likelihood of exposure by altering the manner in which a task is performed.

APPENDIX B

Employee Exposure to Bloodborne Pathogens by Job Classification and TasksJob Classification

Surface Decontamination and Cleaning

Medical Instruments and Equipment

Student Physical Assessment

Waste Disposal

 

Student Personal Care

Nursing

X

X

X

 

X

 

 

 

 

 

 

Special Education

 

 

 

 

 

MH Teachers

 

 

X

 

X

MH Teacher Assistants

 

 

X

 

X

TMH Teachers

 

 

X

 

X

TMH Teacher Assistants

 

 

X

 

X

 

 

 

 

 

 

Athletic Trainer

 

 

X

 

X

 

 

 

 

 

 

Designated Coaches

 

 

 

 

 

Football

 

 

X

 

X

Wrestling

 

 

X

 

X

Basketball

 

 

X

 

X

 

 

 

 

 

 

Designated Secretary

 

 

 

 

 

All Elementary Schools

X

X

 

 

 

 

 

 

 

 

 

Designated Custodians

 

 

 

X

 

 

 

 

 

 

 

Designated Special Education

 

 

 

 

 

Bus Drivers

 

 

 

 

X

APPENDIX C

Cleaning and Decontamination Schedule
School Nurse

 

 

 

 

 

Room(s)

 

 

Item/Surface

Frequency

(Time, Day

or Month)

 

Method/

Disinfectant

 

 

Responsible Party

Instruments/Hand pieces

Nurse Office
First Aid Office

 Stethoscope 
all other items used in examination		 After each use See Plan above School Nurse Secretaries

Pans, Pails, Trays

 Nurse Office Counters 
Exam Tables		 When contaminated or end of day See Plan above School Nurse
Custodial Staff

Handwashing facilities

 Designated
First Aid Site		 Sink/handles Daily   Custodial Staff

Floors/Walls

 Nurse Office Floor Swept daily   Custodial Staff

Equipment/Appliances

          

APPENDIX D

Biological Spill Cleaning and Decontamination Procedure

  1. General Area Maintenance
    1. Work and Equipment Surface
      1. Wearing gloves, clean visible blood and body fluid spills from all equipment surfaces, cabinets and work surfaces with (detergent) and water or 1:10 bleach solution at the end of each work day.
        1. Household bleach solutions are less effective as disinfectants in the presence of high concentrations of protein. It is very important to remove as much body fluid as possible before decontamination.
      2. Wipe down equipment and work area at the end of each day with 1:10 dilution of household bleach or an approved disinfectant solution.
        1. Rinse with water to prevent damage when bleach is used.
  2. Decontamination of Spills
    1. Moist Spills
      1. Place all disposable materials used to decontaminate the spill into a plastic bag and close tightly.
      2. Wipe down the area with 1:10 dilution of household bleach.
      3. Using a detergent solution or approved disinfectant solution, clean the spill site of all visible blood or body fluid.
      4. Wearing gloves, absorb the spill with disposable towels.
    2. Dry Spills
      1. Place all disposable materials used to decontaminate the spill into a plastic bag and close tightly.
      2. If complete removal is not possible, expose the surface to a diluted 1:10 household bleach solution or an approved disinfectant solution for a longer time (20-30 minutes may be necessary).
      3. If a surface or medical device is contaminated with dried blood or body fluid, wearing gloves, remove all of it before disinfection with a 1:10 dilution of household bleach or an approved disinfectant solution.

APPENDIX E

[Statement to be signed by employee]

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 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

________________________________________

Date

 

APPENDIX F

School District
Incident Report
(Report all incidents even if no apparent injury)

DATE OF BIRTH                                     

LAST NAME ________________            FIRST NAME  _______________MIDDLE NAME_______________

ADDRESS                                                 

Date of incident __________, 20                 Time      .m.     

Place                                

Was it necessary to notify physician? Yes__ No__ If yes, name of physician                                 

Time of notification _____ ___.m.       

WITNESS(ES)                  Name                                                  Address                                   Telephone
 

 

 

 

DESCRIBE NATURE OF INCIDENT:

 

 

 

 

 

 

 

DATE REPORT PREPARED: __________ SIGNED _____________________________________________

Signature                                                   Title

INTERVENTION AND OUTCOME:

(Describe actions taken and outcome of the situation)

 

 

 

 

 

 

 

 

 

 

DATE: _________________________    SIGNED: ________________________________________________

Signature                                             Title

Appendix G

Occupational Exposure to Blood or Potentially Infectious Body Fluids

The filing of this report and all information entered on it are to be held in strictest confidence in conformance with Okla. Stat. tit. 63, §§ 1-502.1 et seq.

PART I: EXPOSED EMPLOYEE SECTION (please print)

 

1.      Employee Name:      2. DOB: ___/___/___ 3. Job Title:       

4.      Location of Exposure:                          5. Date of Exposure: ___/___/___

6.      Time of Exposure:   AM/PM

7.      Number of Hepatitis B vaccinations previously received: ❑ None ❑ 1 ❑ 2 ❑ 3

8.      Description of incident (give specific details: ____________________________________________________________

         _______________________________________________________________________________________________

         _______________________________________________________________________________________________

PART II: SOURCE INDIVIDUAL SECTION

 

9.      Name:              10. DOB: ___/___/___ 11. Sex: ❑ M ❑ F

12.    Home Address: _______________________________________________ 13. Phone Number:                                      
                                                       (Box or Street #) (City)


PART III: PHYSICIAN'S OR DESIGNEE STATEMENT

14.    This ❑ (was) ❑ (was not) an exposure which has the potential for transmission of a communicable disease such as HIV/HBV.

15.    In my judgment, ________________________ ❑ (does) ❑ (does not) have contraindications to receiving hepatitis B
vaccine.                               (Employee Name)

16.    _____________________________                                      17. ___/___/___
             Physician/Designee Signature                                                        Date

PART IV: COUNSELOR'S STATEMENT

18.    I have counseled      regarding the risk of HIV/HBV infection following exposure to blood or infectious body fluids and have reviewed with him/her the recommendations for prevention of HIV/HBV.

19.    The following persons involved in this incident received pre-test counseling for HIV/HBV.

A. Source Individual: ❑ Yes ❑ No. If yes, date counseled: ___/___/___

B. Exposed employee: ❑ Yes ❑ No. If yes, date counseled: ___/___/___


20.                                                                                                                21. ___/___/___
                  Certified HIV Counselor Signature                                                         Date

PART V: TESTING

A.      SOURCE INDIVIDUAL TESTING:

22.    HBsAg: ❑ Pos ❑ Neg ❑ Not Done ❑ Refused. If done, date HBsAg drawn: ___/___/___

If "not done", specify why:                                                                                            

23.    HIV: (1) ❑ Pos ❑ Neg ❑ Not Done ❑ Refused. If done, date HIV drawn: ___/___/___

If "not done", specify why:                                                                                            

(2) ❑ Pos ❑ Neg ❑ Not Done ❑Refused. If done, date HIV drawn: ___/___/___

If "not done", specify why:                                                                                            

B.      EMPLOYEE TESTING:

24.    Anti-HBs (for vaccinated employees only):

❑ Pos ❑ Neg ❑ Not Done ❑ Refused. If done, date Anti-HBs drawn: ___/___/___

         25.    HIV Baseline:

                ❑ Pos ❑ Neg ❑ Not Done            ❑ Refused Date Drawn ___/___/___

          6 weeks:    
          ❑ Pos ❑ Neg ❑ Not Done            ❑ Refused          Date Drawn ___/___/___

                    12 weeks:    

          ❑ Pos ❑ Neg ❑ Not Done   ❑ Refused                Date Drawn ___/___/___

                    6 months:    

          ❑ Pos ❑ Neg ❑ Not Done ❑ Refused                    Date Drawn ___/___/___

                  12 months:    
          ❑ Pos ❑ Neg ❑ Not Done ❑ Refused                    Date Drawn ___/___/___

PART VI: EMPLOYEE TREATMENT

            26. HBIG: ❑ Yes ❑ No ❑ Refused. If yes, date: ___/___/___

            27. Hepatitis B vaccine:           Dose 1: ❑ Yes ❑ No ❑ Refused. If yes, date: ___/___/___

                                                     Dose 2: ❑ Yes ❑ No ❑ Refused. If yes, date: ___/___/___

           28.   Tetanus: ❑ Yes ❑ No ❑ Refused. If yes, date: ___/___/___

           29.   Specify any other medical treatment for this exposure:

  ________________________________________________________________________________________________________

  ________________________________________________________________________________________________________

PART VII: COMMENTS

  ________________________________________________________________________________________________________

  ________________________________________________________________________________________________________

  ________________________________________________________________________________________________________

  ________________________________________________________________________________________________________

  ________________________________________________________________________________________________________

  ________________________________________________________________________________________________________

Appendix H

Bloodborne Pathogen Training Program

Training sessions are held on an as-needed basis for new employees in job classifications with occupational exposure. Training is provided within ten (10) days of initial assignment to tasks where occupational exposures occur and annually thereafter or whenever modifications of tasks or procedures or the institution of new tasks or procedures affect an employee's occupational exposure to the extent that additional training is indicated and appropriate.

Each employee who attends a training session receives a copy of the OSHA Bloodborne Pathogens Regulation along with a copy of the Employee Training Program Outline.

A trained representative of the School District is present at the end of the training session to answer participants' questions and to provide additional clarification if needed.

Employee Training Program
OSHA Regulation on Bloodborne Pathogens

  1. Review of Final OSHA Standard on Bloodborne Pathogens
    1. Basis for OSHA Rule – Preventing occupational exposure to other potentially infectious materials (e.g. infectious body fluids), which could result in transmission of HIV or HBV infection to employees.
      1. Regulation effective March 6, 1992:
        1. Various sections to be complied with by March 5, June 4 and July 6, 1002.
        2. Regulation fully in force at this time.
          1. Regulation requires three major intervention strategies
  2. Engineering Controls
  3. Work Practices
  4. Personal Protective Equipment
  5. Major Requirement of Bloodborne Pathogens Rule
    1. Identification of job classifications which have occupational exposure;
    2. Written exposure control plan;
    3. Methods of compliance (How exposures are prevented);
    4. Personal protective equipment;
    5. Housekeeping – spill cleanup including written schedule;
    6. Infectious waste disposal;
    7. Contaminated laundry;
    8. Identifying labels and signs;
    9. Hepatitis B vaccination;
    10. Post-exposure follow-up and prophylaxis;
    11. Record keeping
  6. Epidemiology of HIV/AIDS Infection
    1. HIV/AIDS Description of Virus and Testing
      1. HIV-(Human (I)mmunodeficiency (V)irus;
      2. Not very infectious – millions of particles to infect;
      3. Weak, non-viable within a few hours – won’t live outside human body;
      4. Dry spot non-infectious;
      5. HIV blood test- produce antibodies within six months – virus is not self-limiting – eventually results in infection – within ten years.
    2. Transmission
      1. Body Fluids
      2. Blood
      3. Semen
      4. Vaginal Fluids
      5. Others
      6. Blood Exposure
      7. Percutaneous - needle stick, cut
      8. Non-intact skin
      9. Mucous membrane - other than blood - probably non-existent
      10. Sexual contact
      11. Mother to baby - all babies HIV positive at birth - one-third will develop AIDS
  7. Incidence and Progression of Disease
    1. Several hundred thousand infected with symptoms. 418,000 worldwide, 229,000 in U.S.; 2.1 million infected and well.
    2. Forty percent in U.S. practice self-protection in some manner – abstinence, condoms, abstain from sharing needles.
    3. CDC will publish new diagnostic criteria after election.
  8. Epidemiology of Hepatitis B (HBV) Infection
    1. Description of Virus
      1. Very infectious, hardy and environmentally stable – viable for one week outside human body.
      2. Hepatitis B – 100 million, up to a billion, viral particles per cc of blood.
      3. Infects liver – jaundice, dark urine.
      4. Incubation period 2-6 months, average 3 months.
      5. Carriers infectious one month before symptoms and until virus is no longer present.
    2. Transmission
      1. Blood exposure
      2. Mother to baby (Nine out of ten infected)
      3. Sexual contact
      4. Human bites
    3. Testing
      1. HBsAG+ = infectious (If negative, will not transmit disease).
      2. Anti-HBs+ = immunity (If negative, will not transmit disease).
    4. Spectrum of Illness
      1. Seventy-five percent asymptomatic.
      2. If symptomatic, 2/100 will have fulminant disease.
      3. One out of ten adults become carriers (whether or not they are symptomatic).
      4. Nine out of ten babies become carriers.
      5. Carriers most likely did not have symptoms when initially infected.
    5. Consequences of HBV Infection
      1. Immunity – 90% of adults, 10% of babies.
      2. Acute fulminant disease – death in a few weeks.
      3. Cirrhosis/Liver cancer – many patients develop these in later years.
  9. Occupational Risks for HIV and HBV
    1. Incidence of Occupational Exposures
      1. HIV – Study done on deep needle stick exposures of 65 U.S. health care workers – one out of every 200 exposures (0.3%) becomes infected.
      2. HBV – Many thousands: One out of every three exposures (30%) becomes infected:
      3. Before vaccine – 12-18,000/year; 250-300-year dying
      4. Thirty percent of all emergency room nurses infected.
    2. How Risk Exposures Occur
    3. Management of Exposure
    4. Reporting Exposures
      1. Notify the supervisor immediately.
      2. Fill out Incident Report and Occupational Exposure to Blood and Potentially Infectious Body Fluids form.
      3. Report to Health Services.
      4. Consult with physician.
    5. Treating Exposures
      1. HBV
        1. HBIG + Hepatitis B vaccine within seven days or check for antibodies.
        2. Effective in 85-95% of case if begun in time.
      2. HIV
        1. Check for antibodies at time of exposure.
        2. Repeat at six weeks, three months and six months.
    6. During the test period for HIV antibodies or if source is high risk, observe the following behavioral guidelines.
      1.  Don’t donate blood, plasma, semen or body organs;
      2.  Use condoms for sex;
      3.  Don’t get pregnant or get anyone else pregnant;
      4.  Use blood precautions at home and at work.
  10. Prevention of Exposures
    1. Universal Precautions
      1. Treat all blood or potentially infectious material as if infected.
    2. Hepatitis B Vaccinations
      1. Offer to all potentially exposed employees or declination statement signing required.
    3. Engineering Controls (What you do your work with)
      1. Handwashing facilities
    4. Personal Protective Equipment
      1. Gloves - disposal and utility
      2. Body protective clothing
    5. Work Practice Controls (How you do your work)
      1. Handwashing – ASAP – after removing gloves
      2. Materials – handle in manner as not to splash or spray. Wear gloves.
      3. Do not eat, drink, smoke, apply cosmetics, apply lip balm or handle contact lenses, in area of possible exposure: No food storage in specimen cabinets or refrigerators.
      4. Equipment – clean and disinfect appropriately.
      5. Routine cleaning – adhere to written schedule.
      6. Spills – clean up ASAP.
      7. Broken glass – use broom and dustpan.
  11. School District Exposure Control Plan
    1. Written Plan
      1. All administrators have copy.
      2. Employee may request a copy.
      3. Identifies employee job classification with occupational exposures to bloodborne pathogens.
      4. Delineates specific work practices and engineering controls and required and personal protective equipment for School District.
    2. Specific Personal Protective Equipment
      1. Gloves
      2. Body Protective Clothing
    3. Contaminated Laundry
      1. Contaminated laundry should be separated from laundry which is not contaminated.
      2. Contaminated laundry should be handled with gloves.
    4. Cleaning
      1. Immediate spill cleanup with gloves and appropriate materials.
      2. No hand handling of broken glass.
      3. Written cleaning schedule.
      4. Reusable pans, pails.
      5. Floors, walls, counter tops.
      6. Equipment.
      7. Bleach solution (1:10 dilution) recommended for most cleaning and decontamination – after removal of as much body fluid as possible.

Appendix I

Training Record

Date of Session:  
Summary of Session:  
Name/Qualifications
Of Person(s)
Conducting Session:

 
Seminar Participants: Name Job Title
     
     
     
     
     
     
     
     
     
     

Amended April 2019