Occupational Safety Health Act of 1970 (OSHA)

Introduction

Services:

• regulates biologic hazards
• has authority to enforce existing standards of practice to protect workers
• ensures that the workplace is free from hazards
• ensures proper records are maintained
• ensures post-exposure treatment for employees at employers expense

Employers all responsible for all employees in the workplace.

Exposure control plan:

• employers are required to have a written infection control plan, to be updated annually
• the plan must identify the job classification of employees & the tasks in which exposure to blood-bourne pathogens occurs & describe the plan for evaluating exposures
• appropriate plans include
  • provision for voluntary HIV & hepatitis B testing of the source patient
  • baseline serologic evaluation of the health care worker
  • follow-up HIV1 serology testing in 6 weeks, 12 weeks & 6 months
  • instruction in the prevention of HIV transmission
  • post-exposure antiretroviral prophylaxis

Universal precautions:

• blood & certain body fluids of all patients must be regarded as potentially infectious
• employers &/or the employee may NOT decide to consider some exposures to body fluids as less risky on the basis of their perception of the patient
• universal precautions apply to all blood & other body fluids visibly contaminated by blood, semen, vaginal secretions, & cerebrospinal, synovial, pleural, pericardial, peritoneal & amniotic fluids

Engineering & work practices controls:

• employers must require employees to follow standard hygienic practices such as hand washing
• the employer must provide materials to permit the proper packaging of specimens & disposal of needles & other contaminated equipment

Personal protective equipment:

• employer must provide & ensure that employee(s) use appropriate protective equipment, including gloves, gowns, goggles & face shields
• barrier precautions should be used when touching blood or other body fluids requiring universal precautions & for handling items & surfaces contaminated by these fluids
• protective equipment must be provided by the employer to the employee at no cost

Cleaning & decontamination:

• employers are required to adhere to a written schedule for cleaning & decontaminating equipment & surfaces
• commonly used chemical germicides are effective in inactiviating HIV

Laundry:

• employers must have procedures for handling contaminated laundry
• soiled laundry should be bagged & not sorted in patient care areas
• laundry workers must wear gloves
• contaminated laundry may not be cleaned at home

Hepatitis B vaccine:

• must be made available to employees within 10 days of beginning work

Post-exposure evaluation & follow-up:

• the employer is required to provide at no cost to the employee
  • post-exposure evaluation
  • source patient testing if possible
  • counseling

Additional terms

• universal precautions