Which of the following is a required training topic for occupationally exposed worker?

Scope and Application

One of the major goals of the Occupational Safety and Health Administration (OSHA) is to promote safe work practices in an effort to minimize the incidence of illness and injury experienced by employees. Relative to this goal, OSHA enacted the Occupational Exposure To Bloodborne Pathogens Standard, codified as 29 CFR §1910.1030. The purpose of the Bloodborne Pathogen Standard is to "reduce occupational exposure to Hepatitis B Virus (HBV), Human Immunodeficiency Virus (HIV) and other bloodborne pathogens" that employees may encounter in their workplace.

Youngstown State University (YSU) realizes that occupational exposure to blood or other potentially infectious materials can occur to its employees. Therefore, in order to protect the health and welfare of its employees, the University has established certain precautions and safeguards for all employees who may come into contact with blood or blood products. Under this rule other potentially infectious materials as defined on page 5 of this document will also be subject to this standard.

YSU believes that there are a number of "good general principles" that should be followed when working with bloodborne pathogens. These include:

It is prudent to minimize all exposure to bloodborne pathogens.

Risk of exposure to bloodborne pathogens should never be underestimated.

YSU should institute as many work practices and engineering controls as possible to eliminate or minimize employee exposure to bloodborne pathogens.

YSU has implemented this Exposure Control Plan to meet the letter and intent of the OSHA Bloodborne Pathogen Standard. The objective of this plan is:

To protect employees from the health hazards associated with bloodborne pathogens.

To provide appropriate treatment and counseling should an employee be exposed to bloodborne pathogens.

29 CFR 1910.1030

Definitions

In order to better understand the function of the Bloodborne Standard, it is important that employees have a clear understanding of the definitions used by OSHA. The following is a list of the most important definitions:

• Blood - Human blood, human blood components, and products made from human blood.
• Bloodborne Pathogens - 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).
• Contaminated - The presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.
• Contaminated Sharps - Any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires.
• Contaminated Laundry - Laundry which has been soiled with blood or other potentially infectious materials, or may contain sharps.
• 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.
• Engineering Controls - Controls (e.g., sharps disposal containers, self-sheathing needles, etc.) that isolate or remove the bloodborne pathogens hazard from the workplace.
• Exposure Incident - A specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties.
• Handwashing Facilities - A facility providing an adequate supply of running potable water, soap, and single use towels or hot air drying machines.
• HBV - Hepatitis B Virus.
• HIV - Human Immunodeficiency Virus.
• 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 employee's duties.
• Other Potentially Infectious Materials - (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, 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). (3) HIV-containing cell or tissue cultures, organ cultures, and HIV or HBV-containing culture medium or other solutions: and blood, organs, or other tissues from experimental animals infected with HIV or HBV.
• Personal Protective Equipment - Specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g., uniforms, pants, shirts, or blouses) not intended to function as protection against a hazard are not considered to be personal protective equipment.
• Regulated Waste - Liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials.
• Source Individual - Any individual, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to an employee. Examples include, but are not limited to, hospital and clinic patients; clients in institutions for the developmentally disabled; trauma victims; clients of drug and alcohol treatment facilities; residents of hospices and nursing homes; human remains; and individuals who donate or sell blood or blood components.
• Universal Precautions - Treating all blood and certain human body fluids as if they are known to be infectious for HIV, HBV and other bloodborne pathogens.
• Work Practice Controls - Controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g., prohibiting recapping of needles by a two-handed technique).

General Program Management

The "Exposure Control Officer" will be responsible for the overall management of YSU's Bloodborne Pathogens Compliance Program. Activities which are delegated to the Exposure Control Officer will include the following:

• Overall responsibility for implementing the Exposure Control Plan for YSU.
• Revision and updating of the plan on a yearly basis and as necessary if circumstances dictate.
• Maintaining information on the Bloodborne Pathogen Standard and Bloodborne pathogen safety and health information.
• Acting as facility liaison during OSHA inspections.
• Knowing current legal requirements concerning bloodborne pathogens.
• Conducting periodic facility audits to maintain an up-to-date Exposure Control Plan.

The Director of Environmental and Occupational Health and Safety (EOHS) will act as YSU's Exposure Control Officer.

Department chairpersons, department directors, immediate supervisors, and faculty are responsible for exposure control in their respective areas. They work directly with the Exposure Control Officer and employees to ensure that the proper exposure control procedures are followed. Although students are not covered by the Exposure Control Plan, it will be the responsibility of individual faculty to inform students of any hazards associated with the use of blood, blood products or any other infectious materials that may be used in the teaching environment.YSU's Education/Training Coordinator will be responsible for providing information and training to all employees who have the potential for exposure to bloodborne pathogens. Individual faculty are responsible for training students who may have a potential for bloodborne exposure. Activities falling under the direction of the Education/Training Coordinator include:

• Scheduling periodic training seminars for employees.
• Maintaining appropriate training documentation (e.g., "Sign-in Sheets", Quizzes, Tests, etc.)
• Periodically reviewing the training programs with the Exposure Control Officer to include appropriate new information.
• The University's Coordinator of Training and Development will serve as the Education/Training Coordinator.
• YSU realizes that its employees have the most important role in the bloodborne pathogen compliance program. Employees are responsible for the following:
• Knowing what tasks they perform that have a potential for occupational exposure.
• Attending the bloodborne pathogen training sessions.
• Planning and conducting all operations in accordance with universal precautions and work practice controls.
• Developing good personal hygiene habits.

Exposure Control Plan

The Exposure Control Plan is available to employees at all times. Employees are advised of the location of the plans during their education/training sessions. Copies of the Exposure Control Plan are available in the following locations:

• Department of Environmental and Occupational Health and Safety - 2046 Cushwa Hall.
• YSU Police Department.

Individual departments that are covered by the University's Bloodborne Pathogen Standard:

• Athletics
• Biology
• Campus Recreation and Intramural Sports
• Chemistry
• Dean’s Office-Engineering & Science
• Environmental & Occupational Health & Safety
• Health Professions
• Human Performance and Exercise Science
• Janitorial Services
• Nursing
• Physical Therapy
• Special Events
• Student Health Services
• YSU Police

We recognize that it is important to keep our Exposure Control Plan up-to-date. To ensure this, the plan will be reviewed and updated by the Exposure Control Officer under the following circumstances:

• Annually, on or before June 30th of each year.
• Whenever new or modified tasks and procedures are implemented which affect occupational exposure of our employees.
• Whenever employees' jobs are revised such that new instances of occupational exposure may occur.
• Whenever we establish new positions that may involve exposure to bloodborne pathogens.

The key to implementing a successful Exposure Control Plan is to identify exposure situations employees may encounter. To facilitate this, we have prepared the following lists:

• Job classifications in which all employees in these classifications may have occupational exposure to bloodborne pathogens.
• Job classifications in which some employees in these classifications may have occupational exposure to bloodborne pathogens.

Tasks and procedures in which occupational exposure to bloodborne pathogens occurs (these tasks and procedures are performed by employees in the job classifications shown on the two previous lists).

The initial lists were compiled on June 28, 1994. The Exposure Control Officer will work with department heads to revise and update these lists as tasks, procedures, and classifications change.

Job Title Classifications

Below are listed the job classifications in our facility where all employees in these job classifications may come into contact with human blood or other potentially infectious materials, which may result in possible exposure to bloodborne pathogens:

• Athletic Trainer Athletics
• Director EOHS
• Environmental Scientist 3 EOHS
• Environmental Scientist 2 EOHS
• Environmental Technician 2 EOHS
• Nurse Supervisor Health Services
• Nurse 2 Health Services
• Nurse 1 Health Services
• Lifeguard HPES
• Chief YSU Police
• Sergeant YSU Police
• Lieutenant YSU Police
• Police Officer YSU Police

Below are listed the job classifications where some employees with these job classifications may come into contact with human blood or other potentially infectious materials which may result in possible exposure to bloodborne pathogens:

• Professor Health Professions
• Associate Professor Health Professions
• Assistant Professor Health Professions
• Instructor Health Professions
• Student Assistant Health Professions
• Student Athletic Trainer Athletics
• Professor Biology
• Associate Professor Biology
• Assistant Professor Biology
• Instructor Biology
• Graduate Assistant Biology
• Student Assistant Biology
• Chemical Storekeeper 1 Biology
• Professor Chemistry
• Associate Professor Chemistry
• Assistant Professor Chemistry
• Instructor Chemistry
• Graduate Assistant Chemistry
• Student Assistant Chemistry
• Student Assistant EOHS
• Recreational Facility Manager 1 Campus Recreation and Intramural Sports
• Housekeeping Manager 1 Janitorial Services
• Professor Nursing
• Associate Professor Nursing
• Assistant Professor Nursing
• Instructor Nursing
• Dispatcher YSU Police

Job Task Classifications

Below are listed the tasks and procedures where employees may come into contact with human blood or other potentially infectious materials which may result in exposure to bloodborne pathogens.

• Dental Clinic Professor Health Professions
• Dental Clinic Associate Professor Health Professions
• Dental Clinic Assistant Professor Health Professions
• Dental Clinic Instructor Health Professions
• Emergency Care Professor Health Professions
• Emergency Care Assistant Professor Health Professions
• Emergency Care Instructor Health Professions
• Lab Instruct Professor Health Professions
• Lab Instruct Associate Professor Health Professions
• Lab Instruct Assistant Professor Health Professions
• Lab Instruct Instructor Health Professions
• Respiratory Professor Health Professions
• Respiratory Associate Professor Health Professions
• Respiratory Astistant Professor Health Professions
• Respiratory Instructor Health Professions
• Training/First Aid Athletic Trainer Athletics
• Training/First Aid Student Athletic Trainer Athletics
• First Aid Aquatic Director Athletics
• First Aid Lifeguard HPES
• Research Professor Biology
• Research Associate Professor Biology
• Research Assistant Professor Biology
• Research Instructor Biology
• Research Graduate Assistant Biology
• Research Student Assistant Biology
• Research Professor Chemistry
• Research Associate Professor Chemistry
• Research Assistant Professor Chemistry
• Research Instructor Chemistry
• Research Graduate Assistant Chemistry
• Research Student Assistant Chemistry
• Spill Cleanup/Sterilization Director EOHS
• Spill Cleanup/Sterilization Environmental Scientist 3 EOHS
• Spill Cleanup/Sterilization Environmental Scientist 2 EOHS
• Spill Cleanup/Sterilization Environmental Technician 2 EOHS
• Lab Sterilization Student Assistant EOHS
• First Aid Nurse Supervisor Health Services
• First Aid Nurse 2 Health Services
• First Aid Nurse 1 Health Services
• Equipment Issue Recreation Facility Mgr 3 HPES
• Equipment Issue Recreation Facility Mgr 1 Recreation & Intramural
• Patient Care Professor Nursing
• Patient Care Associate Professor Nursing
• Patient Care Assistant Professor Nursing
• Patient Care Instructor Nursing
• First Aid Chief YSU Police
• First Aid Sergeant YSU Police
• First Aid Lieutenant YSU Police
• First Aid Dispatcher YSU Police

Bloodborne Standards

There are a number of areas that must be addressed in order to effectively eliminate or minimize exposure to bloodborne pathogens. The following is a list of how YSU intends to comply with the bloodborne standard:

• The use of Universal Precautions.
• Establishing appropriate Engineering Controls.
• Using necessary Personal Protective Equipment.
• Implementing appropriate Housekeeping Procedures.
• Implementing appropriate Work Practice Controls.

Each of these areas are reviewed with employees during their bloodborne pathogen related training. By following the requirements of OSHA's Bloodborne Pathogen Standard in these five areas, we feel that we will eliminate or substantially minimize employees' occupational exposure to bloodborne pathogens as much as possible.

YSU began a program of Universal Precautions on June 30, 1994. As a result, we treat all human blood and other potentially infectious material as if they are known to be infectious for HBV, HIV, or other bloodborne pathogens.

In circumstances where it is difficult or impossible to differentiate between body fluid types, we assume all body fluids to be potentially infectious.

The Exposure Control Officer is responsible for overseeing our Universal Precautions Program.

One of the aspects of the Exposure Control Plan is the use of Engineering Controls to eliminate or minimize employee exposure to bloodborne pathogens. As a result, employees use cleaning, maintenance and other equipment that is designed to prevent contact with blood or other potentially infectious materials. The Exposure Control Officer works with department heads to review tasks and procedures performed where engineering controls can be implemented or updated. Engineering controls are reexamined during the annual Exposure Control Plan review and when additional tasks are added that require the use of engineering controls. Existing engineering control equipment is reviewed for proper function and needed repair or replacement every three months by the appropriate department head where the equipment is located.

Engineering Controls

The following operations have, or should have, Engineering Control Equipment to eliminate or minimize employee exposure to bloodborne pathogens.

• EOHS Spill Cleanup Tongs, Brush, Dustpan
• Biology Research Involving Blood Plexiglass Shields
• Chemistry Research Involving Blood Plexiglass Shields
• Health Professions Lab Analysis of Blood Plexiglass Shields
• In addition to the engineering controls identified on the previous list, the following engineering controls are used throughout our facility:
• Handwashing facilities which are readily accessible to all employees who have the potential for exposure to bloodborne pathogens.
• Where handwashing facilities are not readily available, antiseptic towelettes are provided until the person can go to a handwashing facility.
• Containers for sharps are puncture-resistant, color-coded or labeled with the biohazard warning label, and are leak-proof on the sides and bottom.
• Containers for contaminated materials, other than sharps, are color-coded or labeled with the biohazard warning label.
• Specimen containers are leak-proof, color-coded with the biohazard warning label and are puncture-resistant, when necessary.
• Secondary containers are leak-proof, color-coded or labeled with the biohazard warning label and are puncture-resistant when necessary.
• Bloodborne Pathogen Kits, are provided in the areas where there is a potential risk of bloodborne pathogens or other infectious materials.

Work Practice Controls

In addition to engineering controls, a number of Work Practice Controls to help eliminate or minimize employee exposure to bloodborne pathogens have been implemented. The Exposure Control Officer is responsible for overseeing the implementation of Work Practice Controls. The Exposure Control Officer works closely with the department directors to assure proper and effective implementation.

The following Work Practice Controls have been adopted as part of the Bloodborne Pathogen Compliance Program:

• Employees wash their hands immediately, or as soon as feasible, after removal of potentially contaminated gloves or other personal protective equipment.
• Following any contact of body area with blood or any other infectious materials, employees wash their hands and any other exposed skin with soap and water as soon as possible. They also flush exposed mucous membranes with water.
• Contaminated needles and other contaminated sharps are not bent, recapped or removed unless the action is required by specific medical procedure. If this is necessary, recapping or needle removal is accomplished through the use of a mechanical device or a one-handed technique.
• Contaminated sharps are placed in appropriate containers immediately or as soon as possible after use.
• Eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses is prohibited in work areas where there is a potential for exposure to bloodborne pathogens.
• Food and drink is not kept in refrigerators, freezers, on countertops or in other storage areas where blood or other potentially infectious materials are present.
• Mouth pipetting/suctioning of blood or other infectious materials is strictly prohibited.
• All procedures, involving blood or other infectious materials minimize splashing, spraying or other actions generating droplets of these materials.
• Specimens of blood or other materials are placed in designated leak-proof containers, appropriately labeled, for handling and storage.
• If outside contamination of primary specimen container occurs, that container is placed within a second leak-proof container, appropriately labeled, for handling and storage. (If specimen can puncture the primary container, the secondary container must be puncture-resistant as well).
• Equipment which becomes contaminated is examined prior to servicing or shipping, and decontaminated as necessary (unless it can be demonstrated that decontamination is not feasible).
• An appropriate biohazard warning label is attached to any contaminated equipment, identifying the contaminated portions.
• Information regarding the remaining contamination is conveyed to all affected employees, the equipment manufacturer and the equipment service representative prior to handling, servicing or shipping.
• Biohazard bags containing contaminated materials will not be allowed to overflow. All contaminated material should be brought to Environmental and Occupational Health and Safety (2120 Cushwa Hall) as soon as the container becomes full.
• Sharps containers that are three fourths (3/4) full should be brought to Environmental and Occupational Health and Safety (2120 Cushwa Hall) for proper decontamination and disposal.
• If a new employee is hired, or if an existing employee changes job descriptions in which the potential for exposure to bloodborne pathogens is present, he/she will be trained by the Training Coordinator at the time of employment in the appropriate work practice controls.

Personal protective equipment is the "last line of defense" against bloodborne pathogens. YSU provides (at no cost to the employee) the Personal Protective Equipment necessary to protect employees against any exposures. This equipment includes, but is not limited to the following:  Gloves, Safety Glasses, Goggles, Face shields/masks, Bloodborne Pathogen Kits.

Exposure Control Officer working with department heads is responsible for ensuring that all departments and work areas have appropriate personal protective equipment available to employees.

Employees are trained regarding the use of the appropriate personal protective equipment for their job classifications and tasks/procedures they perform. Initial training about personal protective equipment was completed on January 10,1995. Additional training is provided, when necessary, if an employee takes a new position or new job functions are added to their current position. Any needed training is provided by their department supervisor in conjunction with the Training Coordinator.

To ensure that personal protective equipment is not contaminated and is in the appropriate condition to protect employees from potential exposure, YSU adheres to the following practices:

• All personal protective equipment is inspected prior to wearing and is repaired or replaced if necessary.
• Reusable personal protective equipment is cleaned and decontaminated as needed.
• Single-use personal protective equipment or equipment which cannot be decontaminated is disposed of by forwarding that equipment to Environmental and Occupational Health and Safety (2120 Cushwa Hall).

To assure that the personal protective equipment is used as effectively as possible, employees adhere to the following practices:

• Any garment penetrated by blood or other infectious material is removed immediately, or as soon as feasible and placed in appropriate biohazardous containers.
• Only disposable outer garments are permitted to be worn when working with blood.
• All potentially contaminated personal protective equipment is removed prior to leaving the work area.
• Gloves are worn in the following circumstances:
  • Whenever employees anticipate hand contact with potentially infectious materials.
  • When handling or touching contaminated items or surfaces.
• Disposable gloves are replaced as soon as practical after contamination or if they are torn, punctured or otherwise lose their ability to function as an "exposure barrier".
• Utility gloves are decontaminated for reuse unless they are cracked, peeling, torn or exhibit other signs of deterioration, at which time they are discarded.
• Masks and eye protection (goggles, face shields, etc.) are used whenever splashes or spray may generate droplets of infectious materials.
• Protective clothing (such as coats) is worn whenever potential exposure to the body is anticipated. These garments must be of the disposable type.

Maintaining our facility in a clean and sanitary manner is an important part of the Bloodborne Pathogen Compliance Program. Cleaning and decontamination of appropriate areas will be conducted by the person who has been using or processing the potentially infectious body fluid.

All equipment and surfaces are cleaned and decontaminated:

• After contact with blood or other potentially infectious materials.
• After the completion of medical or research procedures.
• Immediately (or as soon as feasible) when surfaces are overtly contaminated.
• After any spill of blood or infectious materials.
• At the end of the work shift or procedure.
• Protective coverings (such as plastic trash bags or wrap, aluminum foil or absorbent paper) are removed and replaced:
• As soon as it is feasible when overtly contaminated.
• At the end of the work shift if they may have been contaminated during the shift.

All biohazard containers intended for the disposal of infectious materials are inspected, cleaned and decontaminated as soon as possible if visibly contaminated.

Potentially contaminated broken glassware or sharps are picked up using mechanical means such as a dustpan and brush, tongs, forceps, etc.

Our facility is very careful in the handling of regulated waste and other potentially infectious materials. Starting on or before May 1, 1990 the following procedures are used with all of these types of waste:

Potentially infectious materials are "bagged" in containers that are:

• Closeable
• Puncture-resistant if the discarded materials have the potential to penetrate the container.
• Leak-proof if the potential for fluid spill or leakage exists.
• Red/Orange in color or labeled with the appropriate biohazard warning label.

Containers for infectious waste are placed in appropriate locations within laboratories or medical facilities that are easily accessible to employees and are as close as possible to the source of waste.

Waste containers are maintained upright, are replaced when necessary and are not allowed to overflow.

Contaminated laundry is handled as little as possible and is not sorted or rinsed where it is used. Contaminated laundry is placed immediately in the appropriate biohazard container. Wet contaminated laundry will be placed in containers which are leakproof to prevent any leakage of fluids to the exterior. Laundry which is contaminated will be decontaminated.

Whenever containers of regulated waste are moved from one area to the disposal area the containers are immediately closed and placed inside an appropriate secondary container if leakage is possible from the first container.

Protective clothing, such as disposable coats and gloves are worn whenever potential exposure to the body is anticipated.

Youngstown State University recognizes that even with strict adherence to all exposure prevention practices, exposure incidents can occur. As a result, YSU has implemented a Hepatitis B Vaccination Program, as well as set procedures for post-exposure evaluation and follow-up should exposure to bloodborne pathogens occur.

To protect our employees from the possibility of Hepatitis B infection YSU has implemented a vaccination program. This program is available, at no cost, to all employees who may have occupational exposure to bloodborne pathogens.

The vaccination program consists of a series of three inoculations over a six-month period. As part of their bloodborne pathogen training, employees have received information regarding the Hepatitis vaccination, including its safety and effectiveness.

The Exposure Control Officer is responsible for setting up the vaccination program through  YSU’s Student Health Service Clinic. Employees can schedule an appointment with the Clinic to receive all three of the inoculations.

Vaccinations are performed under the supervision of a licensed physician or other healthcare professional. Employees taking part in the vaccination program are listed on file in the Department of EOHS. Employees who have declined to take part in the program have been informed of their right to receive the vaccination at a later date if they so choose. Those who have refused the vaccination have signed a "Hepatitis B Declination Form". A listing of those that have refused the vaccination can be found on file in the Department of EOHS.

If a routine booster of Hepatitis B Vaccine is recommended by the U.S. Public Health Service at a future date, such booster dose will be made available to employees at no cost.

To ensure that all employees are aware of our vaccination program memos explaining the program were sent to all departments who have employees that may have an exposure to bloodborne pathogens. Copies of these memos can be found on file in the Department of EOHS.

If an employee is involved in an incident where exposure to bloodborne pathogens may have occurred, two things will immediately be focused on:

• Investigating the circumstances surrounding the exposure incident.
• Making sure that the employee receives medical consultation and treatment, if required, as expeditiously as possible.

The Exposure Control Officer, or his designee, investigates every exposure incident. The investigation is initiated within 24 hours of notice of the incident and involves gathering the following information:

• When the incident occurred. (Date and Time)
• Where the incident occurred. (Location)
• What potentially infectious materials were involved in the incident. (Type of material e.g. blood)
• Source of material
• Under what circumstances the incident occurred (Type of work being performed).
• How the incident was caused (accident).
• Unusual circumstances such as equipment malfunction, power outage, etc.
• Personal protective equipment being used at the time of the incident.
• Actions taken as a result of the incident (Employee decontamination, cleanup, notifications made).

After this information is gathered and evaluated, a written summary of the incident and its causes is prepared and recommendations are made for avoiding similar incidents in the future. A copy of the "Incident Investigation Form" is found at the end of this section.

In order to assure that employees receive the best and most timely treatment if an exposure to bloodborne pathogens should occur, YSU has set up a comprehensive post-exposure evaluation and follow-up process. The Exposure Control Officer will oversee this process.

Much of the information involved in the process must remain confidential, and everything will be done to protect the privacy of the people involved.

• The first step in the process will be to provide the exposed employee with the following confidential information:
  • Documentation regarding the routes of exposure and circumstances under which the exposure incident occurred.
  • Identification of the source individual, unless infeasible or prohibited by law.
• Next, if possible, we will have the source individual's blood tested to determine HBV and HIV infectivity. This information will be made available to the exposed employee, if obtained. At that time, the employee will be made aware of any applicable laws and regulations concerning disclosure of the identity and infectious status of a source individual.
• Lastly, the blood of the exposed individual will be tested for HBV and HIV status.

Once these procedures have been completed, the employee is advised to arrange for an appointment with a qualified healthcare professional to discuss the employee's medical status. This includes an evaluation of any reported medical illness, as well as any recommended treatment. The cost of this examination will be charged to the University.

To assist the healthcare professional, a number of documents are forwarded, including the following:

• A copy of the Bloodborne Pathogen Standard.
• A description of the exposure incident.
• The exposed employee's relevant medical records.
• Other pertinent information.

After consultation, the healthcare professional provides YSU with a written opinion, within fifteen days, evaluating the exposed employee's situation. We, in turn, furnish a copy of this opinion to the exposed employee.

In keeping with this process' emphasis on confidentiality, the written opinion will contain only the following information:

• Whether Hepatitis B Vaccination is indicated for the employee.
• Whether the employee has received the Hepatitis B Vaccination.
• Confirmation that the employee has been informed of the results of the evaluation.
• Confirmation that the employee has been told about any medical conditions resulting from the exposure incident which require further evaluation or treatment.

All other findings or diagnoses will remain confidential and will not be included in the written report.

To assure that as much medical information is available to the participating healthcare professional as possible, YSU maintains comprehensive medical records on our employees who have had an occupational exposure. The Exposure Control Officer is responsible for setting up and maintaining these records, which include the following information:

• Name of employee.
• Social security number of the employee.
• A copy of the employee's Hepatitis B Vaccination status.
• Dates of any vaccinations.
• Medical records relative to the employee's ability to receive vaccination.
• Copies of the results of the examinations, medical testing and follow-up procedures which took place as a result of an employee's exposure to bloodborne pathogens.
• A copy of the information provided to the consulting healthcare professional as a result of any exposure to bloodborne pathogens.

As with all information in these areas, it is recognized that it is important to keep the information in these medical records confidential. YSU will not disclose or report this information to anyone without the employee's written consent, except as required by law.

One of the most obvious warnings of possible exposure to bloodborne pathogens are biohazard labels. Because of this, YSU has implemented a comprehensive biohazard warning labeling program using labels of the type shown on the following page, or when appropriate, using red "color-coded" containers. The Exposure Control Officer is responsible for setting up and maintaining this program.

The following items in our facility are labeled with the biohazard symbol:

• Containers of regulated waste.
• Refrigerators/Freezers containing blood or other potentially infectious materials.
• Sharps disposal containers.
• Other containers used to store, transport, or ship blood and other infectious materials.
• Contaminated equipment.
• Laundry bags and containers.

On labels affixed to contaminated equipment we have also indicated which portions of the equipment are contaminated.

YSU recognizes that biohazard signs must be posted at entrances to HIV and HBV research laboratories and production facilities. Since YSU does not have these types of operations in its facility, it is not affected by these special signage requirements.

In order to minimize employee exposure to bloodborne pathogens, it is extremely important to have well informed and educated employees. Therefore, all employees who have the potential for exposure to bloodborne pathogens are required to attend a comprehensive training program. This program provides employees with as much information as possible on bloodborne pathogens.

All employees received initial training and will be required to attend annual refresher training sessions. Additionally, all new employees, as well as employees changing jobs or job functions, will be given any additional training their new position requires at the time of their new job assignment.

The Education/Training Coordinator is responsible for seeing that all employees who have potential exposure to bloodborne pathogens receive training.

The following are the topics covered in our training program:

• The Bloodborne Pathogen Standard itself
• The epidemiology and symptoms of bloodborne diseases
• The modes of transmission of bloodborne pathogens
• Our facility's Exposure Control Plan and the location of the plan
• Appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials

A review of the use and limitations of methods that will prevent or reduce exposure, including:

• Engineering controls
• Work practice controls
• Personal protective equipment
• Selection and use of personal protective equipment including:
• Types available
• Proper use
• Location within the facility
• Removal
• Handling
• Decontamination
• Disposal

Visual warning of biohazards including labels, signs and color-coded containers.

• Information on the Hepatitis B Vaccine, including its:
• Efficacy
• Safety
• Method of Administration
• Benefits of Vaccination
• Free vaccination program
• Actions to take and persons to contact in an emergency involving blood or other potentially infectious materials.
• The procedures to follow if an exposure incident occurs, including reporting.
• Information on the post-exposure evaluation and follow-up, including medical consultation.
• Training presentations will be conducted using the following training techniques:
• Classroom type atmosphere with personal instruction.
• Videotape programs.
• Training manuals/employee handouts.
• Individual training.

Time is allotted at the end of each training session for employees to have an opportunity to ask questions. Employees can also contact the Exposure Control Officer at any time if questions arise. He can be reached by contacting the department of Environmental and Occupational Health and Safety (ext. 3700) during regular business hours. After hours, he can be reached by contacting the University Police Department (ext. 3527).

To document the training process, the following information is contained in our records.

• Dates of all training sessions.
• Contents/summary of the training sessions.
• Names and qualifications of the instructors.
• Names and job titles of employees attending the training sessions.

These training records are available for examination and copying to our employees and their representatives, as well as OSHA and its representatives.