BLOODBORNE PATHOGEN POLICY

The Bloodborne Pathogen Policy was developed by an ad-hoc committee composed of a cross section of University professionals, as a basic guideline to aid departments and individuals in their development of protective measures and practices. The formulation of the plan was guided by the federal regulations which are available from the University Office of Environmental Health and Safety. As regulations change, periodic revisions of the plan are necessary. The 2004 edition reflects the latest regulations and guidelines.

As an initial step, each department/area supervisor should determine whether any of their employees or students are potentially exposed to bloodborne pathogens as a function of their jobs or academic assignments. Supervisors should document their assessments of the level of exposure associated with job classifications and student assignments within their jurisdiction. Supervisors shall be responsible for developing an exposure control plan (using the model presented in these guidelines) if any employees or students within their jurisdiction are at risk for exposure to bloodborne pathogens.

The Office of Environmental Health and Safety will serve as the contact to assist individuals or departments with exposure determination as well as development and implementation of the Administrative Units' Exposure Control Plans.

The University of Alabama endeavors to maintain a safe and healthy working environment for its faculty, staff, and students. In support of this goal, the University is committed to developing and implementing health and safety programs for the benefit of its employees and students.

In accordance with this commitment the University established the Ad-Hoc Bloodborne Pathogens Committee to formulate guidelines for University employees and students who work with, or who may be at risk, occupationally or academically for exposure to, bloodborne pathogens or other potentially infectious materials. These guidelines will specify procedures to provide University employees and students with education and training about bloodborne pathogens and identify procedures and precautions that will reduce the likelihood of accidental exposure to these infectious substances. The Office of Environmental Health and Safety will oversee the implementation of this policy.

"Administrative Unit" means the units identified by the vice-presidents which are responsible for conducting annual risk appraisals and implementing the Bloodborne Pathogens Policy.

"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:

"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).

"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.

"Contaminated Sharps" means any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, scissors, broken glass, broken capillary tubes and exposed 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, needleless systems and sharps with engineered sharps injury protection) that isolate or remove the bloodborne pathogens hazard from the workplace.

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 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 or hot air drying machines.

"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.

"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 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.

"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 liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi liquid state if compressed: items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling: contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials.

"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, which is a record of each exposure incident involving a sharp.

"Sterilize" means the use of a physical or chemical procedures to destroy all microbial life including highly resistance bacterial endospores.

"Student Academic Exposure" means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the student's participation in academic assignments.

"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 or 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).

1. Between October-November each year, each of the vice-presidents of the university will be responsible for conducting a risk appraisal survey within their respective divisions to identify all employees and students who are at risk for occupational or student academic exposure to bloodborne pathogens.

B. Step 2: Developing an Exposure Control Plan

Written exposure control plans shall be developed by each Administrative Unit in which there are employees or students at risk for occupational or student academic exposure. The plan should be individualized for each Administrative Unit. The model plan available from the Office of Environmental Health and Safety (or in Attachment B of this policy) may be used as a guideline in developing each individual plan.

(1) A list of all job classifications in which all employees and students in those job classifications have occupational or student academic exposure.

(2) A list of job classifications in which some employees or students have occupational or student academic exposure.

(3) A list of all tasks and procedures, or groups of closely related tasks and procedures, in which occupational or student academic exposure occurs and that are performed by employees or students in the job classifications listed in paragraph 1a(2) above.

(4) This exposure determination shall be made without regard to the use of personal protective equipment.

(5) An effective procedure for gathering the information required by the Sharps Injury Log.

(6) 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.)

(7) 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;

(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.

b. Methods of compliance with the plan including schedules for implementing or periodically maintaining the compliance procedures;

f. The procedure for the post exposure evaluation and follow-up after exposure incidents; and

2. The Exposure Control Plans should be submitted for review to the Director of the Office of Environmental Health and Safety by February 1 following the October-November risk appraisal.

3. The Plans should be reviewed annually (by February) by the supervisor in each Administrative Unit who is designated by the Vice-president as having responsibility for implementing this policy. The review will occur at the time the risk appraisal survey is administered to determine the need for revision to reflect occupational or student academic exposure to new job positions or activities.

a. To reflect new or modified tasks and procedures which affect occupational exposure;

b. If sharps are used in the employer's place of employment, to reflect progress in implementing the use of needleless systems and sharps with engineered sharps injury protection.

d. To review and evaluate the exposure incidents which occurred since the previous update;

e. To review and respond to information indicating that the Exposure Control Plan is deficient in any area.

5. At any time when a student or employee assumes responsibilities that would place them at risk for exposure, all of the exposure control procedures in the Plan shall apply.

6. A copy of the Exposure Control Plan shall be accessible in the work place to all employees and students at risk for occupational or student academic exposure.

C. Step 3: 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 exposure incident shall be recorded on the log within 14 working days of the date the incident is reported to the employer. The information recorded shall include the following information, if known or reasonably available:

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

f. 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;

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 control could have prevented the injury.

The following methods of compliance should be incorporated in the Exposure Control Plans, as appropriate, in Administrative Units where students or employees are at risk for student academic or occupational exposure to bloodborne pathogens. Universal precautions shall be observed to prevent contact with blood or potentially infectious materials (pim). Unless differentiation between body fluid types is possible, all body fluid types shall be considered potentially infectious material.

A. Engineering Controls

Engineering controls shall be used whenever possible to eliminate or minimize exposure. They shall be examined and maintained or replaced on a regular schedule to ensure their effectiveness.

1. Handwashing facilities shall be readily accessible to employees and students.

2. Contaminated sharps shall be placed in appropriate containers immediately or as soon as possible after use. The containers shall be:

d. Constructed in such a manner so it is not necessary for a person to reach into the container to retrieve sharps.

3. Specimens of blood or potentially infectious materials shall be placed in containers which prevent leakage during collection, handling, processing, storage, or transport.

a. If Universal Precautions are utilized in the handling of all specimens additional labeling or color coding is not necessary if the containers are recognizable as containing specimens and do not leave the facility.

b. If specimen containers leave the facility they must be labeled in accordance with the communication of hazards section of this policy.

c. If the primary container begins leaking or outside contamination occurs it shall be placed within a secondary container which meets all of the construction and labeling requirements.

d. Equipment which may become contaminated with blood or other potentially infectious materials shall be examined prior to servicing or shipping and decontaminated as necessary.

1. Employees or students shall wash their hands immediately after removal of gloves or other personal protective equipment, using an appropriate disinfectant soap.

2. Administrative Units shall ensure that employees/students wash immediately following contact of body areas with blood or potentially infectious material, using an appropriate disinfectant soap.

3. All personal protective equipment must be removed immediately upon leaving the work area or as soon as possible if overtly contaminated and placed in an appropriately designated area or container for storage, washing, decontamination or disposal.

4. Contaminated needles and sharps shall not be bent, recapped, sheared, broken or removed.

5. If recapping or removal is required by a specific medical procedure, documentation of this necessity must be maintained. Recapping or removal must be with the use of a mechanical device or a one-handed technique.

6. Eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses are prohibited in work areas where there is a possibility of occupational or student academic exposure.

7. Food and drink shall not be consumed or stored in areas where blood or other potentially infectious materials are present.

8. All procedures involving blood or other potentially infectious materials shall be performed in a manner that minimizes splashing, spraying, or generation of droplets.

9. Mouth pipetting or suctioning of blood or other potentially infectious materials is prohibited.

10. If conditions are such that handwashing facilities are not available, antiseptic hand cleaners are to be used. Because this is an interim measure, employees/students are to wash hands at the first available opportunity.

a. Withdrawal of body fluids after initial venous or arterial access is established.

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:

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 subsection III C.

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 judgment, 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.

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.

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.

1. Each Administrative Unit shall provide personal protective equipment such as gloves, gowns, coats, face shields, masks, eye protection, resuscitation mouthpieces, or resuscitation bags.

2. The personal protective equipment will be adequate only if it does not permit blood or potentially infectious materials to reach the employee's/student's work clothes, skin, eyes, mouth or other mucous membranes.

3. The Administrative Unit shall ensure that the employee/student uses personal protective equipment whenever appropriate.

4. 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.

5. 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.

6. Contaminated personal protective equipment shall be removed as soon as possible.

7. All personal protective equipment shall be removed prior to leaving the work area.

8. When personal protective equipment is removed it shall be placed in an appropriately designated area or container for storage, washing, decontamination or disposal.

9. Gloves shall be worn when the employee/student may have hand contact with blood, potentially infectious material or contaminated items or surfaces.

10. Gloves must be discarded as soon as their ability to function as a barrier is compromised.

12. Masks, eye protection and/or face shields shall be worn whenever splashes, spray or droplets of blood or potentially infectious materials may be generated.

13. Gowns, aprons and other protective body clothing shall be worn in exposure situations.

14. Surgical caps or hoods and boots or shoe covers shall be worn when gross contamination is anticipated.

1. Each Administrative Unit shall develop a written schedule for cleaning and methods of decontamination based upon type of surface, and the procedures being performed.

2. All equipment and surfaces shall be cleaned and decontaminated as soon as possible after contact with blood or potentially infectious material.

3. Protective coverings shall be removed and replaced as soon as possible after contamination.

4. Receptacles with a possibility of contamination shall be inspected and decontaminated on a regularly scheduled basis and decontaminated as soon as possible upon visible contamination.

6. Specimens of blood or other potentially infectious materials shall be placed into a closable, leakproof container labeled or color-coded according to the University's Medical Waste Management Plan prior to being stored or transported. If outside contamination of the primary container is likely, then a second leakproof container that is labeled or color-coded (as per the Medical Waste Management Plan) shall be placed over the first and closed to prevent leakage during handling, storage or transport. If puncture of the primary container is likely, it shall be placed within a leakproof, puncture-resistant secondary container.

7. Reusable items contaminated with blood or other potentially infectious materials shall be decontaminated prior to washing and/or reprocessing.

All infectious waste destined for disposal shall be placed in closable, leakproof containers or bags that are color-coded or labeled as described in the University of Alabama Medical Waste Management Plan.

1. If outside contamination of the container or bag is likely to occur, then a second leakproof container or bag which is closable and labeled or color-coded (as per the Medical Waste Management Plan) will be placed over the outside of the first and closed to prevent leakage during handling, storage and transport.

2. Immediately after use, sharps shall be disposed of in closable, puncture resistant, disposable containers which are leakproof on the sides and bottom and that are labeled or color-coded, per the Medical Waste Management Plan.

3. These containers will be easily accessible to personnel and located in the immediate area of use.

4. These containers will be replaced routinely and not allowed to overfill. Employees must not have to insert hands into the container in order to dispose of a sharp.

5. When moving containers of sharps from the area of use they must be closed immediately prior to removal or transport.

6. Reusable containers may not be opened, emptied or cleaned manually or in any other manner which would pose the risk of percutaneous injury.

7. Disposal of contaminated personal protective equipment will be provided at no cost to employees or students.

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);

a. Employers shall ensure that the worksite is maintained in a clean and sanitary condition.

b. Employers shall determine and implement an appropriate written schedule for cleaning and decontamination of the worksite.

c. The method of cleaning or decontamination used shall be effective and shall be appropriate for the: location within the facility; type of surface or equipment to be treated; type of soil or contamination present; and 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.

a. Contaminated Work Surfaces. Contaminated work surfaces shall be cleaned and decontaminated immediately or as soon as feasible when: surfaces become overtly contaminated; there is a spill of blood or OPIM; procedures are completed; and 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.

1. Contaminated laundry shall be bagged at the area of use and not sorted or rinsed.

2. Contaminated laundry shall be placed and transported in containers labeled according to the hazards communication section unless the facility utilizes Universal Precautions (UP) in handling all soiled laundry. Then alternative labeling is sufficient if all employees recognize the containers as requiring compliance with Universal Precautions.

4. Each Administrative Unit shall ensure that employees or students who contact contaminated laundry wear appropriate gloves and other appropriate personal protective equipment.

5. Laundering of personal protective equipment is to be provided by the Administrative Unit at no cost to employees or students.

6. If laundry is shipped offsite to a second facility which does not utilize Universal Precautions in its handling of all laundry, bags or containers with appropriate labeling and/or color-coding will be used to communicate the hazards associated with this material.

a. The University Medical Center (UMC) shall make available the hepatitis B vaccine and vaccination series to all employees who are at risk for occupational exposure. University Medical Center will provide post exposure evaluation and follow up to all employees who have an exposure incident.

c. Laboratory tests shall be conducted by an appropriate accrediting agency, approved by the UMC Chief Medical Officer, at no cost to the employee.

d. The hepatitis B vaccination shall be made available to an employee who has occupational exposure, within 10 workdays of initial assignment. Exceptions are:

(1) The employee has previously received the complete hepatitis B vaccination series and submits acceptable proof thereof;

(4) The employee signs a statement (Attachment D) declining the vaccination series.

e. The University Medical Center shall not make participation in a pre-screening program a prerequisite for receiving the vaccination.

f. Employees who accept the vaccination will receive information about the vaccine from the University Medical Center and sign a consent form (see Attachment C). A copy of the consent form will be maintained in the University Medical Center files.

g. Employees who decline the hepatitis B vaccination shall sign the prescribed statement shown in Attachment D. This signed statement shall be placed in the departmental file.

h. If an employee initially declines the vaccination but at a later time (while still covered by this policy) desires to accept it, it shall be made available after signing the appropriate consent form (Attachment C).

i. Documentation of the employee's hepatitis B vaccination status (Attachment E) will be maintained in the University Medical Center.

a. Students who are at risk for student academic exposure to bloodborne pathogens will be required to submit proof of immunity to Hepatitis B (either by vaccination or previous exposure) to their supervisor, or sign a statement (Attachment D) indicating that they understand their risks of exposure but have declined vaccination. If a student is under the age of 19, parental signature on the declination form will be required.

b. Documentation of the vaccination status for a student at risk for exposure (Attachment E) and, if applicable, the signed statement declining vaccination (Attachment D), may be placed in the student's Health Center records. A copy of this documentation shall be provided to the student to be submitted to the faculty member responsible for the academic activity associated with a risk for exposure.

Should an employee be exposed to a potentially infectious material (via needle stick, splash, etc.) post-exposure evaluations will be provided as described herein.

a. Following a report of an exposure incident, the University Medical Center will provide a confidential medical evaluation and follow-up including:

(1) Documentation of the route(s) of exposure, HBV and HIV antibody status of the source patient(s) (if known), and the circumstances under which the exposure occurred.

(2) If the source patient can be determined and permission is obtained, collection and testing of the source patient's blood to determine the presence of HIV or HBV infection.

(3) Collection of blood from the exposed employee as soon as possible after the exposure incident for determination of HIV/HBV status. Actual antibody or antigen testing of the blood or serum sample may be done at that time or at a later date, if the employee so requests. Samples will be preserved for at least 90 days, but not more than 120 days, unless a longer period is requested by the employee.

(4) Follow-up of the exposed employee including antibody or antigen testing, counseling, illness reporting, and safe and effective post-exposure prophylaxis, according to standard recommendations for medical practices.

(1) A description of the affected employee's duties as they relate to the employee's occupational exposure.

(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.

(5) All employee medical records, including vaccination records, relevant to the treatment of the employee.

c. The attending physician will provide a written opinion to this employer concerning the following:

(1) The physician's recommended limitations upon the employee's ability to receive the Hepatitis B vaccination.

(2) A statement that the employee has been informed of the results of the medical evaluation and that the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment.

(3) All other findings and diagnoses shall remain confidential and shall not be included in the written report.

d. For each evaluation under this section, University Medical Center will obtain and provide the employee with a copy of the attending physician's written opinion within 15 days of the completion of the evaluation.

Should a student be exposed to a potentially infectious material (via needle stick, splash, etc.) post-exposure evaluations will be provided as described herein.

a. Following a report of an exposure incident, the University Russell Student Health Center will provide a confidential medical evaluation and follow-up including:

b. The attending physician at the University Russell Student Health Center will be provided the following information:

c. The attending physician will provide a written opinion to the appropriate academic unit concerning the following:

M. Communication of Hazards

b. Containers of blood, blood products or components released for transfusion or other clinical use; and

c. Individual containers of blood or potentially infectious material that are in a labeled container during storage, transport, shipment or disposal.

a. At the time of initial assignment to tasks where occupational exposure may take place.

a. Copy and Explanation of Standard. An accessible copy of the regulatory text of this standard and an explanation of its contents;

b. Epidemiology and Symptoms. A general explanation of the epidemiology and symptoms of bloodborne diseases;

c. Modes of Transmission. An explanation of the modes of transmission of bloodborne pathogens;

d. Employer's Exposure Control Plans. An explanation of the employer's exposure control plan and the means by which the employee can obtain a copy of the written plan;

e. Risk Identification. An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and OPIM;

f. Method 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;

g. Decontamination and Disposal. Information on the types, proper use, location, removal, handling, decontamination and disposal of personal protective equipment;

h. Personal Protective Equipment. An explanation of the basis for selection of personal protective equipment;

i. 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;

j. Emergency. Information on the appropriate actions to take and persons to contact in an emergency involving blood or OPIM;

k. 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

l. 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;

m. Signs and Labels. An explanation of the signs and labels and/or color coding required by subsection (g)(1); and

n. Interactive Questions and Answers. An opportunity for interactive questions and answers with the person conducting the training session.

b. Medical records shall be maintained in confidentiality for duration of employment or enrollment plus thirty years. These records are not disclosed or reported without the employee's or student's written consent to any person within or outside the workplace except as may be permitted or required by law.

(To be completed annually by each Administrative Unit within the University. Completed surveys should be returned by October 1 to the Office of Environmental Health and Safety.)

Name and Phone Number of Supervisor Completing This Form: __________________________________

The purpose of this survey is to identify job classifications and courses in which employees or students within your Administrative Unit are at risk for occupational or student academic exposure to bloodborne pathogens. In addition, this survey will be used to identify specific employees or students within your Administrative Unit who are at risk for occupational or student academic exposure to bloodborne pathogens.

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 any employee's duties whether on or off campus.

Student Academic Exposure means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the student's participation in academic assignments or activities.

A. 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 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.

B. Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and

C. 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.

Please list the job classifications in your Administrative Unit where all employees will have reasonably anticipated exposure to human blood or other potentially infectious materials:

Please list the job classifications and work activities in your Administrative Unit in which some of the employees will have reasonably anticipated exposure to human blood and other potentially infectious materials:

Please list the names of all employees in your Administrative Unit who are at risk for occupational exposure to bloodborne pathogens.

Please list the name, number, and responsible faculty member for each course or describe each university-sponsored activity in your Administrative Unit where there may be student academic exposure to bloodborne pathogens.

Please return this form by October 30 to the University Office of Environmental Health and Safety, Box 870178, 15 Research Drive. Please call Hal Barrett at the Office of Environmental Health and Safety if you need assistance with completing this form (348-5905).

1. Non-needle sharps and needle devices used for withdrawing body fluids, accessing a vein or artery, or administering medications or other fluids must have a built in safety feature that effectively reduces the risk of an exposure incident (i.e. needle stick).

2. A committee must be established, which includes non-managerial employees responsible for direct patient care who are potentially exposed to injuries from contaminated sharps.

3. This committee is to identify, evaluate and select needle and non-needle sharps with built in safety devices.

4. This committee may select different devices for different job tasks. However, the employer (UA) is not required to provide different devices for each area with similar job tasks.

5. If an employee is physically unable to use the selected device, the employer must provide a device that can be used.

7. Interactive, hands on training shall be provided for employees who will use the selected devices. Training shall be documented.

Complete a Log record for each exposure incident involving a sharp. The exposure incident shall be recorded on the log within 14 working days of the date the incident is reported.

Institution:___________________________________ Building: ______________________

Address: ____________________________________ Date filled out: _________________

Date of injury: _____________Time of injury: _______ Department ___________________

Procedure being performed at the time of incident: ___________________________________________________________________________

How the incident occurred: ___________________________________________________________________________

The body part involved in the exposure incident: ____________________________________

FOR ACADEMIC UNITS WITHIN

(To be completed by each Administrative Unit with students or employees at risk for academic or occupational exposure to bloodborne pathogens. Completed plans should be submitted to the Office of Environmental Health and Safety.)

(This is intended to be used only as a guideline in completing each individual exposure control plan)

In the interest of preventing accidental exposure to bloodborne pathogens and other infectious materials, The University of Alabama has established a policy of employee and student protection and workplace safety. This Exposure Control Plan has been prepared in accordance with The University of Alabama Bloodborne Pathogens Policy. This Plan will be the focus of annual personnel development training and new employee orientation for all affected employees.

Employees and students are urged to study all provisions of the Plan very carefully. All questions or comments should be directed to The Office of Environmental Health and Safety (348-5905). We encourage your input and involvement in this program so that we can continue to make our workplace a safe and healthful environment for everyone. The Plan will be subject to review and revision, as needed. Annual review of the Plan will be scheduled for each October.

In this Plan, all references to "occupational exposure" will mean reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of any employee's duties whether on or off campus.

For more definitions, consult the University of Alabama Policy on Bloodborne Pathogens.

Attach a copy of the Risk Appraisal Survey completed annually by your Administrative Unit.

In all circumstances, Universal Precautions, as recommended or defined by the Centers for Disease Control (CDC), will be observed in order to prevent contact with blood and other potentially infectious materials, unless they interfere with the proper delivery of healthcare or would create a significant risk to the personal safety of the worker or student.

Wherever possible, engineering controls will be utilized to reduce potential exposure. Listed below are all controls in this Administrative Unit:

_______________________________________ will be responsible for inspection and maintenance of these controls. Records will be maintained for frequency of inspection and repairs.

1. Employees/students shall wash their hands immediately or as soon as possible after removal of gloves or other personal protective equipment and after hand contact with blood or other potentially infectious materials.

2. All personal protective equipment must be removed immediately upon leaving the work area or as soon as possible if overtly contaminated and placed in an appropriately designated area or container for storage, washing, decontamination or disposal.

3. Non-needle sharps and needle devices used for withdrawing body fluids, accessing a vein or artery, or administering medications or other fluids must have a built in safety feature that effectively reduces the risk of an exposure incident (i.e. needle stick).

4. Used needles an other sharps may not be sheared, bent, broken, recapped or resheathed by hand. Used needles may not be removed from disposable syringes. Recapping is permitted only if no other alternative is feasible and must be done using an approved mechanical device or one-handed technique.

5. Eating, drinking, smoking, applying cosmetics or lip balm and handling contact lenses are prohibited in work areas were there is a potential for occupational exposure.

6. Food and drink shall not be stored in refrigerators, freezers, or cabinets where blood or other potentially infectious materials are stored or in areas of possible contamination.

7. All procedures involving blood or other potentially infectious materials will be done in a manner which minimizes splashing, spraying, and aerosolization of these substances.

9. If conditions are such that handwashing facilities are not available, antiseptic hand cleaners are to be used. Because this is an interim measure, employees/students are to wash hands at the first available opportunity.

______________________________________________________________________________________________________________________________________________________

Where there is potential for occupational or student academic exposure, employees/students will be provided and required to use personal protective equipment including, but not limited to, gloves, aprons, gowns, lab coats, head and foot coverings, eye protectors (i.e., goggles, glasses with side shields, face shields). This equipment will be provided at no cost to employees. When necessary, hypoallergenic, powderless or other alternative gloving will be provided to employees/students who are allergic to types normally provided.

Supplies may be obtained at the following locations: ________________________________________________________________________

Single use gloves (disposable gloves may not be decontaminated or washed for re-use.

Prior to leaving the work area, personal protective equipment (including lab coats) must be removed and properly disposed of or placed into designated storage or laundry areas. Employees are not permitted to carry any type of personal protective equipment home for cleaning or other use. Employees and students should adhere to the designated work practice policies related to use of personal protective equipment.

Personal protective equipment will be considered "appropriate" only if it does not permit blood or other potentially infectious materials to pass through or contact the employees' or students' clothing, skin, mouth or mucous membranes.

Listed below are types of personal protective equipment available for employees' and students' use and circumstances under which it must be used. (Refer to III, Section E [Personal Protective Equipment] of the Bloodborne Pathogens Policy as guidelines to identify specific procedures in your Administrative Unit that require the use of Personal Protective Equipment.)

Decontamination of personal protective equipment will be performed in the following manner:

1. Work surfaces shall be decontaminated with an appropriate disinfectant after completion of a procedure; when surfaces are overtly contaminated; immediately after any spill of blood or other potentially infectious materials; and at the end of the work shift.

2. Protective coverings such as plastic wrap, aluminum foil, or imperviously-backed absorbent paper may be used to cover equipment and environmental surfaces. These coverings shall be removed and replaced as necessary (i.e., upon contamination, at the end of the workday).

3. Receptacles with a possibility of contamination shall be inspected and decontaminated on a regularly scheduled basis and decontaminated as soon as possible after visible contamination.

5. Equipment which may become contaminated with blood or other potentially infectious materials will be checked routinely and prior to servicing or shipping and shall be decontaminated as necessary.

6. All bins, pails, cans, and similar receptacles intended for reuse which have a potential for becoming contaminated with blood or other potentially infectious materials shall be inspected, cleaned and disinfected immediately or as soon as possible upon visible contamination. A regular cleaning schedule will be established and addressed elsewhere in this program.

7. 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 dustpan, tongs, or forceps.

8. Specimens of blood or other potentially infectious materials shall be placed into a closable, leakproof container labeled or color-coded according to the University's Medical Waste Management Plan prior to being stored or transported. If outside contamination of the primary container is likely, then a second leakproof container that is labeled or color-coded (as per the Medical Waste Management Plan) shall be placed over the first and closed to prevent leakage during handling, storage or transport. If puncture of the primary container is likely, it shall be placed within a leakproof, puncture-resistant secondary container.

9. Reusable items contaminated with blood or other potentially infectious materials shall be decontaminated prior to washing and/or reprocessing.

10. It is the responsibility of _________________________________ to assure that the worksite is maintained in a clean and sanitary condition. Facilities will be cleaned and disinfected with an appropriate agent according to the following schedule:

1. All infectious waste destined for disposal shall be placed in closable, leakproof containers or bags that are color-coded or labeled as herein described. It shall be the responsibility of _____________________ to assure that waste is properly disposed and the following rules are observed.

2. If outside contamination of the container or bag is likely to occur, then a second leakproof container or bag which is closable and labeled or color-coded (as per the Medical Waste Management Plan) will be placed over the outside of the first and closed to prevent leakage during handling, storage and transport.

3. Immediately after use, sharps shall be disposed of in closable, puncture resistant, disposable containers which are leakproof on the sides and bottom and that are labeled or color-coded, per the Medical Waste Management Plan.

4. These containers will be easily accessible to personnel and located in the immediate area of use.

5. These containers will be replaced routinely and not allowed to overfill. Employees must not have to insert hands into the container in order to dispose of a sharp.

6. When moving containers of sharps from the area of use they must be closed immediately prior to removal or transport.

7. Reusable containers may not be opened, emptied or cleaned manually or in any other manner which would pose the risk of percutaneous injury.

8. Disposal of contaminated personal protective equipment will be provided at no cost to employees.

9. In accordance with other applicable Federal, State and local regulations concerning medical waste, the following disposal procedures will be observed:

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

1. Laundry which has been contaminated with blood or other potentially infectious materials or may contain contaminated sharps will be handled as little as possible and with a minimum of agitation.

2. Contaminated laundry must be bagged at the location where it was used and shall not be sorted or rinsed in patient care areas.

3. Contaminated laundry shall be placed and transported in bags that are labeled or color-coded as herein described. Whenever this laundry is wet and present the potential for soaking or leaking through the bag, it will be placed and transported in leakproof bags.

4. Employees/students responsible for handling potentially contaminated laundry are required to wear protective gloves and other appropriate personal protective equipment to prevent occupational exposure during handling of sorting.

5. Laundering of personal protective equipment is to be provided by the Administrative Unit at no cost to employees.

6. If laundry is shipped off site to a second facility which does not utilize Universal Precautions in its handling of all laundry, bags or containers with appropriate labeling and/or color-coding will be used to communicate the hazards associated with this material.

7. Persons responsible for ensuring the proper handling, storage, shipping or cleaning of contaminated laundry are: ______________________________________.

8. Additional requirements pertaining to the handling of laundry are as follows:

a. The University Medical Center shall make available the hepatitis B vaccine and vaccination series to all employees who are at risk for occupational exposure. The University Medical Center will also provide post exposure evaluation and follow-up to all students who have an exposure incident. University Medical Center will provide post exposure evaluation and follow-up to all employees who have an exposure incident.

c. Laboratory tests shall be conducted by an appropriate accrediting agency, approved by the Chief Medical Officer, at no cost to the employee.

d. The hepatitis B vaccination shall be made available to an employee who has occupational exposure, within 10 workdays of initial assignment. Exceptions are:

(1) The employee has previously received the complete hepatitis B vaccination series and submits acceptable proof thereby;

(4) The employee signs a statement (Attachment D) declining the vaccination series.

e. Participation in a pre-screening program must not be a prerequisite for receiving the vaccination.

g. Employees who decline the hepatitis B vaccination shall sign the prescribed statement shown in Attachment D. This signed statement shall be placed in the employee's departmental file.

i. Documentation of the employee's hepatitis B vaccination status (Attachment E) will be maintained in the University Medical Center.

b. Documentation of the vaccination status for students at risk for exposure (Attachment E) and, if applicable, the signed statement declining vaccination (Attachment D), shall be placed in the Student's Health Center records. A copy of this documentation shall be provided to the student to be submitted to the faculty member responsible for the academic activity associated with a risk for exposure.

Should an employee be exposed to a potentially infectious material (via needle stick, splash, etc.) post-exposure evaluations will be provided as described herein.

a. Following a report of an exposure incident, the employee will be provided a confidential medical evaluation and follow-up including:

(1) Documentation of the route(s) of exposure, HBV and HIV antibody status of the source patient(s) (if known), and the circumstances under which the exposure occurred.

(2) If the source patient can be determined and permission is obtained, collection and testing of the source patient's blood to determine the presence of HIV or HBV infection.

(1) A description of the affected employee's duties as they relate to the employee's occupational exposure;

(3) All employee medical records, including vaccination records, relevant to the treatment of the employee.

c. The attending physician will provide a written opinion to this employer concerning the following:

(1) The physician's recommended limitations upon the employee's ability to receive the Hepatitis B vaccination.

(3) All other findings and diagnoses shall remain confidential and shall not be included in the written report.

D. For each evaluation under this section, University Medical Center will obtain and provide the employee with a copy of the attending physician's written opinion within 15 days of the completion of the evaluation.

Should a student be exposed to a potentially infectious material (via needle stick, splash, etc.) post-exposure evaluations will be provided as described herein.

A. Following a report of an exposure incident, the student will be provided a confidential medical evaluation and follow-up including:

(1) Documentation of the route(s) of exposure, HBV and HIV antibody status of the source patient(s) (if known), and the circumstances under which the exposure occurred.

(2) If the source patient can be determined and permission is obtained, collection and testing of the source patient's blood to determine the presence of HIV or HBV infection.

(3) Collection of blood from the exposed student as soon as possible after the exposure incident for determination of HIV/HBV status. Actual antibody or antigen testing of the blood or serum sample may be done at that time or at a later date, if the employee so requests. Samples will be preserved for at least 90 days.

(4) Follow-up of the exposed student including antibody or antigen testing, counseling, illness reporting, and safe and effective post-exposure prophylaxis, according to standard recommendations for medical practices.

(1) A description of the affected student's duties as they relate to the student's academic exposure;

(3) All student medical records, including vaccination records, relevant to the treatment of the student.

c. The attending physician will provide a written opinion to the appropriate academic unit concerning the following:

(1) The physician's recommended limitations upon the student's ability to receive the Hepatitis B vaccination.

(2) A statement that the student has been informed of the results of the medical evaluation and that the student has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment.

(3) All other findings and diagnoses shall remain confidential and shall not be included in the written report.

D. For each evaluation under this section, the University Medical Center will obtain and provide the student with a copy of the attending physician's written opinion within 15 days of the completion of the evaluation.

Signs will bear the International Biohazard Symbol in a florescent orange-red color.

a. Warning labels shall be affixed to containers of infectious waste; refrigerators and freezers containing blood and other potentially infectious materials; and other containers used to store or transport blood or other potentially infectious materials except as provided below.

b. Labels will bear the International Biohazard Symbol including BIOHAZARD written under the symbol. They will be fluorescent orange or orange-red or predominantly so, with lettering or symbols in a contrasting color.

c. All labels will be an integral part of the container or will be affixed as close as safely possible to the container by string, wire, adhesive or any other method that prevents their loss or unintentional removal.

d. Red bags or red containers may be substituted for labels on containers of infectious waste.

e. The person responsible for ensuring that containers of biohazardous waste are properly labeled is

*Inquiries concerning the availability of labels should be made to The Office of Environmental Health and Safety.

1. All workers/students with occupational or student academic exposure are required to participate in Exposure Control training prior to their initial assignment and at least annually thereafter. This training will be free of charge to employees and students and scheduled during working hours.

2. Refusal or failure to attend a required training session will result in the following disciplinary actions:

____________________________________________________________________________________

3. The person(s) responsible for providing this training and coordinating the program for employees is a representative from the University Office of Environmental Health and Safety. The person(s) responsible for coordinating the training for students is the coordinator of the Bloodborne Pathogen policy in the division where the risk for academic exposure occurs.

4. At the end of each training session, employees and students will acknowledge their participation in the program by signing a form provided by the University, an example of which may be found in Attachment F of the University Bloodborne Pathogens Policy. This form should be provided to the student and employee to be filed in the personnel file or student record.

5. Employees/students will receive training and information in the following areas:

a. A copy of the University Policy on Bloodborne Pathogens and an explanation of its contents;

b. A general explanation of the epidemiology and symptoms of bloodborne diseases;

e. An explanation of the appropriate methods for recognizing tasks and procedures that may involve exposure to blood or other potentially infectious materials;

f. An explanation of the use and limitations of practices that will prevent or reduce exposure, including appropriate engineering controls, work practices, and personal protective equipment;

g. Information on personal protective equipment which will address types available, proper use, location, removal, handling, decontamination and/or disposal;

i. Information on the Hepatitis B vaccine, including information on its efficacy, safety, and benefits of being vaccinated;

j. Information on the appropriate actions to take and persons to contact in the event of an emergency;

k. Procedures to follow if an exposure incident occurs, including the method of reporting the incident;

l. Information on the medical follow-up that will be made available and on medical counseling provided to exposed individuals;

K. RECORDKEEPING

1. Medical records following an exposure incident shall be kept for the length of the worker's employment or the student's enrollment plus 30 years. Records will be maintained in the health care facility which attends the person.

2. All Sharps Injury Logs shall be maintained by the department in which the exposure incident occurred.

3. Training records shall be kept for 3 years. These records will be maintained in the employee's personnel files or in the student's academic records.

Hepatitis means inflammation of the liver. Hepatitis B, which is a viral infection, is one of multiple causes of hepatitis. Most people with Hepatitis B recover completely, but approximately 5-50% become chronic carriers; 1-2% die of fulminant hepatitis. In the group of chronic carriers, many have no symptoms and appear well, yet can transmit the virus to others. Others may develop a variety of symptoms and liver problems varying from mild to severe (chronic persistent hepatitis, chronic active hepatitis, cirrhosis and liver failure). There is also an association between Hepatitis B virus and hepatoma (a form of liver cancer).

Hepatitis B virus can be transmitted by contact with body fluids including blood (including contaminated needles), semen, tears, saliva, urine, breast milk, and vaginal secretions. Health workers are at high risk of acquiring Hepatitis B because of frequent contact with blood or potentially contaminated body fluids and, therefore, vaccine is recommended to prevent the illness.

"Engerix-B" (Hepatitis B Vaccine [Recombinant]) is a noninfectious Recombinant DNA Hepatitis B Vaccine. Clinical studies have shown that after three doses 96% of health adults have been seroprotected.

Persons with immune system abnormalities, such as dialysis patients, have less response to the vaccine, but over 67% of those receiving it do develop antibodies. If you have immune deficiency problems, you should obtain a written release from your physician.

Three doses of Hepatitis B Vaccine are needed to confer protection. "Engerix-B" is administered at 0, 1, and 6 months or alternatively at a 0, 1, and 2 month regimen. This regimen is designated for protection of individuals at immediate risk of Hepatitis B infection -- those recently exposed to the virus (including needlestick exposure), certain travelers to high-risk areas, and neonates born of infected mothers. Studies have shown that 99% of subjects vaccinated with the 0, 1, 2 month dosing regimen have developed protective antibody titers by month 3.

"Engerix-B" (Hepatitis B Vaccine {Recombinant}) is generally well tolerated. During clinical studies involving over 10,000 individuals distributed over all age groups, no serious adverse reactions attributable to vaccine administration were reported. As with any vaccine, however, it is possible that expanded commercial use of the vaccine could reveal rare adverse reactions not observed in clinical studies. The most frequently reported adverse reactions were injection-site soreness, fatigue, induration, erythema, swelling, fever, headache, and dizziness. Other more serious adverse reactions have occurred infrequently. If you have any questions about Hepatitis B or about "Engerix-B", please ask.

Hypersensitivity to yeast or any other component of the vaccine (e.g.: formalin or mercury derivatives) is a contraindication for use of the vaccine.

Patients experiencing hypersensitivity after an "Engerix-B" (Hepatitis B Vaccine [Recombinant]) injection should not receive further injections of "Engerix-B" (see Contraindications).

Hepatitis B has a long incubation period. Hepatitis B Vaccination may not prevent Hepatitis B infection in individuals who have an unrecognized Hepatitis B infection at the time of vaccine administration. Additionally, small percentages of healthy people do not respond to the vaccine and do not develop an immunity to the HBV.

Pregnancy Category C: Animal reproduction studies have not been conducted with "Engerix-B." It is also not known whether "Engerix-B" can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. "Engerix-B" should be given to a pregnant woman only if clearly needed.

It is not known whether "Engerix-B" is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when "Engerix-B" is administered to a nursing woman.

I, ______________________________________________, have read the above statement about Hepatitis B and the Hepatitis B Vaccine, "Engerix-B". I have been provided with updated information and have had the opportunity to ask questions about the benefits and risks of Hepatitis B Vaccination. I understand that there is no guarantee that I will become immune and that there is a possibility that I will experience an adverse side effect from the vaccine.

I have been advised that studies have not been conducted to determine the effect of the vaccine on a developing fetus. Therefore, the safety of the vaccine is not known on the developing fetus. I have opted to receive the Hepatitis B vaccine, and hereby consent to the administration of three doses of the Hepatitis B Vaccine over the next 6 months.

I have read the information provided by the University Medical Center about Hepatitis B and the Hepatitis B Vaccine, "Engerix-B". I have had an opportunity to ask questions, understand the benefits and risks of the Hepatitis B Vaccine, and do not wish to receive this vaccine. I request that it not be given to me.

I understand that due to my occupational exposure to blood or other potentially infectious materials 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 other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me.

2. Antibody Testing indicates employee/student is immune to Hepatitis B ___________

3. Hepatitis B vaccine is contraindicated for medical reasons _____________________

4. Employee/student declines the vaccination series (attach signed statement) ________

On ___________________________, I attended University-provided training on Bloodborne Pathogens.

Section	Page
Preface	2
Statement of Philosophy	2
Definitions	2
Exposure Control Plan	6
Methods of Compliance	9
Engineering Controls	9
Required Work Practices (General)	10
Personal Protective Equipment	12
Housekeeping	13
Waste Disposal	13
Requirements for Handling Contaminated Sharps	14
Sharps Containers for Contaminated Sharps	14
Cleaning and Decontamination of Worksite	15
Laundry	16
Hepatitis B Vaccination	16
Post-Exposure Evaluation/Follow-Up	18
Communication of Hazards	20
Information and Training	21
Recordkeeping	22
Attachment A - Risk Appraisal Survey	23
Attachment B - Sharps Evaluation and Sharps Injury Log	27
Attachment C - Model Exposure Control Plan	29
Attachment D - Hepatitis B Vaccination Series Information Sheet and Consent Form	41
Attachment E - Hepatitis B Vaccination Decline to Accept Form	44
Attachment F- Documentation of Student/Employee Hepatitis B Vaccination Status	45
Attachment G - Documentation of Participation in Training Program	46

Name	Job Title	Procedures Placing Employee at Risk	Location of Employee

Control	Location	Installation Date	Maintenance Due Date
1. handwashing facilities
2. needleless systems
3. sharps injury protection mechanism
4. containers for sharps
5. containers for infectious materials.
6. other

Name and No. of Course or Description of University-Sponsored Activity in which Academic Exposure Might Occur	Individual Responsible for Course or Activity	Procedures Placing Student At Risk

Job Title	Dept./Location	Task/Activities

ITEM	PROCEDURE

EQUIPMENT	CLEANSER/DISINFECTANT	FREQUENCY

LOCATION	CLEANSER/DISINFECTANT	FREQUENCY