Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 12 - Bureau of Emergency Medical Services › Subpart 31 - Emergency Medical Services › Chapter 10 - Critical Care Paramedic › Appendix 15-12-31-10-5 - RELATED OSHA REGULATIONS General Industry

Current through June 25, 2024
Part 1910 of title 29 of the Code of Federal Regulations is
					 amended as follows:
PART 1910-[AMENDED]
Subpart Z-[Amended]
The general authority citation for subpart Z of 29 CFR part
					 1910 continues to read as follows and a new citation for 1910.1030 is
					 added:
Authority: Sec. 6 and 8, Occupational Safety and Health
					 Act, 29 U.S.C. 655.657. Secretary of Labor's Orders Nos. 12-71 (36 FR 8754).
					 8-76 (41 FR 25059), or 9-83 (48 FR 35736), as applicable; and 29 CFR part
					 1911.
Section 1910.1030 also issued under
					 29
					 U.S.C. 653.
Section 1910.1030 is added to read as follows:
1910.1030 Blood borne Pathogens.
Scope and Application. This section applies to all
					 occupational exposure to blood or other potentially infectious materials as
					 defined by paragraph (b) of this section.
Definitions. For purposes of this section, the following
					 shall apply:
Assistant Secretary means the Assistant Secretary of Labor
					 for Occupational Safety and Health, or designated representative.
Blood means human blood, human blood components, and
					 products made from human blood.
Blood borne 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 which has been soiled
					 with blood or other potentially infectious materials on an item or
					 surface.
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 removed, inactivate, or destroy blood borne 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.
Director means the Director of the National Institute for
					 Occupational Safety and Health, U.S. Department of Health and Human Services,
					 or designated representative.
Engineering Controls means controls (e.g., sharps disposal
					 containers, self-sheathing needles) that isolate or remove the blood borne
					 pathogens hazard for 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 result from the performance of an
					 employee's duties.
Handwashing 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 by paragraph (f) Hepatitis B Vaccination and Post-exposure
					 Evaluation and Follow-up.
HBV means hepatitis B virus.
HIV means human immunodeficiency virus.
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 means
The following human blood 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;
Any unfixed tissue or organ (other than intact skin) from a
					 human (living or dead); and
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 needlesticks, 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 is 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 potentially infectious
					 materials 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
					 product high concentrations of HIV or HBV but not in the volume found in
					 production facilities.
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 know to be infectious for HIV, HBV, and
					 other blood borne 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).
EXPOSURE CONTROL
Exposure Control Plan: Each employer having an employee(s),
					 with occupational exposure as defined by paragraph (b) of this section shall
					 establish a written Exposure Control Plan designed to eliminate or minimize
					 employee exposure.
The Exposure Control Plan shall contain at least the
					 following elements;
The exposure determination required by
					 paragraph(c)(2).
The schedule and method of implementation for paragraphs
					 (d) Methods of Compliance, (e) HIV and HBV Research Laboratories and Production
					 Facilities, (f) Hepatitis B Vaccination and Post- Exposure Evaluation and
					 Follow-up, (g) Communication of Hazards to Employees, and (h) Recordkeeping, of
					 this standard and
The procedure for the evaluation of circumstances
					 surrounding exposure incidents as required by paragraph(f)(3)(i) of this
					 standard.
Each employer shall ensure that a copy of the Exposure
					 Control Plan is accessible to employees in accordance with 29 CFR
					 1910.20(e).
The Exposure Control Plan shall be reviewed and updated at
					 least annually and whenever necessary to reflect new or modified tasks and
					 procedures which effect occupational exposure and to reflect new or revised
					 employee positions with occupational exposure.
The Exposure Control Plan shall be made available to the
					 Assistant Secretary and the Director upon request for examination and
					 copying.
Exposure determination.
Each employer who has an employee(s) with occupational
					 exposure as defined by paragraph (b) of this section shall prepare an exposure
					 determination. This exposure determination shall contain the following:
A list of all job classifications in which all employees in
					 those job classifications have occupational exposure;
A list of job classifications in which some employees have
					 occupational exposure, and
A list of all tasks and procedures or groups of closely
					 related task and procedures in which occupational exposure occurs and that are
					 performed by employees in job classifications listed in accordance with the
					 provisions of paragraph(c)(2)(i)(B) of this standard.
This exposure determination shall be made without regard to
					 the use of personal protective equipment.
METHODS OF COMPLIANCE
General-Universal precautions shall be observed to prevent
					 contact with blood or other 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.
Engineering and work practice controls.
Engineering and work practice controls shall be used to
					 eliminate or minimize employee exposure. Where occupational exposure remains
					 after institution of these controls personal protective equipment shall also be
					 used.
Engineering controls shall be examined and maintained or
					 replaced on a regular schedule to ensure their effectiveness.
Employees shall provide handwashing facilities which are
					 readily accessible to employees.
When provision of handwashing facilities is not feasible,
					 the employer shall provide either an appropriate antiseptic hand cleanser in
					 conjunction with clean cloth/paper towels or antiseptic towelettes. When
					 antiseptic hand cleaners or towelettes are used, hands shall be washed with
					 soap and running water as soon as feasible.
Employers shall ensure that employees wash their hands
					 immediately or as soon as feasible after removal of gloves or other personal
					 protective equipment.
Employers shall ensure that employees wash their hands and
					 any other skin with soap and water, or flush mucous membranes with water
					 immediately or as soon as feasible following contact of such body areas with
					 blood or other potentially infectious materials.
Contaminated needles and other contaminated sharps shall
					 not be net, recapped, or removed except as noted in paragraphs (d)(2)(vii)(A)
					 and (d)(2)(vii)(B) below. Shearing or breaking of contaminated needles is
					 prohibited.
Contaminated needles and other contaminated sharps shall
					 not be recapped or removed unless the employer can demonstrate that no
					 alternative is feasible or that such action is required by a specific medical
					 procedure.
Such recapping or needle removal must be accomplished
					 through the use of a mechanical device or a one-handed technique.
Immediately or as soon as possible after use, contaminated
					 reusable sharps shall be placed in appropriate containers until properly
					 processed. These containers shall be:
Puncture resistant;
Labeled or color-coded in accordance with this
					 standard;
Leak proof on the sides and bottom; and
In accordance with the requirements set forth in paragraph
					 (d)(4)(ii)(E) for reusable sharps.
Eating, drinking, smoking applying cosmetics or lip balm,
					 and handling contact lenses are prohibited in work areas where there is a
					 reasonable likelihood of occupational exposure.
Food and drink shall not be kept in refrigerators,
					 freezers, shelves, cabinets or on countertops or bench tops where blood or
					 other potentially infectious materials are present.
All procedures involving blood or other potentially
					 infectious materials shall be performed in such a manner as to minimize
					 splashing, spraying, spattering, and generation of droplets of these
					 substances.
Mouth pipetting/suctioning of blood or other potentially
					 infectious materials is prohibited.
Specimens of blood or other potentially infectious
					 materials shall be placed in a container which prevents leakage during
					 collection, handling, processing, storage, transport, or shipping.
The container for storage, transport, or shipping shall be
					 labeled or color-coded according to paragraph(g)(1)(i) and closed prior to
					 being stored, transported, or shipped. When a facility utilizes Universal
					 Precautions in the handling of all specimens, the labeling/color-coding of
					 specimens is not necessary provided containers are recognizable as containing
					 specimens. This exemption only applies while such specimens/containers remain
					 within the facility. Labeling or color-coding in accordance with
					 paragraph(g)(1)(i) is required when such specimens/containers leave the
					 facility.
If outside contaminations of the primary container occurs,
					 the primary container which prevents leakage during handling, processing,
					 storage, transport, or shipping and is labeled or color-coded according to the
					 requirements of this standard.
If the specimen could puncture the primary container, the
					 primary container shall be placed within a secondary container which is
					 puncture-resistant in addition to the above characteristics.
Equipment which may become contaminated with blood or other
					 potentially infectious materials shall be examined prior to servicing or
					 shipping and shall be decontaminated as necessary, unless the employer can
					 demonstrate that decontamination of such equipment is not feasible.
A readily observable label in accordance with paragraph
					 (g)(1)(i)(H) shall be attached to the equipment stating which portions remain
					 contaminated.
The employer shall ensure that this information is conveyed
					 to all affected employees, the servicing representative, and/or the
					 manufacturer, as appropriate prior to handling, servicing, or shipping so that
					 appropriate precautions will be taken.
Personal protective equipment-
Provision. When there is occupational exposure, the
					 employer shall provide, at no cost to the employee, appropriate personal
					 protective equipment such as, but not limited to, gloves, gowns, laboratory
					 coats, face shields or masks and eye protection, and mouthpieces, resuscitation
					 bags, pocket masks, or other ventilation devices. Personal protective equipment
					 will be considered "appropriate" only if it does not permit blood or other
					 potentially infectious materials to pass through to or reach the employee's
					 work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous
					 membranes under normal conditions of use and for the duration of time which the
					 protective equipment will be used.
Use. The employer shall ensure that the employee uses
					 appropriate personal protective equipment unless the employer shows that the
					 employee temporarily and briefly declined to use personal protective equipment
					 when, under rare and extraordinary circumstances, it was the employee's
					 professional judgment that in the specific instance its use would have
					 prevented the delivery of health care or public safety services or would have
					 posed an increased hazard to the safety of the worker or co-worker. When the
					 employee makes this judgment, the circumstances shall be investigated and
					 documented in order to determine whether changes can be instituted to prevent
					 such occurrences in the future.
Accessibility. The employer shall ensure that appropriate
					 personal protective equipment in the appropriate sizes is readily accessible at
					 the worksite or is issued to employees. Hypoallergenic gloves, glove liners,
					 powderless gloves, or other similar alternatives shall be readily accessible to
					 those employees who are allergic to the gloves normally provided.
Cleaning, Laundering, and Disposal. The employer shall
					 clean, launder, and dispose of personal protective equipment required by
					 paragraphs(d) and (e) of this standard, at not cost to the employee.
Repair and Replacement. The employer shall repair or
					 replace personal protective equipment as needed to maintain its effectiveness,
					 at no cost to the employee.
If a garment(s) is penetrated by blood or other potentially
					 infectious materials, the garment(s) shall be removed immediately or as soon as
					 feasible.
All personal protective equipment shall be removed prior to
					 leaving the work area .
When personal protective equipment is removed prior to
					 leaving the work site.
When personal protective equipment is removed it shall be
					 placed in an appropriately designated area or container for storage or
					 disposal.
Gloves. Gloves shall be worn when it can be reasonably
					 anticipated that the employee may have hand contact with blood, other
					 potentially infectious materials, mucous membranes, and on-intact skin; when
					 performing vascular access procedures except as specified in
					 paragraph(d)(3)(ix)(D); and when handling or touching contaminated items or
					 surfaces.
Disposal (single use) gloves such as surgical or
					 examination gloves, shall be replaced as soon as practical when contaminated or
					 as soon as feasible if they are torn, punctured, or when their ability to
					 function as a barrier is compromised.
Disposable (single use) gloves shall not be washed or
					 decontaminated for re-use.
Utility gloves may be decontaminated for re-use if the
					 integrity of the glove is not compromised. However, they must be discarded if
					 they are cracked, peeling, torn, punctured, or exhibits other signs of
					 deterioration or when their ability to function as a barrier is
					 compromised.
If an employer in a volunteer blood donation center judges
					 that routine gloving for all phlebotomies is not necessary then the employer
					 shall:
Periodically reevaluate this policy;
Make gloves available to all employees who wish to use them
					 for phlebotomy; and
Require that gloves be used for phlebotomy in the following
					 circumstances:
When the employee has cuts, scratches, or other breaks in
					 his or her skin;
When the employee judges that hand contamination with blood
					 may occur, for example, when performing phlebotomy on an uncooperative source
					 individual; and
When the employee is receiving training in
					 phlebotomy.
Make, Eye Protection, and Face Shields. Masks in
					 combination with eye protection devices, such as goggles or glasses with solid
					 side shields, or chin length face shields, shall be worn whenever splashes,
					 spray, spatter, or droplets of blood or other potentially infectious materials
					 may be generated and eye, nose, or mouth contamination can be reasonably
					 anticipated.
Gowns, Aprons, and Other Protective Body Clothing.
					 Appropriate protective clothing such as, but not limited to, gowns, aprons, lab
					 coats, clinic jackets, or similar outer garments shall be worn in occupational
					 exposure situations. The type and characteristics will depend upon the task and
					 degree of exposure anticipated.
Surgical caps or hoods and/or shoe covers or boots shall be
					 worn in instances when gross contamination can reasonably be anticipated (e.g.,
					 autopsies, orthopedic surgery).
Housekeeping.
General. Employers shall ensure that the worksite is
					 maintained in a clean and sanitary condition. The employer shall determine and
					 implement an appropriate written schedule for cleaning and method of
					 decontamination based upon the location within the facility, type of surface to
					 be cleaned, type of soil present, and tasks or procedures being performed in
					 the area.
All equipment and environmental and working surfaces shall
					 be cleaned and decontaminated after contact with blood or other potentially
					 infectious materials.
Contaminated work surfaces shall be decontaminated with an
					 appropriate disinfectant after completion of procedures; immediately or as soon
					 as feasible when surfaces are overtly contaminated or after any spill of blood
					 or other potentially infectious materials; and at the end of the work shift if
					 the surface may have become contaminated since the last cleaning.
Protective coverings, such as plastic wrap, aluminum foil,
					 or imperviously-backed absorbent paper used to cover equipment and
					 environmental surfaces, shall be removed and replaced as soon as feasible when
					 they become overtly contaminated or at the end of the work shift if they may
					 have become contaminated during the shift.
All bins, pails, cans, and similar receptacles intended for
					 reuse which have a reasonable likelihood for becoming contaminated with blood
					 or other potentially infectious materials shall be inspected and decontaminated
					 on a regularly scheduled basis and cleaned and decontaminated immediately or as
					 soon as feasible upon visible contamination.
Broken glassware which may be contaminated shall not be
					 picked up directly with the hands. It shall be cleaned up using mechanical
					 means, such as a brush and dust pan, tongs, or forceps.
Reusable sharps that are contaminated with blood or other
					 potentially infectious materials shall not be stored or processed in a manner
					 that requires employees to reach by hand into the containers where these sharps
					 have been placed.
Regulated Waste.
Contaminated sharps shall be discarded immediately or as
					 soon as feasible in containers that are:
Closable;
Puncture resistant;
Leakproof on sides and bottom; and
Labeled or color-coded in accordance with
					 paragraph(g)(1)(i) of this standard.
During use, containers for contaminated sharps shall
					 be:
Easily accessible to personnel and located as close as is
					 feasible to the immediate area where sharps are used or can be reasonably
					 anticipated to be found (e.g., laundries);
Maintained upright throughout use; and
Replaced routinely and not be allowed to overfill.
When moving containers of contaminated sharps from the area
					 of use, the containers shall be:
Closed immediately prior to removal or replacement to
					 prevent spillage or protrusion of contents during handling, storage, transport,
					 or shipping;
Placed in a secondary container if leakage is possible. The
					 second container shall be:
Closable;
Constructed to contain all contents and prevent leakage
					 during handling, storage, transport, or shipping; and
Labeled or color-coded according to paragraph(g)(1)(i) of
					 this standard.
Reusable containers shall not be opened, emptied, or
					 cleaned manually or in any other manner which would expose employees to the
					 risk of percutaneous injury.
Regulated waste shall be placed in containers which
					 are:
Closable;
Constructed to contain all contents and prevent leakage of
					 fluids during handling, storage, transport or shipping;
Labeled or color-coded in accordance with
					 paragraph(g)(1)(i) this standard; and
Closed prior to removal to prevent spillage or protrusion
					 of contents during handling, storage, transport, or shipping.
If outside contamination of the regulated waste container
					 occurs, it shall be placed in a second container. The second container shall
					 be:
Closable;
Constructed to contain all contents and prevent leakage of
					 fluids during handling, storage, transport or shipping;
Labeled or color-coded in accordance with
					 paragraph(g)(1)(i) of this standard; and
Closed prior to removal to prevent spillage or protrusion
					 of contents during handling, storage, transport, or shipping.
Disposal of all regulated waste shall be in accordance with
					 applicable regulations of the United States, States and Territories, and
					 political subdivisions of States and Territories.
Laundry
.
Contaminated laundry shall be handled as little as possible
					 with a minimum of agitation.
Contaminated laundry shall be bagged or containerized at
					 the location where it was used and shall not be sorted or rinsed in the
					 location of use.
Contaminated laundry shall be placed and transported in
					 bags or containers labeled or color-coded in accordance with paragraph(g)(1)(i)
					 of this standard. When a facility utilizes Universal Precautions in the
					 handling of all soiled laundry, alternative labeling or color-coding is
					 sufficient if it permits all employees to recognize the container as requiring
					 compliance with Universal Precautions.
Whenever contaminated laundry is wet and presents a
					 reasonable likelihood of soak-through of or leakage from the bag or container,
					 the laundry shall be placed and transported in bags or containers which prevent
					 soak-through and/or leakage of fluids to the exterior.
The employer shall ensure that employees who have contact
					 with contaminated laundry wear protective gloves and other appropriate personal
					 protective equipment.
When a facility ships contaminated laundry off-site to a
					 second facility which does not utilize Universal Precautions in the handling of
					 all laundry, the facility generating the contaminated laundry must place such
					 laundry in bags or containers which are labeled or color-coded in accordance
					 with paragraph(g)(1)(i).
HIV and HBV Research Laboratories and Production
					 Facilities.
This paragraph applies to research laboratories and
					 production facilities engaged in the culture, production, concentration,
					 experimentation, and manipulation of HIV and HBV. It does not apply to clinical
					 or diagnostic laboratories engaged solely in the analysis of blood, tissues, or
					 organs. These requirements apply in addition to the other requirements of the
					 standard.
Research laboratories and production facilities shall meet
					 the following criteria:
Standard microbiological practices. All regulated waste
					 shall either be incinerated or decontaminated by a method such as autoclaving
					 known to effectively destroy blood borne pathogens.
Special practices.
Laboratory doors shall be kept closed when work involving
					 HIV or HBV is in progress.
Contaminated materials that are to be decontaminated at a
					 site away from the work area shall be placed in a durable, leak proof, labeled
					 or color-coded container that is closed before being removed from the work
					 area.
Assess to the work area shall be limited to authorized
					 persons. Written policies and procedures shall be established whereby only
					 persons who have been advised of the potential biohazard, who meet any specific
					 entry requirements, and who comply with all entry and exit procedures shall be
					 allowed to enter the work areas and animal rooms.
When other potentially infectious materials or infected
					 animals are present in the work area or containment module, a hazard warning
					 sign incorporating the universal biohazard symbol shall be posted on all access
					 doors. The hazard warning sign shall comply with paragraph(g)(1)(ii) of this
					 standard.
All activities involving other potentially infectious
					 materials shall be conducted in biological safety cabinets or other
					 physical-containment devices within the containment module. No work with these
					 other potentially infectious materials shall be conducted on the open
					 bench.
Laboratory coats, gowns, smocks, uniforms, or other
					 appropriate protective clothing shall be used in the work area and animal
					 rooms. Protective clothing shall not be worn outside of the work area and shall
					 be decontaminated before being laundered.
Special care shall be taken to avoid skin contact with
					 other potentially infectious materials. Gloves shall be worn when handling
					 infected animals and when making band contact with other potentially infectious
					 materials is unavoidable.
Before disposal, all waste from work areas and from animal
					 rooms shall either be incinerated or decontaminated by a method such as
					 autoclaving known to effectively destroy blood borne pathogens.
Vacuum lines shall be protected with liquid disinfectant
					 traps and high-efficiency particulate air (HEPA) filters or filters of
					 equivalent or superior efficiency and which are checked routinely and
					 maintained or replaced, as necessary.
Hypodermic needles and syringes shall be used only for
					 parenteral injection and aspiration of fluids from laboratory animals and
					 diaphragm bottles. Only needle-locking units (i.e., the needle is integral to
					 the syringe) shall be used for the injection or aspiration of other potentially
					 infectious materials. Extreme caution shall be used when handling needles and
					 syringes. A needle shall not be bent, sheared, replaced in the sheath or guard,
					 or removed from the syringe following use. The needle and syringe shall be
					 promptly placed in a puncture-resistant container and autoclaved or
					 decontaminated before reuse or disposal.
All spills shall be immediately contained and cleaned up by
					 appropriate professional staff or others properly trained and equipped to work
					 with potentially concentrated infectious materials.
A spill or accident that results in an exposure incident
					 shall be immediately reported to the laboratory director or other responsible
					 person.
A biosafety manual shall be prepared or adopted and
					 periodically reviewed and updated at least annually or more often if necessary.
					 Personnel shall be advised of potential hazards, shall be required to read
					 instructions on practices and procedures, and shall be required to follow
					 them.
Containment equipment.
Certified biological safety cabinets (Class I, II, or III)
					 or other appropriate combinations of personal protection or physical
					 containment devices, such as special protective clothing, respirators,
					 centrifuge safety cups, sealed centrifuge rotors, and containment caging for
					 animals, shall be used for all activities with other potentially infectious
					 materials that pose a threat of exposure to droplets, splashes, spills, or
					 aerosols.
Biological safety cabinets shall be certified when
					 installed, whenever they are moved and at least annually.
HIV and HBV research laboratories shall meet the following
					 criteria:
Each laboratory shall contain a facility for hand washing
					 and an eye wash facility which is readily available within the work
					 area.
An autoclave for decontamination of regulated waste shall
					 be available.
HIV and HBV production facilities shall meet the following
					 criteria:
The work areas shall be separated from areas that are open
					 to unrestricted traffic flow within the building. Passage through two sets of
					 doors shall be the basic requirement for entry into the work area from access
					 corridors or other contiguous areas. Physical separation of the
					 high-containment work area from access corridors or other areas or activities
					 may also be provided by a double-doored clothes-change room (showers may be
					 included), airlock, or other access facility that requires passing through two
					 sets of doors before entering the work area.
The surfaces of doors, walls, floors, and ceilings in the
					 work area shall be water resistant so that they can be easily cleaned.
					 Penetrations in these surfaces shall be sealed or capable of being sealed to
					 facilitate decontamination.
Each work area shall contain a sink for washing hands and a
					 readily available eye wash facility. The sink shall be foot, elbow, or
					 automatically operated and shall be located near the exit door of the work
					 area.
Access doors to the work area or containment module shall
					 be self-closing.
An autoclave for decontamination of regulated waste shall
					 be available within or as near as possible to the work area.
A ducted exhaust-air ventilation system shall be provided.
					 This system shall create directional airflow that draws air into the work area
					 through the entry area. The exhaust air shall not be recirculated to any other
					 area of the building, shall be discharged to the outside, and shall be
					 dispersed away from occupied areas and air intakes. The proper direction of the
					 airflow shall be verified (i.e., into the work area).
Training Requirements. Additional training requirements for
					 employees in HIV and HBV research laboratories and HIV and HBV production
					 facilities are specified in paragraph(g)(2)(ix).
Hepatitis B vaccination and post-exposure evaluation and
					 follow-up-
General.
The employer shall make available the hepatitis B vaccine
					 and vaccination series to all employees who have occupational exposure, and
					 pot-exposure evaluation and follow-up to all employees who have had an exposure
					 incident.
The employer shall ensure that all medical evaluations and
					 procedures including the hepatitis B vaccine and vaccination series and
					 post-exposure evaluation and follow-up, including prophylaxis are:
Made available at not cost to the employee;
Made available to the employee at a reasonable time and
					 place;
Performed by or under the supervision of a licensed
					 physician or by or under the supervision of another licensed healthcare
					 professional; and
Provided according to recommendations of the U.S. Public
					 Health Service current at the time these evaluations and procedures take place,
					 except as specified by this paragraph(f).
The employers hall ensure that all laboratory at no cost to
					 the employee.
Hepatitis B Vaccination
Hepatitis B vaccination shall be made available after the
					 employee has received the training required in paragraph (g)(2)(vii)(I) and
					 within 10 workings days of initial assignment to all employees who have
					 occupational exposure unless the employee has previously received the complete
					 hepatitis B vaccination series, antibody testing has revealed that the employee
					 is immune, or the vaccine is contraindicated for medical reasons.
The employee shall not make participation in a
					 pre-screening program a prerequisite for receiving hepatitis B
					 vaccination.
If the employee initially declines Hepatitis B vaccination
					 but at a later date while still covered under the standard decides to accept
					 the vaccination, the employer shall make available hepatitis B vaccination at
					 that time.
The employer shall assure that employees who decline to
					 accept hepatitis B vaccination offered by the employer sign the statement in
					 appendix A.
If a routine booster dose(s) of hepatitis B vaccine is
					 recommended by the U.S. Public Health Service at a future date, such booster
					 dose(s) shall be made available in accordance with section(f)(1)(ii).
Post-exposure Evaluation and Follow-up. Following a report
					 of an exposure incident, the employer shall make immediately available to the
					 exposed employee a confidential medical evaluation and follow-up, including at
					 least the following elements:
Documentation of the route(s) of exposure, and the
					 circumstances under which the exposure incident occurred;
Identification and documentation of the source individual,
					 unless the employer can establish that identification is infeasible or
					 prohibited by state or local law;
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. If consent is not obtained, the employer shall establish that
					 legally required consent cannot be obtained. 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.
When the source individual is already known to be infected
					 with HBV or HIV, testing for source individual's known HBV or HIV status need
					 not be repeated.
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.
Collection and testing of blood for HBV and HIV serological
					 status;
The exposed employee's blood shall be collected as soon as
					 feasible and tested after consent is obtained.
If the employee consents to baseline blood collection, but
					 does not give consent at that time for HIV serologic testing, the sample shall
					 be preserved for at least 90 days. If within 90 days of the exposure incident,
					 the employee elects to have the baseline sample tested, such testing shall be
					 done as soon as feasible.
Post-exposure prophylaxis, when medically indicated, as
					 recommended by the U.S. Public Health Service;
Counseling; and
Evaluation of reported illnesses.
Information Provided to the Healthcare
					 Professional.
The employer shall ensure that the healthcare professional
					 responsible for the employee's Hepatitis B vaccination is provided a copy of
					 this regulation.
The employer shall ensure that the healthcare professional
					 evaluating an employee after an exposure incident is provided the following
					 information:
A copy of this 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 which are the employer's
					 responsibility to maintain.
Healthcare Professional's Written Opinion. The employer
					 shall obtain and provide the employee with 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 Hepatitis
					 B vaccination shall be limited to whether Hepatitis B vaccination is indicated
					 for an employee, and if the employee has received such vaccination.
The healthcare professional's written opinion for
					 post-exposure evaluation and follow-up shall be limited to the following
					 information:
That the employee has been informed of the results of the
					 evaluation; and
That the employee has been told about any medical
					 conditions resulting from exposure to blood or other potentially infectious
					 materials which require further evaluation or treatment.
All other findings or diagnoses shall remain confidential
					 and shall not be included in the written report.
Medical recordkeeping. Medical records required by this
					 standard shall be maintain in accordance with paragraph(h)(1) of this
					 section.
Communication of hazards to employees- Labels and
					 signs.
Labels. Warning labels shall be affixed to containers of
					 regulated waste, refrigerators and freezers containing blood or other
					 potentially infectious material; and other containers used to store, transport
					 or ship blood or other potentially infectious material; except as provided in
					 paragraph(g)(1)(i)(E), (F) and (G).
Labels required by this section shall include the following
					 legend: Biohazard
These labels shall be fluorescent orange or orange-red or
					 predominantly so, with lettering or symbols in contrasting color.
Labels required by affixed as close as feasible to the
					 container by string, wire, adhesive, or other method that prevents their loss
					 or unintentional removal.
Red bags or red containers may be substituted for
					 labels.
Containers of blood, blood components, or blood products
					 that are labeled as to their contents and have been released for transfusion or
					 other clinical use are exempted from the labeling requirements of paragraph
					 (g).
Individual containers of blood or other potentially
					 infectious materials that are placed in a labeled container during storage,
					 transport, shipment, or disposal are exempted from the labeling
					 requirement.
Labels required for contaminated equipment shall be in
					 accordance with this paragraph and shall also state which portions of the
					 equipment remain contaminated.
Regulated waste that has been decontaminated need not be
					 labeled or color-coded.
Signs. The employer shall post signs at the entrance to
					 work areas specified in paragraph(e), HIV and HBV Research Laboratory and
					 Production Facilities, which shall bear the following legend:
Biohazard
(Name of the Infectious Agent)
(Special requirements for entering the area)
(Name, telephone number of the laboratory director or other
					 responsible person).
These signs shall be fluorescent orange-red or
					 predominantly so, with lettering or symbols in a contrasting color.
Information and Training. Employers shall ensure that all
					 employees with occupational exposure participate in a training program which
					 must be provided at no cost to the employee and during working hours.
Training shall be provided as follows:
At the time of initial assignment to tasks where
					 occupational exposure may take place;
Within 90 days after the effective date of the standard;
					 and
At least annually thereafter.
For employees who have received training on blood borne
					 pathogens in the year preceding the effective date of the standard, only
					 training with respect to the provisions of the standard which were not included
					 need be provided.
Annual training for all employees shall be provided within
					 one year of their previous training.
Employers shall provide additional training when changes
					 such as modification of tasks or procedures or institution of new tasks or
					 procedures affect the employee's occupational exposure. The additional training
					 may be limited to addressing the new exposures created.
Material appropriate in content and vocabulary to
					 educational level, literacy, and language of employees shall be used.
The training program shall contain at a minimum the
					 following elements;
Inaccessible copy of the regulatory text of this standard
					 and an explanation of its contents;
A general explanation of the epidemiology and symptoms of
					 blood borne diseases;
An explanation of the modes of transmission of blood borne
					 pathogens;
An explanation of the employer's exposure control plan and
					 the means by which the employee can obtain a copy of the written plan;
An explanation of the appropriate methods for recognizing
					 tasks and other activities that may involve exposure to blood and other
					 potentially infectious materials;
An explanation of the use and limitations of methods that
					 will prevent or reduce exposure including appropriate engineering controls,
					 work practices and personal protective equipment;
Information on the types, proper use, location, removal,
					 handling, decontamination and disposal of personal protective equipment;
An explanation of the basis for selection of personal
					 protective equipment;
Information on the hepatitis B vaccine, including
					 information on its efficacy, safety, method of administration, the benefits of
					 being vaccinated, and that the vaccine and vaccination will be offered free of
					 charge;
Information on the appropriate actions to take and persons
					 to contact in an emergency involving blood or other potentially infectious
					 materials;
An explanation of the procedure to follow if an exposure
					 incident occurs, including the method of reporting the incident and the medical
					 follow-up that will be made available;
Information on the post-exposure evaluation and follow-up
					 that the employer is required to provide for the employee following and
					 exposure incident;
An explanation of the signs and label and/or color coding
					 required by paragraph(g)(1); and
An opportunity for interactive questions and answers with
					 the person conducting the training session.
The person conducting the training shall be knowledgeable
					 in the subject matter covered by the elements contained in the training program
					 as it relates to the workplace that the training will address.
Additional Initial Training for Employees in HIV and HBV
					 Laboratories and Production Facilities. Employees in HIV or HBV research
					 laboratories and HIV or HBV production facilities shall receive the following
					 initial training in addition to the above training requirements.
The employer shall assure that employees demonstrate
					 proficiency in standard microbiological practices and techniques and in the
					 practices and operations specific to the facility before being allowed to work
					 with HIV or HBV.
The employer shall assure that employees have prior
					 experience in the handling of human pathogens or tissue cultures before working
					 with HIV or HBV.
The employer shall provide a training program to employees
					 who have no prior experience in handling human pathogens. Initial work
					 activities shall not include the handling of infectious agents. A progression
					 of work activities shall be assigned as technique are learned and proficiency
					 is developed. The employer shall assure that employees participate in work
					 activities involving infectious agents only after proficiency has been
					 demonstrated.
Recordkeeping-
Medical Records. The employer shall establish and maintain
					 an accurate record for each employee with occupational exposure, in accordance
					 with 29 CFR 1910.20. This record shall include:
The name and social security number of the employee;
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 vaccination as required by
					 paragraph(f)(2);
A copy of all results of examinations, medical testing, and
					 follow-up procedures as required by paragraph (f)(3);
The employer's copy of the healthcare professional's
					 written opinion as required by paragraph (f)(5); and
A copy of the information provided to the healthcare
					 professional as required by paragraphs (f)(4)(ii)(B)(C) and (D).
Confidentiality. The employer shall ensure that employee
					 medical records required by paragraph (h)(1) are:
Kept confidential; and
Are not disclosed or reported without the employee's
					 express written consent to any person within or outside the workplace except as
					 required by this section or as may be required by law.
The employer shall maintain the records required by
					 paragraph(h) for at least the duration of employment plus 30 years in
					 accordance with 29 CFR 1910.20.
Training Records.
Training records shall include the following information:
					 The dates of the training sessions; The contents or a summary of the training
					 sessions; The names and qualifications of persons conducting the training; and
					 The names and job titles of all persons attending the training sessions.
Training records shall be maintained for 3 years from the
					 date on which the training occurred.
Availability.
The employer shall ensure that all records required to be
					 maintained by this section shall be made available upon request to the
					 Assistant Secretary and the Director for examination and copying.
Employee training records required by this paragraph shall
					 be provided upon request for examination and copying to employees, to employee
					 representatives, to the Director, and to the Assistant Secretary in accordance
					 with 29 CFR 1910.20.
Employee medical records required by this paragraph shall
					 be provided upon request for examination and copying to the subject employee,
					 to anyone having written consent of the subject employee, to the Director, and
					 to the Assistant Secretary in accordance with 29 CFR 1910.20.
Transfer of Records.
The employer shall comply with the requirements involving
					 transfer of records set forth in 29 CFR 1910.20(h).
If the employer ceases to do business and there is no
					 successor employer to receive and retain the records for the prescribed period,
					 the employer shall notify the Director, at least three months prior to their
					 disposal and transmit them to the Director, if required by the Director to do
					 so, within that three month period.
Dates-Effective Date. The standard shall become effective
					 on March 6, 1992.
The Exposure Control Plan required by paragraph(c)(2) of
					 this section shall be completed on or before May 5, 1992.
Paragraph (g)(2) Information and Training and (h)
					 Recordkeeping shall take effect on or before June 4, 1992.
Paragraphs (d)(2) Engineering and Work Practice Controls,
					 (d)(3) Housekeeping, (e) HIV and HBV Research Laboratories and Production
					 Facilities, (f) Hepatitis B Vaccination and Post-Exposure Evaluation and
					 Follow-up, and (g) (1) Labels and Signs, shall take effect July 6, 1992.
Appendix A to Section 1910.1030-Hepatitis B Vaccine
					 Declination (Mandatory)
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)a 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.
(FR Doc.91-28886 Filed 12-2-91; 8:45 am) Billing Code
					 4510-26-M
Miss. Code
					 Ann.§
											41-59-5