Bloodborne pathogens are microorganisms that are present in human blood and can cause illness and disease. These pathogens include, but are not limited to, the Hepatitis B Virus (HBV) and the Human Immunodeficiency Virus (HIV). Bloodborne pathogen exposure is very rare for non-medical industries, but all workplaces should establish a Bloodborne Pathogen Exposure Control Program to eliminate or minimize exposure, particularly for those employees trained in first aid procedures.
This publication outlines the requirements necessary to implement and maintain an Occupational Safety and Health Administration (OSHA) compliant Bloodborne pathogen program.
OVERVIEW
A Bloodborne Pathogen Exposure Control Program has the following elements.
1. Engineering and work-practice controls
2. Personal protective equipment (PPE)
3. Housekeeping
4. Hepatitis B vaccination, post-exposure evaluation and follow-up
5. Training
6. Record-keeping
ENGINEERING AND WORK-PRACTICE CONTROLS
1. Treat all human blood and bodily fluids as if infected with HIV, HBV or other disease-causing bloodborne pathogens.
2. Hand washing facilities should be readily accessible. When not available, provide antiseptic hand cleanser and paper towels or clean cloth.
3. Employees must wash their hands and/or flush mucous membranes with water after removal of gloves and other PPE immediately following exposure.
4. Remove garments immediately or as soon as possible after penetration by blood or other potentially infectious material.
5. No eating, drinking, smoking, applying cosmetics or handling contact lenses in a work area where there is a reasonable likelihood of bloodborne-pathogen exposure.
6. Perform all procedures involving blood or other potentially infectious materials in such a manner as to minimize splashing, spraying, splattering and generation of droplets.
7. Examine and disinfect equipment or areas contaminated with blood or other potentially infectious materials before returning to service.
PPE
1. Use PPE when exposure situations arise.
2. Replace all protective garments that are torn, punctured or that lose their ability to function as a barrier to bloodborne pathogens.
3. Remove all PPE before leaving a contaminated area.
4. Place all protective garments in the designated area or container for cleaning, decontamination or disposal.
Bloodborne Pathogen PPE Kit (Typical)
HOUSEKEEPING
1. Clean and disinfect contaminated equipment and work areas after each incident of exposure.
2. Clean and disinfect contaminated reusable first aid instruments after each incident of exposure.
3. Clean and disinfect bins, pails, cans and similar receptacles daily.
4. Do not pick up broken glass directly with hands; use a broom and dustpan or tongs.
5. Place contaminated laundry in the appropriate container and handle it as little as possible.
HEPATITIS B VACCINATION
The HBV vaccine and vaccination series is available at no cost to employees who may anticipate bloodborne pathogen exposure while performing job-related tasks. Employees may obtain the HBV vaccination after receiving required training and within 10 working days of initial job assignment, unless:
1. An employee has previously received the complete HBV vaccination series.
2. Antibody testing has revealed that the employee is immune.
3. For medical reasons, the employee is advised not to receive the vaccination.
4. The employee declines the HBV vaccination or requests the vaccination later.
An employee who declines the HBV vaccination must sign a statement indicating that they have the right to receive an HBV vaccination at no cost. (See sample of the Hepatitis B Vaccine Declination.) An employee who had an occupational exposure may also receive at no cost an HBV vaccine or a booster dose of the HBV vaccine within 24 hours of exposure.
Exposed Employees receive the following medical evaluation under the supervision of a licensed physician. An accredited laboratory must conduct all tests. All procedures are at no cost to the employee.
1. The HBV vaccine.
2. The HBV vaccination series.
3. Post-exposures evaluation and follow-up, including treatment
The post-exposures evaluation and follow-up includes the following.
1. Documentation of the route(s) of exposure.
2. A description of the circumstances under which the exposure occurred.
3. The identification and documentation of the source individual. Identification is not required if it can be establish that identification is impossible or prohibited by state or local laws.
4. Collection and testing of the source individual’s blood for HBV and HIV serological status.
5. Post-exposure treatment for the Employee, when medically indicated in accordance with the U.S. Public Health Service.
6. Counseling.
7. Evaluation of any reported illness.
8. Evaluating health care professional’s written opinion.
a) The employee will receive a copy of the evaluating health care professional’s written opinion within 15 days of the completion of the evaluation.
b) The written opinion for HBV vaccination is limited to the following.
(1) Whether the employee needs an HBV vaccination.
(2) Whether the employee has received the vaccination.
c) The health care professional’s written opinion for post-exposure evaluation and follow-up is limited to the following information.
(1) That the Employee received the results of the evaluation.
(2) That the Employee received information about any medical conditions resulting from exposure to blood or other infectious materials that require further evaluation or treatment.
d) All other findings or diagnoses are confidential and are not in the report. The health care professional evaluating an employee is provided with the following information.
(1) A copy of the OSHA Bloodborne Pathogens regulation 29 CFR 1910.1030.
(2) A description of the exposed employee’s duties as they relate to the exposure incident.
(3) Documentation of the route(s) of exposure.
(4) A description of the circumstances under which the exposure occurred.
(5) Results of the source individual’s blood testing, if available.
(6) All medical records applicable to treatment of the Employee, including vaccination status.
TRAINING
All employees with potential exposure to bloodborne pathogens will participate in training. Training should occur before the time of the first assignment to a job where exposure may exist. Any employee exposed to infectious material also must receive training. Training is annually or when modifications of procedures affect the potential for exposure.
The training program contains the following.
1. A general explanation of bloodborne pathogens.
2. An explanation of the modes of transmission of bloodborne pathogens.
3. An explanation of the engineering and work practice controls.
4. The use of PPE.
5. Information on actions to take in an emergency involving blood or other potentially infectious material.
6. Information on post-exposure evaluation and follow-up for Employees exposed.
7. Providing an accessible copy of OSHA Bloodborne Pathogens regulation 29 CFR1910.1030.
RECORD-KEEPING
Establish and maintain an accurate medical record for each employee with bloodborne pathogens exposure.
Medical records include the following information.
1. The name and Social Security number of the employee.
2. A copy of the employee’s hepatitis B vaccination status including the dates of all the hepatitis B vaccinations and any medical records relative to the employee’s ability to receive the vaccination.
3 A copy of the results from all examinations, medical testing and follow-up procedures.
4 The employee’s copy of the health care professional’s written opinion and a copy of the information provided to the health care professional.
Maintain the following Training information.
1. The dates of the training sessions.
2. The contents or a summary of the training sessions.
3. The names and qualifications of persons conducting the training.
4. The names and job titles of all persons attending the training sessions.
Maintain medical records for at least the duration of the employee’s employment, plus 30 years. Maintain Training records three years from the date of training. All medical and training records are available only to the employee, to anyone having the written consent of the employee, to the director of the National Institute for Occupational Safety and Health (NOSH) and to the assistant secretary of labor for OSHA.
WORKERS’ COMPENSATION
The Workers’ Compensation requirements for infectious diseases vary from state to state. For example, some states have a specific time frame for individuals who have had a significant exposure to potentially infectious bloodborne disease to get a baseline blood test or they become ineligible for benefits if they contract a disease.
The following section outlines a Bloodborne Pathogens Exposure Control Program.
BLOODBORNE-PATHOGENS EXPOSURE-CONTROL PROGRAM
Facility name: ______________________________________
Address: __________________________________________
City, State, ZIP code: _________________________________
Phone Number: _____________________________________
Prepared by: ________________________________________
PURPOSE
The purpose of this program is to eliminate or minimize Employee exposure to bloodborne pathogens.
RESPONSIBILITY
____________________________ is responsible for the program and has authority
to make decisions to ensure the success of the program.
____________________________ will develop written instructions covering each of the elements in this program and will update the instructions as necessary.
JOB CLASSIFICATIONS/EMPLOYEES
These job classifications listed below may experience occupational exposure to bloodborne infectious materials.
Job Title
____________________________ ____________________________
____________________________ ____________________________
____________________________ ____________________________
____________________________ ____________________________
____________________________ ____________________________
____________________________ ____________________________
ENGINEERING AND WORK-PRACTICE CONTROLS
Everyone at this facility will observe “universal precautions.” All human blood and bodily fluids is treated as if infected with HIV, HBV or other disease causing bloodborne pathogens. is responsible for examining, maintaining and, when appropriate, replacing the engineering controls on a monthly basis to ensure their effectiveness.
PPE
____________________________ will provide gloves, masks, eye protection and all other appropriate personal protective equipment at no cost to employees.
____________________________ will replace, repair or clean personal protective equipment as necessary and at no cost to employees.
HOUSEKEEPING
Equipment, work areas, first aid instruments and laundry will be cleaned and disinfected after each incident of exposure. is responsible for ensuring that all equipment, work areas, first aid instruments and laundry will be cleaned and disinfected after each incident of exposure.
HEPATITIS B VACCINATION
The HBV vaccine and vaccination series is available at no cost to employees who may anticipate bloodborne-pathogen exposure while performing job-related tasks. An employee who had an occupational exposure may receive an HBV vaccination no cost. An employee can decline the HBV vaccination or request the vaccination later, also at no cost. When an exposure incident has occurred, the exposed employee (if consenting) will receive a confidential medical evaluation and follow-up.
____________________________ is responsible for ensuring that all employees who may anticipate bloodborne-pathogen exposure or had an occupational exposure are aware of the right to receive the HBV vaccine and vaccination series.
TRAINING
All employees with the potential of exposure to bloodborne pathogens will participate in training. Training will occur prior to the time of the first assignment where exposure exists. Training is annually or when modification of procedures affects the employees potential to exposure. Any employee exposed to infectious material will receive training, even if the employee received the HBV vaccine after exposure.
____________________________ will provide all appropriate training to employees with the potential for exposure or those exposed.
RECORD KEEPING
Maintain accurate medical record for each employee with bloodborne-pathogens exposure All medical and training records are available only to the employee, to anyone having written the consent of the Employee, to the director of the National Institute for Occupational Safety and Health (NOSH) and to the assistant secretary of labor for OSHA.
Maintain training records for three years from the date of training. Keep a copy of this plan for employee review.
____________________________ will maintain updated and accurate medical and training records.
HEPATITIS B VACCINE DECLINATION FORM
I understand that due to my occupational exposure to blood or other infectious materials that I may be at risk of acquiring the Hepatitis B virus (HBV) infection. I have the opportunity to receive the Hepatitis B vaccine at no charge to myself. However, at this time I decline the Hepatitis B vaccination. 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 the Hepatitis B vaccine, I can receive the vaccine at no charge to me.
Print Name: ____________________________
Title: __________________________________
Signature: ____________________________ Date: ____________________________
Copy of the OSHA Bloodborne Pathogens Standard can be found at 29 CFR1910.1030.
John Sadlouskos 