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HomeMy WebLinkAbout300-5500000 cirr aF Renton (.D POLICY &PROCEDURE Subject: OCCUPATIONAL EXPOSURE TO Index: Human Resources & Risk BLOODBORNE PATHOGENS Management Number: 30 Effective Date: I Supersedes: I Page: Staff Contact: I t, ApproveA By: 11/05/2018 1 2/1/95 1 1 of 12 1 Ellen Bradley-Mak 1.0 PURPOSE: To establish and communicate an Exposure Control Plan in order to protect employees from the risk of disease caused by bloodborne pathogens through exposure control to blood or other potentially infectious materials. To outline procedures and provide medical evaluation information if occupational exposure occurs. 2.0 ORGANIZATIONS AFFECTED: All departments/divisions. 3.0 REFERENCES: WAC 296-823 OSHA 29 CFR 1910.1030 Bloodborne Pathogens Post -Exposure Packet: BBP 300-55 Forms C-F BBP 300-55 Form A: Hepatitis B Vaccination Written Opinion BBP 300-55 Form B: Hepatitis B Vaccine Declination Form BBP 300-55 Form C: Valley Medical Center (VMC) Occupational Health Services Referral Form & Directions BBP 300-55 Form D: Post -Exposure Incident Checklist BBP 300-55 Form E: Post -Exposure Incident Report BBP 300-55 Form F: Post -Exposure Written Opinion Form Renton PD Lexipol Policy 905 Communicable Diseases (Contact PD for access) Renton PD Lexipol Policy 304 Bloodborne Pathogens (Contact PD for access) WAC 296-27-01109 Appendix A: Job Classifications with Significant Risk of Occupational Exposure to Bloodborne Pathogens Appendix B: Job Classifications with Moderate to Low Risk of Occupational Exposure to Bloodborne Pathogens Occupational Exposure to Bloodborne Pathogens 300-55 4.0 POLICY: It is the policy of the City of Renton to provide a safe and healthful working environment for its employees and to control employee exposure to diseases caused by bloodborne pathogens as set forth in this Exposure Control Plan. The City of Renton and its employees will follow universal precautions and treat all human blood and certain human body fluids as if they are known to be infectious for HIV, Hepatitis B, and other bloodborne pathogens. Where differentiation of types of body fluids is difficult or impossible, all body fluids are to be considered potentially infectious. For all commissioned and non-commissioned members of the Renton Police Department, this policy is applicable in all circumstances except where there is a conflict with departmental Renton PD Lexipol Policy 905 and/or 304 in which case these departmental policies shall prevail. 5.0 DEFINITIONS: 5.1 Blood: Human blood, human blood components and products made from human blood. 5.2 Bloodborne Pathogens (BBP): Pathogenic microorganisms that are present in human blood and can cause disease in humans. These include, but are not limited to, Human Immunodeficiency virus (HIV) and Hepatitis B virus (HBV). 5.3 Contaminated: The presence or the reasonably anticipated presence of blood or other potentially infections materials (OPIM) on an item or surface. 5.4 Contaminated Sharps: Any contaminated object that can penetrate the skin including, but not limited to, needles or broken glass. 5.5 Decontamination: The use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal. 5.6 Exposure Control Officer (ECO): The Human Resources and Risk Management (HRRM) Administrator or a designee assigned by the HRRM Administrator shall be the Exposure Control Officer for the City of Renton. The ECO is responsible for the overall implementation of the Exposure Control Plan for the City of Renton. Specific duties can be found in section 6.1.1 of this policy. 5.7 Exposure Incident: Specific eye, mouth, other mucous membrane, non -intact skin, or parenteral contact with blood or other potentially infectious materials (OPIM). Examples of non -intact skin include skin with dermatitis, hangnails, cuts, abrasions, chafing, or acne. Occupational Exposure to Bloodborne Pathogens 300-55 5.8 Occupational Exposure: Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM that may result from the performance of an employee's duties. 5.9 Other Potentially Infectious Materials (OPIM): Includes all of the following: (1) Human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva, and any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids; (2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and (3) HIV -containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing cell or tissue or organ cultures. 5.10 Parenteral Contact: When mucous membranes or skin are pierced by needle sticks, human bites, cuts, or abrasions. 5.11 Personal Protective Equipment (PPE): Specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes not intended to function as protection against a hazard are not considered to be PPE. 5.12 Regulated Waste: Any of the following: (1) Liquid or semiliquid blood or other potentially infectious materials (OPIM); (2) Contaminated items that would release blood or OPIM in a liquid or semiliquid state if compressed; (3) Items that are caked with dried blood or OPIM and are capable of releasing these materials during handling; (4) Contaminated sharps; or 5) Pathological and microbiological wastes containing blood or OPIM. 5.13 Sharps Container: Puncture -resistant disposal containers for contaminated sharp instruments such as needles and broken glass. 5.14 Source Person (or Source Individual): A person, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to the employee. 5.15 Sterilize: The use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores. 5.16 Universal Precautions: An approach to infection control. According to the concept of universal precautions, all human blood and certain human body fluids are treated as if they are known to be infectious for HIV, HBV and other bloodborne pathogens. 5.17 Written Opinion: Health care professional's correspondence to include but not limited to: (1) hepatitis B vaccination recommendation, and (2) post -exposure evaluation information per section 6.2.4. Occupational Exposure to Bloodborne Pathogens 300-55 p. 4 6.0 PROCEDURE: 6.1 Controlling Employee Exposure 6.1.1 Exposure Control Plan 6.1.1.1 This policy is the Exposure Control Plan for the City of Renton and will be accessible to every employee. 6.1.1.2 This Exposure Control Plan and its linked forms, including the post -exposure packet, may be accessed electronically on the city's internal employee network, Sharepoint, via the City Clerk's page under "Policies & Procedures" or it can be provided by the HRRM department upon request. 6.1.1.3 The Exposure Control Officer (ECO) is responsible for the overall implementation of this Exposure Control Plan for the City of Renton and for the supervision of training and maintenance of records. 6.1.1.4 The ECO will work with department administrators, their designees and/or other personnel to provide support to the effective implementation of this plan. 6.1.1.5 The ECO is responsible for ensuring that the plan is accessible to all employees and that the links to all forms in 6.1.1.2 remain current. 6.1.1.6 The ECO will ensure that the Exposure Control Plan is reviewed and updated at least annually and whenever necessary to reflect changes per WAC 296-823-110. 6.1.2 Exposure Controls 6.1.2.1 Work Practice Controls 6.1.2.1.1 All employees must use universal precautions and consider the blood and OPIM from all persons as containing a bloodborne disease, whether or not the source person has been identified as having a bloodborne disease. 6.1.2.1.2 Employees must wash their hands as soon as feasible after removing gloves and whenever there is a potential for contact with blood or OPIM. When hand washing facilities are not immediately available, antiseptic hand cleanser or antiseptic towelettes will be used and hands will be washed with soap and running water as soon as feasible. 6.1.2.1.3 Eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses is prohibited in work areas where there is risk of occupational exposure. Occupational Exposure to Bloodborne Pathogens 300-55 P. 5 6.1.2.1.4 Each work location will be kept clean and sanitary with an appropriate cleaning and decontamination schedule performed by the Facilities division in accordance with WAC 296-823-14055. 6.1.2.1.5 All working surfaces and equipment must be cleaned and decontaminated after contact with blood or OPIM per section 6.1.5.4. 6.1.2.2 Personal Protective Equipment (PPE) 6.1.2.2.1 Personal protective equipment (PPE) will be provided at no cost to the employee and will be used when work practices and controls will not fully protect employees from the risk of exposure to blood or OPIM. 6.1.2.2.2 Departments will determine the type of PPE required and assure that it is either issued or readily accessible in sizes to fit employees. Appropriate PPE, determined per WAC 296-823-150, may include gloves, gowns, face shields or masks used with eye protection, mouthpieces, resuscitation bags, pocket masks or other ventilation devices. 6.1.2.2.3 Disposable (single use) gloves must be replaced as soon as practical when contaminated, if they are torn or punctured, or when their ability to function as a barrier is compromised. Disposable gloves must only be used once. 6.1.2.2.4 Utility gloves may be decontaminated for reuse if they can continue to function as a barrier. The employee must discard utility gloves if they are cracked, peeling, torn, punctured, or show other signs of deterioration or when their ability to function as a barrier is compromised. 6.1.2.2.5 One of the following will be readily accessible for employees who are allergic to the gloves that are normally provided: Non -latex, glove -lined, powderless gloves, or other similar alternatives. 6.1.2.2.6 To reduce the risk of transfer of bloodborne pathogens during CPR, resuscitator devices will be readily available and accessible to employees who can reasonably be expected to perform resuscitation procedures. 6.1.2.2.7 When a specific need for storage, washing, decontamination or disposal of PPE is required, employees must communicate this to their supervisor and place PPE in an appropriately designated area or container as directed. Occupational Exposure to Bloodborne Pathogens 300-55 p. 6 6.1.3 Hepatitis B virus (HBV) Vaccinations 6.1.3.1 Hepatitis B vaccinations are available to employees who are identified as being at risk of occupational exposure, at no cost to the employee, in order to protect them from the Hepatitis B virus (HBV). Per WAC 296-823-11005, occupational exposure risk determination for City of Renton employees is detailed in Appendix A: Job Classifications with Significant Risk of Occupational Exposure to Bloodborne Pathogens and Appendix B: Job Classifications with Moderate to Low Risk of Occupational Exposure to Bloodborne Pathogens. All employees in the listed job classification are at that determined risk level. 6.1.3.2 Employees can receive the Hepatitis B vaccination series through the health care professional of their choice. The vaccinations must be performed by or under a licensed health care professional and in accordance with current US Public Health Services procedures. 6.1.3.3 Employees should bring the Hepatitis B Vaccination Written Opinion Form (BBP 300-55 Form A) with them to their first vaccination appointment. Employees choosing to get their vaccination series through Valley Medical Center (VMC) Occupational Health Services should also bring the VMC referral form (BBP 300-55 Form C), filling in the general information section and indicating "Hepatitis B Vaccination Series" in the "OTHER" category under "Immunizations." Directions to the clinic are on the back of the form. 6.1.3.4 Employees do not need the Hepatitis B vaccine if they are assigned to provide first aid only as a secondary duty plus other conditions are met per WAC 296-823-13005. 6.1.3.5 Vaccination is also not necessary if: (1) the employee has previously received the complete Hepatitis B vaccination series, (2) antibody testing reveals that the employee is immune, or (3) there is a medical reason not to receive the vaccine. If any of these conditions apply, a copy of applicable paperwork or vaccination records should be added to the employee's benefits/medical record file. 6.1.3.6 Employees may decline the HBV vaccination by signing a Hepatitis B Vaccine Declination Form (BBP 300-55 Form B). The vaccination will still be made available to an employee who initially declines it if he/she decides later to accept it. Occupational Exposure to Bloodborne Pathogens 300-55 p. 7 6.1.3.7 The Exposure Control Officer will ensure he/she receives the completed Hepatitis 8 Vaccination Written Opinion Form from the health care professional and provides it to the employee within 15 days of evaluation. If the employee receives it directly from the health care professional, there is no need to give the employee the completed form. Additionally, if the employee uses his/her personal health care professional for the evaluation, there is no need to obtain the health care professional's written opinion. 6.1.3.8 Bloodborne pathogen paperwork, such as the Hepatitis 8 Vaccination Written Opinion and Hepatitis 8 Declination Form will be filed in the employee's benefits/medical record file and retained per section 6.3. 6.1.4 Exposure Control Training 6.1.4.1 Department administrators or their designee, assisted by the HRRM department upon request, are responsible for organizing and providing appropriate Bloodborne Pathogen Exposure Control training to their employees in accordance with WAC 296-823-120 at least annually and within one year of the previous training. 6.1.4.2 Training will be provided at no cost to the employee and conducted during compensated working hours. Training may be given by a department/internal representative or by a contracted/external agency as long as the person conducting the training is knowledgeable about the subject matter. Training must be provided before employees perform tasks where occupational exposure might occur. 6.1.4.3 Training records will be maintained within the department for 3 years from the date of training and must include (1) dates of the training sessions, (2) contents or a summary of the training sessions, (3) names and qualifications of persons conducting the training, and (4) names and job titles of all persons attending the training sessions. A copy of the training record must also be submitted to the HRRM department. 6.1.5 Clean-up and Disposal of Regulated Waste 6.1.5.1 Whenever possible, Facilities personnel should be called for clean-up and decontamination anytime the presence of blood or other potentially infections material (OPIM) exists. Monday through Friday, 7:30am to 4:30pm, Facilities can be reached through their Help Desk at 425-430-6640. After 4:30pm and on weekends, contact the Facilities on -call technician at 425-766- 1672. Occupational Exposure to Bloodborne Pathogens 300-55 p. 8 6.1.5.2 The Facilities division provides and maintains disposable Spill Kits at each City building for use in cleaning -up spills of blood or OPIM. Each kit has instructions for use and all necessary equipment for cleaning and decontamination if it is not possible to reach or wait for the arrival of Facilities personnel. 6.1.5.3 Employees must wear protective gloves and other appropriate PPE per WAC 296-823-150 when in contact with potentially contaminated materials. 6.1.5.4 All working surfaces and equipment must be cleaned and decontaminated after contact with blood or OPIM. Appropriate disinfectant is one that is effective against tuberculosis, HBV and HIV such as an EPA registered disinfectant or a bleach solution of 1 part bleach to 10 parts water per WAC 296-823-14055. 6.1.5.5 In rare circumstances where the amount of blood is exceedingly great, a Facilities representative will determine the need and contract with a third -party service for clean-up. 6.1.5.6 Employees will discard contaminated sharps immediately, or as soon as possible, in Sharps Containers or in a similar container that is puncture -resistant and disposable in accordance with WAC 296-823-14060. Sharps containers, when feasible, will be provided and located as close as possible to the area where sharps can be anticipated to be found such as in custodial, park, recreation and police vehicles and/or offices. Sharps containers, maintained upright throughout use, must be properly disposed of, per 6.1.5.10 of this section, and replaced before becoming full around 2/3 capacity). 6.1.5.7 Broken glassware which may be contaminated shall not be picked up directly with the hands. It must be cleaned up using mechanical means, such as a brush and dust pan, tongs, or forceps. 6.1.5.8 Employees will handle contaminated laundry or other contaminated waste as little as possible and must wear protective gloves and other appropriate PPE per WAC 296-823- 150. Laundry must be put into a bag or container that is properly labeled and color -coded, such as those provided in each building's Spill Kit Occupational Exposure to Bloodborne Pathogens 300-55 P. 9 6.1.5.9 Labels must be affixed securely, color -coded fluorescent orange or orange -red and include the following symbol per WAC 296-823-14025. Red biomedical waste bags or containers satisfy this requirement and can be found in each building's Spill Kit. 6.1.5.10 Disposal of biomedical waste (filled sharps containers, red biomedical waste bags and/or other appropriate labeled containers) shall comply with local law and regulation. City departments may contract with a biomedical waste disposal service provider for disposal or can dispose of biomedical waste through the Regional Fire Authority. Once safe for transport, Facilities or applicable personnel will drop-off the biomedical waste with the Regional Fire Authority at Fire Station 16 (12923 156t" Ave SE, Renton WA 98059). At that location, all biomedical waste will be placed in a marked container for removal by the contracted biomedical waste disposal service provider. 6.1.5.11 Human vomit or other human waste (such as urine or feces), when visibly contaminated with blood or when differentiation from other types of body fluid is difficult, will be cleaned up using universal precautions and treated as potentially infectious. Bags of this type of waste can be disposed of in the garbage/landfill. 6.2 Post -Exposure Procedures 6.2.1 First Aid Employees exposed to blood or other potentially infectious material (OPIM) must immediately follow first -aid procedures. Appropriate post -exposure first aid includes: Eyes: If the eyes are splattered with blood or body fluids, flush immediately with water for at least five minutes, preferably with clean running water. Mouth: If blood or OPIM enters the mouth, rinse mouth with water or saline, if available. Skin: If blood or OPIM touch the skin, wash well with soap and warm water. Note whether the skin is intact or cut or scraped. Occupational Exposure to Bloodborne Pathogens 300-55 0.10 Needle sticks, punctures, or cuts with blood contaminated sharp objects: Induce the wound to bleed by means other than mouth contact, wash the wound thoroughly with soap and water, and cover the wound with a sterile dressing. Bite or scratch wound that may have had blood or potentially infectious bodyfluid exposure: Wash the area thoroughly with soap and water and cover the wound with a sterile dressing. 6.2.2 Post -Exposure Reporting 6.2.2.1 As soon as possible after receiving first aid, the exposure incident must be reported to the supervisor who will contact the Exposure Control Officer (in the HRRM department) and give the exposed employee the Post -Exposure packet. The employee will follow the Post -Exposure Incident Checklist (BBP 300-55 Form D) and fill out the Post -Exposure Incident Report (BBP 300-55 Form E). 6.2.2.2 The Post -Exposure Packet includes the following and each form has individual instructions to help the employee and supervisor in post -exposure action. The ECO will offer additional assistance as necessary. Valley Medical Center (VMC) Occupational Health Services Referral Form & Directions (BBP 300-55 Form C) Post -Exposure Incident Checklist (BBP 300-55 Form D) Post -Exposure Incident Report (BBP 300-55 Form E) Post -Exposure Written Opinion Form (BBP 300-55 Form F) 6.2.3 Post -Exposure Medical Evaluation 6.2.3.1 A confidential post -exposure medical evaluation is immediately available to the employee at no cost to the employee. With input from the ECO, the employee makes the ultimate determination whether or not to seek a medical assessment. Employees are encouraged to seek post -exposure medical evaluation whenever a possible exposure occurred. 6.2.3.2 Employees may select the medical facility for post -exposure medical evaluation. Employees choosing evaluation at Valley Medical Center VMC) Occupational Health Clinic should fill out the VMC Occupational Health Clinic Referral Form (BBP 300-55 Form C) with the date, their name and job position. In the "OTHER" section, on the line labeled "Other," employees should fill in 'Bloodborne Pathogen Post -Exposure Evaluation." Directions to the clinic are on the back of the referral form. Occupational Exposure to Bloodborne Pathogens 300-55 P. 11 6.2.3.3 Employees getting evaluated at VMC Occupational Health Clinic should bring the VMC referral form (BBP 300-55 Form C), a copy of the Post -Exposure Incident Report (BBP 300-55 Form E) and the Post - Exposure Written Opinion Form (BBP 300-55 Form F) with them to the medical evaluation. If being seen elsewhere, the employee should bring the Post -Exposure Incident Report (BBP 300-55 Form E) and the Post -Exposure Written Opinion Form (BBP 300-55 Form F). The Post -Exposure Incident Report (BBP 300-55 Form E) includes the following: (1) WAC 296-823-160 by providing the URL http://www.lni.wa.gov/rules/; (2) A description of the job duties the exposed employee was performing when exposed; (3) Documentation of the routes of exposure and circumstances under which exposure occurred; (4) Results of the source person's blood testing, if available; and (5) The employee's City - maintained medical records that are relevant to the post - exposure treatment including vaccination status. 6.2.3.4 With the exposed employee's consent, the health care professional will collect and test the employee's blood as soon as feasible. If the employee gives consent for blood draw but does not consent to HIV serologic testing at that time, the sample shall be preserved for at least 90 days. Should the employee elect HIV serologic testing during that period, the testing will be done as soon as possible. 6.2.3.5 Post -exposure preventative treatment, including medical counseling, for HIV or HBV will be offered to the exposed worker by the health care professional at no cost to the employee and in accordance with the current recommendations of the US Public Health Service. 6.2.3.6 Additionally, following the law for consent and specifics found in WAC 296-823-16015, the source person's blood should be tested as soon as feasible. If testing is possible, the results of the source person's test must be provided to the exposed employee as well as guidance about applicable laws and regulations regarding disclosure of identity and about medical or infection status of the source person. 6.2.4 Post -Exposure Follow -Up 6.2.4.1 The ECO will obtain and provide to the employee a copy of the health care professional's written opinion within 15 days of the completion of the evaluation. If the health care professional provides the written opinion directly to the employee, the ECO does not need to do so. Occupational Exposure to Bloodborne Pathogens 300-55 p. 12 6.2.4.2 The health care professional's written opinion shall 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 OPIM which require further evaluation or treatment. All other findings or diagnoses shall remain confidential and shall not be included in the written report. 6.3 Record Keeping 6.3.1 Post -Exposure Medical Records For each employee with occupational exposure to bloodborne pathogens, a post - exposure medical record, containing information in accordance with WAC 296-823- 17005, will be maintained in the employee's benefits/medical file in the HRRM department for at least 30 years beyond the length of employment. They shall be kept confidential and shall not be disclosed without the employee's written consent except as allowed by law or by circumstance per WAC 296-823-170. 6.3.2 Sharps Injury and OSHA 300 Logs 6.3.2.1 In accordance with WAC 296-27-01109, all injuries from contaminated sharps will be recorded in the Sharps Injury Log and OSHA 300 Log. Sharp Injury Log entries, without personally identifiable information, must include the date of the injury, the type and brand of the device if known, and where and how the incident occurred. 6.3.2.2 The Exposure Control Officer will electronically maintain the Sharps Injury Log for 5 years following the end of the calendar year and will review it with the annual program review. Personal identifiers must be removed. 6.3.3 Training Records 6.3.3.1 Training records must be maintained for 3 years from the date of training and must include (1) dates of the training sessions, (2) contents or a summary of the training sessions, (3) names and qualifications of person(s) conducting the training, and (4) names and job titles of all persons attending the training sessions. 6.3.3.2 Training records will be maintained by the department and a copy must also be provided to the HRRM department.