Occupational Safety Health Act of 1970 (OSHA)

Services: 1) regulates biologic hazards 2) has authority to enforce existing standards of practice to protect workers 3) ensures that the workplace is free from hazards 4) ensures proper records are maintained 5) ensures post-exposure treatment for employees at employers expense Employers all responsible for all employees in the workplace. Exposure control plan: 1) employers are required to have a written infection control plan, to be updated annually 2) the plan must identify the job classification of employees & the tasks in which exposure to blood-bourne pathogens occurs & describe the plan for evaluating exposures 3) appropriate plans include a) provision for voluntary HIV & hepatitis B testing of the source patient b) baseline serologic evaluation of the health care worker c) follow-up HIV1 serology testing in 6 weeks, 12 weeks & 6 months d) instruction in the prevention of HIV transmission e) post-exposure antiretroviral prophylaxis Universal precautions: 1) blood & certain body fluids of all patients must be regarded as potentially infectious 2) employers &/or the employee may NOT decide to consider some exposures to body fluids as less risky on the basis of their perception of the patient 3) universal precautions apply to all blood & other body fluids visibly contaminated by blood, semen, vaginal secretions, & cerebrospinal, synovial, pleural, pericardial, peritoneal & amniotic fluids Engineering & work practices controls: 1) employers must require employees to follow standard hygienic practices such as hand washing 2) the employer must provide materials to permit the proper packaging of specimens & disposal of needles & other contaminated equipment Personal protective equipment: 1) employer must provide & ensure that employee(s) use appropriate protective equipment, including gloves, gowns, goggles & face shields 2) barrier precautions should be used when touching blood or other body fluids requiring universal precautions & for handling items & surfaces contaminated by these fluids 3) protective equipment must be provided by the employer to the employee at no cost Cleaning & decontamination: 1) employers are required to adhere to a written schedule for cleaning & decontaminating equipment & surfaces 2) commonly used chemical germicides are effective in inactiviating HIV Laundry: 1) employers must have procedures for handling contaminated laundry 2) soiled laundry should be bagged & not sorted in patient care areas 3) laundry workers must wear gloves 4) contaminated laundry may not be cleaned at home Hepatitis B vaccine: - must be made available to employees within 10 days of beginning work Post-exposure evaluation & follow-up: - the employer is required to provide at no cost to the employee a) post-exposure evaluation b) source patient testing if possible c) counseling

References

Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998