OSHA Inspection: ARBOUR HEALTH CARE CENTER, LTD.

Issued

Apr 23, 1991

Abate by

May 28, 1991

Penalty

Initial $1,875 · Current $1,200 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 employed by Arbour Health Care Center,
Ltd. were potentially exposed to infection by Hepatitis B Virus
(HBV and/or Human Immunodeficiency Virus (HIV) through possible
direct contact with blood or other body fluids. Employees po-
tentially exposed but are not limited to: Registered Nurses, Li-
censed Practical Nurses, Certified Nursing Assistants, House-
keeping and Laundry personnel.
Feasible abatement methods include but are not limited to:
(1) Development of a infection control program that identifies
(1) the tasks and work areas that are likely to present ex-
posures to blood, or other potentially infectious products,
(2) the employee positions that are involved, and (3) the
controls that will be used to reduce the potential risk.
(2) Presentation of a training program which ensures that all
employees with potential exposure will participate. The
training program shall include the following elements: (a)
a general explanation of epidemiology and symptoms of
bloodborne diseases. (b) an explanation of modes of trans-
mission of bloodborne pathogens. (c) an explanation of the
employee's infection control program. (d) methods for rec-
ognizing tasks that may involve exposure to blood and other
potentially infectious materials. (e) methods of reducing
exposure including appropriate engineering controls, work
practices, and personal protective equipment.
(f) information on types, proper use, location, removal, handl-
ing, decontamination and/or disposal of personal protective eq-
uipment. (g) an explanation of the basis for selection of
personal protective equipment. (h) information on the Hepatitis
B vaccine, including information on its efficacy, safety and
benefits of being vaccinated. (i) information on appropriate
actions to take and persons to contact in case of exposure, and
the medical follow-up that will be made available, including
medical counseling. (j) explanation of signs/labels, color
coding with regard to biohazards.
(3) Hepatitis B vaccinations shall be offered to all employees
with potential exposure to blood or body fluids free of
charge, according to standard recommendations for medical
practice.
(4) Post-exposure follow-up shall be provided for all employees
with an occupational exposure incident and shall include at
least the following elements:
(a) Documentation of the route(s) of exposure, HBV and HIV
antibody status of the source patient (if known), and
the circumstances under which the exposure occurred.
(b) If the source patient can be determined and permission
is obtained, collection of and testing of the source
patients' blood to determine the presence of HIV or
HBV infection.
(c) If patient consent id refused or if the patient tests
positive for HIV, the exposed employee shall be tested
for HIV antibody as soon as possible, and again at 6
weeks, 12 weeks, and 6 months post exposure. The em-
ployee shall be advised to report and seek medical
evaluation of any acute fibrile illness that occurs
within 12 weeks after exposure.
(d) For employees potentially exposed to HBV, the follow-
up procedures would depend on the immunization status
of the worker and the HBV serologic status of the
source patient. (The CDC Morbidity and Mortality Re-
port, June 7, 1985 may be consulated for recommenda-
tions on post-exposure prophylaxis.)

Issued

Apr 17, 1991

Abate by

May 21, 1991

Penalty

Initial $1,125 · Current $625 Reduced

Issued

Apr 17, 1991

Abate by

Apr 22, 1991

Penalty

Initial $750

Issued

Apr 17, 1991

Abate by

May 6, 1991

Penalty

Initial $750

Issued

Apr 17, 1991

Abate by

May 6, 1991

Issued

Apr 17, 1991

Abate by

Apr 29, 1991

Issued

Apr 17, 1991

Abate by

May 21, 1991