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Escondido Union ESD |  AR  4119.42, 4219.42,4319.42  Personnel

Exposure Control Plan For Bloodborne Pathogens   

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Definitions

"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." (8 CCR 5193(b))

"Exposure Incident" means "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." Parenteral contact means "piercing mucous membranes or the skin barrier through such events as needlesticks, human bites, cuts, and abrasions." (8 CCR 5193(b))

A sharp is any object that can be reasonably anticipated to penetrate the skin or any other part of the body and to result in an exposure incident. (8 CCR 5193(b))

A sharps injury is any injury caused by a sharp, including but not limited to cuts, abrasions or needlesticks. (8 CCR 5193(b))

Work practice controls are controls that reduce the likelihood of exposure by defining the manner in which a task is performed. (8 CCR 5193(b))

Engineering controls are controls, such as sharps disposal containers, needleless systems, and sharps with engineered sharps injury protection, that isolate or remove the bloodborne pathogens hazard from the workplace. (8 CCR 5193(b))

Engineered sharps injury protection is a physical attribute built into a needle device or into a non-needle sharp, which effectively reduces the risk of an exposure incident. (8 CCR 5193(b))

Exposure Control Plan

The district's Exposure Control Plan shall contain at least the following components: (8 CCR 5193(c))

1. A determination of which employees have occupational exposure to blood or other potentially infectious materials

2. A description of the schedule and method for implementing exposure control requirements, including but not be limited to:

a. Methods of compliance required by 8 CCR 5193 (d), such as universal precautions, general and specific engineering, and work practice controls, and personal protective equipment

(cf. 4119.43/4219.43/4319.43 - Universal Precautions)

b. Hepatitis B vaccination

c. Bloodborne pathogen post-exposure evaluation and follow-up

d. Communication of hazards to employees, including labels, signs, information, and training

e. Recordkeeping

3. The district's procedure for evaluating circumstances surrounding exposure incidents.

4. An effective procedure for gathering information about each exposure incident involving a sharp, as required for the log of sharps injuries

5. An effective procedure for periodically determining the frequency of use of the types and brands of sharps involved in exposure incidents documented in the sharps injury log

6. An effective procedure for identifying currently available engineering controls and selecting such controls as appropriate for the procedures performed by employees in their work areas or departments

7. An effective procedure for documenting instances when a licensed healthcare professional directly involved in a patient's care determines, in the reasonable exercise of clinical judgment, that the use of an engineering control would jeopardize an individual's safety or the success of a medical, dental, or nursing procedure involving the individual

8. An effective procedure for obtaining the active involvement of employees in reviewing and updating the exposure control plan with respect to the procedures performed by employees in their respective work areas or departments

The Exposure Control Plan shall be reviewed and updated at least annually and whenever necessary to:

1. Reflect new or modified tasks and procedures affecting occupational exposure,

2. Reflect new or revised employee positions with occupational exposure,

3. Review and evaluate the exposure incidents which occurred since the previous update, (8 CCR 5193(c))

4. To the extent that sharps are used in the district, reflect progress in implementing the use of needleless systems and sharps with engineered sharps injury protection

The district's Exposure Control Plan shall be accessible to employees upon request. (8 CCR 3204(e))

Exposure Determination

The district's exposure determination shall be made without regard to the use of personal protective equipment and shall include:

1. All job classifications in which all employees have occupational exposure,

2. Job classifications in which some employees have occupational exposure,

3. All tasks and procedures or groups of closely related tasks and procedures in which occupational exposure occurs and which are performed by employees listed in item #2 above, (8 CCR 5193(c))

The superintendent or designee shall use engineering and work practice controls to eliminate or minimize employee exposure, and shall regularly examine and update controls to ensure their effectiveness. (8 CCR 5193(d))

Hepatitis B Vaccination

Hepatitis B vaccinations shall be provided at no cost to those employees determined to have occupational exposure to blood and other potentially infectious materials. The hepatitis B vaccination shall be made available after an employee with occupational exposure has received the required training and within 10 working days of initial assignment, unless the employee has previously received the complete hepatitis B vaccination series, or antibody testing has revealed that the employee is immune, or vaccination is contraindicated by medical reasons. Employees, who decline to accept the vaccination, shall sign the hepatitis B declination statement as required by law. (E 4119.42) (8 CCR 5193(f))

The district may exempt "designated first-aid providers" from the pre-exposure hepatitis B vaccine in accordance with 8 CCR 5195(f):

1. Rendering first aid is not the primary job responsibility of the employee and is not performed on a regular basis

2. The district's Exposure Control Plan provides that:

a. Employees report all first aid incidents involving the presence of blood or other potentially infectious materials before the end of the work shift during which the incident occurred.

b. Designated first aid providers participate in the bloodborne pathogens training program.

c. The full hepatitis B vaccination series shall be made available to unvaccinated first aid providers no later than 24 hours after they render assistance in any situation involving the presence of blood or other potentially infectious material regardless of whether an exposure incident occurred.

3. The district implements a procedure to ensure the above requirements are met. (8 CCR 5193(f))

Protective Equipment

The district shall provide appropriate personal protective equipment at no cost to the employee. The district shall maintain, repair, make accessible, and require employees to use and properly handle protective equipment. (8 CCR 5193(d))

Information and Training

The superintendent or designee shall ensure that all employees with occupational exposure participate in a training program containing the elements required by state regulations, during working hours, and at no cost to the employee. This program shall be offered at the time of initial assignment to tasks where occupational exposure may take place, at least annually thereafter, and whenever a change of tasks or procedures affects the employee's exposure. (8 CCR 5193(g))

Designated first-aid providers shall receive training that includes the specifics of reporting first aid incidents which involve blood or body fluids, which are potentially infectious. (8 CCR 5193(g))

Sharps containers maintained in classrooms must be approved through Risk Management and the coordinator of Pupil Personnel Services. These containers will be maintained under lock and key at all times. The outside drawer or cabinet where the sharps container is located must be posted with directions on how to administer and handle medical equipment (i.e., epipens) that may require disposal in a sharps container.

First Aid Incidents

Unvaccinated designated first aid providers must report any first aid incident involving the presence of blood or other potentially infectious material, regardless of whether an exposure incident occurred, by the end of the work shift. The full hepatitis B vaccination series shall be made available to such employees no later than 24 hours after the first aid incident. (8 CCR 5193(f))

Reporting Incidents

All exposure incidents shall be reported as soon as possible to the superintendent or designee.

Sharps Injury Log

The superintendent or designee shall establish and maintain a log recording each exposure incident involving a sharp. The exposure incident shall be recorded within 14 working days of the date the incident is reported to the district. (8 CCR 5193(c))

The information recorded shall include the following, if known or reasonably available: (8 CCR 5193(c))

1. Date and time of the exposure incident

2. Type and brand of sharp involved in the exposure incident

3. A description of the exposure incident, including:

a. Job classification of the exposed employee

b. Department or work area where the exposure incident occurred

c. The procedure that the exposed employee was performing at the time of the incident

d. How the incident occurred

e. The body part involved in the incident

f. If the sharp had engineered sharps injury protection, whether the protective mechanism was activated and whether the injury occurred before, during or after the protective mechanism was activated

g. If the sharp had no engineered sharps injury protection, the injured employee's opinion as to whether and how such a mechanism could have prevented the injury

h. The employee's opinion about whether any other engineering, administrative, or work practice could have prevented the injury

Post-exposure Evaluation and Follow-up

Following a report of an exposure incident, the superintendent or designee shall immediately make available to the exposed employee, at no cost, a confidential medical evaluation, post-exposure evaluation and follow-up. The superintendent or designee shall, at a minimum: (8 CCR 5193(f))

1. Document the route(s) of exposure and the circumstances under which the exposure incident occurred

2. Identify and document the source individual, unless that identification is infeasible or prohibited by law

3. Provide for the collection and testing of the employee's blood for hepatitis B, hepatitis C, and HIV serological status

4. Provide for post-exposure prophylaxis, when medically indicated, as recommended by the U.S. Public Health Service

5. Provide for counseling and evaluation of reported illnesses

The superintendent or designee shall provide the health care professional with a copy of 8 CCR 5193; a description of the employee's duties as they relate to the exposure incident; documentation of the route(s) of exposure and circumstances under which exposure occurred; results of the source individual's blood testing, if available; and all medical records maintained by the district relevant to the appropriate treatment of the employee, including vaccination status. (8 CCR 5193(f))

The district shall maintain the confidentiality of the affected employee and the exposure source during all phases of the post-exposure evaluation. (8 CCR 5193(f))

Upon an employee's initial employment and at least annually thereafter, the superintendent or designee shall inform employees with occupational exposure of the existence, location and availability of related records; the person responsible for maintaining and providing access to records; and the employee's right of access to these records. (8 CCR 3204)

(cf. 1340 - Access to District Records)

(cf. 3580 - District Records)

Medical records for each employee with occupational exposure shall be kept confidential and not disclosed or reported without the employee's written consent to any person within or outside the workplace except as required by law. (8 CCR 5193(h))

Upon request by an employee, or a designated representative with the employee's written consent, the superintendent or designee shall provide access to a record in a reasonable time, place and manner, no later than 15 days after the request is made. (8 CCR 3204(e))

Records shall be maintained as follows: (8 CCR 3204(d), 5193(h))

1. Medical records shall be maintained for the duration of employment plus 30 years,

2. Training records shall be maintained for three years from the date of training,

3. The sharps injury log shall be maintained five years from the date the exposure incident occurred,

4. Exposure records shall be maintained for at least 30 years,

5. Each analysis using medical or exposure records shall be maintained for at least 30 years,

ESCONDIDO UNION SCHOOL DISTRICT

October 23, 2003 Escondido, California