OSHA Inspection: MIDWEST DENTAL INC

Issued

Feb 8, 1990

Abate by

Feb 9, 1990

Penalty

Initial $1,000 · Current $1,000

Hazardous substances 8880

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
the following conditions which increase the risk of employees
contracting blood-borne diseases:
An HBV vaccination program was not made available to the following
employees:
a) Dentists whose work duties include direct patient care, direct
injection of anesthetics and invasive dental procedures.
b) Dental Assistants whose work duties include direct patient care in
conjunction with the dentist's procedures, instrument handling and
washing.
c) Dental Hygienists whose work duties include direct patient care,
cleaning procedures using various instruments, polishing equipment
and an ultrasonic cleaner which can result in widespread splattering
of blood/saliva, and occasional washing of contaminated instruments
and equipment.
d) An X-ray technician whose work duties, include the handling of
potentially contaminated materials (e.g., bloody guaze) during
patient preparation for X-rays.
e) An office housekeeper whose work duties include disposal of blood
contaminated waste and clean-up of blood spills on walls or floors.
In accordance with recommended practices from the CDC's guidelines for
protection from blood-borne diseases, feasible methods of abatement
include, but are not limited to:
1) An evaluation of exposure potential based on job duties leading to
exposure to infectious materials as a universal precaution. Employees
requiring inclusion in an HBV vaccination program shall include but
not be limited to those employees listed in the instance description.
2) Make available Hepatitis B (HBV) vaccinations to all potentially
exposed employees (e.g., instances listed).
3) Initiate a complete medical surveillance program to allow early
identification of HBV infection in non-immunized personnel, track
immunization status and provide booster HBV vaccinations as
necessary.

Issued

Feb 8, 1990

Abate by

Feb 9, 1990

Hazardous substances 8880

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
the following conditions which increase the risk of employees
contracting blood-borne diseases:
Appropriate post exposure evaluation and follow-up procedures were
not implemented for the following employees:
a) In the central sterilization area, a dental assistant who was
punctured with a blood contaminated instrument while removing
instruments from the ultrasonic cleaner.
b) In the central sterilization area, a dental hygienist who was
punctured with a blood contaminated instrument while scrubbing
the sink.
In accordance with recommded practices from the CDC's guidelines for
protection from blood-borne diseases, feasible methods of abatement
include, but are not limited to:
1) Implement a determination and documentation of the exposure incident
describing:
-route of exposure
-source patient's antibody status (positive, negative or unknown)
-circumstances under which exposure occurred.
2) Request permission from the source patient for antigen/antibody
testing HBV or HIV infection status. Such testing is voluntary for
the source patient.
3) Offer blood collection and antibody testing to the exposed employee
as soon as possible after the exposure incident. Blood testing is
voluntary for the employee. Actual antigen/antibody testing may be
done at the time of collection or at a later date if the employee so
requests. Follow-up testing should be continued according to current
standard medical procedures.
4) Provide counseling and illness reporting advice to the exposed
employee.
5) Make available information on the exposed employee's job duties as
relates to the exposure and on the exposure incident to the
evaluating physician. Any medical assessment or written opinion
from the evaluating physician must be kept as a medical record,
with a copy made available to the employee within 15 working days.

Issued

Jul 20, 1989

Abate by

Aug 25, 1989

Penalty

Initial $540 · Current $400 Reduced

Hazardous substances 8880

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
the following conditions which increase the risk of employees
contracting blood-borne diseases:
A complete and effective training and information program on the
hazards of blood-borne diseases and effective precautions for
reducing the risk of infection was not made available to the
following employees:
a) Dentists whose work duties include direct patient care, direct
injection of anesthetics and invasive dental procedures.
b) Dental Assistants whose work duties include direct patient care in
conjuction with the dentist's procedures, instrument handling and
washing.
c) Dental Hygienists whose work duties include direct patient care,
cleaning procedures using various instruments, polishing equipment
and a ultrasonic cleaner which can result in widespread splattering
of blood-saliva, and occasional washing of contaminated instruments
and equipment.
d) An X-ray technician whose work duties include the handling of
potentially contaminated materials (e.g., bloody guaze) during
patient preparation for X-rays.
e) An office housekeeper whose work duties include disposal of blood
contaminated waste and clean-up of blood spills on walls or floors.
In accordance with recommended practices from the CDC's guidelines for
protection from blood-borne diseases, feasible methods of abatement
include, but are not limited to the provision of training and
information in the following categories:
1) Hazards --e.g., risk factors, illness descriptions, epidemiology and
potential for fetal risk.
2) Protective Measures -- e.g., engineering controls, personal
protective equipment, biohazard labeling.
3) Emergency or Non-routine Procedures -- e.g., precautions for CPR,
spill cleanup and exposure incidence reports and tracking.
4) Medical Procedures -- e.g., medical treatment, surveillance and
records.

Issued

Jul 20, 1989

Abate by

Aug 8, 1989

Penalty

Initial $540 · Current $100 Reduced

Hazardous substances 8880

Issued

Jul 20, 1989

Abate by

Aug 1, 1989

Hazardous substances 8880

Issued

Jul 20, 1989

Abate by

Aug 1, 1989

Hazardous substances 8880

Issued

Jul 20, 1989

Abate by

Nov 25, 1989

Penalty

Initial $360 · Current $150 Reduced

Hazardous substances 8880

Issued

Jul 20, 1989

Abate by

Aug 25, 1989

Penalty

Initial $450 · Current $225 Reduced

Hazardous substances 8880

Issued

Jul 20, 1989

Abate by

Aug 25, 1989

Penalty

Initial $360 · Current $180 Reduced

Hazardous substances 195313611774

Issued

Jul 20, 1989

Abate by

Aug 25, 1989

Penalty

Initial $270 · Current $100 Reduced

Hazardous substances 1631

Issued

Jul 20, 1989

Abate by

Aug 25, 1989

Hazardous substances 163117201774

Issued

Jul 20, 1989

Abate by

Aug 25, 1989

Penalty

Initial $270 · Current $135 Reduced

Hazardous substances 1774172015600670

Issued

Jul 20, 1989

Abate by

Aug 25, 1989

Penalty

Initial $180 · Current $95 Reduced

Hazardous substances 1774172015600670

Issued

Jul 20, 1989

Abate by

Aug 25, 1989