OSHA Inspection: QUEENS-LONG ISLAND MEDICAL GROUP, INC.

Issued

Jan 4, 1990

Abate by

Feb 28, 1990

Penalty

Initial $900 · Current $500 Reduced

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: 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 employees in that employees were exposed to:
a) The hazards of exposure, including but not limited to carcinogenic
and teratogenic effects while preparing, storing, administering and
disposing of cytotoxic (antineoplastic) drugs. Health Care Workers
exposed include physicians and nurses; on or about 7/27/89.
Feasible abatement methods for reducing this hazard, include but are
not limited to:
1) Education and training of all staff involved in handling any aspect
of cytotoxic (antineoplastic) drugs, including their known risks,
procedures for their handling, proper use of protective equipment
and materials, spill procedures and medical policies.
2) A Class II Bio Safety Cabinet (BSC) that meets current National
Sanitation Foundation Standard 49 must be used.
3) Personal protective equipment, such as surgical latex gloves,
disposable gowns, surgical masks and splash goggles must be made
available, and worn when appropriate.
4) Adherence to Appendix A of the OSHA Workplace Practice Guidelines for
Personnel Dealing with Cytotoxic (Antineoplastic) Drugs, dated
January 29, 1986.

Issued

Jan 4, 1990

Abate by

Jan 9, 1990

Penalty

Initial $800 · Current $425 Reduced

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $800 · Current $425 Reduced

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $800 · Current $425 Reduced

Issued

Jan 4, 1990

Abate by

Jan 10, 1990

Penalty

Initial $500 · Current $400 Reduced

Issued

Jan 4, 1990

Abate by

Jan 10, 1990

Penalty

Initial $900 · Current $500 Reduced

Issued

Jan 4, 1990

Abate by

Feb 7, 1990

Penalty

Initial $600 · Current $300 Reduced

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $600 · Current $300 Reduced

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $600 · Current $300 Reduced

Issued

Jan 4, 1990

Abate by

Feb 7, 1990

Penalty

Initial $600 · Current $300 Reduced

Issued

Jan 4, 1990

Abate by

Mar 7, 1990

Penalty

Initial $600 · Current $300 Reduced

Issued

Jan 4, 1990

Abate by

Mar 7, 1990

Penalty

Initial $10,000 · Current $5,300 Reduced

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: 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 employees in that employees were exposed to:
a) The hazards to employees working with blood and body fluids thus
causing or likely to cause employee exposure to and contraction of
Hepatitis B Virus (HBV) and/or Human Immunodeficiency Virus (HIV).
Health Care workers exposed include physicians, nurses, nursing
assistants, phlebotomists, medical technologists, technicians,
housekeeping and maintenance personnel; on or about 7/26/89.
Feasible abatement methods for reducing this hazard, include but are not
limited to:
TRAINING AND EDUCATION
Training and Education of Health Care Workers such as but not limited
to physicians, pathologists, dentists, dental technicians, x-ray
technicians, phlebotomists, emergency room, intensive care and
operating nurses and technicians, laboratory and blood bank technicians
housekeeping personnel, laundry workers, orderlies, morticians,
research laboratory workers, paramedics and medical examiners. 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 as a minimum the
following elements;
I) A general explanation of the modes of transmission of bloodborne
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 will involve exposure to blood or body
fluids or 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 efficacy, 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 procedures 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 workplace; and
X) A copy of the Center for 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
as 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.
The writen 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 at substantial risk of
directly contacting body fluids.
All such employees shall be offered Hepatitis B vaccinations in amounts
and at time prescribed by standard medical practice.
FOLLOW-UP PROCEDURES AFTER POSSIBLE EXPOSURE TO HIV/HBV):
I) If a health care worker has a percutaneous (needlestick) or cut or
mucous membrane, (splash to eye, nasal mucosa, or mouth exposure) to
blood or body fluids or has a cutaneous exposure to blood or body
fluids when the worker's skin is chapped, abraded, or otherwise
nonintact, the source pateint shall be informed of the incident and
tested for HIV and HBV infections, after consent is obtained.
II) If patient consent is refused or if the source patient tests
positive, the health care worker 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
restested 6 weeks post-exposure and on a periodic basis thereafter
(12 weeks and 6 months after exposure).
III) Follow-up procedures shall be taken for haelth care workers exposed
or potentially exposed to HBV. The type of procedures depend on the
immunization status of the worker (i.e., whether HBV vaccination
has been received and antibody response is adequate) and the HBV
serologic status of the source patient.

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $10,000 · Current $5,300 Reduced

Issued

Jan 4, 1990

Abate by

Jan 18, 1990

Penalty

Initial $500 · Current $225 Reduced