OSHA’s Bloodborne Pathogens Standard Richard J. Green, MSc Safety Training Manager Office of Health and Safety Centers for Disease Control and Prevention

Overview Compliance Components Summary

 29 CFR “Occupational Exposure to Bloodborne Pathogens”  Effective: March, 1992  Revisions:  November, 1999: Compliance Directive  April, 2001: Needlestick Prevention Act  Scope  ALL occupational exposure to blood and other potentially infectious material (OPIM)  29 CFR “Occupational Exposure to Bloodborne Pathogens”  Effective: March, 1992  Revisions:  November, 1999: Compliance Directive  April, 2001: Needlestick Prevention Act  Scope  ALL occupational exposure to blood and other potentially infectious material (OPIM) Overview

Major Provisions by Paragraph (b)Definitions (c)Exposure Control Plan (ECP) (d)Engineering and Work Practice Controls (e)HIV and HBV Research Labs (f)Vaccination, Post-Exposure Follow-up (g)Labeling and Training (h)Record keeping Major Provisions by Paragraph (b)Definitions (c)Exposure Control Plan (ECP) (d)Engineering and Work Practice Controls (e)HIV and HBV Research Labs (f)Vaccination, Post-Exposure Follow-up (g)Labeling and Training (h)Record keeping Components

(b)Definitions  Bloodborne Pathogen “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).” (b)Definitions  Bloodborne Pathogen “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).” Components

(b)Definitions  Bloodborne Pathogen “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).” (b)Definitions  Bloodborne Pathogen “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).” Components

(b) Definitions  Occupational Exposure “Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employees duties.” (b) Definitions  Occupational Exposure “Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employees duties.” Components

(b) Definitions  Occupational Exposure “Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employees duties.” (b) Definitions  Occupational Exposure “Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employees duties.” Components

(c)Exposure Control Plan (ECP)  Provides employees with work practices, procedures, and policies designed to minimize or eliminate employee exposure.  Includes current safety technologies, documentation of safer device implementation, and input from non- managerial workers. (c)Exposure Control Plan (ECP)  Provides employees with work practices, procedures, and policies designed to minimize or eliminate employee exposure.  Includes current safety technologies, documentation of safer device implementation, and input from non- managerial workers. Components

(c)Exposure Control Plan (ECP)  Provides employees with work practices, procedures, and policies designed to minimize or eliminate employee exposure.  Includes current safety technologies, documentation of safer device implementation, and input from non- managerial workers. (c)Exposure Control Plan (ECP)  Provides employees with work practices, procedures, and policies designed to minimize or eliminate employee exposure.  Includes current safety technologies, documentation of safer device implementation, and input from non- managerial workers. Components

(c) Exposure Control Plan (ECP)  Exposure Determination:  Identify worker exposures to blood or OPIM  Review all processes and procedures with exposure potential  Re-evaluate when new processes or procedures are used (c) Exposure Control Plan (ECP)  Exposure Determination:  Identify worker exposures to blood or OPIM  Review all processes and procedures with exposure potential  Re-evaluate when new processes or procedures are used Components

(c)Exposure Control Plan (ECP)  Exposure Determination:  Identify worker exposures to blood or OPIM  Review all processes and procedures with exposure potential  Re-evaluate when new processes or procedures are used (c)Exposure Control Plan (ECP)  Exposure Determination:  Identify worker exposures to blood or OPIM  Review all processes and procedures with exposure potential  Re-evaluate when new processes or procedures are used Components

Universal/Standard Precautions:  Treat all human blood and body fluids as if they were infected.  Treat all HIV/HBV/HCV containing cell or tissue culture, culture medium, solutions or tissues from experimental animals infected with HIV/HBV/HCV as infected.  Utilize: Handwashing, Sharps Precautions, Barrier Protections Universal/Standard Precautions:  Treat all human blood and body fluids as if they were infected.  Treat all HIV/HBV/HCV containing cell or tissue culture, culture medium, solutions or tissues from experimental animals infected with HIV/HBV/HCV as infected.  Utilize: Handwashing, Sharps Precautions, Barrier Protections Compliance

Universal/Standard Precautions:  Treat all human blood and body fluids as if they were infected.  Treat all HIV/HBV/HCV containing cell or tissue culture, culture medium, solutions or tissues from experimental animals infected with HIV/HBV/HCV as infected.  Utilize: Handwashing, Sharps Precautions, Barrier Protections Universal/Standard Precautions:  Treat all human blood and body fluids as if they were infected.  Treat all HIV/HBV/HCV containing cell or tissue culture, culture medium, solutions or tissues from experimental animals infected with HIV/HBV/HCV as infected.  Utilize: Handwashing, Sharps Precautions, Barrier Protections Compliance

(d) Engineering and Work Practice Controls  Employers must select, implement, and document appropriate engineering controls (e.g. sharps disposal containers, sharps with engineered sharps injury protections {SESIP}, needleless systems, directional airflow) that isolate or remove the bloodborne pathogens hazard from the workplace and reduce or eliminate employee exposure. (d) Engineering and Work Practice Controls  Employers must select, implement, and document appropriate engineering controls (e.g. sharps disposal containers, sharps with engineered sharps injury protections {SESIP}, needleless systems, directional airflow) that isolate or remove the bloodborne pathogens hazard from the workplace and reduce or eliminate employee exposure. Compliance

(d) Engineering and Work Practice Controls  Employers must select, implement, and document appropriate engineering controls (e.g. sharps disposal containers, sharps with engineered sharps injury protections {SESIP}, needleless systems, directional airflow) that isolate or remove the bloodborne pathogens hazard from the workplace and reduce or eliminate employee exposure. (d) Engineering and Work Practice Controls  Employers must select, implement, and document appropriate engineering controls (e.g. sharps disposal containers, sharps with engineered sharps injury protections {SESIP}, needleless systems, directional airflow) that isolate or remove the bloodborne pathogens hazard from the workplace and reduce or eliminate employee exposure. Compliance

(d) Engineering and Work Practice Controls  Selection of engineering and work practice controls is dependent on the employer’s exposure determination. (d) Engineering and Work Practice Controls  Selection of engineering and work practice controls is dependent on the employer’s exposure determination. Compliance

(d) Engineering and Work Practice Controls  Selection of engineering and work practice controls is dependent on the employer’s exposure determination. (d) Engineering and Work Practice Controls  Selection of engineering and work practice controls is dependent on the employer’s exposure determination. Compliance

(d) Engineering and Work Practice Controls  Personal Protective Equipment:  Specialized clothing or equipment.  Selection based on quantity and type of exposure expected.  Ex: aerosol production = face protection (d) Engineering and Work Practice Controls  Personal Protective Equipment:  Specialized clothing or equipment.  Selection based on quantity and type of exposure expected.  Ex: aerosol production = face protection Compliance

(d) Engineering and Work Practice Controls  Work Practices:  Hand washing  Personal hygiene  Personal attire  Not wearing personal protective equipment (PPE) out of the work area  Changing PPE when contaminated  Decontaminating/cleaning regularly & after spills  … (d) Engineering and Work Practice Controls  Work Practices:  Hand washing  Personal hygiene  Personal attire  Not wearing personal protective equipment (PPE) out of the work area  Changing PPE when contaminated  Decontaminating/cleaning regularly & after spills  … Compliance

(d) Engineering and Work Practice Controls  Housekeeping:  Written schedule for cleaning and decontaminating  Documented eye wash checks  Material decontamination before exit from lab  Removal of PPE from lab is prohibited  Home laundering of PPE is prohibited  Segregated waste  … (d) Engineering and Work Practice Controls  Housekeeping:  Written schedule for cleaning and decontaminating  Documented eye wash checks  Material decontamination before exit from lab  Removal of PPE from lab is prohibited  Home laundering of PPE is prohibited  Segregated waste  … Compliance

(d) Engineering and Work Practice Controls  Housekeeping:  Written schedule for cleaning and decontaminating  Documented eye wash checks  Material decontamination before exit from lab  Removal of PPE from lab is prohibited  Home laundering of PPE is prohibited  Segregated waste  … (d) Engineering and Work Practice Controls  Housekeeping:  Written schedule for cleaning and decontaminating  Documented eye wash checks  Material decontamination before exit from lab  Removal of PPE from lab is prohibited  Home laundering of PPE is prohibited  Segregated waste  … Compliance

(e) HIV/HBV Research Labs and Production Facilities  BSL 3 practices and procedures  Separated work areas  Sealed surfaces  Waste incineration/autoclaving  BSC usage  Directional airflow (e) HIV/HBV Research Labs and Production Facilities  BSL 3 practices and procedures  Separated work areas  Sealed surfaces  Waste incineration/autoclaving  BSC usage  Directional airflow Compliance

(f) Vaccination, Post-Exposure Follow-up  Hepatitis B vaccine made available to all workers with potential risk of exposure  Offered within 10 days of employment  No cost to worker  “Declination” signed if employee declines vaccine; may accept at a later date (f) Vaccination, Post-Exposure Follow-up  Hepatitis B vaccine made available to all workers with potential risk of exposure  Offered within 10 days of employment  No cost to worker  “Declination” signed if employee declines vaccine; may accept at a later date Compliance

(f) Vaccination, Post-Exposure Follow-up  Hepatitis B vaccine made available to all workers with potential risk of exposure  Offered within 10 days of employment  No cost to worker  “Declination” signed if employee declines vaccine; may accept at a later date (f) Vaccination, Post-Exposure Follow-up  Hepatitis B vaccine made available to all workers with potential risk of exposure  Offered within 10 days of employment  No cost to worker  “Declination” signed if employee declines vaccine; may accept at a later date Compliance

(f) Vaccination, Post-Exposure Follow-up  Report the incident immediately  Inform supervisor  Go to clinic/medical services provider  Confidential medical evaluation  Route of exposure  Circumstances of the incident  Source known  Important to start drug therapy within 2 hours  Testing of victim/source only with consent (baseline blood stored for 90 days) (f) Vaccination, Post-Exposure Follow-up  Report the incident immediately  Inform supervisor  Go to clinic/medical services provider  Confidential medical evaluation  Route of exposure  Circumstances of the incident  Source known  Important to start drug therapy within 2 hours  Testing of victim/source only with consent (baseline blood stored for 90 days) Compliance

(f) Vaccination, Post-Exposure Follow-up  Report the incident immediately  Inform supervisor  Go to clinic/medical services provider  Confidential medical evaluation  Route of exposure  Circumstances of the incident  Source known  Important to start drug therapy within 2 hours  Testing of victim/source only with consent (baseline blood stored for 90 days) (f) Vaccination, Post-Exposure Follow-up  Report the incident immediately  Inform supervisor  Go to clinic/medical services provider  Confidential medical evaluation  Route of exposure  Circumstances of the incident  Source known  Important to start drug therapy within 2 hours  Testing of victim/source only with consent (baseline blood stored for 90 days) Compliance

(g)Labeling and Training  Labels must include universal biohazard symbol and the term “Biohazard”  Wherever BBP or OPIM are  Fluorescent orange-red  Secured with: string, tape, wire, adhesive  Exceptions: Blood products for clinical use, blood samples in containers, blood drawing tubes (g)Labeling and Training  Labels must include universal biohazard symbol and the term “Biohazard”  Wherever BBP or OPIM are  Fluorescent orange-red  Secured with: string, tape, wire, adhesive  Exceptions: Blood products for clinical use, blood samples in containers, blood drawing tubes Compliance

(g)Labeling and Training  Labels must include universal biohazard symbol and the term “Biohazard”  Wherever BBP or OPIM are  Fluorescent orange-red  Secured with: string, tape, wire, adhesive  Exceptions: Blood products for clinical use, blood samples in containers, blood drawing tubes (g)Labeling and Training  Labels must include universal biohazard symbol and the term “Biohazard”  Wherever BBP or OPIM are  Fluorescent orange-red  Secured with: string, tape, wire, adhesive  Exceptions: Blood products for clinical use, blood samples in containers, blood drawing tubes Compliance

(g)Labeling and Training  Signs posted at all work area entrances:  Biohazard symbol  Infectious agent  Entry requirements  Name & telephone # of responsible person (g)Labeling and Training  Signs posted at all work area entrances:  Biohazard symbol  Infectious agent  Entry requirements  Name & telephone # of responsible person Compliance

(h)Record Keeping  Occupational exposure/sharps injury record  Confidential  Kept for duration of employment, + 30 years  Includes:  Name & social security number  Vaccination status  Examination results (h)Record Keeping  Occupational exposure/sharps injury record  Confidential  Kept for duration of employment, + 30 years  Includes:  Name & social security number  Vaccination status  Examination results Compliance

(h)Record Keeping  Occupational exposure/sharps injury record  Confidential  Kept for duration of employment, + 30 years  Includes:  Name & social security number  Vaccination status  Examination results (h)Record Keeping  Occupational exposure/sharps injury record  Confidential  Kept for duration of employment, + 30 years  Includes:  Name & social security number  Vaccination status  Examination results Compliance

(h)Record Keeping  Sharps Injury Log (each incident)  Type and brand of device involved  Department or area of incident  Description of incident (h)Record Keeping  Sharps Injury Log (each incident)  Type and brand of device involved  Department or area of incident  Description of incident Compliance

(h)Record Keeping  Sharps Injury Log (each incident)  Type and brand of device involved  Department or area of incident  Description of incident (h)Record Keeping  Sharps Injury Log (each incident)  Type and brand of device involved  Department or area of incident  Description of incident Compliance

(h)Record Keeping  Training records  Kept for 3 years  Dates  Contents  Names & qualifications of instructors  Names & job titles of students  Annual documentation (h)Record Keeping  Training records  Kept for 3 years  Dates  Contents  Names & qualifications of instructors  Names & job titles of students  Annual documentation Compliance

(h)Record Keeping  Training records  Kept for 3 years  Dates  Contents  Names & qualifications of instructors  Names & job titles of students  Annual documentation (h)Record Keeping  Training records  Kept for 3 years  Dates  Contents  Names & qualifications of instructors  Names & job titles of students  Annual documentation Compliance

Inspection Items  Exposure Control Plan  Jobs  Tasks  Compliance Methods  Engineering Controls  Workplace Practices  PPE  HBV Vaccination/Post-Exposure Follow-up  Records Management  Medical  Sharps Injury Log  Training Inspection Items  Exposure Control Plan  Jobs  Tasks  Compliance Methods  Engineering Controls  Workplace Practices  PPE  HBV Vaccination/Post-Exposure Follow-up  Records Management  Medical  Sharps Injury Log  Training Summary

More Information U.S. Department of Labor, OSHA 200 Constitution Avenue NW, Room N-3603 Washington, DC (202) Or contact your Regional, Area, or State-Plan Office U.S. Department of Labor, OSHA 200 Constitution Avenue NW, Room N-3603 Washington, DC (202) Or contact your Regional, Area, or State-Plan Office