OSHA Inspection: MASPETH DENTAL ASSOCIATES

Issued

Mar 27, 1991

Abate by

Apr 15, 1991

Penalty

Initial $810 · Current $810

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) Job Site - On 10/3/90 - Health Care Workers (Dentists, Dental
Hygienists, Dental Assistants) working in the Dental Office, did not
participate in the training and education segments of the employer's
infection control program. The employers infection control program
had not been implemented. Employees were not informed of the
existence, and availability of a Hepatitis B virus (HBV) vaccination
to prevent HBV infection and employee training did not include
methods to prevent HBV and Human Immunodeficiency virus (HIV).
The hazards of such exposure include, but are not limited to, the
onset of clinical symptoms of acute Hepatitis B, anorexia, abdominal
pain, jaundice, and the potential for becoming a chronic carrier of
the Hepatitis B and/or Human Immunodeficiency virus.
The facility's I.C. policy regarding Hepatitis B vaccination shall
address all circumstances warranting such vaccinations and shall
identify employees at substantial risk of directly contacting body
fluids. All Hepatitis B vaccines shall be offered free of charge in
amounts and 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 eye, nasal mucosa, or mouth) exposure to
blood or body when the worker's skin is chapped, abraded or otherwise
non-intact, the source patient 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
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 workers (i.e., whether the
HBV vaccination has been received and antibody response is adequate),
and the HBV serologic status of the source patient. The C.D.C.
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 (ii) or (iii)
above, when such procedures are medically indicated, no adverse
action may be taken on that ground alone since the procedures are
designed for the benefit of the exposed employee.
Training and Education of Health Care Workers:
i) All high risk health care workers shall receive education on
precautionary measures, epidemiology, modes of transmission and
prevention of HIV/HBV. Health care workers shall be counseled
regarding possible risks to the fetus from HIV/HBV and other
associated infectious agents.
ii) In addition, such high risk workers must receive training regarding
the location and proper use of personal protective equipment. They
shall be trained concerning proper work practices and if the facility
has implemented them. Tmeployees shall understand the concept of
"universal precautions" as it applies to their work practices. They
shall be trained about the meaning of color coding or other methods
(except tags) used to designate contaminated articles or infectious
waste.