A Be Prac ice Approach for educing Bloo borne Pathoge s xposure This page intentionally left blank. A Best practices Approch for Reducing Bloodborne Pathogens Exposure Publishing Information A Best Practices Approach for Reducing Bloodborne Pathogens Exposure was developed by the Education Unit, Cal/OSHA Consultation Service, California Department of Industrial Relations. The document was pre- pared for publication by the staff of CDE Press, California Department of Education. It was distributed under the provisions of the Library Distribu- tion Act and Government Code Section 11096. Published 2001 by the California Department of Industrial Relations This booklet is not meant to be a substitute for or a legal interpretation of the occupational safety and health standards. Please see California Code of Regulations, Title 8, or the Labor Code for detailed and exact information, specifications, and exceptions. Photo Credits Cal/OSHA gratefully acknowledges Richard Munn, M.D., Department of Pathology, University of California Davis Medical School, for the slides used as photographs in this booklet. Contents About This Booklet ......................................................................................................................... v Identifying and Selecting Appropriate and Currently Available Engineering Control Devices...................................................................................... 1 1. Set Up a Process ....................................................................................................................... 3 2. Define Needs ............................................................................................................................ 5 3. Gather Information ................................................................................................................... 6 4. Test and Select Products ......................................................................................................... 13 5. Use New Products .................................................................................................................. 24 6. Conduct Follow-up ................................................................................................................. 26 Methods of Compliance .............................................................................................................. 27 Engineering and Work Practice Controls–General Requirements ............................................... 29 Engineering Controls–Specific Requirements ............................................................................. 31 Exceptions to the Use of Engineering Controls ........................................................................... 33 Work Practice Controls ................................................................................................................ 39 Work Practice Controls–Prohibited Practices .............................................................................. 40 Requirements for Handling Contaminated Sharps....................................................................... 41 Regulated Waste–Containers for Disposal ................................................................................... 42 Handling Specimens of Blood or Other Potentially Infectious Materials ................................... 44 Cleaning and Decontaminating Equipment and Surfaces ............................................................ 45 Servicing or Shipping Contaminated Equipment......................................................................... 46 Cleaning and Decontamination of the Worksite .......................................................................... 47 Hygiene ........................................................................................................................................ 50 Laundry ........................................................................................................................................ 51 Personal Protective Equipment .................................................................................................... 52 iii Hepatitis B Vaccination and Bloodborne Pathogens Post-Exposure Evaluation and Follow-up ............................................................................................................ 57 Hepatitis B Vaccination Series ..................................................................................................... 58 Post-Exposure Evaluation and Follow-up ..................................................................................... 60 Information Provided to the Health Care Professional ................................................................. 64 Health Care Professional’s Written Opinion ................................................................................. 65 Counseling .................................................................................................................................... 66 Communication of Hazards to Employees .............................................................................. 67 Warning Labels ............................................................................................................................. 68 Information and Training .............................................................................................................. 70 Recordkeeping ............................................................................................................................... 73 Medical Records ........................................................................................................................... 74 Training Records ........................................................................................................................... 74 Sharps Injury Log.......................................................................................................................... 75 Availability of Records ................................................................................................................. 75 Transfer of Records ....................................................................................................................... 75 Access to Employee Exposure and Medical Records ................................................................... 75 Resources ........................................................................................................................................ 77 Web Sites ....................................................................................................................................... 78 Scientific and Professional Publications ....................................................................................... 78 Organizations ................................................................................................................................ 80 Governmental Agencies ................................................................................................................ 81 Other Sources ................................................................................................................................ 81 Definitions of Regulated Waste..................................................................................................... 82 Cal/OSHA Publications................................................................................................................. 84 WeWant to Hear from You ........................................................................................................ 87 Acknowledgments ......................................................................................................................... 89 iv About This Booklet his booklet is a companion to the Exposure Control Plan for Bloodborne Pathogens. It was designed to further assist employers and employees with addressing the requirements of the T bloodborne pathogens regulation (California Code of Regulations, Title 8, Section 5193, subsections d through h). A practical, step-by-step approach is presented that can be modified to fit the particular needs of your organization. This approach promotes the use of safer engineering controls and more effective work practices in hospitals, nursing homes, dental offices, and other workplace settings where occupational exposure to blood or other potentially infectious materials (OPIM) is likely to occur. Definitions of terms and resources are provided to help readers understand bloodborne pathogens issues. In addition, simplified worksheets help employers document progress in eliminating bloodborne pathogens exposure in the workplace. The topics covered are as follows: “Identifying and Selecting Appropriate and Currently Available Engineering Control Devices” contains simplified steps to guide the selection, evaluation, and follow-up of new products. “Methods of Compliance” provides guidance on topics such as assessing and updating engineering and work practice controls, determining whether the exceptions to the use of new products are applicable, handling regulated waste and contaminated laundry, using personal protective equipment, cleaning and decontaminating equipment and the worksite, and other issues. “Hepatitis B Vaccination and Bloodborne Pathogens Post-Exposure Evaluation and Follow-up” details the policies and procedures to help care for employees after the occurrence of an occupational exposure incident. “Communication of