OSHA Inspection: NEW BRUNSWICK PEDIATRIC GROUP

Issued

Nov 14, 1990

Abate by

Jan 14, 1991

Penalty

Initial $420 · Current $210 Reduced

General-duty citation text

SECTION 5(A)(1) OF THE OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970: ON OR
ABOUT 5/23/90, THE EMPLOYER DID NOT FURNISH EMPLOYMENT AND A PLACE OF
EMPLOYMENT WHICH WERE FREE FROM RECOGNIZED HAZARDS THAT WERE CAUSING OR
LIKELY TO CAUSE DEATH OR SERIOUS PHYSICAL HARM TO EMPLOYEE(S) IN THAT
EMPLOYEE(S) WERE EXPOSED TO THE HAZARDS OF WORKING WITH BLOOD AND BODY
FLUIDS THUS CAUSING OR LIKELY TO CAUSE EMPLOYEE EXPOSURE TO AND
CONTRACTION OF HEPATITIS B (HBV) AND/OR HUMAN IMMUNODEFICIENCY VIRUS
(HIV):
A) HEALTH CARE WORKERS SUCH AS NURSING STAFF AND PHYSICIANS, ARE
POTENTIALLY EXPOSED TO BLOOD BORNE PATHOGENS.
FEASIBLE ABATEMENT METHODS FOR REDUCING THIS HAZARD INCLUDE, BUT ARE NOT
LIMITED TO:
TRAINING AND EDUCATION:
TRAINING AND EDUCATION OF EMPLOYEES SUCH AS, BUT NOT LIMITED TO, NURSING
STAFF AND PHYSICIANS.
SUCH TRAINING AND EDUCATION SHALL BE AT THE TIME OF INITIAL EMPLOYMENT
AND AT LEAST ANNUALLY THEREAFTER. THE TRAINING MATERIALS USED SHALL BE
APPROPRIATE IN CONTENT AND VOCABULARY TO EDUCATIONAL LEVEL, LITERACY,
AND LANGUAGE BACKGROUND OF THE EMPLOYEES BEING TRAINED.
THE TRAINING AND EDUCATION PROGRAM SHALL CONTAIN AT THE MINIMUM THE
FOLLOWING ELEMENTS:
I) A GENERAL EXPLANATION OF THE MODES OF TRANSMISSION OF BLOOD
BORNE PATHOGENS;
II) AN EXPLANATION OF THE EMPLOYER'S INFECTION CONTROL PROGRAM;
III) AN EXPLANATION OF THE APPROPRIATE METHODS FOR RECOGNIZING TASKS
AND OTHER ACTIVITIES THAT MAY INVOLVE EXPOSURE TO BLOOD OR BODY
FLUIDS AND OTHER POTENTIALLY INFECTIOUS MATERIALS;
IV) AN EXPLANATION OF THE USE AND LIMITATIONS OF WORK PRACTICES THAT
WILL PREVENT OR REDUCE EMPLOYEE EXPOSURE, INCLUDING APPROPRIATE
ENGINEERING CONTROLS, WORK PRACTICES AND PERSONAL PROTECTIVE
EQUIPMENT;
V) AN EXPLANATION OF THE BASIS FOR SELECTION OF PERSONAL PROTECTIVE
EQUIPMENT;
VI) INFORMATION ON THE HEPATITIS B VACCINATION, INCLUDING INFORMATION
ON ITS EFFICIENCY, SAFETY AND THE BENEFITS OF BEING VACCINATED;
VII) INFORMATION ON THE APPROPRIATE ACTIONS TO BE TAKEN AND THE PERSON
TO CONTACT IN AN EMERGENCY;
VIII) AN EXPLANATION OF THE PROCEDURE TO FOLLOW IF AN EXPOSURE INCIDENT
OCCURS, INCLUDING THE METHOD OF REPORTING THE INCIDENT AND THE
MEDICAL FOLLOW-UP THAT WILL BE MADE AVAILABLE;
IX) AN EXPLANATION OF THE SIGNS AND LABELS AND/OR COLOR CODING USED IN
THE WORK PLACE; AND
X) A COPY OF THE CENTER OF DISEASE CONTROL (CDC) GUIDELINES.
WRITTEN INFECTION CONTROL PROGRAM:
THE EMPLOYER SHALL DESIGN AND IMPLEMENT A WRITTEN INFECTION CONTROL
PROGRAM TO MINIMIZE OR ELIMINATE EMPLOYEE EXPOSURE. THIS INFECTION
CONTROL PROGRAM SHALL BE REVIEWED AND UPDATED AS NECESSARY TO REFLECT
SIGNIFICANT CHANGES IN TASKS OR PROCEDURES. THIS PROGRAM SHALL CONTAIN
AT A MINIMUM THE FOLLOWING:
I) A DETERMINATION OF THE EXPOSURE POTENTIAL OF ALL EMPLOYEES;
II) THE SCHEDULE AND METHOD OF IMPLEMENTATION OF THE INFECTION CONTROL
PROGRAM;
III) INCORPORATE ALL THE ITEMS CONTAINED IN THE EMPLOYER'S INFECTION
CONTROL TRAINING AND INFORMATION PROGRAM AS IT RELATES TO
IDENTIFICATION EVALUATION AND CONTROL OF BLOOD PATHOGENS AND
EXPOSURE TO BLOOD AND BODY FLUIDS.
THE WRITTEN INFECTION CONTROL PROGRAM SHALL BE MADE AVAILABLE TO ALL
EMPLOYEES DURING THE TRAINING PROGRAM.
HEPATITIS B VACCINATION:
THE FACILITY'S INFECTION CONTROL POLICY REGARDING HEPATITIS B
VACCINATIONS SHALL ADDRESS ALL CIRCUMSTANCES WARRANTING SUCH
VACCINATIONS AND SHALL IDENTIFY EMPLOYEES OF SUBSTANTIAL RISK OF
DIRECTLY CONTACTING BLOOD OR BODY FLUIDS. ALL SUCH EMPLOYEES SHALL BE
OFFERED HEPATITIS B VACCINATIONS IN AMOUNTS AND AT TIMES PRESCRIBED BY
STANDARD MEDICAL PRACTICE.
FOLLOW-UP PROCEDURES AFTER POSSIBLE EXPOSURE TO HIV/HBV:
IF AN EMPLOYEE HAS A PERCUTANEOUS (NEEDLE-STICK OR CUT) OR MUCOUS
MEMBRANE (SPLASH TO EYE, NASAL MUCOSA, OR MOUTH), EXPOSURE TO BLOOD OR
BODY FLUIDS OR HAS CUTANEOUS EXPOSURE TO BLOOD OR BODY FLUIDS WHEN THE
WORKER'S SKIN IS CHAPPED, ABRADED OR OTHERWISE NON-INTACT, THE FOLLOWING
PROCEDURES SHALL BE FOLLOWED:
A) THE EXPOSED EMPLOYEE(S) SHALL BE EVALUATED CLINICALLY BY HIV ANTIBODY
TESTING AS SOON AS POSSIBLE AND ADVISED TO REPORT AND SEEK MEDICAL
EVALUATION OF ANY ACUTE FEBRILE ILLNESS THAT OCCURS WITHIN 12 WEEKS
AFTER EXPOSURE. HIV SERONEGATIVE WORKERS SHALL BE RETESTED 6 WEEKS
POST-EXPOSURE AND ON A PERIODIC BASIS THEREAFTER (12 WEEKS AND 6
MONTHS AFTER EXPOSURE).
B) FOLLOW-UP PROCEDURES SHALL BE TAKEN FOR EMPLOYEE(S) EXPOSED OR
POTENTIALLY EXPOSED TO HBV. THE TYPE OF PROCEDURES DEPENDS ON THE
IMMUNIZATION STATUS OF THE WORKER, (I.E., WHETHER HBV VACCINATION
HAS BEEN RECEIVED AND ANTIBODY RESPONSE IS ADEQUATE). THE CDC
IMMUNIZATION PRACTICES ADVISORY COMMITTEE HAS PUBLISHED ITS
RECCOMMENDATIONS REGARDING HBV POST-EXPOSURE PROPHYLAXIS IN TABLE
FORMAT IN THE JUNE 5, 1985, MORBIDITY AND MORTALITY WEEKLY REPORT.
C) IF AN EMPLOYEE(S) REFUSES TO SUBMIT TO THE PROCEDURES, (A) OR (B)
ABOVE, WHEN SUCH PROCEDURES ARE MEDICALLY INDICATED, NO ADVERSE
ACTION CAN BE TAKEN ON THAT GROUND ALONE SINCE THE PROCEDURES ARE
DESIGNED FOR THE BENEFIT OF THE EXPOSED EMPLOYEE.

Issued

Nov 14, 1990

Abate by

Nov 17, 1990

Issued

Nov 14, 1990

Abate by

Nov 17, 1990

Issued

Nov 14, 1990

Abate by

Nov 17, 1990

Issued

Nov 14, 1990

Abate by

Nov 17, 1990

Issued

Nov 14, 1990

Abate by

Nov 17, 1990