BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN

I. Exposure Determination:

A. Category I: In the following job classifications , as determined in each school, all employees may have contact with blood or other potentially infectious materials,

OSHA classification Category I is a task or activity that may bring about direct contact with blood or other body fluids to which universal precautions apply.

School Nurse

School Secretaries

B. Category II: In the following job classifications some employees may occasionally have contact with blood or other potentially infectious materials.

OSHA classification Category II is task or activity performed without blood exposure, but exposure may occur in emergency situations.

Custodians Bus Drivers

Physical Education Teachers

1:1 Special Education Aides

C. Category III: In the following job classifications in this facility the following employees do not have predictable exposure to blood or other bodily fluids.

OSHA classification Category III is a task or activity that does not entail predictable exposure to blood or other body fluids.

Teachers and other staff not previously classified

II. Methods of Implementation

A. Universal Precautions

All blood and other potentially infections materials (OPIM) will be treated as if they are infectious regardless of the perceived status of the source individual.

B. Compliance Methods and Personal Protective Equipment

1. Sharps Container, if needed, which are puncture resistant, labeled with biohazard labels, and are leak proof, will be located in the nurse's office. Contaminated needles, cutting blades and other contaminated sharps will not be bent, recapped, or broken, but will be disposed in the biohazard container . Teachers using these supplies will review these procedures with their students each time a new class starts.

2. Gloves shall be worn where it is reasonably anticipated that employees will have hand contact with blood or OPIM. Each employee will have gloves in his/her classroom or workplace. Replacement gloves will be available from the nurse's office.

Gloves, which have been contaminated, will be removed and appropriately disposed of.

Gloves will only be worn once and then disposed of.

Utility gloves may be washed and reused if they are intact. Hands will be washed after removal of gloves.

3. Decontamination will be accomplished by utilizing one of the following materials:

a. 1:10 solution of chlorine bleach and water;

b. approved germicide/tuberculocide.

4. Contaminated work surfaces will be decontaminated after use using the above solutions after any spill of blood or OPIM.

5. Contaminated broken glass and other materials will not be picked up without wearing gloves. Remaining refuse will then be swept up using a dustpan and brush and properly disposed of. Vacuuming is permissible if the pieces are not too large.

6. Handwashing facilities are available for use in all school buildings. Hands and other skin surfaces should be washed immediately and thoroughly if exposed to blood or OPIM. Hands should be washed, after removing gloves, even if gloves appear intact, using soap and water.

7. Students who bloody their clothing will change into clean clothes. The contaminated clothing will be bagged and sent home with the student.

8. All blood soaked materials will be bagged and appropriately disposed of.

III. Hepatitis B Vaccine

A. All employees who have been identified as Category I and may have exposure to blood or OPIM will be offered this Hepatitis B vaccine at no charge to the employee. The vaccine will be offered within ten (10) days of the employee's initial assignment, unless the employee has already had the vaccine or antibody testing showing sufficient immunity. Documentation of an employee' s immunity shall be required.

B. Employees in Category I who do not want the vaccine must sign a declination statement. Employees who decline the vaccine can change their minds and have the vaccine at a later date. It will be the responsibility of each school nurse to ensure that the vaccine is offered to the Category I employees. The vaccine will be administered by a physician.

C. When an employee has been exposed to blood or OPIM a report will be sent to the school nurse.

D. All employees who have been exposed will be offered post­ exposure evaluation and follow-up. The follow-up will include:

1 . Documentation of route of exposure and circumstances of the incident;

2. Documentation of source individual and his/her HIV/HBV status if known; (We will try to get permission to test the source individual's blood for HIV/HBV.)

3. If the source individual is tested, we will make the results available to the exposed employee. The employee must obey all confidentially requirements

4. The exposed employee will be offered testing for HIV/HBV. The blood sample will be saved for 90 days to allow the employee to decide if he/she wants it to be tested for HIV. If the employee decides during that period, the blood sample can be dealt with appropriately.

5. The exposed employee will be offered post exposure treatment by the latest U.S. Public Health Service recommendation.

6. The exposed employee will be given counseling regarding precautions to take during the period after the exposure incident and potential illnesses to be alert for. The employee will be asked to report related experiences to appropriate personnel.

7. The school nurse will assure that this policy will be effectively carried out.

IV. Interaction with Health Care Professionals

A. A written report shall be obtained from the health professional who evaluated employees of the school. Written reports will be obtained in the following instances:

1. When the employee is sent to obtain the HBV vaccine;

2. Whenever the employee is sent to a health care professional following an exposure incident

B. Health care professionals shall be instructed to limit their report to:

1 . Whether the HBV is indicated and if the employee has received the vaccine, or for evaluation following an incident;

2. That the employee has been informed of the results of the evaluation;

3. That the employee has been told about any medical condition resulting from exposure to blood or OPIM.

V. Training

A. Training for all employees will be conducted prior to initial assignment where occupational exposure may occur.

B. Training will be conducted by the School Nurse in the following manner:

1. The training for employees will be held during one of the workshop days at the beginning of the school year and will include the following:

a. OSHA standard for Bloodborne pathogens;

b. Epidemiology and symptoms of Bloodborne pathogens;

c. Modes of transmission;

d. Explanation of the school's exposure plan;

e. Incidents that might cause exposure to blood or OPIM;

f. Control methods used at the school to prevent exposure;

g. Personal protective equipment available and who to contact;

h. Post exposure evaluation and follow-up;

i. Signs and labels used in the school;

j. The Hepatitis B vaccine program at the school;

VI. Recordkeeping

A. All records required by the OSHA Standard will be maintained by the school nurse and copies sent to the Superintendent's Office.

All provisions required by the OSHA Standard will be implemented by July 1993.

PROTOCOL FOR EXPOSURE TO BLOODBORNE PATHOGENS

Universal precautions are steps taken to prevent the exchange of potentially infectious blood and body fluids from one person to another. Universal precautions apply to body tissue, semen, and vaginal secretions. They also apply to other fluids such as nasal secretions, saliva, sweat, urine, etc. if they contain visible blood.

In the school setting, universal precautions will most often be used for blood or fluids containing blood.

Because the potential infectivity of a person's blood/body fluid cannot be known, universal precautions must always be used. Each employee must protect himself/herself. A kit containing gloves and gauze will be supplied.

A custodian must be called to clean up any blood spills.

If a student can care for self:

Hand student gauze squares to apply to source of blood; Send student to school nurse or principal's office; Check the area for blood; and

Call the custodian if necessary.

If a student needs help:

Hand student gauze squares to apply to source of blood;

Employee puts on the gloves and helps the student apply pressure to source of bleeding;

Employee accompanies the student to the school nurse or designated area for First Aid;

Employee carefully removes gloves without touching skin and washes hands thoroughly with soap and water;

Employee checks the area for blood; and

Call the custodian if necessary.

If employee is contaminated with blood or body fluids:

1. Get help from school nurse or other designated First Aid providers;

2. Have custodian check the area for blood;

3. Immediately wash thoroughly with soap and water. If a splash into eye/mouth has occurred, flush area thoroughly. Use eye cups available in the school nurse's office or closest eye wash station;

4. Complete and submit exposure form to the school nurse;

5. Arrange for medical follow-up.

GLOSSARY

Bloodborne Pathogens - pathogenic microorganisms, present in human blood that can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV)

Contaminated - the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item of surface.

Contaminated Sharps - any contaminated object that can penetrate the skin including, but not limited to needles, scalpels, broken glass, broken capillary tubes , and exposed ends of dental wires.

Decontamination - the use of physical or chemical means to remove, inactivate or destroy Bloodborne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles, and the surface or item is rendered safe for handling, use or disposal.

Exposure Incident - a specific eye, mouth, other mucous membrane, non-intact skin or parental contact with blood or other potentially infectious material that results from the performance of an employee's duties.

HBV - Hepatitis B Virus

HIV - Human Immunodeficiency Virus

Other Potentially Infectious Materials (OPIM) - the following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.

Parenteral - when mucous membranes or skin have been pierced by human bites, cuts, abrasions, needle-sticks, etc.

Personal Protective Equipment - specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes are not intended to function as protection against a hazard and are not considered to be personal protective equipment .

Universal Precautions - an approach in infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, or other Bloodborne pathogens.

Definitions from 29 CFR Part 1910.1030 OSHA Standard

Adopted: January 23, 1995

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INFORMATION SHEET FOR EMPLOYEES

Hepatitis B Vaccine

During the orientation, you will be provided with information concerning the risk of exposure to the Hepatitis B Virus. The primary risk is through personal practices, such as, high risk sexual behavior and/or I,V, drug use. However , some employees may be at risk through contact with blood or body fluids of Hepatitis B Virus. The best means of protection in the workplace is following the policies/procedures for Universal Precautions.

After completing the series of three immunizations, the Hepatitis B vaccine provides protection by building up a sufficient level of antibodies. The vaccine is specific to Hepatitis Band is not effective against other types of hepatitis.

If you feel that your work activities place you at risk for Hepatitis B, please consider the following before taking the vaccine.

You may want to consult your own physician before taking the vaccine.

YOU SHOULD NOT TAKE THE VACCINE unless under the advise of your physician and then documentation must be provided to the school nurse.

1. If you have an allergy to yeast;

2. If you are pregnant or nursing;

3. If you are planning to become pregnant within the next six months;

4. If you have had a fever, gastric symptoms, respiratory symptoms, or other signs of illness in the last 48 hours.

The vaccine used is derived from recombinant yeast cultures which means it is free of association with human blood or blood products. The vaccine has a low incidence of side effects. However, as with any pharmaceutical product, there may be a reaction.

Common Side Effects Include

Local Reaction - pain, itching, bruising at the injection site . You may use a cold pack for 5-7 minutes to relieve symptoms.

General Body - sweating, weakness, chills, flushing, tingling. This may be described as mild flu-like symptoms. You may wish to take your preferred over the counter analgesic, such as aspirin, Tylenol or ibuprofen.

Occasionally more severe reactions may be experienced. If you think you have a reaction, you should seek medical attention.

To be effective, it is critical that you complete the series of three injections at 1 month and 6 months after the first dose. Each injection is given intramuscularly via the deltoid muscle. The exact duration of protective effect from the vaccine is unknown at present. The need for booster doses is not yet defined.

If you terminate your employment before the completion of the vaccination series, it is the employee's responsibility to contact his/her own medical provider to complete the series.

*This informative sheet is given to Category I employees