Oakland Public Works Bloodborne Pathogens Exposure Control Plan Written Safety Program 2014

Transcription

1 Oakland Public Works Bloodborne Pathogens Exposure Control Plan Written Safety Program 2014 Du-All Safety Hotchkiss St. Fremont, CA (510)

2 TABLE OF CONTENTS I. Policy and Purpose 3 II. Program Administration 3 III. Other Responsibilities 4 IV. Employee Exposure Determination 4 V. Methods of Control and Implementation 6 VI. Personal Protective Equipment (PPE) 8 VII. Regulated Waste 10 VIII. Vaccination, Post Exposure Evaluation and Follow-up 11 IX. Information Provided to Healthcare Professional 13 X. Training 14 Appendix A Universal Precautions Appendix B Declination Form Appendices 2014 Du-All Safety, LLC. All Rights Reserved. This document may not be reproduced by any means without written permission from Du-All Safety. This document is for internal use of the City of Oakland, Public Works. Du-All and the City of Oakland Risk Management and Oakland Public Works are the only authorized entities allowed to alter or reproduce this document for internal use. THIS] 2

3 BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN Policy and Purpose Oakland Oakland Public Works is committed to providing a safe and healthful work environment for the entire staff. In pursuit of this endeavor, the following Exposure Control Plan (ECP) is provided to eliminate or minimize occupational exposure to bloodborne pathogens in accordance with Cal/OSHA Bloodborne Pathogens, Title 8, California Code of Regulations, Title 8, Section This plan applies to all Oakland Public Works employees. The purpose of this ECP is to identify the hazards and specify workplace controls to eliminate or minimize occupational exposure to Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV) and other bloodborne pathogens that employees may encounter in the workplace. Oakland Public Works, through their operating departments and in accordance with this ECP, has instituted engineering, administrative and work practice controls to eliminate or minimize employee exposure to bloodborne pathogens. The exposure control plan is a key provision because it requires the employer to identify the individuals who will receive the training, protective equipment, vaccination and other protections of the standard set forth by the CCR, Title 8, Section The ECP is a key document to assist in implementing and ensuring compliance with the CalOSHA Standard, thereby protecting our employees. This ECP includes: Determination of employee exposure Implementation of various methods of exposure control, including: Universal precautions o Engineering and work practice controls o Personal protective equipment o Housekeeping Hepatitis B vaccination Post-exposure evaluation and follow-up Communication of hazards to employees and training Recordkeeping Procedures for evaluating circumstances surrounding an exposure incident The methods of implementation of these elements of the standard are discussed in the subsequent pages. Program Administration The Safety Administrator is designated as the Exposure Control Officer for Oakland Oakland Public Works and is responsible for the implementation of the ECP. THIS] 3

4 Responsibilities of the Exposure Control Officer include: a) Overall responsibility for implementing the Exposure Control Plan for Oakland Public Works b) Working with management and soliciting the active involvement of employees to develop, administer and update any additional bloodborne pathogen-related policies, procedures and practices needed to support the effective implementation of this plan c) Looking for ways to improve the Exposure Control Plan as well as to revise and update the plan when necessary d) Knowing current legal requirements concerning bloodborne pathogens e) Acting as the Oakland Public Works representative during Cal/OSHA inspections f) Conducting periodic audits to maintain an up-to-date Exposure Control Plan g) Maintaining up-to-date list of personnel who require training as well as of personnel who have completed training h) Developing and scheduling educational and training programs; maintaining complete training records, sharps injury logs, vaccination records, etc. i) Periodically reviewing training programs with departmental managers and supervisors in order to include new information j) Maintain, review and update the ECP at least annually, and whenever necessary to include new or modified tasks and procedures Other Responsibilities Employees who are determined to have potential occupational exposure to blood or other potentially infectious materials (OPIM) must comply with the procedures and work practices outlined in this ECP. Managers and supervisors are responsible for exposure control in their respective areas. They work directly with the Exposure Control Officer to ensure proper exposure control procedures are followed and exposure incidents are investigated. They also maintain and provide all necessary personal protective equipment (PPE), engineering controls, labels and red bags as required by the Standard. Employee Exposure Determination The State of California CalOSHA requires employers to perform an exposure determination concerning which employees may incur operational exposure to blood or other potentially infectious materials (OPIM) regardless of frequency. Since there is no population that is risk-free for HIV, HBV or other bloodborne disease infection, any employee who has occupational exposure to blood or OPIM will be included within the scope of this standard. The exposure determination requires employers to identify and document: THIS] 4

5 a) Job classifications in which employees are HIGHLY LIKELY to have occupational exposure to bloodborne pathogens (category 1). b) Job classifications in which employees are SOMEWHAT LIKELY to have occupational exposure to bloodborne pathogens (category 2). c) Job classifications in which employees are NOT LIKELY to have occupational exposure to bloodborne pathogens (category 3). High Risk (classifications & positions in which the employee has a high risk of exposure) Job Classification Tasks Placing Employees at Risk Maintenance Worker Sewer repair/cleaning; refuse/debris collection (sharps exposure); Facilities/Operations building maintenance; special events Maintenance Lead Worker Sewer repair/cleaning; refuse/debris collection (sharps exposure); Facilities/Operations building maintenance; special events Maintenance Worker Park clean-up & refuse collection (sharps exposure); restroom Parks & Building Services cleaning; maintenance of recreation facilities; special events Maintenance Lead Worker Park clean-up & refuse collection (sharps exposure); restroom Environmental Services cleaning; maintenance of recreation facilities; special events Building Maintenance Building maintenance; debris collection; cleaning of restrooms (sharps exposure) & other facilities/grounds; special events Custodian Restroom cleaning; building maintenance; trash removal, Moderate Risk (classifications & positions in which the employee has a moderate risk of exposure) Job Classification Building Inspector Civil Engineer Oakland Public Works Supervisor Electrician Environmental Health Coordinator Volunteer Program Coordinator Tasks Placing Employees at Risk Inspections of homes & constructions sites, including unsanitary conditions Construction inspections Inspections of sewer repairs, special events Sewer lift station repairs, sharps exposure, storm drain pump stations Transfer station inspections; biological/chemical testing of solid or liquid waste Responsible for/may assist with programs for youth & seniors; may administer first aid/cpr; maintenance of recreation facilities, special events Low Risk (classifications & positions in which employees are expected to have minimal, if any, risk)) Job Classification All other classifications Tasks Placing Employees at Risk Unforeseen potential exposures not necessarily related to assigned tasks THIS] 5

6 Methods of Control and Implementation Universal Precautions Universal precautions are CalOSHA s required methods of control to protect employees from exposure to all human blood or OPIM. Oakland Public Works will observe the practice of universal precautions in order to prevent contact with blood or OPIM. Universal precautions refer to the concept that all human blood and other body fluids will be treated as if they are known to be infectious for Hepatitis B (HBV), Hepatitis C (HCV), HIV and other bloodborne pathogens. In circumstances where it is difficult or impossible to differentiate between body fluid types, all body fluids are assumed to be potentially infectious. Hazard Controls This section explains the engineering controls, work practice controls, and personal protective equipment used to control the hazard of exposure to bloodborne pathogens. Engineering Controls The following engineering controls are to be followed whenever possible: Department Municipal Service Centers 7101 Edgewater 5740 Shepherd Canyon City Hall Plaza Buildings Other Facilities: th Street 5050 Coliseum Way 666 Bellevue Lakeside Gardens 7 th Street Museum Work Practice Controls Pliers/tweezers Antiseptic towelettes First aid kits and CPR masks are in most OPW shops and trucks Sharps containers located at lift stations, park sheds and Service Center Bleach Wall-mounted first aid station kits in buildings Work Practice Controls Several work practice controls are utilized to help minimize employee exposure to bloodborne pathogens. a) 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. It should be noted that some petroleum-based hand creams can adversely affect glove integrity, and the hand-washing requirements must be followed. b) All procedures involving blood or other potentially infectious materials shall be performed in such a manner as to minimize spraying, splashing and general spreading of droplets. THIS] 6

7 c) Contaminated sharps (needles, razors, broken glass) shall be handled with mechanical means such as pliers, grabbers or broom and dustpan. The mechanical means used are to be cleaned in a solution of one (1) part bleach to ten (10) parts water. Collected needles and sharps are to be packaged in the appropriate sharps container. Sharps are never to be picked up with bare or unprotected hands. d) Fecal matter Any fecal matter that contains visible blood MUST be handled as bio-hazardous waste and disposed of in properly labeled bags or containers. Before placing the matter in the bag, a 10% bleach solution should be poured on it to decontaminate most organisms that may be living in it. The bags/containers may then flushed down the toilet or brought to the Fire Department for proper disposal. e) All other fecal matter that does not contain visible signs of blood may be disposed by flushing down a toilet without the need for either decontamination or labeled containers. f) Because cans, bins, pails and so forth are intended for reuse and may become contaminated with blood or OPIM because of the manner in which they are used, they must be cleaned immediately or as soon as possible upon visible contamination. g) Disposable gloves shall be worn whenever an employee may come in contact with blood, OPIM, mucous membranes and non-intact skin as well as handling or touching contaminated equipment, items or surfaces. Employees shall make sure that the gloves are not torn before using them and periodically check to ensure their integrity during use. h) Masks, in combination with goggles, glasses or face shields shall be worn whenever splashes, spray, splatter or droplets may be generated and whenever eye, nose or mouth contamination can be reasonably anticipated or when in close proximity to airborne agents. Overall protective suits should be worn when possible, if it becomes likely that a uniform will be contaminated. i) Any open wounds or cuts of a non-emergency nature, should be covered with bandages in order to help avoid contact with blood and/or bodily fluids. Bandages should be changed if they become wet, soiled or contaminated. Any emergency care should be handled according to first aid training, reported to supervisor. j) After coming into contact with blood, bodily fluids or suspected infectious persons, all employees should thoroughly wash their hands with hot water and germicidal soap as soon as possible. Hand washing should be done even if latex gloves have been worn. k) To minimize migration of contamination beyond the work area, employees must remove contaminated PPE or clothing before they enter any vehicle, shop, office, break room or lunchroom. If a garment is contaminated, the garment is to be removed immediately. All PPE shall be removed and properly cleaned or disposed of into the designated biohazard waste container in the Municipal Service Center. THIS] 7

8 l) Contaminated areas are to be decontaminated with an appropriate disinfectant (Lysol, bleach, etc ) immediately or as soon as possible. The same decontamination procedures apply to mechanical means or tools used for the pick-up or disposal of contaminated objects. m) First responders should use a one-way CPR mask when performing rescue breathing and CPR. n) Shearing or breaking of contaminated needles and other contaminated sharps is prohibited. o) Contaminated sharps shall not be bent, recapped or removed from devices. p) Sharps that are contaminated with blood or OPIM 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. q) Sharps containers shall not be opened, emptied or cleaned manually or in any other manner, which would expose employees to the risk of injury. r) Food and drink shall not be kept in refrigerators, freezers, shelves, cabinets or on countertops or bench tops where blood or OPIM are present. s) Equipment which may become contaminated with blood or OPIM shall be examined prior to servicing or using, and shall be decontaminated as necessary, unless the employer can demonstrate that decontamination of such equipment or portions of such equipment is not feasible or will interfere with a manufacturer's ability to evaluate failure of the device. t) The containers for collection, storage, transport or shipping of items exposed to blood or OPIM shall prevent leakage, and shall be of a size to fully enclose the exposed item to be collected. u) Trash/Garbage Cans Personnel emptying trash or garbage cans shall either dump the container into a larger container or use mechanical means, rather than pull the trash out by hand, which could lead to being stuck or cut by sharp objects or exposed to blood or other potentially infectious materials. Personal Protective Equipment (PPE) Oakland Public Works provides at no charge to the employees, personal protective equipment (PPE) based on the potential for occupational exposure. Personal protective equipment will be considered appropriate only if it does not permit blood or OPIM to pass through and reach the employee s work or street clothes, undergarments and 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. The employer is required to provide PPE in appropriate sizes and accessible locations. The type and amount of PPE must be chosen to protect against contact with blood or OPIM based upon the type of exposure and quantity of these substances reasonably anticipated to be encountered during the performance of a task or procedure. Each employee must inspect all PPE for defects and must immediately repair or replace any defective PPE and notify his/her supervisor. Disinfecting agents may cause THIS] 8

9 deterioration of the glove material, which may transport blood or OPIM via undetectable pores to the skin or other mucous membranes. For this reason, disposable gloves and contaminated clothing may not be washed and reused. Note: An employee s decision not to use PPE is to be made on a case-by-case basis and must be prompted by legitimate and extenuating circumstances. This does not relieve the employer of the responsibility to ensure that PPE is readily accessible at all times. The employer must investigate and document why PPE was not used in each case and evaluate the circumstances surrounding the incident to reduce the likelihood of a future unprotected incident. Supervisors are to contact the Exposure Control Officer should an employee refuse to use PPE. PPE available to protect from bloodborne pathogens: Work Group Field, shops and other maintenance workers Personal Protective Equipment Disposable protective gloves Goggles/safety glasses Appropriate protective apparel Boots CPR mouth barrier (in First Aid Kits) Office Workers Disposable protective gloves Goggles/safety glasses CPR mouth barriers (in First Aid Kits) Housekeeping The employer must determine and implement an appropriate written schedule of cleaning and decontamination based upon the location within the facility, type of surface to be cleaned, type of soil present (gross contamination versus minor splattering) and tasks and procedures being performed. No designated employees are assigned responsible for the clean-up of blood on City property, with the exception that the Fire Department, which will clean up roadways and streets. Decontamination and housekeeping will be accomplished by utilizing solution of bleach and water, generally a ratio of one (1) part bleach to ten (10) parts water, mixed at the time of decontamination because the effectiveness of the solution dissipates over time and is not effective over twenty-four (24) hours. Laundry Oakland Public Works will provide, at no charge to the employee, a cleaning service for uniforms/work clothing that becomes contaminated with blood or OPIM. The laundry service provider will decontaminate the clothing where possible. When clothing can not be decontaminated and reused, it will be replaced at no cost to the employee. Although some employees may traditionally launder their own uniforms or the like, if the item s intended function is to act as PPE, then it is the employer s responsibility to provide, clean, replace and/or dispose of it. THIS] 9

10 Home laundering of contaminated clothing by employees is not permitted since the standard requires that the laundering be performed at no cost to the employee. Home laundering is unacceptable because the employer cannot ensure that proper handling or laundering procedures are being followed and because contamination could migrate to the homes of employees. If the employee is permitted and wishes to choose, wear and maintain his/her own uniform or the like, then s/he would need to don additional employer-handled and employer-controlled PPE when performing tasks where it is reasonable to anticipate exposure to blood or OPIM. The material for the bags or containers used in laundry collection must prevent soakthrough or leakage of fluids to the exterior. Not all contaminated laundry must be placed in such bags or containers, only laundry wet enough to leak or soak-through and expose workers handling the bags/containers. If an employee s uniform is soaked with blood or OPIM, then it is permissible to dispose of the uniform entirely in properly labeled bags or containers and have the uniform replaced. Regulated Waste Labels and Procedures The Bloodborne Pathogens Standard uses the term regulated waste to refer to the following categories of waste which require special handling, at a minimum: liquid or semi-liquid blood or OPIM; items contaminated with blood or OPIM and which would release these substances in a liquid or semi-liquid state if compressed; items that are caked with dried blood or OPIM and are capable of releasing these materials during handling; contaminated sharps; pathological and microbiological wastes containing blood or OPIM. Regulated waste shall be placed in designated red biohazard containers that are: a) Closable b) Thick enough to contain the waste without leakage c) Double bag if necessary d) Labeled and color-coded e) Placed in designated containers for storage and transport As described in Health and Safety Code Sections through , labels shall include any of the following legend: BIOHAZARD (or in the case of regulated waste) BIOHAZARDOUS WASTE OR SHARPS WASTE These labels shall be fluorescent orange or orange-red or predominantly so, with lettering and symbols in a contrasting color. Labels shall either be an integral part of the THIS] 10

11 container or shall be affixed as close as feasible to the container by string, wire, adhesive or other methods that prevent their loss or unintentional removal. The intent of the containerization and labeling of specimens is to eliminate or minimize the possibility of inadvertent employee contact with blood or other potentially infectious materials, which may leak out of the container, contaminate exterior surfaces of the container, and/or surrounding surfaces. The labeling requirement warns employees that these substances are present so that proper handling precautions can be taken. Biohazard signs will be affixed to containers of regulated waste or other containers used to store, transport or ship blood or other potentially infectious materials. Biohazard Label The label shall include the universal biohazard symbol and the legend BIOHAZARD. The label will be fluorescent orange or orange-red. In case of regulated waste the word BIOHAZARD WASTE may be substituted for the BIOHAZARD legend. Oakland Public Works currently has a private contractor designated to dispose of all bio-hazardous waste in accordance with their procedures. All bio-hazardous waste is picked up from the appropriately labeled containers. Hepatitis B Vaccination, Post Exposure Evaluation and Follow-up Even with engineering and work practice controls, exposure to bloodborne pathogens and OPIM may still occur. Hepatitis B (HBV) vaccination program is in place, as well as procedures for post-exposure evaluation and follow-up should an exposure occur. Medical evaluations and procedures, including HBV vaccination and post-exposure follow-up procedures are: a) Made available at no cost to the employee b) Made available to the employee within ten (10) working days of initial assignment c) Performed by, or under, the supervision of a licensed physician or by or under the supervision of another licensed health care professional The vaccinations and post-exposure follow ups are provided by Concentra and at the annual Oakland Public Works Health Fair. Employees should contact the Safety Administrator for Health Fair dates. Hepatitis B Vaccination (HBV) THIS] 11

12 The HBV vaccination is available to all employees who have the potential for occupational exposure to bloodborne pathogens. Employee will receive the vaccination after having received training in occupational exposure and within ten (10) working days of initial assignment unless the employee has previously received the HBV vaccine, antibody testing shows the employee to be immune to Hepatitis B or the vaccine is contraindicated for medical reasons. If the employer claims one of these exemptions, it must be documented in the employee s medical record. Each vaccine program consists of a series of three (3) inoculations over a six (6) month period. If an employee declines the HBV vaccination series, but at a later date, while still covered under the standard, decides to accept the vaccination, the employer shall make the HBV vaccination available at no cost to the employee. Employees are to contact their supervisor for vaccine information. Employees who decline to take part in the program shall be recorded and must sign the Cal/OSHA-required HBV Vaccine Declination Statement (Appendix B). Provision for the full HBV vaccination series is to be made available as soon as possible, but in no event later than twenty-four (24) hours, to all unvaccinated employees who may have been exposed to blood or OPIM during the performance of their duties. Employees who have been inoculated should continue to use universal precautions whenever working in a known or potentially contaminated environment or with known or potentially contaminated equipment or materials. Post Exposure Evaluation and Follow-up Post-exposure evaluation and follow-up are provided to employees for bloodborne pathogens, such as Hepatitis B or C, as recommended by the Center for Disease Control (CDC). All exposure incidents shall be reported, investigated and documented. If an employee incurs an exposure incident, it shall be reported immediately to the employee s supervisor. Following an exposure incident, the employee shall immediately receive a confidential medical evaluation and follow-up which includes at least the following: a) Documentation of the route of exposure and the circumstances under which the exposure occurred b) Identification and documentation of the source individual, unless it is established that the identification is not feasible or prohibited by Federal, State or local law c) The source individual s blood must be tested as soon as possible in order to determine HBV, Hepatitis C (HCV) and HIV infection after consent is obtained. If consent is not obtained, the Oakland Public Works shall establish that legally required consent is not required by law, and test the individual s blood if feasible. THIS] 12

13 d) When the source individual is known to be infected with HBV, Hepatitis C (HCV) or HIV, blood testing is not to be repeated e) Results of the source individual s testing shall be made available to the exposed employee, and the employee should 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, Hepatitis C (HCV) and HIV serological status will include the following: a) The exposed employee s blood will be collected as soon as possible and tested after consent is obtained. b) If the employee consents to baseline blood collection, but does not give consent at the time for HIV serologic testing, the sample shall be preserved for ninety (90) days. If, within ninety (90) days of the exposure incident, the employee chooses to have the baseline sample tested, testing shall be done as soon as possible. c) Post-exposure prophylaxis is provided when medically indicated. Counseling and post-exposure evaluation follow-up is also provided. d) The employer does not have a specific right to know the actual results of the source individual s blood testing, but must ensure that the information is provided to the evaluating healthcare professional. Information Provided to the Healthcare Professional Healthcare professional evaluating an employee after occupational exposure will be provided the following: a) A copy of the standard, which outlines the confidentiality requirements of the health care professional b) A written description of the employee s duties as they relate to the exposure incident c) Documentation of the route(s) of exposure and circumstances under which exposure occurred d) Results of the source individual s blood test, if available e) All medical records relevant to the appropriate treatment of the employee including vaccination status Healthcare Professional s Written Opinion A copy of the healthcare professional s written opinion will be provide to the exposed employee within fifteen (15) days of the completion of the evaluation. The following information shall be included: a) The healthcare professional s opinion for HBV vaccination shall be limited to whether HBV vaccination is indicated for an employee, and if the employee has received such vaccination THIS] 13

14 b) A statement that the employee has been informed of the results of the evaluation c) A statement that the employee has been told about any medical conditions resulting from exposure to blood or OPIM, which require further evaluation or treatment All other findings or diagnosis shall remain confidential and will not be included in the written report. Recordkeeping All employers, whether or not they are covered by the Bloodborne Pathogens Standard, must record all work-related needle sticks and cuts from sharp objects that are contaminated with another person s blood or OPIM as an injury. If the employee is later diagnosed with an infectious bloodborne disease, the identity of the disease must be entered and the classification changed to an illness. The records shall include the following: a) The employee s name and employee number b) A copy of the employee s HBV status including the dates of the vaccination and any medical records relative to the employee s ability to receive the vaccination c) A copy of the results of examinations, medical testing and follow-up procedures d) The employer s copy of the healthcare professional s written opinion e) A copy of the information provided to the healthcare professional Employee medical records are kept confidential and 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. All records that are required to be maintained under this section shall be provided upon request for examination and copying to the subject employee, to anyone having written consent and to CalOSHA representatives. The records required by this plan are to be maintained for at least the duration of the employee s employment plus thirty (30) years in accordance with Section 3204, except for the Sharps Injury Log, which shall be maintained for a minimum of five (5) years from the date the exposure incident occurred. Training Training Topic Employees who are potentially at risk of occupational exposure to bloodborne pathogens, and the supervisors who assign their tasks, will be properly trained in order to create awareness and minimize exposure. The training program shall contain the following topics: a) A copy of this Exposure Control Plan and an explanation of its contents THIS] 14

15 b) A general explanation of the epidemiology and symptoms of bloodborne illnesses c) An explanation of the modes of transmission of bloodborne pathogens d) An explanation of the appropriate methods for recognizing tasks and other duties that may involve exposure to blood and OPIM e) An explanation of the use and limitations of methods that will prevent or minimize exposure including engineering controls, work practice controls and PPE f) Information on the types, proper use, location, removal, handling, decontamination and disposal of PPE g) Information on the HBV vaccination h) Information on the appropriate actions to take and persons to contact in case of an emergency involving blood or OPIM i) Information on the procedures to follow if an exposure incident occurs including the Sharps Injury Log, reporting the incident and the medical follow-up that will be made available j) Information on the post-exposure evaluation and follow-up that the employer is required to provide following an exposure incident k) An explanation of the signs and labels used to indicate regulated waste Training Methods Oakland Public Works will provide initial and annual refresher training for bloodborne pathogen awareness and procedures. Training is provided either as an interactive live method by a qualified instructor to facilitate questions and address current topics brought up by employees and/or as an online program provided by the City of Oakland s Risk Management Program. Training Records Training records shall be maintained for a minimum of five (5) years from the date on which the training occurred and shall include the following: a) Dates, time and location of the training session b) Contents or a summary of the training session c) Name(s) and job title(s) of training instructor(s) d) Name(s) and job title(s) of all employees attending the training Sharps Injury Log In addition to the 1904 Recordkeeping Requirements, all percutaneous injuries from contaminated sharps are also recorded in the Sharps Injury Log. An or memo from the supervisor of the injured employee to the Exposure Control Officer with the information below will constitute the Log. All incidences must include at least: a) Date of the injury b) Type and brand of the device involved c) Department and work area where the incident occurred d) Explanation of how the incident occurred THIS] 15

16 This log is reviewed at least annually as part of the annual evaluation of the program and is maintained for at least five years following the end of the calendar year that they cover. If a copy is requested by anyone, it must have any personal identifiers removed from the report. THIS] 16

17 Appendix A Universal Precautions Universal Precautions are developed by the Centers for Disease Control (CDC), and incorporated into the CalOSHA standard governing Bloodborne Pathogens (Title 8 CCR 5193). Bloodborne pathogens include, but are not limited to, Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV). Universal Precautions are developed as an approach to infection control, in that all human body fluids are treated as if known to be infectious for HIV& HBV, and other bloodborne pathogens. Employees should practice Universal Precautions whenever they may be exposed to blood or other body fluids, be it at work or at home. This rule is important because it is often impossible to tell if the person you come in contact with has HBV or HIV. Universal Precautions work practices include: Wash hands with soap and running water. Hands should be washed with soap and running water after contact with body fluids. Wear vinyl gloves when contacting blood. All staff members required to administer first aid involving blood or body fluids that may contain blood must wear vinyl gloves. Dispose of blood contaminated materials in plastic bags or in waste cans with plastic liners. Trash containing blood or fluid that contains blood must be placed in a separate plastic bag or trashcan with a plastic inner liner. Bags should be marked as containing: "BIOHAZARD". Bags should be tied shut to prevent inadvertent contamination to other personnel. Use disinfectant to clean blood contaminated areas. The disinfectant supplied by Oakland Public Works to be used for sanitizing areas that have been contaminated with body fluid spills. This disinfectant is effective in destroying the Hepatitis B and HIV viruses. A mixture of chlorine bleach (diluted 1:10 with water) and mixed daily or as needed, can also be used effectively. Make prior special arrangements for disposal of needles, syringes and other sharp objects. Prior to their use, special arrangement should be made with your supervisor for disposal of needles, syringes or other sharps, which may be encountered in the work setting. Vinyl gloves and plastic bags must be readily available. Disposable vinyl gloves must be available as standard component of first aid supplies in City offices and work sites. They must also be readily available to drivers and other personnel who may administer first aid. Gloves must be properly disposed of in a labeled plastic bag or trash can with a plastic liner. Report exposures immediately. If significant exposure (needle stick, mucous membrane splash or contact to non-intact skin) to blood occurs, report immediately to supervisor for evaluation and follow-up. THIS] 17

18 Appendix B Hepatitis B Vaccine Acceptance/Declination Form Due to your occupational exposure to blood or other potentially infectious material (OPIM) you may be at risk of acquiring hepatitis B virus (HBV) infection. You may obtain the Hepatitis B vaccination series and Post-Exposure Evaluation from the Oakland Medical Center at no cost to you. Hepatitis B vaccination is recommended unless: 1) documentation of prior vaccination and post-vaccination titer is provided to EHS 2) medical evaluation identifies that vaccination is contraindicated. SELECT ONE OF THE OPTIONS BELOW AT THE END OF THE TRAINING CLASS: Note: you can change your decision at any time and discuss questions by contacting the Oakland Medical Center Occupational Health Department at or Sarah Corso, OPW Safety and Training at Check option #1 to request vaccination at this time. #1. I certify that I have been offered and will participate in the Hepatitis B Vaccine Program which includes serological testing at 1-2 months post-vaccination. I understand that I must request an appointment for these medical services within ten (10) working days, by contacting Oakland Medical Center Occupational Health Department at Read option #2 and select a declination reason if you do not want or need to receive Hepatitis B vaccination at this time. #2. I understand that due to my occupational exposure to blood or OPIM I may be at risk of acquiring Hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with Hepatitis B vaccine, at no charge to myself. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease. If in the future I continue to have occupational exposure to blood or OPIM and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me. Declination Reason: I decline because I have previously received the complete Hepatitis B vaccination series. I decline because antibody testing has revealed I am immune to Hepatitis B. I decline to receive the Hepatitis B Vaccine because of unspecified reasons. Employee Name: Job Title: Employee Signature: Date: THIS] 18