Posts filed under ‘E. Infectious Disease Control’

Infectious Disease Control

Exposure Control Plan

Revised June, 2012

Transition Projects is committed to the prevention of incidents or happenings which result in employee injury and illness. This plan complies with the Oregon OSHA Bloodborne Pathogens Standard, Oregon Administrative Rule (OAR) 437-02-1910.1030. Through this written exposure control plan we share assigned responsibility to ensure performance under that responsibility; and hereby adopt this exposure control plan as an element of the Transition Projects Safety and Health Program.

Purpose

The purpose of this exposure control plan is to:

  1. Eliminate or minimize employee occupational exposure to blood or other body fluids;
  2. Identify employees occupationally exposed to blood or other potentially infectious materials (OPIM) while performing their regular job duties.
  3. To provide employees exposed to blood and OPIM information and training. A copy of this plan is available to all employees during the work shift at the Residential Advocate desk.
  4. Comply with OR-OSHA Bloodborne Pathogen Standard, Oregon Administrative Rules (OAR) 437-02-1910.1030.

Exposure Determination

Transition Projects has performed an exposure determination for job classifications which may be expected to incur occupational exposures to blood or other potentially infectious materials. This exposure determination is made without regard to the use of Personal Protective Equipment.

The following is a list of those job classifications, tasks and procedures:

Job Classification Task/Procedure
Client Services Specialist Sorting donations, bagging client belongings
Engagement Specialist Sorting donations, bagging client belongings
Connections Specialist Sorting donations, bagging client belongings
Hygiene Services Specialist Sorting donations, bagging client belongings
Resource Coordinator Sorting donations, bagging client belongings
Resource Specialist Sorting donations, bagging client belongings
Custodian Sorting donations, bagging client belongings

The following is a list of job classifications in which some employees may have occupational exposures. Not all of these employees are expected to incur exposure to blood or OPIM. The job classification, tasks, and procedures are listed below:

Job Classification Task/Procedure
Residential Advocate Sorting donations, bagging client belongings

Compliance Methods

Universal Precautions
“Universal Precautions” recognizes all body fluids as though they are infected with bloodborne pathogens. This method of infection control requires the employer and employee to assume that all human blood and specified human body fluids are infectious for human immunodeficiency virus (HIV), Hepatitis B virus (HBV), and other bloodborne pathogens. Where differentiation of types of body fluids is difficult or impossible, all body fluids are to be considered as potentially infectious.

Engineering Controls and Work Practices
Engineering and work practice controls will be used by all employees to eliminate or minimize occupational exposures. These controls are:

  1. Contaminated disposable sharps will be placed in leak-proof, puncture-resistant, red sharps containers labeled with the universal biohazard label for disposal.
  2. Contaminated needles and sharps are not to be bent, broken, or recapped.
  3. Recapping of sharp and bending or breaking needles is prohibited.
  4. Eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses are prohibited in areas where there is a reasonable likelihood of occupational exposure.
  5. Storage of food and drink is prohibited in places where other potentially infectious materials are kept. This applies to refrigerators, freezers, shelves, cabinets, and countertops.

Personal Protective Equipment
The following Personal Protective Equipment (PPE) will be provided at no cost to employees: Utility gloves – Heavy Rubber or Leather – to be used for sorting donations or bagging client belongings.

The Residential Supervisor is assigned the responsibility to ensure and issue appropriate readily accessible PPE, without cost, to employees. Hypoallergenic gloves, glove liners, powderless gloves, or other similar alternatives shall be readily accessible to those employees who are allergic to the gloves normally provided.

All PPE will be removed prior to leaving the work area. All PPE will be cleaned, laundered, and disposed of by Transition Projects at no cost to the employee. Utility gloves should be collected at the appropriate location in each facility for storage, washing, decontamination and disposal.

Housekeeping and Waste Management
Transition Projects’ facilities will be maintained in a clean and sanitary condition. Spills of blood or potentially infectious materials will be decontaminated prior to clean-up with a disinfectant effective against bloodborne pathogens, HIV and HBV.

SHARPS containers in this facility are closable and puncture- and leak-proof. These containers are not to be overfilled, and are closed and handled to prevent contamination. The containers are red and labeled with the universal biohazard label.

Hepatitis B Vaccine and Post-Exposure Evaluation and Follow-up

Transition Projects recognizes that even with adherence to Universal Precautions, engineering controls, work practices, use of personal protective equipment, and compliance to housekeeping and waste management, exposure incidents can occur.

Transition Projects, Inc. will offer at no cost to potentially exposed employees the Hepatitis B vaccine and vaccination series within 10 working days after receiving the initial job assignment and the post exposure follow-up to those who have had an exposure incident.

The Human Resource Director is in charge of the Hepatitis B vaccination program. The Human Resource Director will ensure that all medical evaluations and procedures including the Hepatitis B vaccine and vaccination series and post exposure follow-up, including prophylaxis, are made available at no charge to the employee at a reasonable place and time; and are performed or supervised by a licensed healthcare professional according to the recommendations of the CDC.

Hepatitis B Vaccination

  1. The vaccination program consists of a series of three inoculations of a six-month period and shall be given after the employee has received training on the vaccine. See Information and Training, below.
  2. Hepatitis B vaccination shall be made available within 10 working days of initial assignment to all employees who have occupational exposure, unless the employee has previously received the complete Hepatitis B vaccination series, antibody testing has revealed that the employee is immune, or the vaccine is contraindicated for medical reasons.
  3. Participation in a prescreening program is not a prerequisite for receiving Hepatitis B vaccination
  4. If an employee initially declines Hepatitis B vaccination (see vaccination declination form) but at a later date decides to accept the vaccination, the Human Resource Director shall make available Hepatitis B vaccination at that time.
  5. If a routine booster dose of Hepatitis B vaccine is recommended by the US Public Health Service at a future date, such a booster dose shall be made available to all eligible employees.

Post Exposure Evaluation and Follow-up

When an employee has an exposure incident, it will be reported to the Residential Supervisor. Following a reported exposure incident, the exposed employee will immediately receive a confidential medical evaluation including the following elements:

  1. Documentation of the route(s) of exposure, and the circumstances under which the exposure incident occurred;
  2. Identification and documentation of the source individual, unless the employer can establish that identification is infeasible or prohibited by state or local law;
  3. The source individual’s blood shall be tested as soon as feasible and after consent is obtained in order to determine HBV and HIV infectivity. If consent is not obtained, the employer shall establish that legally required consent cannot be obtained. When the source individual’s consent is not required by law, the source individual’s blood, if available, shall be tested and the results documented.
  4. When the source individual is already known to be infected with HBV or HIV, testing for the source individual’s known HBV or HIV status need not be repeated.
  5. Results of the source individual’s testing shall be made available to the exposed employee, and the employee shall be informed of applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.
  6. Collection and testing of blood for HBV and HIV serological status;
  7. The exposed employee’s blood shall be collected as soon as feasible and tested after consent is obtained.
  8. If the employee consents to baseline blood collection, but does not give consent at that time for HIV serologic testing, the sample shall be preserved for at least 90 days. If, within 90 days of the exposure incident, the employee elects to have the baseline sample tested, such testing shall be done as soon as feasible.
  9. Post-exposure prophylaxis, when medically indicated, as recommended by the US Public Health Service;
  10. Counseling; and
  11. Evaluation of reported illnesses.

All employees who incur an exposure incident will be offered post-exposure evaluation and follow-up in accordance with the standard. All post exposure follow-ups will be performed by Legacy Occupational Medical Clinic Front Avenue (8:00AM – 5:00PM, 226-6744) or Legacy Good Samaritan Hospital Emergency Department (24 hours, 413-7711).

Information Provided to the Healthcare Professional

The Human Resource Director will ensure that the healthcare professional responsible for the employee’s Hepatitis B vaccination is provided the following:

  1. A copy of the regulation (OAR 437-02-1910.1030);
  2. A description of the exposed employee’s duties as they relate to the exposure incident;
  3. Documentation of the route(s) of exposure and circumstances under which exposure occurred;
  4. Results of the source individual’s blood testing, if available; and
  5. All medical records relevant to the appropriate treatment of the employee including vaccination status which are the employer’s responsibility to maintain.

Healthcare Professional’s Written Opinion

The Human Resource Director will obtain and provide the employee with a copy of the evaluating healthcare professional’s written opinion within 15 days of the completion of the evaluation.

The healthcare professional’s written opinion for HBV vaccination will be limited to whether HBV is indicated for an employee, and if the employee has received such vaccination.

The healthcare professional’s written opinion for post exposure follow-up will be limited to the following information:

  1. That the employee has been informed of the results of the evaluation; and
  2. That the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment.

Information and Training
The Human Resource Director will ensure that training is provided at the time of initial assignment to tasks where occupational exposure may occur, and that it shall be repeated within 12 months of the previous training. The training program will be tailored to the education and language level of the employee, and offered during the normal work shift. The training will contain the following:

  1. An accessible copy of the regulatory text and an explanation of its contents;
  2. A general explanation of the epidemiology and symptoms of bloodborne diseases;
  3. An explanation of the modes of transmission of bloodborne pathogens’
  4. An explanation of Transition Projects’ exposure control plan and the means by which the employee can obtain a copy of the written plan;
  5. An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials;
  6. An explanation of the use and limitations of methods that will prevent or reduce exposure including appropriate engineering controls, work practices, and personal protective equipment;
  7. Information on the types, proper use, location, removal, handling, decontamination and disposal of personal protective equipment;
  8. An explanation of the basis for selection of personal protection equipment;
  9. Information on the Hepatitis B vaccine, including information on its efficacy, safety, method of administration, the benefits of being vaccinated and that the vaccine and vaccination will be offered free of charge;
  10. Information of the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials;
  11. An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available;
  12. Information of the post-exposure evaluation and follow-up that Transition Projects is required to provide for the employee following an exposure incident;
  13. An explanation of the signs and labels and/or color coding required for containers of regulated waste; and
  14. An opportunity for interactive questions and answers with the person conducting the training session.

Additional training will be given to employees when there are any changes of tasks or procedures affecting the employee’s occupational exposure.

Record Keeping
Medical records are maintained by Kaiser-Permanente’s Occupational Health Office. Medical records will include:

  1. The name and social security number of the employee;
  2. A copy of the employee’s Hepatitis B vaccination status including the dates of all the Hepatitis B vaccinations and any medical records relative to the employee’s ability to receive vaccination;
  3. A copy of all results of examinations, medical testing, and follow-up procedures;
  4. The employer’s copy of the healthcare professional’s written opinion; and
  5. A copy of the information provided to the healthcare professional.

These medical records will be 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.

Training Records
These records will be kept by Multnomah County’s Occupational Health Office. Training records will include:

  1. The dates of the training sessions;
  2. The contents or a summary of the training sessions;
  3. The names and qualifications of persons conducting the training; and
  4. The names and job titles of all persons attending the training sessions.

All employee records will be made available to the employee.

Evaluation and Review

The Human Resource Director is responsible for annually reviewing this program and its effectiveness, and for updating if necessary.

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