Bloodborne Pathogen Guidelines & Exposure Control Plan

Current Exposure Control Plan

Background 

The Occupational Safety and Health Administration (OSHA) regulates facilities where employees may be exposed to bloodborne pathogens (BBP). The City of Portland is committed to promoting safe work practices to minimize exposure and the incidence of disease caused by these pathogens.

The City conducts operations, which may result in employee exposure to BBP. The City is committed to ensuring that employees who are at risk of exposure are:

• identified and trained
• provided with tools and resources
• provided with appropriate medical attention if ever needed

Purpose 

The purpose of this policy is to establish framework for the City’s compliance with OSHA Rules governing BBP in the work place. This policy also provides BBP information to City bureaus and employees.

Policy Statement 

• The City takes measures to comply with the regulations and statutes that protect employees from BBP. This is achieved through:
• Identifying employees at risk of exposure by analyzing the type of work they perform;
• Making Hepatitis B vaccinations available to employees with occupational exposure;
• Training affected employees in the dangers of bloodborne, preventative measures and exposure procedures;
• Instituting engineering and administrative controls to eliminate or reduce potential exposure and conduct annual inspections;
• Provide employees with adequate tools, equipment and resources to protect themselves against exposure;
• Adoption of the City’s Exposure Control Plan.

Scope 

This policy applies to all City bureaus and employees who face a reasonably anticipated risk of exposure to BBP in the course and scope of their work.

Authority and Compliance 

• Authority is provided under:

  • City Code 3.54.020, OMF Risk Management Division Responsibilities and Authority
  • BHR Administrative Rule 2.03 ;Bloodborne Pathogen Exposure and the Workplace
  • Division 1, General Administrative Rules, Rules for the Administration of Loss Prevention Activities by Insurers/Self-Insured Employers – General, General Requirements Chapter 437-001-1020 

• In compliance with:

  • OAR 437, Division 1 General Administrative Rules, 437-001-0760 Rules for All Workplaces, (6) Extraordinary Hazards
  • 29 CFR 1910.1030 Bloodborne Pathogens
  • OAR 437-002-1030 Additional Oregon Rules for Bloodborne Pathogens
  • OAR 437-002-1035 Oregon Rule for Sharps Injury Log

Responsibilities

Bureau of Human Resources 

BHR is responsible to:

• Develop and maintain an Exposure Control Plan in compliance with OSHA Rules;
• Provide leadership, consultative services and technical expertise to City bureaus and employees;
• Staff an Occupational Health and Infectious Disease Program Manager position whose duties include:
  • Providing BBP training to City employees,
  • Providing training resource information and assisting with inter-bureau coordination of educational programs,
  • Providing Hepatitis B vaccinations, post exposure evaluation and follow up.

Bureaus

Bureaus are responsible to:

• Ensure that a copy of the City’s Exposure Control Plan is accessible to employees;
• Provide City Risk’s Occupational Health and Infectious Disease Program (OHIDP) Manager with information about any change in technology that will eliminate or reduce exposure to BBP;
• Manage City Risk’s Exposure Control Plan within their respective bureaus and comply with all duties owed to employees by an employer including, but not limited to:
  • Ensuring that employees have received training;
  • Provide employees with equipment, supplies and personal protective devices with which to prevent and protect against exposure to potentially infectious materials during work;
  • Ensure that employees use the appropriate equipment, supplies and personal protective devices when responding to an incident involving exposure to potentially infectious materials;
  • Providing hand washing facilities and supplies so that in the event of exposure, employees may sanitize exposed skin and tissues;
  • Direct employees through the appropriate process and procedure for Hepatitis B vaccinations in a timely manner;
  • Where feasible, maintain housekeeping sufficient that the work site is kept clean and sanitary;
  • Properly clean and sanitize areas contaminated with potentially infectious materials;
  • Properly collect and dispose of all waste that is contaminated with potentially infectious materials;
  • Investigate, assist and provide City Risk’s OHIDP Manager with any needed information;
  • Record an exposure incident on its 300 Log within seven days of the event and ensure confidentiality by recording the incident as a privacy case;
  • Where applicable, maintain a Sharps Injury Log; and,
  • Collect and maintain an accurate record for each employee with occupational exposure.

Note: Portland Fire & Rescue, Portland Police Bureau, and the Bureau of Environmental Services have a separate stand alone Bloodborne Pathogen Policy and Program. 

Affected Employees

Employees are responsible to:

• Identify and report potential BBP hazards.
• Wear required PPE.
• Attend BBP training as assigned.
• Apply BBP training received to the job.
• Follow established safe work practices for minimizing exposure to BBP.

References and Resources 

Related City programs and policies include the following:

• Bloodborne Pathogen Program Guideline 

OSHA resources:

     Bloodborne Pathogens and Needlestick Prevention

Attachment A - Job Classifications at Risk for Exposure

Employees subject to the OR-OSHA bloodborne pathogens standard are those who are reasonably expected to have skin, eye, mucous membrane, or parenteral contact with blood and/or any body fluids that are contaminated with blood resulting from the performance of their assigned job duties. Listed are Job classifications and associated tasks identifying employees at risk of exposure to blood or other potentially infectious materials. Exposure determinations are made without regard to use of PPE.

 Attachment B - Engineering & Work Practice Evaluation Form

Attachment C - PPE Declination Exposure Incident

Attachment D - Hepatitis B Vaccine Declination

Attachment E - Communicable Disease Guidelines

City of Portland Bloodborne Pathogen Program Communicable Disease Guidelines

 Attachment F - Exposure Incident Report Sample

Attachment G - Occupational Exposure Worksheet

Attachment H - Information Sheet for Body Fluid Exposure

You have had an exposure to someone’s blood or body fluid.  We recommend that lab tests be done to document your current (baseline) serum antibody levels for Hepatitis B, Hepatitis C and HIV. 

Risks

The likelihood of disease transmission, although small, is real.  If your “source” person is positive for HIV antibody, there is still only a 0.3% risk of transmission to you.  If the “Source” is positive for Hepatitis B antigen, disease transmission may be as high as 40%, unless you are already immune to Hepatitis B.  Disease transmission for Hepatitis C is approximately 2%-10%.  Some factors i.e., the use of gloves, shallow penetration and size of the needle/sharp, and age of the needle may decrease the exposure magnitude. 

Precautions-just in case

• Practice safer sex, use condoms
• Don’t share razors, tooth brushes or needles
• Don’t donate blood, semen or tissue until your antibody levels are negative 6 months after the exposure 

Lab Results

• You will be notified of your lab test results within a week
• If the “source” person is tested, then you will be notified of their lab results as soon as possible.  You must keep their lab results confidential 

Follow-Up

• After baseline labs, we generally repeat labs at 6 weeks, 3 months and 6 months. 

Warning Signs

• HIV Conversion Syndrome  (2 weeks to 6 months incubation) symptoms may include fever, sore throat, muscle and joint pain, enlarged lymph nodes, and rash
• Hepatitis B (45-180 day incubation) insidious onset of symptoms may include loss of appetite, abdominal pain, nausea, vomiting, joint pain, rash or jaundice (yellowing of the skin)
• Hepatitis C (2 weeks to 6 months incubation) insidious onset of symptoms may include loss of appetite, abdominal pain, nausea, vomiting, joint pain, or jaundice (yellowing of the skin)  

Attachment I - Health Care Professional’s Written Opinion for Post-Exposure Evaluation

 Attachment J - Sharps Injury Log

Attachment K - Cleaning & Decontamination Schedule

Attachment L - Blood Borne Pathogen Exposure Control Plan Template