OSHA Inspection: DR. FREDRICK SCHRANK

Issued

Jun 9, 1992

Abate by

Aug 3, 1992

Penalty

Initial $1,500 · Current $750 Reduced

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The
emloyer 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 hazards of becoming infected with Hepatitis B Virus (HBV) and/or
Human Immunodeficiency Virus (HIV) through possible direct contact with
blood or other body fluids:
(a)  At the Workplace - Dental Assistants were not adequately
trained on the hazards of bloodborne pathogens and how
to protect themselves; on or about 1/28/92.
(b)  At the Workplace - Dental Assistants has no follow-up
procedures after an exposure incident to blood and/or
body fluids; on or about 1/28/92.
Feasible abatement methods to correct this hazard as stipulated in the
Center for Disease Control Guidelines published in Morbidity and
Mortality Weekly Report, June 24, 1988, Volumne 37 Number 24, include
but are not limited to:
(a)  Training and Education for all high risk health care workers.
The Training and Educataion Program shall contain at a minimum,
the following elements:
(i)  A general explanation of the modes of transmission of blood-
borne pathogens:
(ii)  An explanation of the employer's Infection Control Program;
(iii)  An explanation of the appropriate methods for recognizing
tasks and other activities that may involve exposure to blood
or body fluids and other potentially infectious materials;
(iv)  An explanation of the use and limitations of work practices
that will prevent or reduce employee expoure, including
appropriate engineering controls, work practices, and person-
al protective equipment;
(v)  An explanation of the basis for selection of personal protec-
tive equipment;
(vi)  Information on the Hepatitis B vaccination, including infor-
mation on its efficiency, safety and the benenfits of being
vaccinated;
(vii)  Information on the appropriate actions to be taken and the
persons to contact in an emergency;
(viii)  An explanation of the procedures to follow if an exposure
incident occurs, including the method of reporting the
incident and the medical follow-up that will be made available;
(ix)  An explanation of the signs and labels and/or color coding
used in the workplace;
(x)  A copy of the Center for Disease Control (CDC) Guidelines.
(b)  Hepatitis B Vaccination
The facility's infection control policy regarding Hepatitis B
vaccinations shall address all circumstances warranting such
vaccinations and shall identify employees of substantial risk of
directly contacting blood and body fluids.
All such employees shall be offered Hepatitis B vaccinations in
amounts and at times prescribed by standard medical practice, at
no cost to employees.
(c)  Follow-up Procedures After Possible Exposure to HIV/HBV:
(i)  If a health care worker has a percutaneous (needlestick or
cut) or muscous membrane (splash to the eye, nasal mucosa, or
mouth) exposure to blood or body fluids 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 clinical-
ly 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 pro-
cedures depends on the immunization status of the worker
(i.e., whether HBV vaccination 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
post-expoure prophylaxis in the table format in the June 5,
1985, morbidity and Mortality Weekly Report.

Issued

Jun 9, 1992

Abate by

Jun 17, 1992

Penalty

Initial $600 · Current $300 Reduced

Issued

Jun 9, 1992

Abate by

Jun 22, 1992

Penalty

Initial $1,050 · Current $525 Reduced

Issued

Jun 9, 1992

Abate by

Jun 22, 1992

Issued

Jun 9, 1992

Abate by

Jun 22, 1992

Penalty

Initial $750 · Current $375 Reduced

Issued

Jun 9, 1992

Abate by

Jun 26, 1992

Issued

Jun 9, 1992

Abate by

Jul 13, 1992

Penalty

Initial $1,050 · Current $525 Reduced

Issued

Jun 9, 1992

Abate by

Jul 13, 1992

Issued

Jun 9, 1992

Abate by

Jun 22, 1992

Issued

Jun 9, 1992

Abate by

Jun 22, 1992