OSHA Inspection: MEDICS AMBULANCE SERVICE INC.

Issued

Jun 8, 1990

Abate by

Jul 12, 1990

Penalty

Initial $720 · Current $720

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 April 17, 1990, paramedics and EMT personnel
were exposed to the hazard of being infected by HBV and/or HIV
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 risk of
directly contacting blood or other potentially infectious
materials and offers all such employees Hepatitis B vaccinations
in amounts and at times prescribed by standard medical practice.
Reference: Centers for Disease Control Immunization Practices
Advisory Committee: Recommendations for Protection Against Viral
Hepatitis: MMWR1985; 35:313-24, 329-35.
(2) Establishment of a training policy and program for employees
(as above) which includes:
(a) Education on epidemiology, modes of transmission, and
prevention of HIV/HBV,
(b) Counseling regarding potential risks to the fetus from
HIV/HBV and other associated infectious agents;
(c) Training regarding Centers for Disease Controls, guidlines
concerning "Universal Precautions" as it applies to their
workplace and specifies procedures for work practicies. E.g.,
cleaning and disinfecting of vehicles: use of personal protec-
tive equipment, laundry and waste disposal.
(d) Training about Hepatitis B vaccination program and pro-
cedures to be followed and provided if they are exposed to a
needle stick or other direct contact with blood or other
potentially infectious material. References: Centers for
Disease Control, Recommendations for Prevention of HIV
Transmission in Health-Care setting: MMWR 1987; 36 (suppl.28).

Issued

Jun 8, 1990

Abate by

Jul 12, 1990

Penalty

Initial $720 · Current $610 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) On or about April 17, 1990, appropriate post-exposure
medical evaluation: and follow-up procedures were not
established and provided for employee(s) exposed to the hazard
of being infected with HBV and/or HIV through direct contact
with blood or other potentially infectious material i.e.,
incidents of needle stick exposure, mucous membrane exposure or
cutaneous exposure of chapped, abraded or/otherwise non intact
skin and human bites.
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 phrophylaxis as indicated
according to standard recommendations for medical practice.
Reference: Centers for Disease Control. Recommendations for
Prevention of HIV Transmission in Health-Care Settings: MMWR
1987:36 (Suppl.28).
Reference: Centers for Disease Control, Immunization Practices
Advisory Committee, Recommendations for Protection Against Viral
Hepatitis. MMWR 1985;35:313-24, 329-35.
Note: It is recommended that the facility develop policies for
documentation and tracking of post-exposue evaluations and follow-up
procedures (Re: HBV/HIV) which address or specify requirements for:
1. Documentation of source patient identification and cir-
cumstances underwhich exposure occurred.
2. Testing (HIV) of source patients in situations in which
consent cannot be obtained (e.g. an unconscious patient).
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 of tests and evaluations, and dates of
future vaccinations/innoculations, tests or procedures that may
be required.

Issued

Jun 8, 1990

Abate by

Jun 14, 1990

Penalty

Initial $720 · Current $610 Reduced

Issued

Jun 8, 1990

Abate by

Jun 14, 1990

Penalty

Initial $720 · Current $610 Reduced

Issued

Jun 8, 1990

Abate by

Jul 12, 1990

Issued

Jun 8, 1990

Abate by

Jul 12, 1990