OSHA Inspection: QUEENS-LONG ISLAND MEDICAL GROUP, P.C.

Issued

Jan 4, 1990

Abate by

Feb 28, 1990

Penalty

Initial $900 · Current $450 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 terotogenic effects while preparing, storing, administering and
disposing of cytotoxic (antineoplastic) drugs. Health Care workers
exposed included 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 $400 Reduced

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $800 · Current $400 Reduced

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $800 · Current $400 Reduced

Issued

Jan 4, 1990

Abate by

Jan 9, 1990

Penalty

Initial $900 · Current $450 Reduced

Issued

Jan 4, 1990

Abate by

Jan 10, 1990

Penalty

Initial $900 · Current $450 Reduced

Issued

Jan 4, 1990

Abate by

Feb 7, 1990

Penalty

Initial $600 · Current $270 Reduced

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $600 · Current $270 Reduced

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $600 · Current $270 Reduced

Issued

Jan 4, 1990

Abate by

Feb 7, 1990

Penalty

Initial $600 · Current $270 Reduced

Issued

Jan 4, 1990

Abate by

Mar 7, 1990

Penalty

Initial $600 · Current $270 Reduced

Issued

Jan 4, 1990

Abate by

Mar 7, 1990

Penalty

Initial $10,000 · Current $5,500 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 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, decay
technicians, phlebotomists, emergency room, intensive care and
operating nurses and technicians, laboratory and blood bank technicians
housekeeping personnel, laundry workers, orderlines, 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 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 efficacy, safety and the benefits of being vaccianted;
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 wokrplace;
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 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 Hepatits 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 times 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 eve, nasal mucosa, or mouth) exposure to
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 patient shall be informaed 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 clincially 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
be retested 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 health care workers 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 an antibody response is adequate)
and the HBV serologic status of the source patient.
The CDC Immunization Practices Advisory Committee has published its
recommendations regarding HBV post-exposure prophylaxis in table
format in the June 5, 1985, Morbidity and Mortality Weekly Report.
IV) If an employee refuses to submit to the procedures in (b) or (c)
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.
HANDLING OF LINEN
The Infection Control Program shall have identified all laundry
operations involving substantial risk of direct exposure to blood or
body fluids. Linen spoiled with blood or body fluids shall be handled
as little as possible and with minimum agitation to prevent
contamination of the person handling the linen.
All soiled linen shall be bagged at the location where it was used; it
shall not be sorted or rinsed in patient-care areas. Soiled linen shall
be placed and transported in bags that prevent leakage.

Issued

Jan 4, 1990

Abate by

Jan 16, 1990

Penalty

Initial $10,000 · Current $5,500 Reduced

Issued

Jan 4, 1990

Abate by

Jan 9, 1990

Penalty

Initial $100

Issued

Jan 4, 1990

Abate by

Jan 18, 1990

Penalty

Initial $500 · Current $100 Reduced