OSHA Inspection: RIA, INC.

Issued

Dec 18, 1991

Abate by

Jun 21, 1992

Penalty

Initial $750 · Current $375 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.  Health care workers such as Direct Care Staff at 7 Brian
Cliff Drive, Cambridge, Ohio were exposed to the hazard of being
infected by HBV and/or HIV through possible direct contact with blood
or other body fluids.  Feasible and useful abatement methods for
reducing this hazard are:
1.  Hepatitis B Vaccination.  The facility's IC policy
regarding hepatitis B vaccinations shall address all
circumstances  warranting such vaccinations and shall
identify employees at substantial risk of directly
contactig body fluids.  All such employees shall be
offered hepatitis B vaccinations free of charge in
amounts and at times presribed by standard medical
practices.
2.  Linen.  The IC program shall have identified all laundry
operations involving substantial risk of direct exposure
to body fluids.  Linen soiled with 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 rinced
in the patient-care areas.  Soiled linen shall be placed
and transported in bags that prevent leakage.
3.  Bagging the Articles.  Objects that are contaminated
with potentially infectious materials shall be placed
in an impervious bag.  If outside contamination of the
bag is likely, a second bag shall be added.
4.  Handwashing.  After removing gloves, hands or other
skin surfaces shall be washed thoroughly and immediately
after contact with body fluids.
5.  Follow-up Procedures After Possible Exposure To HIV
or HBV:
a.  If a health care worker has a percitaneous (cut)
or mucous membrane (splash to eye, nasal mucous, or
mouth) exposure to body fluids has a cutaneous exposure
to bood when the workers skin is chapped, abraded,
or otherwise nonintact, the source patient shall be
informed of the incident and tested for HIV and HBV
infections, after consent is obtained.
b.  If patient consent is refused or if the source
patient tests positive, the health care worker shall
be evaluated clinically and 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 six weeks post-exposure and
on a periodic basis thereafter (12 weeks and six months
after exposure).
c.  Follow-up procedures shall be taken for health
care workers exposed or potentially exposed to HBV.
The types of procedures depends on the immunization
status of the worker (i.e., whether HBV vaccinatin
has been received  and 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 postex-
posure prophylais in table format in June 7, 1985,
Morbidity and Mortality Weekly Report.
d.  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.
6.  Training and Education Of Health Care Workers.  The
employer's training program shall be evaluated in accordance
with Appendix C.
a.  All high risk health care workers such as those
listed in H.1 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.
b.  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, 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.
Where tags are used, training about tags and precautions
to be used in handling contaminated articles or
infectious waste is governed by 29 CFR 1910.145(f).
(see section M.4.)  Workers shall receive training about
procedures to be used if they are exposed to body fluids.

Issued

Dec 18, 1991

Abate by

Dec 21, 1991

Penalty

Initial $2,500

Issued

Dec 18, 1991

Abate by

Feb 21, 1992

Penalty

Initial $750 · Current $375 Reduced

Issued

Dec 18, 1991

Abate by

Feb 21, 1992

Penalty

Initial $750 · Current $375 Reduced

Issued

Dec 18, 1991

Abate by

Feb 3, 1992