Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(b)
Definitions. For purposes of this section, the following shall apply:
"Biological Cabinet" means a device enclosed except for
necessary exhaust purposes on three sides and top and bottom, designed to draw
air inward by means of mechanical ventilation, operated with insertion of only
the hands and arms of the user, and in which virulent pathogens are used.
Biological cabinets are classified as:
(1) Class I: A ventilated cabinet for
personnel protection with an unrecirculated inward airflow away from the
operator and high-efficiency particulate air (HEPA) filtered exhaust air for
environmental protection.
(2) Class
II: A ventilated cabinet for personnel, product, and environmental protection
having an open front with inward airflow for personnel protection, HEPA
filtered laminar airflow for product protection, and HEPA filtered exhaust air
for environmental protection.
(3)
Class III: A total enclosed, ventilated cabinet of gas-tight construction.
Operations in the cabinet are conducted through attached protective gloves.
"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), hepatitis C
virus (HCV) and human immunodeficiency virus (HIV).
"Chief" means the Chief of the Division of Occupational
Safety and Health of the California Department of Industrial Relations or
designated representative.
"Clinical Laboratory" means a workplace where
diagnostic or other screening procedures are performed on blood or other
potentially infectious materials.
"Contaminated" means the presence or the reasonably
anticipated presence of blood or other potentially infectious materials on a
surface or in or on an item.
"Contaminated Laundry" means laundry which has been
soiled with blood or other potentially infectious materials or may contain
sharps.
"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. Decontamination includes procedures regulated by Health and Safety
Code Section
118275.
"Engineering Controls" means controls (e.g., sharps
disposal containers, needlelesss systems and sharps with engineered sharps
injury protection) that isolate or remove the bloodborne pathogens hazard from
the workplace.
"Engineered Sharps Injury Protection" means
either:
(1) A physical
attribute built into a needle device used for withdrawing body fluids,
accessing a vein or artery, or administering medications or other fluids, which
effectively reduces the risk of an exposure incident by a mechanism such as
barrier creation, blunting, encapsulation, withdrawal or other effective
mechanisms; or
(2) A physical
attribute built into any other type of needle device, or into a non-needle
sharp, which effectively reduces the risk of an exposure incident.
"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.
"Handwashing Facilities" means a facility providing an
adequate supply of running potable water, soap and single use towels or hot air
drying machines.
"HBV" means hepatitis B virus.
"HCV" means hepatitis C virus.
"HIV" means human immunodeficiency virus.
"Licensed Healthcare Professional" is a person whose
licensed scope of practice includes an activity which this section requires to
be performed by a licensed healthcare professional.
"Needle" or "Needle Device" means a needle of any type,
including, but not limited to, solid and hollow-bore needles.
"Needleless System" means a device that does not
utilize needles for:
(1) The
withdrawal of body fluids after initial venous or arterial access is
established;
(2) The administration
of medication or fluids; and
(3)
Any other procedure involving the potential for an exposure incident.
"NIOSH" means the Director of the National Institute
for Occupational Safety and Health, U.S. Department of Health and Human
Services, or designated representative.
"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.
"One-Hand Technique" means a procedure wherein the
needle of a reusable syringe is capped in a sterile manner during use. The
technique employed shall require the use of only the hand holding the syringe
so that the free hand is not exposed to the uncapped needle.
"OPIM" means other potentially infectious
materials.
"Other Potentially Infectious Materials"
means:
(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 other body fluid that is visibly contaminated
with blood such as saliva or vomitus, and all body fluids in situations where
it is difficult or impossible to differentiate between body fluids such as
emergency response;
(2) Any unfixed
tissue or organ (other than intact skin) from a human (living or dead);
and
(3) Any of the following, if
known or reasonably likely to contain or be infected with HIV, HBV, or HCV:
(A) Cell, tissue, or organ cultures from
humans or experimental animals;
(B)
Blood, organs, or other tissues from experimental animals; or
(C) Culture medium or other solutions.
"Parenteral Contact" means piercing mucous membranes or
the skin barrier through such events as needlesticks, human bites, cuts, and
abrasions.
"Personal Protective Equipment" is specialized clothing
or equipment worn or used 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.
"Production Facility" means a facility engaged in
industrial-scale, large-volume or high concentration production of HIV, HBV or
HCV.
"Regulated Waste" means waste that is any of the
following:
(1)
Liquid or semi-liquid blood or OPIM;
(2) Contaminated items that:
(A) Contain liquid or semi-liquid blood, or
are caked with dried blood or OPIM; and
(B) Are capable of releasing these materials
when handled or compressed.
(3) Contaminated sharps.
(4) Pathological and microbiological wastes
containing blood or OPIM.
(5)
Regulated Waste includes "medical waste" regulated by Health and Safety Code
Sections
117600
through
118360.
"Research Laboratory" means a laboratory producing or
using research-laboratory-scale amounts of HIV, HBV or HCV. Research
laboratories may produce high concentrations of HIV, HBV or HCV but not in the
volume found in production facilities.
"Sharp" means any object used or encountered in the
industries covered by subsection (a) that can be reasonably anticipated to
penetrate the skin or any other part of the body, and to result in an exposure
incident, including, but not limited to, needle devices, scalpels, lancets,
broken glass, broken capillary tubes, exposed ends of dental wires and dental
knives, drills and burs.
"Sharps Injury" means any injury caused by a sharp,
including, but not limited to, cuts, abrasions, or needlesticks.
"Sharps Injury Log" means a written or electronic
record satisfying the requirements of subsection (c)(2).
"Source Individual" means any individual, living or
dead, whose blood or OPIM may be a source of occupational exposure to the
employee. Examples include, but are not limited to, hospital and clinical
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" 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, HCV, and other bloodborne pathogens.
"Work Practice Controls" means controls that reduce the
likelihood of exposure by defining the manner in which a task is performed
(e.g., prohibiting recapping of needles by a two-handed technique and use of
patient-handling techniques).
(c) Exposure Response, Prevention and
Control.
(1) Exposure Control Plan.
(A) Each employer having an employee(s) with
occupational exposure as defined by subsection (b) of this section shall
establish, implement and maintain an effective Exposure Control Plan which is
designed to eliminate or minimize employee exposure and which is also
consistent with Section
3203.
(B) The Exposure Control Plan shall be in
writing and shall contain at least the following elements:
1. The exposure determination required by
subsection (c)(3);
2. The schedule
and method of implementation for each of the applicable subsections: (d)
Methods of Compliance, (e) HIV, HBV and HCV Research Laboratories and
Production Facilities, (f) Hepatitis B Vaccination and Post-exposure Evaluation
and Follow-up, (g) Communication of Hazards to Employees, and (h)
Recordkeeping, of this standard;
3.
The procedure for the evaluation of circumstances surrounding exposure
incidents as required by subsection (f)(3)(A).
4. An effective procedure for gathering the
information required by the Sharps Injury Log.
5. An effective procedure for periodic
determination of the frequency of use of the types and brands of sharps
involved in the exposure incidents documented on the Sharps Injury Log;
NOTE: Frequency of use may be approximated by any
reasonable and effective method.
6. An effective procedure for identifying
currently available engineering controls, and selecting such controls, where
appropriate, for the procedures performed by employees in their respective work
areas or departments;
7. An
effective procedure for documenting patient safety determinations made pursuant
to Exception 2. of subsection (d)(3)(A); and
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.
(C) Each employer shall ensure that a copy of
the Exposure Control Plan is accessible to employees in accordance with Section
3204(e).
(D) The Exposure Control Plan shall be
reviewed and updated at least annually and whenever necessary as follows:
1. To reflect new or modified tasks and
procedures which affect occupational exposure;
2.
a. To
reflect changes in technology that eliminate or reduce exposure to bloodborne
pathogens; and
b. To document
consideration and implementation of appropriate commercially available
needleless systems and needle devices and sharps with engineered sharps injury
protection;
3. To include
new or revised employee positions with occupational exposure;
4. To review and evaluate the exposure
incidents which occurred since the previous update; and
5. To review and respond to information
indicating that the Exposure Control Plan is deficient in any
area.
(E) Employees
responsible for direct patient care. In addition to complying with subsections
(c)(1)(B)6. and (c)(1)(B)8., the employer shall solicit input from
non-managerial employees responsible for direct patient care who are
potentially exposed to injuries from contaminated sharps in the identification,
evaluation, and selection of effective engineering and work practice controls,
and shall document the solicitation in the Exposure Control Plan.
(F) The Exposure Control Plan shall be made
available to the Chief or NIOSH or their respective designee upon request for
examination and copying.
(2) Sharps Injury Log.
The employer shall establish and maintain a Sharps
Injury Log, which is a record of each exposure incident involving a sharp. The
information recorded shall include the following information, if known or
reasonably available:
(A) Date and
time of the exposure incident;
(B)
Type and brand of sharp involved in the exposure incident;
(C) A description of the exposure incident
which shall include:
1. Job classification of
the exposed employee;
2. Department
or work area where the exposure incident occurred;
3. The procedure that the exposed employee
was performing at the time of the incident;
4. How the incident occurred;
5. The body part involved in the exposure
incident;
6. If the sharp had
engineered sharps injury protection, whether the protective mechanism was
activated, and whether the injury occurred before the protective mechanism was
activated, during activation of the mechanism or after activation of the
mechanism, if applicable;
7. 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;
and
8. The employee's opinion about
whether any engineering, administrative or work practice control could have
prevented the injury.
(D)
Each exposure incident shall be recorded on the Sharps Injury Log within 14
working days of the date the incident is reported to the employer.
(E) The information in the Sharps Injury Log
shall be recorded and maintained in such a manner as to protect the
confidentiality of the injured employee.
(3) Exposure Determination.
(A) Each employer who has an employee(s) with
occupational exposure as defined by subsection (b) of this section shall
prepare an exposure determination. This exposure determination shall contain
the following:
1. A list of all job
classifications in which all employees in those job classifications have
occupational exposure;
2. A list of
job classifications in which some employees have occupational exposure;
and
3. A list of all tasks and
procedures or groups of closely related task and procedures in which
occupational exposure occurs and that are performed by employees in job
classifications listed in accordance with the provisions of subsection
(c)(3)(A)2. of this standard.
(B) This exposure determination shall be made
without regard to the use of personal protective
equipment.
(d)
Methods of Compliance.
(1) General. Universal
precautions shall be observed to prevent contact with blood or OPIM. Under
circumstances in which differentiation between body fluid types is difficult or
impossible, all body fluids shall be considered potentially infectious
materials.
(2) Engineering and Work
Practice Controls--General Requirements.
(A)
Engineering and work practice controls shall be used to eliminate or minimize
employee exposure.
(B) Engineering
controls shall be examined and maintained or replaced on a regular schedule to
ensure their effectiveness.
(C)
Work practice controls shall be evaluated and updated on a regular schedule to
ensure their effectiveness.
(D) All
procedures involving blood or OPIM shall be performed in such a manner as to
minimize splashing, spraying, spattering, and generation of droplets of these
substances.
(3)
Engineering and Work Practice Controls--Specific Requirements.
(A) Needleless Systems, Needle Devices and
non-Needle Sharps.
1. Needleless Systems.
Needleless systems shall be used for:
a.
Withdrawal of body fluids after initial venous or arterial access is
established;
b. Administration of
medications or fluids; and
c. Any
other procedure involving the potential for an exposure incident for which a
needleless system is available as an alternative to the use of needle
devices.
2. Needle
Devices. If needleless systems are not used, needles with engineered sharps
injury protection shall be used for:
a.
Withdrawal of body fluids;
b.
Accessing a vein or artery;
c.
Administration of medications or fluids; and
d. Any other procedure involving the
potential for an exposure incident for which a needle device with engineered
sharps injury protection is available.
3. Non-Needle Sharps. If sharps other than
needle devices are used, these items shall include engineered sharps injury
protection.
4. Exceptions. The
following exceptions apply to the engineering controls required by subsections
(d)(3)(A)1.-3.:
a. Market Availability. The
engineering control is not required if it is not available in the
marketplace.
b. Patient Safety. The
engineering control is not required if a licensed healthcare professional
directly involved in a patient's care determines, in the reasonable exercise of
clinical judgement, that use of the engineering control will jeopardize the
patient's safety or the success of a medical, dental or nursing procedure
involving the patient. The determination shall be documented according to the
procedure required by (c)(1)(B)7.
c. Safety Performance. The engineering
control is not required if the employer can demonstrate by means of objective
product evaluation criteria that the engineering control is not more effective
in preventing exposure incidents than the alternative used by the
employer.
d. Availability of Safety
Performance Information. The engineering control is not required if the
employer can demonstrate that reasonably specific and reliable information is
not available on the safety performance of the engineering control for the
employer's procedures, and that the employer is actively determining by means
of objective product evaluation criteria whether use of the engineering control
will reduce the risk of exposure incidents occurring in the employer's
workplace.
(B)
Prohibited Practices.
1. Shearing or breaking
of contaminated needles and other contaminated sharps is prohibited.
2. Contaminated sharps shall not be bent,
recapped, or removed from devices.
EXCEPTION: Contaminated sharps may be bent, recapped or
removed from devices if:
a. The
employer can demonstrate that no alternative is feasible or that such action is
required by a specific medical or dental procedure; and
b. The procedure is performed using a
mechanical device or a one-handed technique.
3. Sharps that are contaminated with blood or
OPIM shall not be stored or processed in a manner that requires employees to
reach by hand into the containers where these sharps have been
placed.
4. Disposable sharps shall
not be reused.
5. Broken Glassware.
Broken glassware which may be contaminated shall not be picked up directly with
the hands. It shall be cleaned up using mechanical means, such as a brush and
dust pan, tongs, or forceps.
6. The
contents of sharps containers shall not be accessed unless properly reprocessed
or decontaminated.
7. Sharps
containers shall not be opened, emptied, or cleaned manually or in any other
manner which would expose employees to the risk of sharps injury.
8. Mouth pipetting/suctioning of blood or
OPIM is prohibited.
9. Eating,
drinking, smoking, applying cosmetics or lip balm, and handling contact lenses
are prohibited in work areas where there is a reasonable likelihood of
occupational exposure.
10. Food and
drink shall not be kept in refrigerators, freezers, shelves, cabinets or on
countertops or benchtops where blood or OPIM are present.
(C) Requirements for Handling Contaminated
Sharps.
1. All procedures involving the use of
sharps in connection with patient care, such as withdrawing body fluids,
accessing a vein or artery, or administering vaccines, medications or fluids,
shall be performed using effective patient-handling techniques and other
methods designed to minimize the risk of a sharps injury.
2. Immediately or as soon as possible after
use, contaminated sharps shall be placed in containers meeting the requirements
of subsection (d)(3)(D) as applicable.
3. At all time during the use of sharps,
containers for contaminated sharps shall be:
a. Easily accessible to personnel and located
as close as is feasible to the immediate area where sharps are used or can be
reasonably anticipated to be found (e.g., laundries);
b. Maintained upright throughout use, where
feasible; and
c. Replaced as
necessary to avoid overfilling.
(D) Sharps Containers for Contaminated
Sharps.
1. All sharps containers for
contaminated sharps shall be:
a.
Rigid;
b. Puncture
resistant;
c. Leakproof on the
sides and bottom;
d. Portable, if
portability is necessary to ensure easy access by the user as required by
subsection (d)(3)(C)3.a.; and
e.
Labeled in accordance with subsection (g)(1)(A)(2).
2. If discarded sharps are not to be reused,
the sharps container shall also be closeable and sealable so that when sealed,
the container is leak resistant and incapable of being reopened without great
difficulty.
(E) Regulated
Waste.
1. General.
Handling, storage, treatment and disposal of all
regulated waste shall be in accordance with Health and Safety Code Chapter 6.1,
Sections 117600 through 118360, and other applicable regulations of the United
States, the State, and political subdivisions of the State.
2. Disposal of Sharps Containers.
When any container of contaminated sharps is moved from
the area of use for the purpose of disposal, the container shall be:
a. Closed immediately prior to removal or
replacement to prevent spillage or protrusion of contents during handling,
storage, transport, or shipping; and
b. Placed in a secondary container if leakage
is possible. The second container shall be:
i.
Closable;
ii. Constructed to
contain all contents and prevent leakage dur8ing handling, storage, transport,
or shipping; and
iii. Labeled
according to subsection (g)(1)(A) of this
section.
3.
Disposal of Other Regulated Waste. Regulated waste not consisting of sharps
shall be disposed of in containers which are:
a. Closable;
b. Constructed to contain all contents and
prevent leakage during handling, storage, transport, or shipping;
c. Labeled and color-coded in accordance with
subsection (g)(1)(A) of this section; and
d. Closed prior to removal to prevent
spillage or protrusion of contents during handling, storage, transport, or
shipping.
4. Outside
Contamination. If outside contamination of a container of regulated waste
occurs, it shall be placed in a second container. The second container shall
be:
a. Closable.
b. Constructed to contain all contents and
prevent leakage of fluids during handling, storage, transport or
shipping;
c. Labeled and
color-coded in accordance with subsection (g)(1)(A) of this section;
and
d. Closed prior to removal to
prevent spillage or protrusion of contents during handling, storage, transport,
or shipping.
(F) Handling Specimens of Blood or OPIM.
Specimens of blood or OPIM shall be placed in a
container which prevents leakage during collection, handling, processing,
storage, transport, or shipping.
1.
The container for storage, transport, or shipping shall be labeled or
color-coded according to subsection (g)(1)(A), and closed prior to being
stored, transported, or shipped. When a ffacility utilizes Universal
Precautions in the handling of all specimens, the labeling/color-coding of
specimens is not necessary provided containers are recognizable as containing
specimens. This exemption only applies while such specimens/containers remain
within the facility. Labeling or color-coding in accordance with subsection
(g)(1)(A) is required when such specimens/containers leave the
facility.
2. If outside
contamination of the primary container occurs, the primary container shall be
placed within a second container which prevents leakage during collection,
handling, processing, storage, transport, or shipping and is labeled or
color-coded to the requirements of this standard.
3. If the specimen could puncture the primary
container, the primary container shall be placed within a secondary container
which is puncture-resistant in addition to the above
characteristics.
(G)
Servicing or Shipping Contaminated Equipment.
Equipment which may become contaminated with blood or
OPIM shall be examined prior to servicing or shipping and shall be
decontaminated as necessary, unless the employer can demonstrate that
decontamination of such equipment or portions of such equipment is not feasible
or will interfere with a manufacturer's ability to evaluate failure of the
device.
1. A readily observable label
in accordance with subsection (g)(1)(A)8. shall be attached to the equipment
stating which portions remain contaminated.
2. Information concerning all remaining
contamination shall be conveyed to all affected employees, the servicing
representative, and/or the manufacturer, as appropriate, prior to handling,
servicing, or shipping so that appropriate precautions will be
taken.
(H) Cleaning and
Decontamination of the Worksite.
1. General
Requirements.
a. Employers shall ensure that
the worksite is maintained in a clean and sanitary condition.
b. Employers shall determine and implement
appropriate written methods and schedules for cleaning and decontamination of
the worksite.
c. The method of
cleaning or decontamination used shall be effective and shall be appropriate
for the:
i. Location within the
facility;
ii. Type of surface or
equipment to be treated;
iii. Type
of soil or contamination present; and
iv. Tasks or procedures being performed in
the area.
d. All
equipment and environmental and work surfaces shall be cleaned and
decontaminated after contact with blood or OPIM no later than at the end of the
shift. Cleaning and decontamination of equipment and work surfaces is required
more often as specified below.
2. Specific Requirements.
a. Contaminated Work Surfaces. Contaminated
work surfaces shall be cleaned and decontaminated with an appropriate
disinfectant immediately or as soon as feasible when:
i. Surfaces become overtly
contaminated;
ii. There is a spill
of blood or OPIM;
iii. Procedures
are completed; and
iv. At the end
of the work shift if the surface may have become contaminated since the last
cleaning.
b. Receptacles.
All bins, pails, cans, and similar receptacles intended for reuse which have a
reasonable likelihood for becoming contaminated with blood or OPIM shall be
inspected and decontaminated on a regularly scheduled basis and cleaned and
decontaminated immediately or as soon as feasible upon visible
contamination.
c. Protective
Coverings. Protective coverings, such as plastic wrap, aluminum foil, or
imperviously-backed absorbent paper used to cover equipment and environmental
surfaces, shall be removed and replaced as soon as feasible when they become
overtly contaminated or at the end of the workshift if they may have become
contaminated during the shift.
(I) Hygiene.
1. Employers shall provide handwashing
facilities which are readily accessible to employees.
2. When provision of handwashing facilities
is not feasible, the employer shall provide either an appropriate antiseptic
hand cleanser in conjunction with clean cloth/paper towels or antiseptic
towelettes. When antiseptic hand cleansers or towelettes are used, hands shall
be washed with soap and running water as soon as feasible.
3. Employers shall ensure that employees wash
their hands immediately or as soon as feasible after removal of gloves or other
personal protective equipment.
4.
Employers shall ensure that employees wash hands and any other skin 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
OPIM.
(J) Laundry.
1. Contaminated laundry shall be handled as
little as possible with a minimum of agitation.
a. Contaminated laundry shall be bagged or
containerized at the location where it was used and shall not be sorted or
rinsed in the location of use.
b.
Contaminated laundry shall be placed and transported in bags or containers
labeled or color-coded in accordance with subsection (g)(1)(A) of this
standard. When a facility utilizes Universal Precautions in the handling of all
soiled laundry, alternative labeling or color-coding is sufficient if it
permits all employees to recognize the containers as requiring compliance with
Universal Precautions.
c. Whenever
contaminated laundry is wet and presents a reasonable likelihood of soaking
through or leakage from the bag or container, the laundry shall be placed and
transported in bags or containers which prevent soak-through and/or leakage of
fluids to the exterior.
2. The employer shall ensure that employees
who have contact with contaminated laundry wear protective gloves and other
appropriate personal protective equipment.
3. When a facility ships contaminated laundry
off-site to a second facility which does not utilize Universal Precautions in
the handling of all laundry, the facility generating the contaminated laundry
must place such laundry in bags or containers which are labeled or color-coded
in accordance with subsection (g)(1)(A).
(4) Personal Protective Equipment.
(A) Provision. Where occupational exposure
remains after institution of engineering and work practice controls, the
employer shall provide, at no cost to the employee, appropriate personal
protective equipment such as, but not limited to, gloves, gowns, laboratory
coats, face shields or masks and eye protection, and mouthpieces, resuscitation
bags, pocket masks, or other ventilation devices. Personal protective equipment
will be considered "appropriate" only if it does not permit blood or OPIM to
pass through to or reach the employee's work clothes, street clothes,
undergarments, skin, eyes, mouth, or other mucous membranes under normal
conditions of use and for the duration of time which the protective equipment
will be used.
NOTE: For fire fighters, these requirements are in
addition to those specified in Sections 3401-3411, and are intended to be
consistent with those requirements.
(B) Use. The employer shall ensure that the
employee uses appropriate personal protective equipment unless the employer
shows that the employee temporarily and briefly declined to use personal
protective equipment when, under rare and extraordinary circumstances, it was
the employee's professional judgment that in the specific instance its use
would have prevented the delivery of health care or public safety services or
would have posed an increased hazard to the safety of the worker or co-worker.
When the employee makes this judgment, the circumstances shall be investigated
and documented in order to determine whether changes can be instituted to
prevent such occurences in the future. The employer shall encourage employees
to report all such instances without fear of reprisal in accordance with
Section 3203.
(C) Accessibility. The employer shall ensure
that appropriate personal protective equipment in the appropriate sizes is
readily accessible at the worksite or is issued to employees. Hypoallergenic
gloves, glove liners, powderless gloves, or other similar alternatives shall be
readily accessible to those employees who are allergic to the gloves normally
provided.
(D) Cleaning, Laundering,
and Disposal. The employer shall clean, launder, and dispose of personal
protective equipment required by subsections (d) and (e) of this standard, at
no cost to the employee.
(E) Repair
and Replacement. The employer shall repair or replace personal protective
equipment as needed to maintain its effectiveness, at no cost to the
employee.
(F) Removal.
1. If a garment(s) is penetrated by blood or
OPIM, the garment(s) shall be removed immediately or as soon as
feasible.
2. All personal
protective equipment shall be removed prior to leaving the work area.
3. When personal protective equipment is
removed it shall be placed in an appropriately designated area or container for
storage, washing, decontamination or disposal.
(G) Gloves. Gloves shall be worn when it can
be reasonably anticipated that the employee may have hand contact with blood,
OPIM, mucous membranes, and non-intact skin; when performing vascular access
procedures except as specified in subsection (d)(4)(G)4.; and when handling or
touching contaminated items or surfaces. These requirements are in addition to
the provisions of Section
3384.
1. Disposable (single use) gloves such as
surgical or examination gloves, shall be replaced as soon as practical when
contaminated or as soon as feasible if they are torn, punctured, or when their
ability to function as a barrier is compromised.
2. Disposable (single use) gloves shall not
be washed or decontaminated for re-use.
3. Utility gloves may be decontaminated for
re-use if the integrity of the glove is not compromised. However, they must be
discarded if they are cracked, peeling, torn, punctured, or exhibit other signs
of deterioration or when their ability to function as a barrier is
compromised.
4. If an employer in a
volunteer blood donation center judges that routine gloving for all
phlebotomies is not necessary then the employer shall:
a. Periodically reevaluate this
policy;
b. Make gloves available to
all employees who wish to use them for phlebotomy;
c. Not discourage the use of gloves for
phlebotomy; and
d. Require that
gloves be used for phlebotomy in the following circumstances:
i. When the employee has cuts, scratches, or
other breaks in his or her skin;
ii. When the employee judges that hand
contamination with blood may occur, for example, when performing phlebotomy on
an uncooperative source individual; and
iii. When the employee is receiving training
in phlebotomy.
(H) Masks, Eye Protection, Face Shields, and
Respirators.
1. Masks in combination with eye
protection devices, such as goggles or glasses with solid side shields, or
chin-length face shields, shall be worn whenever splashes, spray, spatter, or
droplets of blood or OPIM may be generated and eye, nose, or mouth
contamination can be reasonably anticipated. These requirements are in addition
to the provisions of Section
3382.
2. Where respiratory protection is used, the
provisions of Sections
5144 and
5147 are required as applicable.
NOTE: Surgical masks are not
respirators.
(I)
Gowns, Aprons, and Other Protective Body Clothing.
1. Appropriate protective clothing such as,
but not limited to, gowns, aprons, lab coats, clinic jackets, or similar outer
garments shall be worn in occupational exposure situations. The type and
characteristics will depend upon the task and degree of exposure anticipated.
These requirements are in addition to the provisions of Section
3383.
2. Surgical caps or hoods and/or shoe covers
or boots shall be worn in instances when gross contamination can reasonably be
anticipated (e.g., autopsies, orthopaedic surgery). These requirements are in
addition to the provisions of Section
3383.
(e) HIV, HBV and HCV Research Laboratories
and Production Facilities.
(1) General.
This subsection applies in addition to the other
requirements of this section to research laboratories and production facilities
engaged in the culture, production, concentration, experimentation, and
manipulation of HIV, HBV and HCV.
EXCEPTION: This subsection does not apply to clinical
or diagnostic laboratories engaged solely in the analysis of blood, tissues, or
organs.
(2) Research
laboratories and production facilities shall meet the following criteria:
(A) Standard Microbiological Practices. All
regulated waste shall either be incinerated or decontaminated by a method such
as autoclaving known to effectively destroy bloodborne pathogens. Such methods
are further specified in Health and Safety Code Section
118215.
(B) Special Practices.
1. Laboratory doors shall be kept closed when
work involving HIV, HBV or HCV is in progress.
2. Contaminated materials that are to be
decontaminated at a site away from the work area shall be placed in a durable,
leakproof, labeled or color-coded container that is closed before being removed
from the work area.
3. Access to
the work area shall be limited to authorized persons. Written policies and
procedures shall be established whereby only persons who have been advised of
the potential biohazard, who meet any specific entry requirements, and who
comply with all entry and exit procedures shall be allowed to enter the work
areas and animal rooms.
4. When
OPIM or infected animals are present in the work area or containment module, a
hazard warning sign incorporating the universal biohazard symbol shall be
posted on all access doors. The hazard warning sign shall comply with
subsection (g)(1)(B) of this standard.
5. All activities involving OPIM shall be
conducted in biological safety cabinets or other physical-containment devices
within the containment module. No work with these OPIM shall be conducted on
the open bench.
6. Laboratory
coats, gowns, smocks, uniforms, or other appropriate protective clothing shall
be used in the work area and animal rooms. Protective clothing shall not be
worn outside of the work area and shall be decontaminated before being
laundered.
7. Special care shall be
taken to avoid skin contact with OPIM. Gloves shall be worn when handling
infected animals and when making hand contact with OPIM is
unavoidable.
8. Before disposal,
all waste from work areas and from animal rooms shall either be incinerated or
decontaminated by a method such as autoclaving known to effectively destroy
bloodborne pathogens.
9. Vacuum
lines shall be protected with liquid disinfectant traps and HEPA filters or
filters of equivalent or superior efficiency and which are checked routinely
and maintained or replaced as necessary.
10. Hypodermic needles and syringes shall be
used only for parenteral injection and aspiration of fluids from laboratory
animals and diaphragm bottles. Only needle-locking syringes or disposable
syringe-needle units (i.e., the needle is integral to the syringe) shall be
used for the injection or aspiration of OPIM. Extreme caution shall be used
when handling needles and syringes. A needle shall not be bent, sheared,
replaced in the sheath or guard, or removed from the syringe following use. The
needle and syringe shall be promptly placed in a puncture-resistant container
and autoclaved or decontaminated before reuse or disposal.
11. All spills shall be immediately contained
and cleaned up by appropriate professional staff or others properly trained and
equipped to work with potentially concentrated infectious materials.
12. A spill or accident that results in an
exposure incident shall be immediately reported to the laboratory director or
other responsible person.
13.
Written biosafety procedures shall be prepared and adopted into the Exposure
Control Plan of subsection (c)(1). Personnel shall be advised of potential
hazards, shall be required to read instructions on practices and procedures,
and shall be required to follow them.
(C) Containment Equipment.
1. Certified biological safety cabinets
(Class I, II, or III) or other appropriate combinations of personal protection
or physical containment devices, such as special protective clothing,
respirators, centrifuge safety cups, sealed centrifuge rotors, and containment
caging for animals, shall be used for all activities with OPIM that pose a
threat of exposure to droplets, splashes, spills, or aerosols.
2. Biological safety cabinets shall be
certified by the employer that they meet manufacturers' specifications when
installed, whenever they are moved and at least
annually.
(3)
HIV, HBV and HCV research laboratories shall meet the following criteria:
(A) Each laboratory shall contain a facility
for hand washing and an eye wash facility which is readily available within the
work area.
(B) An autoclave for
decontamination of regulated waste shall be available.
NOTE: Treatment of medical waste should meet the
requirements of Health and Safety Code Section
118215.
(4) HIV, HBV and HCV production facilities
shall meet the following criteria:
(A) The
work areas shall be separated from areas that are open to unrestricted traffic
flow within the building. Passage through two sets of doors shall be the basic
requirement for entry into the work area from access corridors or other
contiguous areas. Physical separation of the high-containment work area from
access corridors or other areas or activities may also be provided by a
double-doored clothes-change room (showers may be included), airlock, or other
access facility that requires passing through two sets of doors before entering
the work area.
(B) The surfaces of
doors, walls, floors and ceilings in the work area shall be water resistant so
that they can be easily cleaned. Penetrations in these surfaces shall be sealed
or capable of being sealed to facilitate decontamination.
(C) Each work area shall contain a sink for
washing hands and a readily available eye wash facility. The sink shall be
foot, elbow, or automatically operated and shall be located near the exit door
of the work area.
(D) Access doors
to the work area or containment module shall be self-closing.
(E) An autoclave for decontamination of
regulated waste shall be available within or as near as possible to the work
area.
NOTE: Treatment of medical waste should meet the
requirements of Health and Safety Code Section
118215.
(F) A ducted exhaust-air ventilation system
shall be provided. This system shall create directional airflow that draws air
into the work area through the entry area. The exhaust air shall not be
recirculated to any other area of the building, shall be discharged to the
outside, and shall be dispersed away from occupied areas and air intakes. The
proper direction of the airflow shall be verified (i.e., into the work area).
The ventilation system shall conform to the requirements of Article
107.
(5) Training
Requirements.
Training requirements for employees in HIV, HBV and HCV
research laboratories and HIV, HBV and HCV production facilities are specified
in subsection (g)(2) and they shall receive in addition the following initial
training:
(A) The employer shall
assure that employees demonstrate proficiency in standard microbiological
practices and techniques and in the practices and operations specific to the
facility before being allowed to work with HIV, HBV or HCV.
(B) The employer shall assure that employees
have prior experience in the handling of human pathogens or tissue cultures
before working with HIV, HBV or HCV.
(C) The employer shall provide a training
program to employees who have no prior experience in handling human pathogens.
Initial work activities shall not include the handling of infectious agents. A
progression of work activities shall be assigned as techniques are learned and
proficiency is developed. The employer shall assure that employees participate
in work activities involving infectious agents only after proficiency has been
demonstrated.
(f) Hepatitis B Vaccination and Bloodborne
Pathogen Post-exposure Evaluation and Follow-up.
(1) General.
(A) The employer shall make available the
hepatitis B vaccine and vaccination series to all employees who have
occupational exposure, and post-exposure evaluation and follow-up for
bloodborne pathogens exposure to all employees who have had an exposure
incident. When an employer is also acting as the evaluating health care
professional, the employer shall advise an employee following an exposure
incident that the employee may refuse to consent to post-exposure evaluation
and follow-up from the employer-healthcare professional. When consent is
refused, the employer shall make immediately available to exposed employees a
confidential medical evaluation and follow-up from a healthcare professional
other than the exposed employee's employer.
EXCEPTION: Designated first aid providers who have
occupational exposure are not required to be offered pre-exposure hepatitis B
vaccine if the following conditions exist:
1. The primary job assignment of such
designated first aid providers is not the rendering of first aid.
a. Any first aid rendered by such persons is
rendered only as a collateral duty responding solely to injuries resulting from
workplace incidents, generally at the location where the incident
occurred.
b. This exception does
not apply to designated first aid providers who render assistance on a regular
basis, for example, at a first aid station, clinic, dispensary, or other
location where injured employees routinely go for such assistance, and
emergency or public safety personnel who are expected to render first aid in
the course of their work.
2. The employer's Exposure Control Plan,
subsection (c)(1), shall specifically address the provision of hepatitis B
vaccine to all unvaccinated first aid providers who have rendered assistance in
any situation involving the presence of blood or OPIM (regardless of whether an
actual exposure incident, as defined by subsection (b), occurred) and the
provision of appropriate post-exposure evaluation, prophylaxis and follow-ups
for those employees who experience an exposure incident as defined in
subsection (b), including:
a. Provisions for a
reporting procedure that ensures that all first aid incidents involving the
presence of blood or OPIM shall be reported to the employer before the end of
work shift during which the first aid incident occurred.
i. The report must include the names of all
first aid providers who rendered assistance, regardless of whether personal
protective equipment was used and must describe the first aid incident,
including time and date.
A. The description
must include a determination of whether or not, in addition to the presence of
blood or OPIM, an exposure incident, as defined in subsection (b),
occurred.
B. This determination is
necessary in order to ensure that the proper post-exposure evaluation,
prophylaxis and follow-up procedures required by subsection (f)(3) are made
available immediately if there has been an exposure incident, as defined in
subsection (b).
ii. The
report shall be recorded on a list of such first aid incidents. It shall be
readily available to all employees and shall be provided to the Chief upon
request.
b. Provision for
the bloodborne pathogens training program, required by subsection (g)(2), for
designated first aiders to include the specifics of the reporting requirements
of subsection (f)(3) and of this exception.
c. Provision for the full hepatitis B
vaccination series to be made available as soon as possible, but in no event
later than 24 hours, to all unvaccinated first aid providers who have rendered
assistance in any situation involving the presence of blood or OPIM regardless
of whether or not a specific exposure incident, as defined by subsection (b),
has occurred.
3. The
employer must implement a procedure to ensure that all of the provisions of
subsection 2. of this exception are complied
with if pre-exposure hepatitis B vaccine is not to be offered to employees
meeting the conditions of subsection
1. of this
exception.
(B) The
employer shall ensure that all medical evaluations and procedures, including
the hepatitis B vaccine and vaccination series and post-exposure evaluation and
follow-up, including prophylaxis, are:
1. Made
available at no cost to the employee;
2. Made available to the employee at a
reasonable time and place;
3.
Performed by or under the supervision of a licensed physician or by or under
the supervision of another licensed healthcare professional; and
4. Provided according to recommendations of
the U.S. Public Health Service current at the time these evaluations and
procedures take place, except as specified by this subsection
(f).
(C) The employer
shall ensure that all laboratory tests are conducted by an accredited
laboratory at no cost to the employee.
(2) Hepatitis B Vaccination.
(A) Hepatitis B vaccination shall be made
available after the employee has received the training required in subsection
(g)(2)(G)9. and within 10 working days of initial assignment to all employees
who have occupational exposure unless the employee has previously received the
complete hepatitis B vaccination series, antibody testing has revealed that the
employee is immune, or the vaccine is contraindicated for medical
reasons.
(B) The employer shall not
make participation in a prescreening program a prerequisite for receiving
hepatitis B vaccination.
(C) If the
employee initially declines hepatitis B vaccination but at a later date while
still covered under the standard decides to accept the vaccination, the
employer shall make available hepatitis B vaccination at that time.
(D) The employer shall assure that employees
who decline to accept hepatitis B vaccination offered by the employer sign the
statement in Appendix A.
(E) If a
routine booster dose(s) of hepatitis B vaccine is recommended by the U.S.
Public Health Service at a future date, such booster dose(s) shall be made
available in accordance with section (f)(1)(B).
(3) Post-exposure Evaluation and Follow-up.
Following a report of an exposure incident, the employer shall make immediately
available to the exposed employee a confidential medical evaluation and
follow-up, including at least the following elements:
(A) The employer shall document the route(s)
of exposure, and the circumstances under which the exposure incident
occurred;
(B) The employer shall
identify and document the source individual, unless the employer can establish
that identification is infeasible or prohibited by state or local law;
1. The source individual's blood shall be
tested as soon as feasible and after consent is obtained in order to determine
HBV, HCV and HIV infectivity. If consent is not obtained, the employer shall
establish that legally required consent cannot be obtained. When the source
individual's consent is not required by law, the source individual's blood, if
available, shall be tested and the results documented.
2. When the source individual is already
known to be infected with HBV, HCV or HIV, testing for the source individual's
known HBV, HCV or HIV status need not be repeated.
3. Results of the source individual's testing
shall be made available to the exposed employee, and the employee shall be
informed of applicable laws and regulations concerning disclosure of the
identity and infectious status of the source individual.
(C) The employer shall provide for collection
and testing of the employee's blood for HBV, HCV and HIV serological status;
1. The exposed employee's blood shall be
collected as soon as feasible and tested after consent is obtained.
2. If the employee consents to baseline blood
collection, but does not give consent at that time for HIV serologic testing,
the sample shall be preserved for at least 90 days. If, within 90 days of the
exposure incident, the employee elects to have the baseline sample tested, such
testing shall be done as soon as feasible.
3. Additional collection and testing shall be
made available as recommended by the U.S. Public Health
Service.
(D) The employer
shall provide for post-exposure prophylaxis, when medically indicated, as
recommended by the U.S. Public Health Service;
(E) The employer shall provide for counseling
and evaluation of reported illnesses.
(4) Information Provided to the Healthcare
Professional.
(A) The employer shall ensure
that the healthcare professional responsible for the employee's hepatitis B
vaccination is provided a copy of this regulation.
(B) The employer shall ensure that the
healthcare professional evaluating an employee after an exposure incident is
provided the following information:
1. A copy
of this regulation;
2. A
description of the exposed employee's duties as they relate to the exposure
incident;
3. Documentation of the
route(s) of exposure and circumstances under which exposure occurred, as
required by subsection (f)(3)(A);
4. Results of the source individual's blood
testing, if available; and
5. All
medical records relevant to the appropriate treatment of the employee including
vaccination status which are the employer's responsibility to maintain, as
required by subsection (h)(1)(B)2.
(5) Healthcare Professional's Written
Opinion.
The employer shall obtain and provide the employee with
a copy of the evaluating healthcare professional's written opinion within 15
days of the completion of the evaluation.
(A) The healthcare professional's written
opinion for hepatitis B vaccination shall be limited to whether hepatitis B
vaccination is indicated for an employee, and if the employee has received such
vaccination.
(B) The healthcare
professional's written opinion for post-exposure evaluation and follow-up shall
be limited to the following information:
1.
That the employee has been informed of the results of the evaluation;
and
2. That the employee has been
told about any medical conditions resulting from exposure to blood or OPIM
which require further evaluation or treatment.
(C) All other findings or diagnoses shall
remain confidential and shall not be included in the written
report.
(6) Medical
Recordkeeping.
Medical records required by this standard shall be
maintained in accordance with subsection (h)(1) of this
section.
(g)
Communication of Hazards to Employees.
(1)
Labels and Signs.
(A) Labels.
1. Warning labels shall be affixed to
containers of regulated waste, refrigerators and freezers containing blood or
OPIM; and other containers used to store, transport or ship blood or OPIM,
except as provided in subsection (g)(1)(A)5., 6. and 7.
NOTE: Other labeling provisions, such as Health and
Safety Code Sections
118275
through
118320
may be applicable.
2. Labels
required by this section shall include either the following legend as required
by Section 3341:
Click
here to view image
Or in the case of regulated waste the legend:
BIOHAZARDOUS WASTE or SHARPS WASTE
as described in Health and Safety Code Sections
118275
through
118320.
3. These labels shall be fluorescent orange
or orange-red or predominantly so, with lettering and symbols in a contrasting
color.
4. Labels required by
subsection (g)(1)(A) shall either be an integral part of the container or shall
be affixed as close as feasible to the container by string, wire, adhesive, or
other method that prevents their loss or unintentional removal.
5. Red bags or red containers may be
substituted for labels except for sharp containers or regulated waste red bags.
Bags used to contain regulated waste shall be color-coded red and shall be
labeled in accordance with subsection (g)(1)(A)2. Labels on red bags or red
containers do not need to be color-coded in accordance with subsection
(g)(1)(A)3.
6. Containers of blood,
blood components, or blood products that are labeled as to their contents and
have been released for transfusion or other clinical use are exempted from the
labeling requirements of subsection (g).
7. Individual containers of blood or OPIM
that are placed in a labeled container during storage, transport, shipment or
disposal are exempted from the labeling requirement.
8. Labels required for contaminated equipment
shall be in accordance with this subsection and shall also state which portions
of the equipment remain contaminated.
9. Regulated waste that has been
decontaminated need not be labeled or color-coded.
(B) Signs.
1. The employer shall post signs at the
entrance to work areas specified in subsection (e), HIV, HBV and HCV Research
Laboratory and Production Facilities, which shall bear the following legend:
Click
here to view image
(Name of the Infectious Agent)
(Special requirements for entering the area)
(Name, telephone number of the laboratory director or
other responsible person.)
2. These signs shall be fluorescent
orange-red or predominantly so, with lettering and symbols in a contrasting
color, and meet the requirements of Section
3340.
(2) Information and Training.
(A) Employers shall ensure that all employees
with occupational exposure participate in a training program which must be
provided at no cost to the employee and during working hours.
(B) Training shall be provided as follows:
1. At the time of initial assignment to tasks
where occupational exposure may take place;
2. At least annually
thereafter.
(C) For
employees who have received training on bloodborne pathogens in the year
preceding the effective date of the standard, only training with respect to the
provisions of the standard which were not included need be provided.
(D) Annual training for all employees shall
be provided within one year of their previous training.
(E) Employers shall provide additional
training when changes, such as introduction of new engineering, administrative
or work practice controls, modification of tasks or procedures or institution
of new tasks or procedures, affect the employee's occupational exposure. The
additional training may be limited to addressing the new exposures
created.
(F) Material appropriate
in content and vocabulary to educational level, literacy, and language of
employees shall be used.
(G) The
training program shall contain at a minimum the following elements:
1. Copy and Explanation of Standard. An
accessible copy of the regulatory text of this standard and an explanation of
its contents;
2. Epidemiology and
Symptoms. A general explanation of the epidemiology and symptoms of bloodborne
diseases;
3. Modes of Transmission.
An explanation of the modes of transmission of bloodborne pathogens;
4. Employer's Exposure Control Plan. An
explanation of the employer's exposure control plan and the means by which the
employee can obtain a copy of the written plan;
5. Risk Identification. An explanation of the
appropriate methods for recognizing tasks and other activities that may involve
exposure to blood and OPIM;
6.
Methods of Compliance. An explanation of the use and limitations of methods
that will prevent or reduce exposure including appropriate engineering
controls, administrative or work practice controls and personal protective
equipment;
7. Decontamination and
Disposal. Information on the types, proper use, location, removal, handling,
decontamination and disposal of personal protective equipment;
8. Personal Protective Equipment. An
explanation of the basis for selection of personal protective
equipment;
9. Hepatitis B
Vaccination. Information on the hepatitis B vaccine, including information on
its efficacy, safety, method of administration, the benefits of being
vaccinated, and that the vaccine and vaccination will be offered free of
charge;
10. Emergency. Information
on the appropriate actions to take and persons to contact in an emergency
involving blood or OPIM;
11.
Exposure Incident. An explanation of the procedure to follow if an exposure
incident occurs, including the method of reporting the incident, the medical
follow-up that will be made available and the procedure for recording the
incident on the Sharps Injury Log;
12. Post-Exposure Evaluation and Follow-Up.
Information on the post-exposure evaluation and follow-up that the employer is
required to provide for the employee following an exposure incident;
13. Signs and Labels. An explanation of the
signs and labels and/or color coding required by subsection (g)(1);
and
14. Interactive Questions and
Answers. An opportunity for interactive questions and answers with the person
conducting the training session.
NOTE: Additional training is required for employees of
HIV, HBV, and HCV Research Laboratories and Production Facilities, as described
in subsection (e)(5).
(H) The person conducting the training shall
be knowledgeable in the subject matter covered by the elements contained in the
training program as it relates to the workplace that the training will
address.
(h)
Recordkeeping.
(1) Medical Records.
(A) The employer shall establish and maintain
an accurate record for each employee with occupational exposure, in accordance
with Section
3204.
(B) This record shall include:
1. The name and social security number of the
employee;
2. A copy of the
employee's hepatitis B vaccination status including the dates of all the
hepatitis B vaccinations and any medical records relative to the employee's
ability to receive vaccination as required by subsection (f)(2);
3. A copy of all results of examinations,
medical testing, and follow-up procedures as required by subsection
(f)(3);
4. The employer's copy of
the healthcare professional's written opinion as required by subsection (f)(5);
and
5. A copy of the information
provided to the healthcare professional as required by subsections (f)(4)(B)2.,
3. and 4.
(C)
Confidentiality. The employer shall ensure that employee medical records
required by subsection (h)(1) are:
1. Kept
confidential; and
2. Not disclosed
or reported without the employee's express written consent to any person within
or outside the workplace except as required by this section or as may be
required by law.
(D) The
employer shall maintain the records required by subsection (h)(1) for at least
the duration of employment plus 30 years in accordance with Section
3204.
(2) Training Records.
(A) Training records shall include the
following information:
1. The dates of the
training sessions;
2. The contents
or a summary of the training sessions;
3. The names and qualifications of persons
conducting the training; and
4. The
names and job titles of all persons attending the training
sessions.
(B) Training
records shall be maintained for 3 years from the date on which the training
occurred.
(3) Sharps
Injury Log.
The Sharps Injury Log shall be maintained 5 years from
the date the exposure incident occurred.
(4) Availability.
(A) The employer shall ensure that all
records required to be maintained by this section shall be made available upon
request to the Chief and NIOSH for examination and copying.
(B) Employee training records required by
this subsection shall be provided upon request for examination and copying to
employees, to employee representatives, to the Chief, and to NIOSH.
(C) Employee medical records required by this
subsection shall be provided upon request for examination and copying to the
subject employee, to anyone having written consent of the subject employee, to
the Chief, and to NIOSH in accordance with Section
3204.
(D) The Sharps Injury Log required by
subsection (c)(2) shall be provided upon request for examination and copying to
employees, to employee representatives, to the Chief, to the Department of
Health Services, and to NIOSH.
(5) Transfer of Records.
(A) The employer shall comply with the
requirements involving transfer of records set forth in Section
3204.
(B) If the employer ceases to do business and
there is no successor employer to receive and retain the records for the
prescribed period, the employer shall notify NIOSH, at least three months prior
to their disposal and transmit them to the NIOSH, if required by the NIOSH to
do so, within that three month period.
(i) Appendix.
Appendix A to this section is incorporated as a part of
this section and the provision is mandatory.
Appendix A. Hepatitis B Vaccine Declination
(MANDATORY)
The employer shall assure that employees who decline to
accept hepatitis B vaccination offered by the employer sign the following
statement as required by subsection (f)(2)(D):
I understand that due to my occupational exposure to
blood or OPIM I may be at risk of acquiring hepatitis B virus (HBV) infection.
I have been given the opportunity to be vaccinated with hepatitis B vaccine, at
no charge to myself. However, I decline hepatitis B vaccination at this time. I
understand that by declining this vaccine, I continue to be at risk of
acquiring hepatitis B, a serious disease. If in the future I continue to have
occupational exposure to blood or OPIM and I want to be vaccinated with
hepatitis B vaccine, I can receive the vaccination series at no charge to
me.
1. New
section filed 12-9-92; operative 1-11-93 (Register 92, No. 50).
2.
Editorial correction of printing errors in subsections (c)(1)(A) and (d)(2)(C)
(Register 93, No. 32).
3. Amendment of subsections (g)(1)(A)2. and
(g)(1)(B)2. filed 2-5-97; operative 3-7-97 (Register 97, No. 6).
4.
Amendment filed 1-22-99 as an emergency; effective 1-22-99 (Register 99, No.
4). The emergency regulation filed 1-22-99 shall remain in effect until the
nonemergency regulation becomes operative or until August 1, 1999, whichever
first occurs pursuant to Labor Code section
144.7(a).
5.
Permanent adoption of 1-22-99 amendments, including further amendments, filed
7-30-99 pursuant to Labor Code section
144.7(a);
operative 7-30-99 pursuant to Government Code section
11343.4(d)
(Register 99, No. 31).
6. Repealer of subsection (c)(1)(D)2., new
subsections (c)(1)(D)2.a.-b. and (c)(1)(E), subsection relettering, amendment
of subsection (c)(2), new subsections (c)(2)(D)-(E) and amendment of
subsections (d)(3)(B)2.Exception, (d)(3)(E)3.b., (d)(3)(H)1.b. and
(d)(3)(H)2.a. filed 8-3-2001; operative 8-3-2001. Submitted to OAL for printing
only. Exempt from OAL review pursuant to Labor Code section
142.3 (Register
2001, No. 31).
7. Change without regulatory effect providing more
legible illustrations for biohazard symbols filed 3-2-2009 pursuant to section
100, title 1, California Code of
Regulations (Register 2009, No. 10).
8. Editorial correction of
subsection (g)(2)(E) (Register 2015, No. 37).
Note: Authority cited: Sections
142.3 and
144.7, Labor
Code. Reference: Sections
142.3 and
144.7, Labor
Code; Sections
117600
through
118360,
Health and Safety Code.
