Bloodborne Pathogens

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Bloodborne Pathogens

• 29 CFR 1910.1030

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Components of the Standard

• Exposure Control Plan
• Methods of Compliance
• Universal Precautions
• Engineering and Work Practice Controls
• Personal Protective Equipment
• Housekeeping

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Components of the Standard

• Continued...
• Hepatitis B Vaccination
• Hazard Communication
• Recordkeeping

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Exposure Control Plan

• Key provision of the standard, requires employer
  to identify exposed or potentially exposed
  workers, i.e., those who need training, PPE,
  vaccination, and situations where engineering
  controls would eliminate or minimize exposure
• The plan must be available to employees
  1910.1020 requires a hard copy be made available
  to workers within 15 days of request.
• The plan must also include the procedures for
  evaluating the circumstances surrounding an
  exposure incident

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Exposure Control Plan

• (c)(1)(iv) requires plan to be reviewed and
  updated at least annually.
• Plan must be updated to reflect changes in
  technology that eliminate or reduce employee
  exposure.
• Plan MUST document consideration and
  implementation of appropriate, commercially
  available and effective engineering controls

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Exposure Control Plan

• Needlestick Safety and Prevention Act
• Public Law 106-430 on November 6, 2000
• An Act To require changes in the bloodborne
  pathogens standard in effect under the
  Occupational Safety and Health Act of 1970.

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Universal Precautions...

• shall be observed to prevent contact with blood
  or potentially infectious materials. Under
  circumstances in which differentiation between
  body fluid types is difficult or impossible, all
  body fluids shall be considered potentially
  infectious materials. 1030(d)(1)
• In Other Words....

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Engineering and Work Practice Controls

• Engineering and work practice controls to be
  instituted as the PRIMARY means of eliminating or
  minimizing exposure.
• Conforms to OSHAs traditional hierarchy of
  controls.
• The employer MUST use engineering and work
  practice controls to eliminate exposure or reduce
  it to the lowest feasible extent.
• IF engineering and work practice controls do not
  eliminate exposure, the use of PPE is required.

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Engineering and Work Practice Controls

• Where engineering controls will reduce employee
  exposure either by removing, eliminating or
  isolating the hazard, they must be used. CPL
  2-2.44D
• The employer should be using - or at least have
  considered, and documented in exposure control
  plan why he/she CANNOT be using - engineering and
  work practice controls for work operations
  involving exposure to blood or OPIM.

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Cost of Safer Devices

• DEVICE UNIT PRICE
  UNIT PRICE
• (conventional)
  (safer design)
• Phlebotomy 0.10
  0.33
  needles
• Butterfly 0.65
  0.90
  needles
• IV Catheter 0.75
  1.75
• Hypodermic 0.05
  0.25
  needle/syringe
  

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Housekeeping (4)(i)

• Employer must develop and implement a written
  cleaning and decontamination schedule based upon
• location within the facility
• type of surface to be cleaned
• type of soil present
• type of procedures being performed

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Housekeeping

• Areas and equipment must be cleaned and
  decontaminated after contact with blood etc.
• Broken glassware which MAY be contaminated must
  be handled by mechanical means, e.g. tongs,
  forceps
• Contaminated reusable sharps must to processed
  and stored in a manor that precludes employees
  from handling them

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Sharps Containers

• Contaminated sharps shall be discarded
  immediately or as soon as feasible in containers
  that are
• Closable
• Puncture resistant
• Leakproof on sides and bottoms
• Labeled or color-coded

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Laundry

• Contaminated laundry must be handled as little as
  possible, with minimum agitation
• Bagged at location of use in labeled or
  color-coded bags or containers
• NOT sorted or rinsed at location of use

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HBV Vaccinations

• Employer must provide hepatitis B vaccination to
  to all employees who have an occupational
  exposure to BBP
• Employer must provide a post-exposure evaluation
  to all employees who have had an exposure
  incident.

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Hazard Communication

• Labels and Signs
• Biohazard symbol
• Red bags or containers may be substituted
• Information and Training
• at time of initial assignment
• annually thereafter
• upon task and/or procedure change

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Training Material

• Appropriate for educational level, literacy and
  language
• Explains symptoms and epi. of BB disease
• modes of transmission
• Exposure Control Plan

• Use and limitations of engineering , PPE and work
  practice controls
• Hepatitis B vaccine
• BBP Exposure follow-up procedures
• Must be interactive

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Interactive Training

• The trainer must be knowledgeable in the subject
  matter as it relates to the workplace
• Unsupervised video tape and/or computer training
  classes are not appropriate

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Recordkeeping

• Medical Records
• for each employee with occupational exposure
• HBV vaccine dates and status
• for duration of employment 30 years
• Training Records
• dates and summary of session
• name of participants and trainers
• maintained for 3 years

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Needlestick Prevention

• OSHA estimates that 5.6 million workers in the
  health care industry and related occupations
  are at risk of occupational exposure to
  bloodborne pathogens.
• CDC estimated that 600,000 to 800,000
  needlestick injuries (NSIs) and other
  percutaneous injuries occur annually among health
  care workers.
• 1/3 of all sharps injuries have been reported
  to be related to the disposal process.
• 62 88 of sharps injuries can potentially be
  prevented by the use of safer medical devices.

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• Needlestick requirements take effect April 18,
  2001.
• Occupational Exposure to Bloodborne Pathogens
  Needlestick and Other Sharps Injuries Final Rule
  (2001, January 18).
• There is a need for employers to select safer
  needle devices as they become available and to
  involve employees in identifying and choosing the
  devices.
• The updated standard requires employers to
  maintain a log of injuries from contaminated
  sharps.
• The revised OSHA bloodborne pathogens standard
  obligates employers to consider safer needle
  devices when they conduct their annual review of
  their exposure control plan.

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• Safer sharps are considered appropriate
  engineering controls, the best strategy for
  worker protection.
• The new needlestick log will help both
  employees and employers track all the
  needlesticks to help identify problem areas or
  operations
• The Needlestick Safety and Prevention Act took
  effect November 6, 2000. It specified revisions
  of OSHAs bloodborne pathogens standard and
  directed the agency to make these changes within
  6 months.

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Bloodborne Pathogen Questions

• Glenn Lamson
• glamson_at_osha-slc.gov
• 801-524-7914