BLOODBORNE PATHOGENS

EXPOSURE CONTROL PLAN

United States Department of Agriculture

Agricultural Research Service

North Atlantic Area

Your Location Information

# Date 2002

[Table of Contents]{.underline}

1.0 Introduction.

2.0 Responsible Individual.

3.0 Exposure Determination.

4.0 Schedule and Method of Implementation of:

> 4.1 Methods of Compliance
>
> 4.1.1 Specimens' Handling and Sharps Containers
>
> 4.1.2 Personal Protection Equipment
>
> 4.1.3 Gloves
>
> 4.1.4 Eye and Face Protection
>
> 4.1.5 Additional Protection
>
> 4.1.6 Laundry Procedures
>
> 4.1.7 Housekeeping
>
> 4.1.8 Regulated Waste Disposal

4.2 Communication of Hazards to Employees

4.2.1 Labels and Signs

4.2.2 Training

4.3 Record-keeping

4.3.1 Medical Records

4.3.2 Training Records

4.4 Hepatitis B Vaccination

5.0 Procedure for Evaluation of Circumstances Surrounding Exposure
Incidents:

5.1 Post-Exposure Evaluation and Follow-up

5.2 Information Provided to the Healthcare Provider

5.3 Healthcare Professional's Written Opinion

6.0 Definitions:

7.0 Attachments:

7.1 Biohazard Label

7.2 PIADC Hepatitis B Declination form

7.3 29 CFR 1910.1030, OSHA Bloodborne Pathogen Standard.

7.4 Bloodborne Pathogen Training List for 2002

#### 1.0 Introduction

Bloodborne pathogens are disease-causing agents, such as viruses and
bacteria that can be transmitted from one individual to another via
contact with blood and other bodily fluids. The bloodborne pathogen
regulation contained in 29 Code of Federal Regulations (CFR) 1910.1030
applies to all persons who may reasonably anticipate contact with blood
or other potentially infectious materials (OPIM) in the course of their
employment. This includes contact with skin, eyes, mucous membranes or
contact from piercing the skin.

The purpose of the Your Location Bloodborne Pathogens Exposure Control
Plan (BBP) is to eliminate employee occupational exposure to blood or
other bodily fluids.

It is the intent of this plan to cover all workers at Your Location due
to the close proximity between the different employers and the first aid
provisions. No distinction between the different government agencies and
contractor employees is made. The BBP describes how the employers will
protect employees from exposure to these materials. It is written to
comply with 29 CFR 1910.1030, Bloodborne Pathogens. A copy of the OSHA
standard is incorporated into this document as an attachment.

2.0 [Responsible Individual]{.underline}

The AREA Safety Office representative is responsible for the
implementation of the program, conducting and annual review for
effectiveness, and for updating it as needed.

3.0 [Exposure Determination]{.underline}

OSHA requires employers to perform an exposure determination concerning
which employees may incur occupational exposure to blood or OPIM. The
exposure determination is made without regard to the use of personal
protective equipment (i.e. employees are considered to be exposed even
if they wear personal protective equipment).

This exposure determination begins with a list of job classifications in
which:

1.  *All employees that have exposure to bloodborne pathogens*, or

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1.  *Some employees that have exposure*.

When only some employees in a classification have exposure, the specific
tasks in which exposure occurs, regardless of frequency, are listed. At
this facility the following job classifications are in these categories:

1.  *All employees that have exposure*:

    a.  An example is Nurse Practitioner, EMT, research with human
        blood/blood products

> 2\. *Some employees have exposure* (specific tasks may have exposure):

b.  Microbiologist (may handle human blood or blood products)

c.  Animal Caretaker/Janitor/administer first aid / clean up of human
    blood)

d.  Biological Laboratory Technician (may handle human blood or blood
    products)

e.  Laboratory Control Technician (may transport human blood / blood
    products)

f.  Veterinary Medical Officer (may handle human blood or blood
    products)

g.  Operations and Maintenance Personnel (will administer CPR / First
    Aid)

h.  Laundry Operator (bloodied clothing)

i.  Guards (may administer CPR / First Aid)

j.  Emergency Service Personnel (may administer CPR / First Aid)

4.0 [Schedule and Method of Implementation]{.underline}

All sections of this policy are in effect. The schedule for reviewing
this policy and the effectiveness of the controls will be conducted at
least annually.

4.1 [Methods of Compliance]{.underline}

Universal precautions will be observed at this facility in order to
prevent contact with blood or OPIM. All blood or OPIM will be considered
infectious regardless of the perceived status of the source individual.
Universal precautions is an approach to infection control where all
human blood and OPIM are treated as if it was infectious for HIV,
hepatitis B virus and other bloodborne pathogens (see definitions
Section 6).

At this facility engineering controls and specific work practices will
be utilized to eliminate or minimize exposure to employees at this
facility. Where occupational exposure remains after institution of these
controls, personal protective equipment shall also be utilized.

Engineering controls will be be regularly inspected according to the
following schedule:

[Item Inspection Schedule By Whom]{.underline}

Sharps Containers Weekly Supervisor

Class II Biological Safety Cabinet Annual Contractor

Regulated Med Waste Containers Weekly Supervisor

Autoclave Annual Contractor

Safety Needle Devices Weekly Supervisor

Disposable Airway Equipment Weekly EMS Coordinator

Resuscitation Devises Weekly EMS Coordinator

Mechanical Resp. Assist Devices Weekly EMS Coordinator

Hand-washing Stations Weekly Supervisor

Access Control Weekly Supervisor

Hand-washing facilities and showers are readily accessible for personal
cleaning after exposures. Hand-washing facilities are located:

-   in all occupied buildings and field sites

-   in all Building laboratory suites, modules

Emergency medical providers who may not have immediate access to
hand-washing facilities are provided antiseptic hand cleanser to clean
their hands. Employees have been instructed to wash their hands as soon
as feasible with non abrasive soap and water. Supervisors shall follow
up that employees clean up hands and any contaminated skin area as soon
as feasible with non abrasive soap and water after removal of gloves or
other personal protective equipment.

In work areas where there is a reasonable likelihood of exposure to
blood or OPIM, employees are not to eat, drink, apply cosmetics or lip
balm, smoke, or handle contact lenses. Food and beverages are not to be
kept in refrigerators, freezers, shelves, cabinets, or on counter tops
or bench tops where blood or OPIM are present. Mouth
pipetting/suctioning of any material is prohibited at this facility.

All procedures will be conducted in a manner which will minimize
splashing, spraying, splattering, and generation of droplets of blood or
OPIM. Some of the methods which will be employed at this facility to
accomplish this goal are:

-   Universal precautions

-   Use of Class II Biological Cabinet at all times with open vessels

-   Use of sealed cups for use in centrifugation

-   Transfer all containers of human whole blood in sealed carriers at
    all times

-   Use of face shields when manipulating human whole blood

-   Foot operated biohazard waste containers in the nurse's office

-   Placement of all sharps directly into sharps containers

-   Using plastic disposable labware whenever possible

-   Using automatic pipetting devices

4.1.1 [Specimen Handling and Sharps Containers]{.underline}

Specimens of blood or OPIM will be placed in a container which prevents
leakage during the collection, handling, processing, storage, and
transport of the specimens. The container used for this purpose will be
labeled with the "biohazard" (Section 6.1) label, or will be placed in
red bags or container. Specimens which could puncture the primary
container or when the outside of the primary container becomes
contaminated, it will be placed within a labeled puncture resistant
secondary container.

At this facility, the sharps containers are puncture resistant, leak
proof and marked with a biohazard label. the supervisor is responsible
for the weekly check and for arranging with the O&M Forman for
replacement units of filled containers. Contaminated sharps are to be
placed as soon as possible into appropriate sharps containers.

When universal precautions are utilized in the handling of specimens,
the labeling/color-coded of specimens is not necessary, provided that
the containers are recognizable as containing specimens. Plum Island
uses sharps containers that are labeled, other infectous materials are
placed in red bags. This exception only applies while such
specimens/containers remain within the facility. Appropriate labeling is
required when such specimens leave the PIADC.

The supervisor is responsible for ensuring that equipment which may have
been contaminated with blood or OPIM is examined prior to servicing or
shipping and decontaminated unless the decontamination of the equipment
is not feasible. This equipment will be appropriately labeled stating
which area on the equipment is contaminated. The supervisor shall ensure
that this information is conveyed to all affected employees, the
servicing representative, and the manufacturer as appropriate before
handling so that appropriate precautions will be taken.

Note: All equipment shipped from Building is decontaminated prior to
release from Location.

4.1.2 [Personal Protective Equipment (PPE]{.underline})

The supervisors are responsible for providing appropriate personal
protective equipment (PPE) to the employees when there is potential
occupational exposure. The PPE shall be provided at no cost to the
employee. PPE will be chosen based on the anticipated exposure to blood
or OPIM and will be considered appropriate only if it does not permit
blood or OPIM to reach the employee's skin, eyes, mouth, or other mucous
membranes. The Area Office Safety Rep. and Biological Safety Officer are
responsible for evaluating the operations and recommending appropriate
PPE.

The supervisor shall ensure that appropriate PPE in the necessary sizes
is readily accessible at the work site. All personal protective
equipment will be laundered, repaired, replaced and disposed of by the
employer at no cost to the employees. Regular cleaning of some PPE items
e.g. safety glasses will be cleaned by the employees.

All garments which are penetrated by blood shall be removed immediately
or as soon as feasible. All PPE will be removed prior to leaving the
work area. When PPE is removed, it shall be placed in an appropriately
designated area or container. (See Section 4.1.6 Laundry Procedures)

4.1.3 [Gloves]{.underline}

Latex Gloves shall be worn where it is reasonably anticipated that
employees will have hand contact with blood or OPIM especially when
handling or touching contaminated items or surfaces. Hypoallergenic
gloves, glove liners, powderless gloves, or other similar alternatives
shall be readily accessible to those employees who are allergic to the
gloves normally provided.

Disposable gloves are not be washed or decontaminated for re-use and are
to be replaced as soon as feasible when they become contaminated, torn,
punctured, or when their ability to function as a barrier is
compromised.

4.1.4 [Eye and Face Protection]{.underline}

All of the following are available for use and are maintained at each
location where there is potential to blood or OPIM. Masks in combination
with eye protection devices, such as goggles or glasses with solid side
shields, or chin length face shields, are required to be worn whenever
splashes, spray, splatter or droplets of blood or OPIM may be generated
and eye, nose, or mouth contamination can reasonably be anticipated.
Situations at our location which may require such protection are:

*Examples Only- Insert Specific*

> a\. Phlebotomy
>
> b\. Handling of human whole blood
>
> c\. Response for emergency medical treatment
>
> d\. Biohazardous spill response

4.1.5 [Additional Protection]{.underline}

Additional protective clothing (such as lab coats, gowns, aprons, or
similar outer garments) shall be worn in instances when gross
contamination can reasonably be anticipated. The type of clothing
selected will depend upon the tasks being carried out and the degree of
exposure anticipated. The following situations may require that such
protective clothing be utilized:

> a\. Manipulation of human whole blood;
>
> b\. Biohazardous spill response.
>
> c\. Response for emergency medical treatment

4.1.6 [Laundry Procedures]{.underline}

Laundry contaminated with blood or OPIM will be handled as little as
possible. Such laundry will be placed in appropriately marked (biohazard
labeled, or color coded red bag) bags at the location where it was used.
Such laundry will not be sorted or rinsed in the area of use.

Protective laboratory clothing or personal \"street\" clothing, when
overtly contaminated with blood or OPIM must be decontaminated before
being laundered and reissued. Such clothing will be placed into an
appropriately marked (biohazard symbol or color coded) autoclavable bag
or container and autoclaved for 45 minutes at 121ºC before being
laundered. If disposable clothing is worn, it will not be reused and
disposed appropriately as Regulated Medical Waste after use.\"

Whenever contaminated laundry is reasonably expected to soak or leak
through the container, the laundry will be placed and transported in
containers that prevent soak-through and leakage of fluids to the
exterior. **The laundry will be autoclaved before release to the laundry
facility**. In some cases it may be determined that the clothing is not
salvageable and therefore may be disposed as biohazardous waste.

4.1.7 [Housekeeping]{.underline}

This facility will be cleaned according to the following schedule at a
minimum:

[Area]{.underline} [Schedule]{.underline} [Personnel
Cleaning]{.underline} [Cleaning Material]{.underline}

Animal Laboratories Weekly Animal Caretakers Virkon

Administrative Building Weekly Janitorial Staff

Laboratory Support Areas Weekly Janitorial Staff

Ambulance/Related Equip. Weekly Emergency Providers Envirocide

Surfaces contaminated with blood or OPIM will be disinfected as soon as
feasible but no longer than the end of the shift using the above listed
product or by wiping with a 10% bleach in water solution.

Protective coverings (plastic wrap, aluminum foil, or imperious-backed
absorbent paper) used to cover equipment and environmental surfaces that
become contaminated will be removed and replaced as soon as feasible or
at the end of the work-shift if they have become contaminated.

All bins, pails, cans, and similar receptacles intended for reuse that
have a reasonable likelihood for becoming contaminated with blood or
OPIM will be inspected and decontaminated on a need-scheduled basis and
cleaned and decontaminated immediately or as soon as feasible upon
visible contamination.

Reusable sharps, contaminated with blood or OPIM, shall not be stored or
processed in a manner requiring employees to reach into the containers
where these sharps have been placed. Any contaminated broken glassware
will not be picked up by hand.

4.1.8 [Regulated Waste Disposal]{.underline}

Contaminated disposable sharps shall be placed immediately or as soon as
feasible in containers that are closeable, puncture resistant, leakproof
on sides and bottom, and labeled or color coded.

During use, containers for contaminated sharps shall be easily
accessible to personnel and located as close as is feasible where sharps
are used. The container shall be maintained upright through-out the use
and replaced prior to exceeding three quarters full. Sharps containers
must not be shaken or otherwise manipulated to reduce the volume in the
container. Shaking or compacting the containers has the potential to
release aerosols or the sharps from within the container.

When moving contaminated sharps containers, they shall be closed to
prevent spillage or protrusion of contents during handling. Leaking
containers shall be placed in a secondary container. The secondary
container shall be closeable, constructed to contain all contents and
prevent leakage. The secondary container shall be labeled or color coded
to identify its contents. ***All sharps containers shall be autoclaved
for 45 minutes at 121°C before transporting to the disposal point*.**

Reusable containers shall not be opened, emptied, cleaned or handled in
any other manner which would expose employees to the risk of
percutaneous injury.

Other regulated waste (non-sharps) shall be placed in containers which
are closeable, large enough to contain all contents and prevent leakage
of fluids. The container must be labeled and closed prior to removal to
prevent spillage or protrusion of contents.

4.2 [Communication of Hazards to Employees]{.underline}

4.2.1 [Labels and Signs]{.underline}

Supervisors of the unit shall ensure that biohazard labels are affixed
to containers of regulated waste, refrigerators and freezers containing
blood or OPIM, and the containers of such leaving their unit.

The universal biohazard symbol shall be used. The label shall be
fluorescent orange or orange-red. (See Appendix B of this plan) Red bags
or containers may be substituted for labels. However, regulated wastes
must be handled in accordance with the rules and regulations of the
organization having jurisdiction. Biohazard labels and signs are
available from the Biological Safety Officer.

4.2.2 [Training]{.underline}

The Area Representative and Biological Safety Officer shall make
available and the supervisor of the unit shall ensure that employees
attend training where occupational exposure may occur. Training shall be
provided at the time of initial assignment and shall be repeated no
longer than annually. Training shall be tailored to the education and
language of the employee. It shall be offered during the normal work
shift. The person conducting the training shall be knowledgeable in the
subject matter.

The training will cover the following:

a\. The OSHA standard and an explanation of its contents

b\. A discussion of the epidemiology and symptoms of bloodborne diseases

c\. An explanation of the modes of transmission of bloodborne pathogens

> c\. An explanation of the Bloodborne Pathogen Exposure Control Plan
> and a
>
> method for obtaining a copy

d\. The recognition of tasks that may involve exposure

e\. An explanation of the use and limitations of methods to reduce
exposure, such as

engineering controls, work practices and personal protective equipment
(PPE)

f\. Information on the types, use, location, removal, handling,
decontamination and

disposal of PPE

g\. An explanation of the basis of selection of PPE

h\. Information on the Hepatitis B vaccination, including efficacy,
safety, method of

administration, benefits, and that it will be offered free of charge

i\. Information on the appropriate actions to take and persons to
contact in an

emergency involving blood or OPIM

> j\. An explanation of the procedures to follow if an exposure incident
> occurs,
>
> including the method of reporting

k\. Information on the evaluation and follow-up required after an
employee exposure

incident

l\. An explanation of the signs, labels, and color coding systems.

Employees who have received bloodborne pathogen training in the previous
twelve months need only receive training in provisions of this policy
that were not covered. Additional training shall be provided when there
are work place changes affecting the employee's occupational exposure.

4.3 [Recordkeeping]{.underline}

4.3.1 [Medical Records]{.underline}

The Local medical provider, and ARS, together with the FOH Medical
Review Officer, are responsible for maintaining medical records as
indicated below. Records are kept secured in the in accordance with 29
CFR 1910.20. These records shall be kept confidential, and must be
maintained for at least the duration of employment plus 30 years.

The records shall include:

> a\. Name and social security number of the employee
>
> b\. The employee's HBV vaccination status, including the dates of
> vaccination
>
> c\. All results of examinations, medical testing, and follow-up
> procedures
>
> d\. A copy of the information provided to the healthcare professional,
> including a
>
> description of the employee's duties as they relate to the exposure
> incident, and
>
> documentation of the routes of exposure and circumstances of the
> exposure.

All employee's records shall be made available to the employee in
accordance with 29 CFR 1910.20. Employee records shall be made available
to the Assistant Secretary of Labor for the Occupational Safety and
Health Administration (OSHA) and the Director of the National Institute
for Occupational Safety and Health (NIOSH) upon request with Employee
permission.

If this facility is closed or there is no successor employer to receive
and retain the records for the prescribe period, Headquarters, OPM and
the Director of the NIOSH shall be contacted for final disposition.

4.3.1.1 [Pre Hospital Care Reports (PCR's)]{.underline}

Most states require additional information to be processed whenever care
is provided by a State certified Emergency Medical Services (EMS)
personnel. The PCR forms must be completed for any treatment provided by
an EMS personnel, not just blood borne exposures. The EMS section
provider has the responsibility to maintain the forms and collect the
required information. PIADC personnel receiving care are obligated to
provide the requested information.

4.3.2 [Training Records]{.underline}

Training records shall be maintained by the Safety Office for a period
of at least three years.

The records shall include:

a\. Instructor's name and title

> b\. Date of training session
>
> c\. Names and titles of trainees
>
> d\. A copy of the training material

4.4 [Hepatitis B Vaccine]{.underline}

The location shall make available the Hepatitis B vaccine and
vaccination series to all employees who have occupational exposure, and
post exposure follow-up to all employees who have had an exposure
incident. The Area Representaive or local provider or Biological Safety
Officer shall ensure that all medical evaluations and procedures,
including the Hepatitis B vaccine and vaccination series are:

> a\. made available at no cost to the employee,
>
> b\. made available to the employee at a reasonable time and place,
>
> c\. performed by or under the supervision of a licensed physician or
> other licensed
>
> healthcare professional,
>
> d\. all laboratory tests shall be conducted by an accredited
> laboratory,
>
> e\. provided according to the recommendations of the U.S. Public
> Health Service.

The Local medical provider under the OMSP program, together with the
Federal Occupational Health Medical Review Officer, are in charge of the
Hepatitis B vaccination program. A copy of 29 CFR 1910.1030 has been
provided to the local provider as needed.

Hepatitis B vaccination shall be made available after the employee has
received training occupational exposure and within 10 working days of
initial assignment to all employees who have occupational exposure
unless:

> a\. The employee has previously received the complete Hepatitis B
> vaccination series,

b\. The employee has signed a written declination. (See Section 7.2 for
copy.) *Employees that initially decline the Hepatitis B vaccination,
may accept the vaccination at a later date if still covered under the
standard.*

> c\. The vaccine is contraindicated for medical reasons, or
>
> d\. Antibody testing has revealed that the employee is immune,
> (optional)

The healthcare professional's written opinion for HBV vaccination shall
be limited to whether HBV vaccination is indicated for an employee, and
if the employee has received such vaccination. If a routine booster of
Hepatitis B vaccine is recommended by the U.S. Public Health Service,
such boosters shall be made available.

5.0 [Procedure for Evaluation of Circumstances Surrounding Exposure
Incidents]{.underline}

All employee exposure incidents shall be reported, investigated and
documented. The employee's supervisor shall report it as soon as
possible to the CDSO, Area Safety Staff or Biological Safety Officer.
They are responsibile for investigation of exposure incidents. Due to
the long term testing that may be required, the supervisor of government
employees is responsible to complete the CA 1 "Workman's Compensation
First Report of Injury Form. Ensure that there is a current telephone
number included in the report for all personnel concerned with the
incident.

Employees who have an exposure incident will be offered a post exposure
evaluation with follow-up in accordance with the OSHA standard. The
evaluation and follow-up examinations will normally be performed by a
local Practitioner in conjunction with the Federal Occupational Health
(FOH) Medical Review Officer. HOWEVER, when greater than 24 hours may
elapse after an exposure incident before being able to see the
Practitioner (e.g. weekend exposure), the employee should go to the
nearest *Hospital Emergency Room*. There they may begin post exposure
treatment if it is considered necessary.

5.1 [Post Exposure Evaluation and Follow-Up]{.underline}

Following a report of an exposure incident, the exposed employee shall
immediately receive a confidential medical evaluation that includes at
least the following elements:

> a\. Documentation of the route of exposure, and the circumstances
> under which the
>
> exposure incident occurred.
>
> b\. Identification and documentation of the source individual, unless
> it can be
>
> established that identification is infeasible or prohibited by state
> or local law.
>
> c\. The source individual's blood shall be tested as soon as feasible
> and after consent
>
> is obtained in order to determine HBV and HIV infectivity.
>
> 1\. If consent is not obtained, the LAO, together with the
>
> Medical Review Officer, shall establish that legally required consent
>
> cannot be obtained.
>
> 2\. When the source individual's consent is not required by law, the
> source
>
> individual's blood, if available, shall be tested and the results
> documented.
>
> 3\. When the source individual is already known to be infected with
> HBV or
>
> HIV, testing for the source individual's known HBV or HIV status need
>
> not be repeated.
>
> d\. Results of the source individual's testing shall be made available
> to the exposed
>
> employee, and the employee shall be informed of applicable laws and
> regulations
>
> concerning disclosure of the identity and infectious status of the
> source individual.

The exposed employee's blood shall be collected as soon as feasible and
tested after consent is obtained and the employee will be offered the
option of having his or her blood collected for testing of the HIV/HBV
serological status. The blood sample may be preserved for up to 90 days
to allow the employee to decide if the blood should be tested for HIV
serological status.

5.2 [Information Provided To The Healthcare Professional]{.underline}

The Provider and the Medical Review Officer, shall be provided with the
following:

> a\. A written description of the exposed employee's duties as they
> relate to the exposure incident;
>
> b\. Written documentation of the route of exposure and circumstances
> under which exposure occurred;
>
> c\. Results of the source individuals blood testing, if available; and
>
> d\. All medical records relevant to the appropriate treatment of the
> employee including vaccination status.

5.3 [Healthcare Professional's Written Opinion]{.underline}

The Provider shall provide to the employee a copy of the evaluating
Healthcare Professional's Written Opinion within 15 days of the
completion of the evaluation. The Healthcare Professional's Written
Opinion for post exposure follow-up shall be limited to:

> a\. A statement that the employee has been has been informed of the
> results of the evaluation, and
>
> b\. A statement that the employee has been told about any medical
> conditions resulting from exposure to blood or OPIM which require
> further evaluation or treatment.

All other findings or diagnosis shall remain confidential and shall not
be included in the written report.

6.0 [Definitions]{.underline}

**Blood** means human blood, human blood components, and products made
from human blood.

**Bloodborne Pathogens** means pathogenic microorganisms that are
present in human blood and can cause disease in humans. These pathogens
include, but are not limited to, hepatitis B virus (HBV) and human
immunodeficiency virus (HIV).

**Clinical Laboratory** means a workplace where diagnostic or other
screening procedures are performed on blood or other potentially
infectious materials.

**Contaminated** means the presence or the reasonably anticipated
presence of blood or other potentially infectious materials on an item
or surface.

**Contaminated Laundry** means laundry soiled with blood or other
potentially infectious materials or may contain sharps.

**Contaminated Sharps** means any contaminated object that can penetrate
the skin including, but not limited to, needles, scalpels, broken glass,
broken capillary tubes, and exposed ends of dental wires.

**Decontamination** means 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** means controls (e.g., sharps disposal
containers, self-sheathing needles, safer medical devices, such as
sharps with engineered sharps injury protections and needleless systems)
that isolate or remove the bloodborne pathogens hazard from the
workplace.

**Exposure Incident** means a specific eye, mouth, other mucous
membrane, non-intact skin, or parenteral contact with blood or other
potentially infectious materials that results from the performance of an
employee\'s duties.

**Hand washing Facilities** means a facility providing an adequate
supply of running potable water, soap and single use towels or hot air
drying machines.

**Licensed Healthcare Professional** is a person whose legally permitted
scope of practice allows him or her to independently perform the
activities required to administer Hepatitis B Vaccinations, conduct
Post-Exposure Evaluations and Follow-up examinations.

**HBV** means hepatitis B virus.

**HIV** means human immunodeficiency virus.

**Needleless systems** means a device that does not use needles for:

\(1\) The collection of bodily fluids or withdrawal of body fluids after
initial venous or arterial access is established; (2) The administration
of medication or fluids; or (3) Any other procedure involving the
potential for occupational exposure to bloodborne pathogens due to
percutaneous injuries from contaminated sharps.

**Occupational Exposure** means reasonably anticipated skin, eye, mucous
membrane, or parenteral contact with blood or other potentially
infectious materials that may result from the performance of an
employee\'s duties.

**Other Potentially Infectious Materials** (OPIM) means (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, organs, or other tissues from experimental animals
infected with HIV or HBV.

**Parenteral** means piercing mucous membranes or the skin barrier
through such events as needle sticks, human bites, cuts, and abrasions.

**Personal Protective Equipment** is specialized clothing or equipment
worn by an employee for protection against a hazard. General work
clothes (e.g., uniforms, pants, shirts or blouses) not intended to
function as protection against a hazard are not considered to be
personal protective equipment.

**Production Facility** means a facility engaged in industrial-scale,
large-volume or high concentration production of HIV or HBV.

**Regulated Waste** means liquid or semi-liquid blood or other
potentially infectious materials; contaminated items that would release
blood or other potentially infectious materials in a liquid or
semi-liquid state if compressed; items that are caked with dried blood
or other potentially infectious materials and are capable of releasing
these materials during handling; contaminated sharps; and pathological
and microbiological wastes containing blood or other potentially
infectious materials.

**Research Laboratory** means a laboratory producing or using
research-laboratory-scale amounts of HIV or HBV. Research laboratories
may produce high concentrations of HIV or HBV but not in the volume
found in production facilities.

**Sharps with engineered sharps injury protections** means a nonneedle
sharp or a needle device used for withdrawing body fluids, accessing a
vein or artery, or administering medications or other fluids, with a
built-in safety feature or mechanism that effectively reduces the risk
of an exposure incident.

**Source Individual** means any individual, living or dead, whose blood
or other potentially infectious materials may be a source of
occupational exposure to the employee. Examples include, but are not
limited to, hospital and clinic patients; clients in institutions for
the developmentally disabled; trauma victims; clients of drug and
alcohol treatment facilities; residents of hospices and nursing homes;
human remains; and individuals who donate or sell blood or blood
components.

**Sterilize** means the use of a physical or chemical procedure to
destroy all microbial life including highly resistant bacterial
endospores.

**Universal Precautions** is an approach to infection control. According
to the concept of Universal Precautions, 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** means controls that reduce the likelihood of
exposure by altering the manner in which a task is performed (e.g.,
prohibiting recapping of needles by a two-handed technique).

7.0 Attachments

7.1 Biohazard Label

7.2 [Hepatitis B Declination Form]{.underline}

**BLOODBORNE PATHOGEN PROGRAM**

**HEPATITIS B VACCINE DECLINATION**

You are required to attend Bloodborne Pathogen training annually, and be
offered immunization against Hepatitis B. This is because an exposure
determination has concluded that your job classification with specific
tasks may cause you to incur occupational exposure to blood or other
potentially infections materials.

NAME
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_DATE\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

JOB
TITLE\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*Please select Section 1 or 2 below and sign.*

1\. I was immunized against Hepatitis B:

When­­­­­­\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Where\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

2\. The following statement is the mandatory hepatitis B vaccine
declination taken from 29 CFR 1910.1030. Appendix A.

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.

Signature
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

7.3 [29 CFR 1910.1030, OSHA Bloodborne Pathogen Standard.]{.underline}

A copy of the standard is part of the program. A copy may be obtained
by:

1\. Accessing the location intranet common drive and clicking the
hyperlink.

2\. Requesting a copy from NAA safety office at 215-233-6592

3\. Accessing the OSHA web site at: [www.osha.gov](http://www.osha.gov/)
(search on 29CFR 1910.1030)

7.4 Bloodborne Pathogen Training List for 2002

  ----------- ----------- ------------ ----- -------- ----------------------------
  *EMPLOYEE   *EMPLOYEE   *EMPLOYER*         *\#      *DATE RCV\'D*
  Last Name*  First Name*                    Hours*   

  ----------- ----------- ------------ ----- -------- ----------------------------