Bloodborne Pathogen

Lead Custodian

Bloodborne Pathogen

Exposure Control Plan

Iredell-Statesville Schools

704-873-37551

Implementation

Bloodborne Pathogen Committee:

Mike James – Safety and Compliance Office 704-978-2072

Karen Kerley – Lead Nurse 704-832-2548

Linda Gillon – Director of Classified Personnel 704-924-2037

Kelly Marcy – Executive Director of Student Services 704-832-2542

Eric Gilreath – Lead Custodian 704-873-3755

Medical Facility for Post Exposure and Follow Up

Piedmont Healthcare Occupational Health

611 Sullivan Road, Statesville NC 28677 704-878-9309

Piedmont Healthcare Express Care

125 Days Inn Drive, Mooresville NC 28117 704-660-9111

Facility for Hepatitis B Vaccinations and Titers

Iredell County Health Department

318 Turnersburg Hwy, Statesville NC 28625 704-878-5300

Iredell County Health Department

610 E. Center Ave., Mooresville NC 28115 704-664-5281

TABLE OF CONTENTS

Page

Part 1 – Bloodborne Pathogens: Guidelines and Implementation Plan 3 – 4

Part 2 – Specific Application Definitions 4 – 7

Part 3 – Exposure Control Plan 7

Job Classification at Risk 7 - 8

Schedule of Implementation 9

Methods of Compliance

Universal Precautions 10

Engineering and Work Place Controls 10 - 11 Hepatitis B Vaccination/Post-Exposure Evaluation and Follow-up 11 – 13

Training and Information 14

Appendixes A – H

17 - 25

Employees

If you are exposed to body fluids, particularly blood, tell your immediate supervisor immediately.

Bloodborne Pathogens

Guidelines and Implementation Plan for Iredell Statesville Schools

PART 1

1. Introduction

The OSHA Bloodborne Pathogens Standards applies to all job classifications where there is occupational exposure to blood or body fluids containing blood.

Occupational exposure: Means 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.

NOTE: This definition does not cover “Good Samaritan” acts (i.e. voluntarily aiding someone in one’s place of employment) that result in exposure to blood or other potentially infectious materials from voluntary assisting a fellow employee, although OSHA encourages employers to offer follow-up procedures to these employees in such cases.

This bloodborne Pathogens Standard policy and guidelines will apply to all employees who fall under the “Occupational Exposure” category as defined in Part 3 of this policy. Other employees may use the Employee Exposure Determination Questionnaire (Appendix A) to help them assess their status.

The purpose of this policy is to limit occupational exposure of employees to bloodborne and other potentially infectious body fluids and materials that may transmit bloodborne pathogens and lead to disease or death.

2. Responsibilities

The agency head shall ensure that:

A. All elements of the Exposure Control Plan, including but not limited to

Exposure determination, work practice standards, Hepatitis B vaccination procedures, training requirements, and record keeping are met.

B. All employees have access to a copy of the agency’s Policy Directive

And Exposure Control Plan.

C. This policy is reviewed and updated annually.

3. Testing and Examination

An employee, who suspects that he/she has a blood or body fluid exposure may request to be tested at the school systems expense, provided the suspected exposure poses a significant risk of exposure as defined in the rules of the Health Services Commission. The source individual’s test results will be made available to the exposed employee with or without the source individual’s permission as long as significant risk of exposure has occurred (Communicable Disease Control Measure 15A NCAC19A.0202(4) adopted by the North Carolina Health Services Commission). Iredell-Statesville Schools strictly adheres to existing confidentiality rules and laws regarding employees with communicable diseases, including HIV or HIV-associated conditions.

4. Anti-Discrimination

Iredell-Statesville Schools does not discriminate against any applicant or employee who has or is suspected of having HIV infection or AIDS. An employee with HIV infection or AIDS may continue to work as long as the employee is able to satisfactorily perform the duties of the job and there is no medical evidence indication that the employee’s condition is a health threat to co-workers, students, or the public.

PART 2

1. Specific Application

This policy applies to all employees in Iredell-Statesville Schools. All occupational exposures to blood or other potentially infectious materials as defined in the definition section below are covered.

2. Definitions

For purposes of this section, the following shall apply:

BLOOD means human blood, human blood components, and products made from human blood.

BLOODBORNE PATHOGENS means 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 means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.

CONTAMINATED LAUNDRY means laundry which has been soiled with blood or other potentially infectious materials or may contain sharps.

CONTAMINATED SHARPS means any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposure ends of dental wires.

DECONTAMINATION means 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 means controls (e.g., sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needleless systems) that isolate or remove the bloodborne pathogens hazards from the workplace.

EXPOSURE INCIDENT means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that result from the performance of an employee’s duties.

HANDWASHING FACILITIES means a facility providing an adequate supply of running potable water, soap and single use towels r hot air drying machine.

LICENSED HEALTHCARE PROFESSIONAL is a person whose legally permitted scope of practice allows him or her to independently perform the

activities required by paragraph (f) Hepatitis B Vaccination and Post-exposure evaluation and Follow-up.

HBV means hepatitis B virus.

HIV means human immunodeficiency virus.

NEEDLELESS SYSTEMS means a device that does not use needles for:

(1) The collection of bodily fluids or withdrawal of body fluids after initial venous or arterial access is established; (2) the administration of medication or fluids; or (3) any other procedure involving the potential for occupational exposure to bloodborne pathogens due to percutaneous injuries from contaminated sharps.

OCCUPATIONAL EXPOSURE means 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 means (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial 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); and (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.

PARENTERAL means piercing mucous membranes or the skin through such events as needlesticks, human bites, cuts and abrasions.

PERSONAL PROTECTIVE EQUIPMENT is 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 is not considered to be personal protective equipment.

STERILIZE means the use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores.

UNIVERSAL PRECAUTIONS is an approach to infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.

WORK PRACTICE CONTROLS means 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).

3. At Risk Employees:

Employees listed in at-risk job categories are those who because of their usual duties might be exposed to blood or other potentially infectious fluids as an integral part of performing occupational tasks. Therefore, it is reasonable to anticipate that exposure may occur. These employees are required by law to receive Blood borne pathogen training within 10 working days of employment and annually if job duties remain the same. At risk employees should also receive the hepatitis B vaccine series and titer, or sign a hepatitis B declination form.

The following table outlines examples of jobs considered to have occupational exposure, the tasks causing risk, protective barriers, and engineering controls.

At risk employees could include:

School Nurses

Custodians

Athletic Trainers

Designated First Responders

Any employee who performs invasive special healthcare procedure on a daily

basis involving contact with blood or other infectious body fluids.

Collateral Positions:

These are employees that do not in their normal work routine have exposure to blood or body fluids but there is a potential for exposure when performing collateral duties. The identification of occupational exposure through collateral duties permits the employer to provide hepatitis B vaccine series to those employees on a post exposure basis.

Collateral Positions could include:

Administrators

Bus Drivers

Coaches

EpiPen Responders

Self-Contained Exceptional Children’s Teachers and Teacher Assistants

Speech Pathologist

Teachers and Teacher Assistants

“Good Samaritan” acts, such as a teacher or secretary rendering assistance to an accident victim and other exposures that cannot be anticipated, do not constitute at-risk for occupational exposure. Employees who render such assistance shall be entitled to the same post-exposure follow-up as employees who are at-risk for occupational exposure to bloodborne pathogens.

The hepatits B vaccination series shall be offered (immediately and within 24 hours of the exposure incident) to any unvaccinated employee having collateral exposure who has rendered assistance in any situation involving the presence of blood or other potentially infectious materials on a post-exposure basis. Employees who decline the hepatitis B vaccination must sign the Iredell-Statesville Schools Hepatitis B Vaccination Declination Form

Schedule for Implementing and Reviewing Exposure Control Plan

Activity / Scheduled Completion Date / Actual Completion Date
Adopt policy, review guidelines / August, 1993 / August, 1993
Assign responsibility for monitoring / August, 1993 / August, 1993
Determine which employees are at risk of occupational exposure. / September, 1993 / September, 1993
Establish what engineering control protective equipment are needed, and make appropriate purchases. / September, 1993 / September, 1993
Develop training / September, 1993 / April, 1994
Implement training / September, 1993 / April, 1994
Complete annual survey of workplace / September, 1993
June 1994-95
Complete annual review of policy / 1993 / September, 1994
Reviewed/Revised / July, 1995
Reviewed/Revised / July, 1996
Reviewed/Revised / July, 1997
Reviewed/Revised / July, 1998
Reviewed/Revised / August, 2000
Reviewed/Revised / July 25, 2001
Reviewed/Revised / July, 2003
Reviewed/Revised / July, 2005
Reviewed/Revised / July, 2006
Reviewed/Revised / July, 2008
Implement new training and revised Exposure Control Plan / May, 2010
Reviewed/Revised / Dec, 2016 / February, 2017
Reviewed/Revised / Aug, 2017 / Aug 9, 2017
Reviewed/Revised / Aug, 2018

Methods of Compliance

A. Universal Precautions

Universal Precautions as outlined by the Centers of Disease Control shall be observed to prevent contact with blood or other potentially infectious materials. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.

B. Engineering and Work Practice Controls

Engineering and work practice controls shall be used to eliminate or minimize employee exposure. Where occupational exposure remains after institution of these controls, personal protective equipment shall also be used. These engineering controls shall be effectiveness.

Hand Washing

Employers shall provide hand washing facilities which are readily accessible to employees. When provision of had washing facilities is not feasible, the employer shall provide either an appropriate antiseptic hand cleanser in conjunction with clean cloth/paper towels of antiseptic towelettes. When antiseptic hand cleansers or towelettes are used, hands shall be washed with soap and running water as soon as feasible. Employers shall ensure that employees wash hands and any other shin with soap and water, or flush mucous membranes with water immediately or as soon as feasible following contact of such body areas with blood or other potentially infectious materials.

Contaminated Needles and Other Contaminated Sharps

Contaminated needles and other contaminated sharps shall not be bent, recapped, sheared, or broken before disposal, with the following exceptions:

· The employer can demonstrate that no alternative feasible or that such action is required by a specific medical procedure; and/or

· Such recapping or needle removal must be accomplished through the use of mechanical device or a one-handed technique.

Immediately or as soon as possible after use, contaminated sharps shall be placed in appropriate containers for disposal. These containers shall be: (1) puncture resistant, (2) labeled or color-coded in accordance with this

policy, and (3) leak proof on the sides and bottom. Warning labels shall be affixed to containers of regulated waste and containers used to store,

transport or ship blood or other potentially infectious materials. Labels shall include the biohazard legend.

Work Practice Controls means controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g., diapering students unable to control bodily excretion functions, requiring that glass be picked up with tongs or dust pans and brushes).

4. Hepatitis B Vaccination/Post-Exposure Evaluation and Follow-up

A. General

Iredell-Statesville Schools shall make available the Hepatitis B vaccine and vaccination series to all employees who have occupational exposure risk and post-exposure. Iredell-Statesville Schools shall ensure that all medical evaluations and procedures including the Hepatitis B vaccine and vaccination series and post-exposure evaluation and follow-up shall be: