OSHA Inspection: MEDICS AMBULANCE SERVICE INC.

Issued

Jun 8, 1990

Abate by

Jul 12, 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 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 throughpossible
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 ant 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 include:
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 practices. E.g., cleaning and
disinfecting of vehicles: use of personal protective equipment,
laundry and waste disposal.
d) 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.
References: Centers for Disease Control, Recommendations for Prevention
of HIV Transmission in Health-Care setting: MMWR 1987; 36 (suppl.2S).

Issued

Jun 8, 1990

Abate by

Jul 12, 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 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 exposures 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 status
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: MMWR1987: (Suppl.2s)
Reference: Centers for Disease Control, Immunization Practices Advisory
Committee, Recommendations for Protection Against Viral Hepatitis.
MMWR1985;35:313-24, 329-35.
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 or specify requirements for:
1) Documentation of source patient identification and circumstances
under which 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. HBV Vaccine, serial
HIV testing) and notification to exposed employees of results of
tests and evaluations, and dates of future vaccination/innoculations,
tests or procedures that may be required.

Issued

Jun 8, 1990

Abate by

Jun 14, 1990

Penalty

Initial $810 · Current $810

Issued

Jun 8, 1990

Abate by

Jun 14, 1990

Penalty

Initial $810 · Current $810