OSHA Inspection: ST. LUKES HOSPITAL

Issued

Jul 20, 1990

Abate by

Dec 20, 1990

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, health care workers in
substantial risk occupations 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, among others, are:
a) Offering the hepatitis vaccine to employees, specifically nurses,
laboratory and blood bank technologists, x-ray technicians and
housekeeping personnel, at no expense to them.
b) Following up employees after possible exposure to HIV or HBV,
specifically nurses, laboratory and blood bank technologists, x-ray
technicians and housekeeping personnel. The procedure is as follows:
1) If a health care worker has a percutaneous (needlestick or cut)or
mucous membrane (splash to eye, nasal mucosa, or mouth) exposure to
body fluids or has a cutaneous exposure to blood when the worker's
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.
2) 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
6 weeks post-exposure and on a periodic basis thereafter (12 weeks
and 6 months after exposure).
3) Follow-up procedures shall be taken for health care workers exposed
or potentially exposed to HBV. The types of procedures dependon the
immunization status of the worker (i.e., whether HBV vaccination has
been received and antibody response is adequate) and theHBV
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 June 7,
1985, Morbidity and Mortality Weekly Report.
4) If an employee refuses to submit to the procedures in (2) or (3)
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 employees.
c) Provide training and education to employees, specifically x-ray
technicians, laboratory technologists, and housekeeping personnel on
precautionary measures, epidemiology, modes of transmission and
workers shall be counseled regarding possible risks to the fetus from
HIV/HBV and other associated infectious agents.
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 Precaution" 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).
Workers shall receive training about procedures to be used if they
are exposed to needlestick or to body fluids.

Issued

Jul 20, 1990

Abate by

Sep 27, 1990

Penalty

Initial $640 · Current $640

Issued

Jul 20, 1990

Abate by

Aug 27, 1990

Penalty

Initial $810 · Current $810

Issued

Jul 20, 1990

Abate by

Aug 27, 1990

Issued

Jul 20, 1990

Abate by

Sep 27, 1990

Penalty

Initial $640 · Current $640

Issued

Jul 20, 1990

Abate by

Aug 27, 1990

Penalty

Initial $640 · Current $640

Issued

Jul 20, 1990

Abate by

Aug 27, 1990

Issued

Jul 20, 1990

Abate by

Jul 30, 1990

Issued

Jul 20, 1990

Abate by

Aug 27, 1990

Issued

Jul 20, 1990

Abate by

Jul 23, 1990

Issued

Jul 20, 1990

Abate by

Aug 27, 1990

Issued

Jul 20, 1990

Abate by

Aug 20, 1990

Issued

Jul 20, 1990

Abate by

Aug 20, 1990

Issued

Jul 20, 1990

Abate by

Aug 20, 1990