OSHA Inspection: SERVICE CORP. IN'L. DBA COX/PARKER FUNERAL HOME

Issued

Apr 18, 1991

Abate by

May 20, 1991

Penalty

Initial $630 · Current $350 Reduced

General-duty citation text

The alleged violations below have been grouped because they involve
similar or related hazards that may increase the potential for illness.
Section 5(a)(1) of the Occupational Saftey 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) On or about December 6, 1990, funeral service employees
performing embalming and removals of remains were exposed to
the hazard of being infected by Hepatitis B virus and/or human
immunodeficiency virus through possible direct contact with blood
or other potentially infectious materials.
Feasible abatement methods for reducing this hazard include:
1) Establishment of a Hepatitis B vaccination policy and program which
addresses all circumstances warranting such vaccinations and
identifies all employees at substantial rick of directly contacting
blood or other potentially infectious materials, and offer all such
employees Hepatitis V vaccinations/innoculations in amounts and at
times prescribed by standard medical practice.
Reference: Centers for Disease Control Immumnization Practices Advisory
Committee: Recommendations for Protection Against Viral Hepatitis. MMWR
1990:39 (No.s-2).
2) Establishment of a training policy and program for employees (as
above) which includes training about Hepatitis B vaccination program
and procedures to be followed and provided if they are exposed to a
needle stick or other direct contact with blood or other potentially
infectious material.
3) Implementation of engineering controls and workpractices as necessary
to reduce risk of contact with blood (e.g. splashes, aerosols, cuts)
such as:
a) placement of embalming table drain tube and aspirator discharge below
water surface in the embalming sink.
b) covering of embalming sink.
c) maintenance of regulated areas to preclude access of unprotected
employees to areas of facility where fixtures, equipment, etc., may
be contaminated with blood or other potentially infectious material.
Reference: Centers for Disease Control. Recommendations for Prevention
of HIV Transmission in Health-Care Settings: MMWR 1987;36 (Supply. 2S)
Reference: Centers for Disease Control, Immunization Practices Advisory
Committee, Recommendations for Protection Against Viral Hepatitis. MMWR
1990:39: (No.S.2)
NOTE: It is recommended that the facility develop policies for
documentation and tracking of post-exposure evaluations and follow-up
procedures (re: HBV/HIV) which address of specify requirements for:
1) Documentation fo source patient identifications and circumstances
under which exposure occurred.
2) Determination of source HIV status and/or testing of source patients
where feasible.
3) Documentation of seronegative source patients "risk-factors"
evaluation.
4) Development of a chronological tracking system to assure timely
administration of vaccines and procedures (e.g., HB vaccine, serial
HIV testing) and notification to exposed employees of results and
evaluations, and dates of future vaccinations/innoculations, tests
or procedures that may be required.

Issued

Apr 18, 1991

Abate by

May 20, 1991

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) ON OR ABOUT DECEMBER 6, 1990, APPROPRIATE POST-EXPOSURE MEDICAL
EVALUATION AND FOLLOW-UP PROCEDURES WERE NOT ESTABLISHED FOR
EMBALMERS AND OTHER EMPLOYEE(S) EXPOSED TO THE HAZARD OF BEING
INFECTED WITH HBV AND/OR HIV THROUGH DIRECT CONTACT WITH BLOOD OR
OTHER POTENTIALLY INFECTIOUS MATERIALS I.E., INCIDENTS OR
PERCUTANEOUS (NEEDLE STICK OR CUT) EXPOSURE, OR MUCOUS MEMBRANE
(SPLASH TO EYE, NASAL MUCOSA, OR MOUTH) EXPOSURE, OR TO CUTANEOUS
EXPOSURE OF CHAPPED, ABRADED, OR OTHERWISE NON-INTACT SKIN.
REVIEW OF POLICY DOCUMENTS, MANAGEMENT AND EMPLOYEE INTERVIEWS INDICATED
DEFICIENCIES AS FOLLOWS:
1) DIRECT EXPOSURE INCIDENTS WERE NOT DEFINED TO INCLUDE INCIDENTS OTHER
THAN PUNTURES (E.G., SPLASHES TO MUCOUS MEMBRANES OR NON-INTACT SKIN;
AND
2) POLICY DOCUMENTS AND MANAGEMENT STATEMENTS DID NOT SPECIFY, REFER OR
INCLUDE SPECIFIC REQUIREMENTS OF CDC PROTOCOLS FOR HIV AND/OR HBV
(SEE REFERENCES BELOW) FOR POST EXPOSURE FOLLOW-UP.
FEASIBLE ABATEMENT METHODS FOR REDUCING THIS HAZARD INCLUDE:
A CONFIDENTIAL MEDICAL EXAMINATION AND FOLLOW-UP INCLUDING THE FOLLOWING
1) DOCUMENTATION OF THE HBV AND HIV INFECTION STATUS OF THE SOURCE
PATIENT (IF KNOWN) AND,
2) FOLLOW-UP OF THE EXPOSED EMPLOYEE INCLUDING ANTIGEN AND/OR ANTIBODY
TESTING (HBV/HIV), COUNSELING, ILLNESS REPORTING, AND SAFE AND
EFFECTIVE POST-EXPOSURE PROPHYLAXIS AS INDICATED ACCORDING TO
STANDARD RECOMMENDATIONS FOR MEDICAL PRACTICE.

Issued

Apr 18, 1991

Abate by

Apr 21, 1991

Penalty

Initial $630 · Current $350 Reduced

Issued

Apr 18, 1991

Abate by

May 20, 1991

Penalty

Initial $630 · Current $350 Reduced