<p> Eff. Date: 4-30-97</p><p>S.O.P Number: 1.05</p><p>Title:Bloodborne Pathogens Exposure Prevention and Response Issuing Authority: L.E. Nippins, III, PSD/CLEO Eval. Date:5-01-03</p><p>Accreditation 1 Law Enforcement Role and Authority</p><p>Accreditation Standards: 1.3.11d</p><p>Revision Date Page Numbers Sections Approved</p><p>SUBJECT: Bloodborne Pathogens Exposure Prevention and Response 1.05 (13 pgs)</p><p>I. Purpose</p><p>The purpose of this General Order is to provide all department employees with guidelines and procedures for the prevention of exposure to bloodbornes pathogens and response procedures in the event of an exposure.</p><p>II. Policy</p><p>It will be the policy of the department to take all reasonable measures to allow employees to perform their duties in a safe and effective manner. The department will continuously provide employees with information and education on the prevention of Aids and Hepatitis B viruses that can be contracted through exposure to infected blood and other types of bodily secretions. In addition, employees will be provided with up-to- date safety equipment and procedures that will minimize the risk of exposure. The department will also institute post-exposure reporting, evaluation, and treatment for all employees exposed.</p><p>III. Procedure</p><p>A. General Disease Prevention Guidelines</p><p>1. The department’s Bloodborne Pathogens Exposure Control Plan (SOP 1.04) provides the overall strategy for limiting exposure to HIV and HBV viruses, and for responding to potential exposure incidents. Every employee is provided with a copy of SOP 1.04.</p><p>1 of 1.05 2. The department will follow the principles and practices for the prevention of HIV and HBV, as detailed in the “universal precautions” developed by the Centers for Disease Control (CDC) and in compliance with the federal regulations of the Occupational Safety and Health Administration (OSHA). Where otherwise not detailed, employees shall be guided by these “universal precautions”.</p><p>B. Workplace Controls</p><p>1. In order to minimize potential exposure, employees should assume that all persons are potential carriers of HIV and HBV.</p><p>2. Employees must cover all open cuts and abrasions with waterproof bandages prior to reporting for duty.</p><p>3. Employees shall not smoke, eat, drink, or apply make-up around bodily fluid spills.</p><p>4. Any evidence contaminated with bodily fluids shall be completely dried, double-bagged, and marked to identify potential or known communicable disease contamination.</p><p>C. Personal Protective Equipment</p><p>1. Employees shall use protective gear under all appropriate circumstances unless the employee can demonstrate that in a specific instance, its use would have prevented the effective delivery of health care, or other public safety or law enforcement service, or would have imposed and increased risk to their own safety or the safety of others.</p><p> a. All such instances are to be reported to the employees immediate supervisor who shall investigate and appropriately document the incident to determine if procedures should be changed to prevent similar occurrences.</p><p>2. When appropriate protective equipment is available, no officer shall refuse to arrest or otherwise physically handle any person who may carry the HIV or HBV virus. Should an officer encounter such a circumstance, where appropriate equipment is not available, the officer shall immediately contact the duty supervisor and request assistance and direction.</p><p> a. Other employees duties should not normally require them to come into physical contact with such persons. They should however be just as aware of the risk of exposure.</p><p>3. Disposable latex gloves shall be worn by all officers when they anticipate becoming involved in assaultive behavior or other physical contact through which they may become exposed to blood or other bodily fluids. All employees</p><p>2 of 1.05 shall wear gloves when handling any person(s) clothing or any equipment contaminated with bodily fluids.</p><p>4. Masks in combination with eye protection such as goggles or glasses with solid side shields, or chin-length face shields, shall be worn whenever splashes, sprays, splatters, or droplets of potentially infectious materials may be generated, and eye, nose, or mouth contamination can be reasonably anticipated (see section F. Use of the Spit Net).</p><p>5. Gowns, aprons, lab coats, or other outer garments shall be worn as determined by the degree of exposure anticipated.</p><p>6. Plastic mouthpieces or other authorized barrier/resuscitation devices shall be used whenever an employee performs CPR or mouth-to-mouth resuscitation.</p><p> a. Employees shall not put their fingers in or near the mouth of any conscious person. b. Employees wearing protective gloves may insert their fingers into the mouth of an unconscious person in an attempt to clear a blocked airway. This action should be performed in accordance with accepted foreign body airway obstruction procedures.</p><p>7. All sharp instrument such as knives, scalpels, and needles shall be handled with extraordinary care and should be considered contaminated items.</p><p> a. Leather gloves, or their protective equivalent, should be worn when searching person or places or when working in environments such as accident and crime scenes where sharp objects and bodily fluids may reasonably be encountered.  Searches of automobiles or other confined places should be conducted using a flashlight, mirror, and other such devices when appropriate. b. Subsequent to a frisk of outer garments, and when justified by the existence of probable cause or other legal basis, suspects should be required to empty their pockets or purses, and to remove all sharp objects from their person. c. All needles when being collected as evidence, for disposal, or other purpose, shall be placed in puncture-resistant, leakproof containers clearly marked as containing a biohazardous material.  Needles are not to be recapped, bent, broken, removed from syringes, or otherwise manipulated by hand.</p><p>D. Transportation and Transfer of Prisoners</p><p>1. Individuals, with bodily fluids on their person, are to be transported in separate vehicles from other persons. The individual can be required to wear a suitable protective covering if they are bleeding or otherwise emitting bodily fluids (see section F. Use of the Spit Net).</p><p>2. During a transfer of custody, employees have an obligation to advise, in a discreet manner, relevant personnel at the receiving facility, that the suspect or </p><p>3 of 1.05 victim has bodily fluids on their person or have stated that they have a communicable disease. Care should be taken to ensure that this information is not released to the general public or to anyone who has no need to know.</p><p>E. Custody, Processing, and Release of Prisoners</p><p>1. Individuals who are taken into custody with bodily fluids on their persons, and are not in need of medical attention, are to be placed directly in a holding cell immediately upon arrival at the holding facility. Efforts should be made to have the affected cellblock cleared of all other prisoners. If this is not possible other prisoners should be moved to non-adjacent cells. The duty supervisor is to be immediately advised of the prisoner’s status.</p><p>2. If possible the prisoner should be given the opportunity and means with which to decontaminate themselves by washing the areas affected by the bodily fluids. Decontamination shall be conducted in accordance with the procedures contained in this SOP. The monitoring officer will be present to ensure that proper procedures are followed.</p><p>3. If it is not possible to decontaminate the prisoner, or if the bodily fluids are on the prisoner’s clothing, the prisoner is to be provided with disposable outer garments which will be worn over the contaminated clothing. The prisoner is not to remove the contaminated clothing. The disposable garments are to be made of an impermeable material and an adequate supply will be maintained within the holding facility.</p><p> a. The Engineering Controls Officer, as identified in the Exposure Control Plan (SOP 1.04), will be responsible for inventorying these garments.</p><p>4. No attempt is to be made to process any such prisoner, without supervisory authorization, until they have been decontaminated or have donned the outer garment. Physical contact with the prisoner is to be as limited as possible and should be restricted to a single officer for monitoring and processing. All officers required to come into physical contact with the prisoner will wear appropriate protective clothing.</p><p>5. Upon completion of processing, and immediately prior to release or transfer to another facility, the prisoner is to remove the disposable outer garments. The garments are to be bagged and marked appropriately and placed in the biohazard waste containers in the holding facility. The garments are not to be removed from the holding facility except for final disposal as outlined in the Exposure Control Plan (SOP 1.04).</p><p>6. Any area which becomes contaminated and cannot be immediately decontaminated is to be clearly marked by the placement of signs identifying the area as having been exposed to “Infectious Disease Contamination”. The employee who discovers the contamination will be responsible for marking the area. The signs may be handwritten, but must be legible.</p><p>4 of 1.05 a. Officers required to enter this area must wear appropriate protective clothing and utilize appropriate protective equipment.</p><p>F. Use of the Spit Net</p><p>1. The Spit Net should be utilized whenever it is determined that a prisoner is intentionally attempting to spit on officers or others and the prisoner refuses to comply with verbal commands to cease, or a prisoner or other person is excreting saliva bubbles or other bodily fluids from the mouth or nose. Procedures for application of the Spit Net are as follows:</p><p> a. Prisoners should be handcuffed prior to application and officers should wear gloves and other protective clothing as appropriate. b. Place the Spit Net over the prisoner’s head with the solid fabric covering the mouth and nose areas, and the mesh surrounding the rest of the head. The Spit Net should at no time be applied in such a manner so that the solid fabric covers the eyes or in any way obstructs the prisoners vision. c. Then route the straps under the arm pits and through the loops at the back and base of the Spit Net. The straps should be tied in a bow in the middle of the upper back. Excess strapping should be secured so as not to be within reach of the prisoner and so as not to catch on any other objects.  The Spit Net is never to be tied in a knot that would require that it be cut off. The Spit Net should always be able to be removed quickly and without mechanical means. d. Once the Spit Net has been applied the officer is to make sure that it is not so tight as to restrict the prisoner’s breathing but that it is tight enough so that it cannot be easily removed by the prisoner. e. Once the Spit Net is applied the officer must maintain constant visual contact with the prisoner. At no time is a prisoner to be placed in a holding cell wearing a Spit Net unless the officer remains in the holding area and maintains visual contact. Video and/or audio monitoring is not sufficient in these cases. f. The Spit Net may not be applied to an emotionally disturbed or mentally unbalanced person without supervisory approval.</p><p>2. Any prisoner who requires a Spit Net is not to have the Spit Net removed for processing. All phases of processing that can be done with the Spit Net in place, such as the arrest report and fingerprinting, are to be completed. The Spit Net may only be removed when the officer feels it is safe to do so.</p><p> a. If at any point the prisoner begins spitting again after having the Spit Net removed, the Spit Net will be reapplied. b. If processing cannot be completed due to the Spit Net having to remain in place, the duty supervisor will be advised. No prisoner will be transported to another facility or released who has not been fully processed without the approval of the Operations Commander.</p><p>5 of 1.05 3. Prisoners wearing a Spit Net will only be transported in the rear of patrol vehicles equipped with barriers. They are never to be transported in the rear of the Prisoner Transport Vehicle.</p><p> a. Prisoners wearing a Spit Net will always be placed in an upright position in the rear seat in such a manner as to be visible at all times to the officer operating the vehicle or the officer in the passenger seat when two officers are transporting. Central Communications will always be advised if the prisoner being transported is wearing a Spit Net.</p><p>4. The Spit Net will be removed and properly disposed of when the prisoner is released to another facility. The same Spit Net is never to be used on more than one individual.</p><p> a. Unless the Spit Net is saturated with saliva or other bodily fluids it may be disposed of as solid waste. If it is saturated it must be disposed of as biohazardous waste. b. No prisoner is ever to be released to another agency, facility, person, or in any other manner until such time as the Spit Net has been removed. The Spit Net must be removed despite the possibility that the prisoner may spit on members or officers of the receiving agency or facility.</p><p>5. Officers will note what time the Spit Net was applied, the justification for application, and the time of removal in their reports. Use of the Spit Net will also be recorded in the remarks section of the arrest report and the Detention Log.</p><p>6. Officers are responsible for ensuring that their assigned vehicles have an adequate supply of Spit Nets. Shortages are to be brought to the attention of the duty supervisor so that they may be replenished.</p><p>7. The Training Officer will be responsible for ensuring that every officer receives annual training in the proper use of the Spit Net due to its potential to cause serious injury in applied improperly. The Spit Net is a weaponless control technique and the annual training should be included as part of the annual Use of Force training.</p><p> a. All such training is to be documented in accordance with SOP 1.06.</p><p>G. Housekeeping</p><p>1. Supervisors and employees are responsible for maintaining a clean and sanitary workplace. Periodic inspections will be conducted to ensure that such conditions are maintained.</p><p>2. Supervisors shall develop and implement written schedules for the cleaning and decontamination of equipment and facilities. Scheduling should be based on location, type of surface or equipment to be cleaned, type of soil present, and other tasks and procedures that are performed in the area.</p><p>6 of 1.05 3. All equipment and work and environmental surfaces must be cleaned and decontaminated after contact with blood, other bodily fluids, or other potentially infectious materials.</p><p>4. Any protective coverings used for covering surfaces or equipment used in the seizing or processing of evidence, custody of property or persons, or in any other law enforcement operations, are to be removed and/or replaced as soon as possible following actual or possible contamination.</p><p>5. Bins, pails, and other receptacles used to hold actual or possibly contaminated items shall be labeled as biohazardous, and decontaminated as soon as possible. In addition, they will be inspected and decontaminated on a scheduled basis.</p><p>6. Broken glass, needles, or other sharp objects that may possibly be contaminated should not be secured by hand but by other mechanical means. Neither should they be stored in such a manner that requires that they be retrieved or handled manually.</p><p>7. Employees shall remove uniforms, other clothing, or equipment that has been contaminated with bodily fluids as soon as is practicable. Affected skin areas shall be cleansed using the procedures contained in this SOP.</p><p>8. Contaminated laundry and personal protective equipment is to be bagged and containerized at the location where used if possible and practical. Approved leakproof containers are to be used. The items are not to be sorted, rinsed, or cleaned at that location without direct supervisory approval.</p><p>9. The Exposure Control Officer, as designated by the Exposure Control Plan (SOP 1.04), shall assign a member of the Exposure Control Committee to discard actual or possibly contaminated waste materials. Disposal shall be in compliance with all local, county, state, and federal regulations, laws, and procedures. Procedures contained in the Exposure Control Plan comply and should be followed.</p><p>H. Disinfecting Skin Surfaces</p><p>1. Any unprotected skin surfaces that come into contact with bodily fluids should be thoroughly washed as soon as possible with hot running water and soap for a full minute before rinsing and drying. a. Alcohol or antiseptic towelettes may be used when soap and water are not available.</p><p>2. Disposable gloves should be rinsed before removal and then removed inside out. Care should be taken so as not to allow the contaminated side to come into contact with any skin surfaces. The hands and forearms should then be washed as described above.</p><p>7 of 1.05 a. Affected skin surfaces and mucous membranes should be flushed with running water as soon as possible following the removal of any personal protective equipment.</p><p>3. Hand lotion should be applied after disinfecting to prevent chapping and to seal cracks and cuts on the skin.</p><p> a. All open cuts and abrasions are to be covered with waterproof bandages before reporting for or returning to duty.</p><p>I. Disinfecting Vehicles and Other Non-disposable Equipment or Areas</p><p>1. The duty supervisor is to be advised as soon as is practicable anytime a department vehicle or other non-disposable equipment or area becomes contaminated by exposure to bodily fluids. It will be the duty supervisor’s responsibility to assign an employee to decontaminate the vehicle, equipment, or area. Ordinarily the employee assigned to the vehicle, equipment, or area will be assigned this task.</p><p> a. If the affected vehicle can be used for subsequent transportation of the contaminated individual, the duty supervisor may postpone decontamination until all phases of transportation have been completed. Otherwise, decontamination of vehicles, equipment, and areas should be completed as soon as is reasonably possible.</p><p>2. Employees assigned to decontaminate vehicles are to follow these procedures;</p><p> a. Wear disposable gloves and other protective equipment and clothing as appropriate. b. Remove any excess bodily fluids from vehicle surfaces with an absorbent cloth. Special attention should be paid to any cracks, crevices, or seams where fluids may have flowed. c. Affected areas should then be disinfected using a freshly prepared solution of one (1) part bleach to nine (9) parts water, or a fungicide/myco- bactericidal disinfectant. Surfaces should then be allowed to air dry.</p><p>3. Employees assigned to decontaminate non-disposable equipment or other areas are to follow these procedures;</p><p> a. Wear disposable gloves and other protective equipment and clothing as appropriate. b. Excess bodily fluids should first be wiped up with an approved disposable absorbent material. c. The equipment or area should then be washed with a freshly prepared solution of one (1) part bleach to nine (9) parts water, or a fungicide/myco- bactericidal disinfectant. Contaminated shoes and boots, including soles, should also be disinfected in this manner.</p><p>8 of 1.05 4. In the event a vehicle, equipment, or area, is contaminated to such a degree that it cannot be decontaminated by an employee using these procedures, the duty supervisor will be responsible for immediately removing the vehicle or equipment from service and securing the affected area. The vehicle, equipment, or area is to be clearly labeled by the posting of signs, which may be handwritten, identifying it as having been exposed to “Infectious Disease Contamination”. It is to remain out of service or secured until decontaminated.</p><p> a. Vehicles are to be removed from the line. Signs are to be posted on the windshield, driver and passenger side windows, and steering wheel. b. Other equipment is to be labeled as conspicuously as possible and if possible secured in a limited access area. c. Other areas are to be signed off and secured using barricades or other equipment to restrict access. d. Any employee entering any area so labeled is to wear appropriate protective clothing and equipment.</p><p>5. The department training officer shall ensure that all employees receive required training in regards to decontamination procedures.</p><p>J. Supplies</p><p>1. Supervisors are responsible for maintaining an adequate supply of exposure control supplies and equipment that is readily available to all affected employees. This should include but may not be limited to;</p><p> a. Personal protective clothing and equipment in appropriate sizes. b. Disinfecting supplies, materials, and equipment. c. First aid supplies. d. Hypo-allergenic gloves and other materials for those who are allergic to the materials normally provided.</p><p>2. Department vehicles ordinarily assigned to a patrol or investigative function will be equipped with the following:</p><p> a. Personal protective equipment and clothing in appropriate size and quantity to include;  Face and eye protective devices  Coveralls  Disposable gloves and booties  Leather gloves  Puncture resistant and leakproof containers for needles and other sharp objects  Leakproof plastic bags  Barrier resuscitation equipment b. Liquid germicidal cleaner c. Disposable towelettes  70% isopropyl alcohol d. Waterproof bandages</p><p>9 of 1.05 e. Absorbent cleaning materials f. “Isolation Area - Do Not Enter” signs g. Bio-hazard disposal bags h. Portable metal mirrors i. Non-porpis tongs</p><p>3. Officers using supplies from their vehicles are responsible for replacing them prior to the completion of their shift.</p><p>4. Patrol officers must have disposable gloves in their possession at all times. All other employees must have them readily available.</p><p>5. Individual supervisors will be responsible for advising the Engineering Controls Officer, as designated in SOP 1.04, of any supply needs. The Engineering Controls Officer will then submit the appropriate requisitions to the Material and Support Services Bureau via the chain of command.</p><p>K. Vaccination, Exposure, Evaluation, and Treatment</p><p>1. All department employees who have been determined to be at risk for occupational exposure to the Hepatitis B virus will be provided with the opportunity to receive the HBV vaccination series. Vaccination must be provided within ten (10) working days of assignment to an occupationally exposed duty. The vaccination will be provided at no cost to the employee.</p><p>2. Any employee who comes in unprotected physical contact with the blood or other bodily fluids of another person, while in the performance of their duties, job, or assignment, shall be considered as having been potentially exposed to HBV and/or HIV. In all such cases the employee is to immediately notify their immediate supervisor. If their immediate supervisor is unavailable an officer of supervisory rank is to be contacted.</p><p>3. There are two types of exposures. Supervisors must be aware of the differences between them. They are described as follows:</p><p> a. Outside Exposure  An employee is exposed to blood or other bodily fluids and the area affected consists of an intact skin surface and there is no evidence that the blood or bodily fluid penetrated the skin. Decontamination procedures outlined in section G.1. of this SOP should be followed and are sufficient if there are no other injuries. b. Inside Exposure  An employee is exposed to blood or other bodily fluids and the area affected consists of skin in which there is a break that would allow the blood or bodily fluids to penetrate the skin, or is in an area identified as a route through which infectious materials may enter the body; mucous membranes such as the eyes, nose, and mouth. Decontamination procedures outlined in section G.1. of this SOP should be followed in addition to actions described in section 5. Below.</p><p>10 of 1.05 4. For all exposures a supervisor will be assigned to complete and submit appropriate injury and medical reports prior to the completion of the affected employee’s shift. The supervisor will also initiate an investigation to determine the means and circumstances under which the exposure occurred. The Operations Commander is to be advised of all such exposures by the supervisor as soon as is practical.</p><p>5. In addition, for all inside exposures the supervisor will make arrangements for the employee to proceed immediately to a designated health care facility to be tested for evidence of any infection and treated for any injuries.</p><p> a. Testing will consist of a baseline blood test to determine any immediate infection and to be used as a reference point in future evaluations. The test will be covered under Workmen’s Compensation and the appropriate forms and reports will be completed and submitted. b. The employee shall receive a copy of the health care provider’s written opinion within fifteen (15) days of the evaluation, and information on any conditions resulting from the exposure that require further evaluation and/or treatment. c. The department will ensure continued testing of the employee if there is evidence of infection and provide psychological counseling if necessary as determined by competent medical authority. d. Unless disclosure to an appropriate department or township official is authorized by the employee or law, the employee’s medical evaluation, test results, and any follow-up procedures shall remain confidential.</p><p>6. Any individual responsible for potentially exposing an employee to a communicable disease shall be encouraged to undergo testing. The individual and the affected employee will be provided with a copy of any test results. The employee will also be advised of applicable laws and regulations concerning the disclosure of the identity of the individual and infectious status.</p><p> a. Criminal charges may be brought against any individual who intentionally exposes an employee to a communicable disease. 7. Employees who test positive for HIV or HBV may continue working as long as they maintain an acceptable level of performance and do not pose a safety or health risk to themselves, the public, or other employees. All decisions regarding the employee’s work status will be based solely on their medical condition and the advice of physicians retained by the department. The department can require affected employees to be examined by said physicians.</p><p> a. All department employees will treat fellow employees, who have contracted a communicable disease, fairly, courteously, and with dignity. L. Recordkeeping</p><p>1. As part of its personnel function the department will maintain an accurate record for each employee with occupational exposure. The record will include but may not be limited to the following:</p><p>11 of 1.05 a. Vaccination status b. Results of all examinations, tests, and follow-up procedures, to include the written opinions of health care professionals c. All other relative health care information</p><p>2. The records shall be retained in a secured area with limited access for the duration of employment plus thirty (30) years. In addition, they may not be disclosed or reported to anyone without the express written consent of the employee.</p><p>M. Training</p><p>1. The department’s training officer will ensure that all employees with occupational exposure are provided with a complete course of instruction on the prevention of bloodborne diseases prior to their initial assignment. In addition, they shall receive annual refresher training, and additional training whenever job tasks or procedures are modified in a manner that may alter their risk of exposure. All employees shall have access to applicable state and federal laws and regulations pertaining to bloodborne pathogens.</p><p>2. The training officer will also ensure that complete records are maintained on employee training. The records must be retained for a period of three (3) years from the date of training and must contain at least the following information:</p><p> a. Dates and contents of training sessions b. Names and qualifications of instructors conducting the training c. Names and job titles of all employees attending the training</p><p>N. Rights of Victims of Communicable Diseases</p><p>1. Victims of communicable diseases have the right to expect police to provide them with the same level of service and enforcement as any other individual would receive. 2. Officers assume and accept that a certain degree of risk exists in law enforcement and emergency service work. This holds true with any potential risk of contracting a communicable disease as surely as it does with confronting a violent criminal.</p><p>3. Any officer who refuses to take proper action in regard to a victim of a communicable disease, when appropriate protective equipment is available, shall be subject to disciplinary action as well as civil and/or criminal prosecution.</p><p>4. Whenever an officer is required to include in a report that an individual has or may have a communicable disease, “Contains Confidential Information” will be written across the top margin of the first page of the report. Supervisors will be responsible for ensuring that the statement appears on all reports as required.</p><p>12 of 1.05 5. Any employee who disseminates information to the media shall make certain that confidential information is not released.</p><p>6. All requests, to include subpoenas, for copies of reports involving indictable or juvenile offenses that have been marked as containing confidential information, shall be referred to the Burlington County Prosecutors Office. Requests for similarly marked reports involving lesser adult offenses, and non-offenses, are to be referred to the township solicitor. All other circumstances involving the releasing of confidential information regarding a victim or suspected victim of a communicable disease shall be referred directly to the Director of Public Safety/Chief Law Enforcement Officer (PSD/CLEO) and/or the township solicitor.</p><p> a. Prior approval must be obtained from the Burlington County Prosecutors Office before advising any victim, including the victim of a sexual assault, that a suspect has or is suspected of having a communicable disease.</p><p>- End -</p><p>Resources: OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) Bloodborne Pathogens Compliance Manual International Association of Chiefs of Police National Law Enforcement Model Policy Center</p><p>13 of 1.05</p>