OSHA Inspection: WCA HOSPITAL

Issued

Sep 18, 1991

Abate by

Oct 21, 1991

Penalty

Initial $1,625 · Current $650 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
the hazard of becoming infected with Hepatitis B Virus (HBV) or Human
Immunodeficiency Virus (HIV) through possible exposure to blood or other
body fluids:
a)   Cardiology Unit, On or about 5/24/91 - Cardiology Nurses,
exposed or potentially exposed to blood and/or body fluids
while performing health care duties which include intravenous
needle insertions, were not offered by their employer HBV
vaccinations, nor were HBV and HIV followup procedures imple-
mented to address post-exposure incidents involving employee
exposure to blood and/or body fluids containing blood.
The hazards of such exposure include, but are not limited to, the onset
of clinical symptoms of acute Hepatitis B, anorexia, abdominal pain,
jaundice, the potential for becoming a chronic carrier of the Hepatitis
B, or contraction of H.I.V.
Amond other methods, one feasible abatement methods to reduce the hazard,
is to establish and enforce adequate procedures regarding employee
exposure to blood and body fluids, such as those stipulated by the
Centers for Disease Control (CDC) Guidelines published in Morbidity and
Mortality Weekly Report, June 24, 1988, Volume 37, Number 24, which
includes:
1)   Hepatitis B Vaccination.  All employees at substantial risk
of directly contacting blood or body fluids shall be offered
hepatitis B vaccinations free of charge in amounts and at times
prescribed by standard medical practices.
2.   Follow-up Procedures After Possible Exposure to HIV or HBV:
(a)   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 ob-
tained.
(b)   If patient consent is refused or if the source patient
tests positive, the health care worker shall be evaluate
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).
(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 vaccination has been received and antibody
response is adequate) and the HBV serologic status of the
source patient.  The CDC Immunization Practices Advisory
Committee had published its recommendations regarding HBV post
exposure prophylaxis 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.

Issued

May 28, 1991

Abate by

Jun 7, 1991

Penalty

Initial $1,875 · Current $750 Reduced

Issued

May 28, 1991

Abate by

Jun 7, 1991

Penalty

Initial $1,875 · Current $750 Reduced

Issued

May 28, 1991

Abate by

Jun 30, 1991

Penalty

Initial $1,125 · Current $450 Reduced

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 30, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 30, 1991

Issued

May 28, 1991

Abate by

Jun 30, 1991

Issued

May 28, 1991

Abate by

Jun 30, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991

Issued

May 28, 1991

Abate by

Jun 7, 1991