1. Consultation Education & Training (CET) Division
MIOSHA Part 554 Bloodborne Infectious Diseases Train the Trainer Program Module 2
Presented By:
Consultation Education & Training (CET) Division
Michigan Occupational Safety & Health Administration Michigan Department of Energy, Labor & Economic Growth
(517)

2. Welcome
Welcome to the MIOSHA Bloodborne Infectious Diseases Online Training Module 2.
This is a continuation of the MIOSHA program designed to provide an overview of the MIOSHA bloodborne standard.
It does NOT fullfill all the training requirements in the Bloodborne Standard nor is it intended to replace facility specific training.

3. Intended Use: “Train the Trainer”
Provide bloodborne infectious diseases information to those who provide training to employees who are at risk of occupational exposure.
Provide additional resources to assist trainers in becoming more knowledgeable in topics related to bloodborne infectious diseases.

4. Module 2
This is a continuation of the MIOSHA Bloodborne Infectious Diseases online training program. This module will provide an overview of Rules
Note: Rule 12 covers HIV and HBV research laboratories and productions facilities. Due to limited application, this rule will not be included in this overview.

5. Overview of the Bloodborne Standard
Module 1:
Module 2:
Rule 1 Scope
Rule 2 Definitions
Rule 3 Exposure determination
Rule 4 Exposure control plan
Rule 5 Universal precautions
Rule 6 Engineering controls
Rule 7 Work practices
Rule 8 Protective work clothing and equipment
Rule 9 Housekeeping
Rule 10 Regulated waste
Rule 11 Laundry
Rule 12 HIV and HBV research laboratories and production facilities
Rule 13 Vaccinations and postexposure follow-up
Rule 14 Communication of hazards to employees
Rule 15 Recordkeeping
Rule 16 Information and training
Appendices

6. Rule 10 Regulated Waste Disposal
Regulated Waste shall be placed into containers or bags that are:
Closable
Leakproof
Color-coded or labeled
For contaminated sharps all the above plus puncture-resistant

7. Rule 11 Laundry Minimize agitation
Bag at the location where it is generated
Color-coded bags or containers
Cleaned and laundered in such a way to inactivate or destroy bloodborne pathogens

8. The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard:
Rule 10 Regulated Waste
Rule 11 Laundry

9. Rule 10-11 Waste and Laundry Questions and Answers:
Questions and answers will appear below. There will be delays to allow time to answer the questions.
True or False:
This container is acceptable for disposal of contaminated sharps:
False. Improper label and/or color.
See Rule 10 (2)
Employees may launder their contaminated work clothes at home.
False. Rule 11 (5) states that the employer is responsible to laundry contaminated clothing.
Detergent

10. Rule 13 Vaccinations and postexposure follow-up
Performed by a licensed health care professional
Provided at no cost by the employer
Provided according to U.S. public health service (Centers for Disease Control and Prevention).
Counseling

11. Rule 13 Vaccinations and postexposure follow-up Continued
Hepatitis B Vaccine
Offered within 10 days
HBV antibody testing offered after new employee vaccination
Employees may decline the series
Note: Clarification related to offering the HBV vaccination to 1st Aid providers is available through a Federal OSHA letter of interpretation (External link)

12. HBV Antibody Testing
May request an antibody titre test. (i.e. if vaccinated from a previous employer).
According to Current CDC recommendations (for new employees):
Must offer antibody titre within 60 days of the last vaccine in series.
If not responder, offer series of 3 again and titre as described above.
If still non-responder, follow CDC guidelines as appropriate.
Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis (External link)

13. The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard:
Rule 13 Vaccinations and postexposure follow-up

14. Rule 13 HBV Vaccination and Titre Questions and Answers:
Questions and answers will appear below. There will be delays to allow time to answer the questions.
True or False. Antibody testing is to be offered to new employees who accept the HBV vaccine within days following administration of the HBV vaccination series.
True. Rule 13(2) states that an employer shall provide according to the current recommendations of the U.S. public health service [CDC].
Note: Current CDC recommendations can be found in the Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis (External link)

15. Rule 13 Vaccinations and postexposure follow-up Continued
Medical Evaluation
Confidential
Route of exposure (i.e. needlestick, splash to eyes, etc.)
Source individual identification and testing
Exposed individual blood testing
Postexposure prophylaxis as recommended by U.S. public health service (CDC)
Counseling
Evaluation of illnesses

16. Rule 13 Vaccinations and postexposure follow-up Continued
Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV and HIV and Recommendations for Postexposure Prophylaxis
Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis (External link)

17. Rule 13 Vaccinations and postexposure follow-up Continued
Employers shall provide to health care professionals a copy of the BID Rules and appendices

18. Rule 13 Vaccinations and postexposure follow-up Continued
Employers shall ensure that health care professionals who evaluate employees after an exposure have been given the following information:
Description of employees duties as related to the exposure incident
Documentation of the route and circumstances surrounding the exposure
Results of the source individual’s blood testing
Relevant medical records (including vaccine)
Description of PPE used or to be used

19. Rule 13 Vaccinations and postexposure follow-up Continued
Employer shall obtain and provide to exposed employee a copy of the health care professional’s written opinion limited to:
Any limitation on employee use of PPE
HBV vaccine information
Statement that employee has been informed of test results and medical conditions that may have resulted from exposure

20. The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard:
Rule 13 Vaccinations and postexposure follow-up

21. Rule 13 Post-exposure Follow-up Questions and Answers:
Questions and answers will appear below. There will be delays to allow time to answer the questions.
True or False:
Employee medical evaluations and test results are confidential.
True. Rule 13 (5)
Employers have the right to know the HIV status of their employees.
False. Rule 13 (7) (c) states that the employer has the right to receive a statement that employee has been informed of test results and medical conditions that may have resulted from exposure

22. Rule 14 Communication of Hazards to Employees
Signs posted in work areas
Labels affixed to containers of blood or OPIM

23. Rule 15 Recordkeeping
Employer shall establish and maintain medical records for each category A employee for duration of employment plus 30 years.
Training records shall be maintained for 3 years

24. Rule 15 Recordkeeping Continued
Sharps Injury Log for contaminated sharps injuries must contain:
Type and brand of device
Work unit or area where the incident occurred
Explanation of how it happened
Must protect employee confidentiality
Applies to employers required to maintain a log under Part 11 Recording and Reporting of Occupational Injuries and Illnesses
Note: Employers are permitted to use the 300 Log to record sharps injuries and are encouraged to use separate page(s) of the log just for recording sharps injuries.

25. The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard:
Rule 14 Communication of hazards to employees
Rule 15 Recordkeeping

26. Rule 15 Recordkeeping Questions and Answers:
Questions and answers will appear below. There will be delays to allow time to answer the questions.
True or False:
Employee medical records shall be kept for 5 years.
False. Rule 15 (4) states that an employer shall establish and maintain medical records for each employee for duration of employment plus 30 years.
Employers shall establish and maintain a log of contaminated sharps injuries.
True. Rule 12 (A) Note: Exception described in Rule 12 (b) and (c) .

27. Rule 16 Information and Training
Required for all category A employees
At no cost
During work hours
At the time of initial assignment
Annual refresher
Appropriate for the educational level, literacy, and language of employees

28. Rule 16 Information and Training Continued
Contents of the training program:
Accessibility and explanation of the BID Rules
Epidemiology and symptoms of bloodborne diseases
Modes of BID transmission
Exposure Control Plan with SOPs
Methods for recognizing tasks and procedures that involve exposure to blood or OPIM

29. Rule 16 Information and Training Continued
Contents of the training program (continued):
Use and limitations of:
Engineering controls
Work Practices
PPE
PPE selection criteria
Hepatitis B vaccine including availability, efficacy, benefits and no cost

30. Rule 16 Information and Training Continued
Contents of the training program (continued):
What actions to take in case of an emergency involving blood or OPIM
Follow-up procedures
Signs and labels or color coding

31. The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard:
Rule 16 Information and training

32. Rule 16 Information and Training Questions and Answers:
Questions and answers will appear below. There will be delays to allow time to answer the questions.
True or False:
Training is required for Category A employees initially and at least annually.
True. Rule 16 (2).
This MIOSHA training program meets all the employee training provisions.
False. Refer to Rule 16 (5) (a)-(l) for all the required training elements.

33. Contact MIOSHA for Additional Information
Questions:
Consultation Education and Training Division: (517)
General Industry Safety and Health Division (Compliance): (517)
Link to additional online resources.
Return to the MIOSHA homepage.

34. Thank you for participating
This completes the overview of the MIOSHA Bloodborne Infectious Diseases Standard.
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