Friday, April 26, 2013

OSHA Regional News Release

Region 3 News Release: 13-635-PHI (osha 13-035)
April 18, 2013
Contact: Joanna Hawkins      Leni Fortson
Phone: 215-861-5101      215-861-5102
US Labor Department's OSHA cites Keystone Pain Institute in Altoona, Pa.,
for bloodborne pathogen hazards

ALTOONA, Pa. – The U.S. Department of Labor's Occupational Safety and Health Administration has cited Keystone Pain Institute with eight serious health violations involving bloodborne pathogen hazards at the company's Altoona facility. The February inspection by OSHA's Pittsburgh Area Office was prompted by a complaint and resulted in $46,800 in proposed penalties.

The serious violations include the company's failure to conduct a written hazard assessment; provide workers with the Hepatitis B vaccination series and training on bloodborne pathogens; provide a written cleaning schedule; utilize engineering controls for sharps (IV catheters); properly color code and construct regulated waste containers to prevent leakage; implement adequate procedures for handling of blood or other potentially infectious materials to minimize splashing; and include an exposure determination in the written exposure control plan. A serious citation is issued when there is substantial probability that death or serious physical harm could result, and the employer knew, or should have known, of the hazard.

"Employers must protect workers who are occupationally exposed to blood or other potentially infectious materials," said Christopher Robinson, director of the OSHA Pittsburgh Area Office. "All medical facilities have a duty to provide a safe and healthful workplace for their employees."

Keystone Pain Institute, one of seven clinics operated by Lighthouse Medical LLC in Altoona, has 15 business days from receipt of the citations to comply, request an informal conference with the OSHA area director in Pittsburgh or contest the citations and proposed penalties before the independent Occupational Safety and Health Review Commission.

Friday, April 19, 2013

CDC:Information for Employers Complying with OSHA's Bloodborne Pathogens Standard

The Bloodborne Pathogens Standard applies to employees who have occupational exposure (reasonably anticipated job-related contact with blood or other potentially infectious materials). The three most common bloodborne pathogens (BBPs) are human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV).

Exposure Control Plan

Identify job classifications, tasks, and procedures where there is occupational exposure.
Establish a written Exposure Control Plan and make it available to employees. Review and update it annually.

Safety Devices

Evaluate medical devices with engineered sharps injury protections (safety devices).
Use appropriate, effective, and commercially available safety devices.
Involve front‑line employees in the evaluation and selection process.
Document the evaluation and selection of safety devices annually.

Hepatitis B Vaccination

Offer free hepatitis B vaccinations to all employees with occupational exposure to blood or other potentially infectious materials (OPIM).

Other Controls

Ensure that employees comply with Universal Precautions.
Use engineering and work practice controls to eliminate or minimize employee exposure.
Provide and ensure the use of appropriate personal protective equipment, such as gloves, gowns, lab coats, face shields or masks and eye protection, and mouthpieces, resuscitation bags, pocket masks, or other ventilation devices.
Ensure that contaminated sharps are disposed of in proper sharps disposal containers.

Post-Exposure Incident Procedures

Document the route of exposure and other circumstances. Identify the source individual where feasible.
Offer post-exposure medical evaluation by a healthcare professional at no cost to employees.
Test the source individual’s blood for BBPs where possible, and test the exposed employee’s blood after consent is obtained.
Ensure the provision of post-exposure medication when medically indicated and as recommended by the Department of Health & Human Services.


Train occupationally exposed employees at initial assignment and at least annually by a knowledgeable person.
Training must include a number of elements, such as:
• An accessible copy of the BBP standard
(29 CFR 1910.1030).
• Information on the epidemiology and symptoms of bloodborne diseases.
• Information on modes of transmission of BBPs.
• Description of employer’s Exposure Control Plan and how to get a copy.
• How to recognize tasks that may involve exposure to blood or OPIM.
• Use and limitations of methods to reduce exposure, including engineering controls, work practices, and personal protective equipment.
• Information on the hepatitis B vaccine.
• What to do and whom to contact after
an exposure.
• Information on post-exposure evaluation and follow-up.
• An opportunity for interactive questions
and answers.

Thursday, April 11, 2013

Exposture to Blood: Follow-up After An Exposure

What precautions should be taken during the follow-up period?


If you are exposed to HBV and receive postexposure treatment, it is unlikely that you will become infected and pass the infection on to others. No precautions are recommended.


Because the risk of becoming infected and passing the infection on to others after an exposure to HCV is low, no precautions are recommended.


During the follow-up period, especially the first 6-12 weeks when most infected persons are expected to show signs of infection, you should follow recommendations for preventing transmission of HIV. These include not donating blood, semen, or organs and not having sexual intercourse. If you choose to have sexual intercourse, using a condom consistently and correctly may reduce the risk of HIV transmission. In addition, women should consider not breast-feeding infants during the follow-up period to prevent the possibility of exposing their infants to HIV that may be in breast milk.


Hepatitis B virus is largely preventable through vaccination. For HBV, HCV, and HIV, however, preventing occupational exposures to blood can prevent occupational infections with HBV, HCV, and HIV. This includes using appropriate barriers such as gown, gloves and eye protection as appropriate, safely handling needles and other sharp instruments, and using devices with safety features.

Thursday, April 4, 2013

Exposture to Blood: Follow-up After An Exposure

What follow-up should be done after an exposure?

Because postexposure treatment is highly effective in preventing HBV infection, CDC does not recommend routine follow-up after treatment. However, any symptoms suggesting hepatitis (e.g., yellow eyes or skin, loss of appetite, nausea, vomiting, fever, stomach or joint pain, extreme tiredness) should be reported to your healthcare provider. If you receive hepatitis B vaccine, you should be tested 1-2 months after completing the vaccine series to determine if you have responded to the vaccine and are protected against HBV infection.
You should be tested for HCV antibody and liver enzyme levels (alanine aminotransferase or ALT) as soon as possible after the exposure (baseline) and at 4-6 months after the exposure. To check for infection earlier, you can be tested for the virus (HCV RNA) 4-6 weeks after the exposure. Report any symptoms suggesting hepatitis (mentioned above) to your healthcare provider.
You should be tested for HIV antibody as soon as possible after exposure (baseline) and periodically for at least 6 months after the exposure (e.g., at 6 weeks, 12 weeks, and 6 months). If you take antiviral drugs for postexposure treatment, you should be checked for drug toxicity by having a complete blood count and kidney and liver function tests just before starting treatment and 2 weeks after starting treatment. You should report any sudden or severe flu-like illness that occurs during the follow-up period, especially if it involves fever, rash, muscle aches, tiredness, malaise, or swollen glands. Any of these may suggest HIV infection, drug reaction, or other medical conditions. You should contact the healthcare provider managing your exposure if you have any questions or problems during the follow-up period.

National Safety Compliance has also developed numerous safety training materials specifically for the Healthcare Industry.