THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA

             BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN



The Risk Management Department developed the Bloodborne Pathogens Exposure

Control Plan in an effort to protect District employees from blood and other potentially

infectious materials. The point of contact for the plan is Mr. Aston A. Henry, Jr.,

Supervisor, (754 321-3200) of the Risk Management Department. For additional

information please access the Risk Management Website.



What is the purpose of the plan?



The plan includes actions to eliminate or minimize occupational exposure to blood or

Other Potentially Infectious Materials (OPIM).



Who is responsible for conducting the Bloodborne Pathogens Program, training and

maintaining records?



A representative from the Risk Management Department is responsible for conducting

the training, performing periodic program audits, and maintaining records.



What is included in the plan? The plan includes the following:



�    Definitions employees need to know

�    Name of the Bloodborne Pathogens Program Coordinator

�    Exposure Determination

�    Work practices employees must follow to protect themselves against

     bloodborne pathogens or OPIM

�    Personal Protective Equipment that must be utilized

�    Hepatitis B Vaccine Program

�    Training employees must receive

�    Records Risk Management Department must maintain

�    Positions Risk Management believes have the potential for occupationally

     exposing employees to bloodborne pathogens or OPIM

�    Hepatitis B Immunization Consent/Refusal Form



What definitions are useful in understanding the requirements of the plan?



A.      Blood - In the plan, blood refers to human blood and human blood components.

B.      Bloodborne Pathogens - Any micro-organism in human blood or other

        potentially infectious materials capable of causing disease in people who are

        exposed to it. Hepatitis B Virus (HBV) and Human Immunodeficiency Virus

        (HIV) are specifically identified by OSHA as bloodborne pathogens.

C.      Biohazard - Any viable infectious agent presenting a risk or a potential risk to an

        employee.

D.      Contaminated � The presence or the reasonably anticipated presence of blood or

        other potentially infectious materials on an item or surface.





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E.    Decontamination � The use of physical 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.

F.    Disinfect � To inactivate virtually all recognized pathogenic microorganisms but

      not necessarily all microbial forms (bacterial endospores) on inanimate objects.

G.    Exposure Incident - Actual contact with human blood or other potentially

      infectious material while an employee is performing his/her job. If an employee

      has non-intact skin, eye, mucous membrane, or parenteral contact with blood or

      other potentially infectious material while performing his/her job, an exposure

      incident has been experienced.

H.    Infectious Waste/Medical Waste - Waste containing human tissue, fluids, blood

      or blood products. Examples of infectious or medical waste include:

          � First aid bandages

          � Medical Needles (Used Needles)

          � Material used in cleaning up blood or human body fluids

          � Gloves or clothing contaminated with blood or other potentially infectious

             material

I.    Good Samaritan � An employee is a good samaritan if he/she voluntarily helps

      someone in the workplace when he/she is injured or sick.

J.    Occupational Exposure � An employee is occupationally exposed if Risk

      Management determines he/she may reasonably have non-intact skin, eye,

      mucous membrane, or parenteral contact with blood or other potentially

      infectious material while performing his/her job.

      Note: Risk Management will not consider an employee occupationally

      exposed if there is potential that he/she may be a good samaritan at the

      workplace.

K.   Other Potentially Infectious Materials (OPIM) - Human body fluids (other than

     blood) or human tissue that may contain blood or transmit pathogens.

L.   Parenteral - Human bites that break the skin, or other violent situations that result

     in exposure to another person’s blood or body fluids.

M.    Universal Precautions - Procedures used to control infection by treating all

     human blood and human body fluids as if they were infectious.



What exposure determinations have been made at SBBC sites??



A.   The Risk Management Department has determined some employees may

     potentially be exposed to blood or OPIM while performing job-related

     responsibilities at their school/facility. Certain job classifications and specific

     employees have the potential for exposure. This determination was made

     utilizing the concept of universal precautions, without regard to personal

     protective equipment provided by the District for employees to wear while

     performing job-related duties.

B.   If an employee has been trained to give first aid or CPR, and first aid response is a

     part of his/her job, Risk Management considers that employee occupationally

     exposed.

C.   If the District has not trained an employee to give first aid or CPR and first aid





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     response is not a part of an employee’s normal job duties/tasks, the employee is

     not automatically considered occupationally exposed. This determination has

     been made as the employee does not perform first aid or CPR as a routine part of

     his/her job. An employee renders first aid in response to injuries resulting from

     workplace accidents and performs emergency first aid on a voluntary basis as a

     good samaritan.

D.   If an employee has an exposure incident while acting as a good samaritan, he/she

     will be covered by this plan and must follow the post-exposure procedures.



What work practices must an employee use to avoid exposure to Bloodborne Pathogens

and OPIM?



Employees normally do not perform invasive medical treatment or provide intravenous

medication; therefore, exposure to bloodborne pathogens and OPIM would come from

emergency first-aid treatment of common workplace injuries and illnesses. The

employee must utilize universal precautions to prevent contact with blood or OPIM

and general safety rules to prevent the spread of viral and bacterial organisms. The

employee must:



A.    Consider all blood or OPIM infectious, regardless of the source.

B.    Treat all human body fluids and items soiled with human body fluids as if they

      were contaminated with the Hepatitis B or C Virus (HBV/HCV) or Human

      Immunodeficiency Virus (HIV).

C.   Wash exposed areas (hands, arms, etc.) with antibacterial soap before and

     immediately after giving first aid. Hand-washing facilities with sinks, soap

     dispensers and paper towels are located in every restroom in the school/facility.

     If the workplace does not have hand-washing facilities, antiseptic towelettes must

     be made available for employees to utilize. Information concerning the location

     of the antiseptic towelettes should be easily accessible. A clearly visible statement

     must be posted indicating hands must be washed with antibacterial soap and

     water as soon as possible after contact.

D.   Even if an employee was wearing personal protective gloves, hands and other

     potentially contaminated skin areas must be washed with soap and water as soon

     as possible after contact with blood or OPIM.

E.   Clean and decontaminate spills of blood after an incident utilizing the following

     procedures:

      � Wear gloves and eye protection

      � Remove visible material with disposable towels

      � Disinfect the area with an approved germicide. Advise employees where the

          solution is located in the school/facility

      � Place soiled materials in a double plastic bag. Seal the bag. Place the double

          bag into the trash.

      � Wash hands with antiseptic cleanser

F.   Do not eat, drink, apply cosmetics or lip balm, or handle contact lenses in work

     areas where there is a potential for exposure to a health hazard.

G.   Do not store food or drinks in refrigerators, freezers or cabinets where blood or

     OPIM is stored or in other areas of possible contamination. Those refrigerators,





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      freezers or cabinets where blood or OPIM are stored must be labeled with a Bio-

      hazard warning label.



What Personal Protective Equipment will be provided to District employees?



The District provides personal protective equipment to prevent blood or OPIM from

reaching employee’s clothing, skin, eyes, mouth, or other mucous membranes under

normal use. The District will provide all personal protective equipment required to use

free of charge and will train all employees on proper use. (Please refer to the infection

control videotape, “Bloodborne Pathogens for School Employees: The Straight Facts.�)



A.    The following protective equipment is available for an employee to use. (Staff

      must be made aware of who has the equipment (i.e., facility manager. safety

      representative) and its location (i.e. in the personal protective equipment locker.)

(1)   Packaged bloodborne pathogen protective kits containing, (at a minimum)

      disposable non-latex gloves, antimicrobial/disinfectant wipe, and waste bags.

(2)   Packaged kits containing the above items, plus absorbent treatment material

      (gauze pads, tape, etc.) and surface antimicrobial/disinfectant wipes.

B.    One-way resuscitation devices and disposable non-latex gloves are available in

      first aid kits in the area designated by the facility.



What Personal Protective Equipment should an employee use for first aid or medical

emergencies at his/her workplace? Please use the following information as a general

guide:



               Task                     Gloves        Apron        Mask       Eye Wear

Control bleeding-spurting blood           x             x           x             x

Control bleeding with minimal

blood                                      x

Taking temperature                         x



What should an employee do with personal protective equipment after it is possibly

contaminated with blood or OPIM?





A.    Remove all garments which were in contact with blood as soon as possible.

B.    Remove all personal protective equipment before leaving the facility/workplace.

C.    Place all used personal protective equipment in a doubled plastic bag and

      dispose of it as required in paragraph 6E of this plan.

D.    Do not wash or attempt to decontaminate disposable gloves. Disposable gloves

      will be replaced if they are contaminated, torn, punctured, or lose their ability to

      act as a barrier to blood and OPIM.

E.    Discard personal protective equipment if it shows any signs of deterioration.

      Notify the Risk Management Department when gloves or any other personal

      protective equipment has been discarded so the equipment may be replaced.

F.    Each location must have an adequate supply of personal protective equipment





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      which must be maintained at all times.



What should an employee do if he/she is exposed to human blood or OPIM while at

work?



A.    IMMEDIATELY report any suspected exposure to blood or contact with human

      body fluid (via broken skin, human bites, needle sticks, etc.) to your supervisor.

B.    Report the suspected exposure to the appropriate administrator. He/she will

      furnish information about the procedures to be followed and determine if the

      employee should be included in the Hepatitis B Vaccination Program.



What is the Hepatitis B (HBV) Vaccination Program and how can an employee

participate in the Program?



A.    If an employee’s job title is identified on the Occupational Exposure list, the

      employee will be eligible to receive a HBV vaccination free of charge. Eligible

      employees should contact his/her supervisor who will contact the Risk

      Management Department for the Hepatitis B Consent form. A HBV vaccination

      is not mandatory and an employee may decline the vaccine. If the employee

      refuses the HBV vaccine when initially offered, he/she must complete the HBV

      Immunization Consent/Refusal Form. Risk Management will document the

      offer and the employee’s declination and the form will be kept on file in the Risk

      Management Department. If the employee decides at a later date that he/she

      wants the vaccine, the employee should notify his/her supervisor or the

      appropriate administrator at the school/facility.



If an employee has a possible exposure incident when he/she gives emergency first aid

or CPR as a good samaritan in his/her workplace, will he/she be offered HBV

vaccination? Yes.



A.    The vaccine will be offered free of charge within 24 hours from the time the

      employee was possibly exposed. As a precaution, a HBV vaccination will be

      offered to the employee whether he/she was actually exposed to blood/OPIM or

      not.

B.    Any time an employee gives first aid or CPR at his/her workplace, the employee

      must inform his/her supervisor. The supervisor must make certain proper

      precautions concerning the incident are followed and that the employee is

      offered the HBV vaccine within 24 hours of the exposure incident.

      Note: The HBV vaccine will not be offered if you were previously vaccinated

      within the past ten years.



What actions will be taken if an employee has an exposure incident at his/her

workplace?



If an employee comes in contact with blood or OPIM from an injured or ill person from

an open wound, or mucous membrane, or if an employee is injured by a sharp object





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that was contaminated with someone’s blood or OPIM, the following actions will take

place:



A.    The incident must be reported to the employee’s supervisor. The supervisor will

      report the incident to the Risk Management Department. The incident report

      must include the names of everyone involved, a description of the incident,

      when and where the incident occurred, and any other pertinent information.

B.    The administrator/supervisor at the school/facility will contact the Risk

      Management Department who in turn will contact the person with whom the

      occupational exposure occurred and request that he/she be tested for

      HIV/HBV/HCV, at the District’s expense. That person will be tested as soon as

      possible after consent is obtained.



Note: The person who may have exposed the employee is not required by law to

      submit to blood testing. His/her future employment with the District will not

      be adversely affected for refusing to be tested.

C.    The employee will be offered services from a licensed physician or health care

      worker. Tests will be performed by an accredited laboratory. These services will

      be provided to the employee by the District, at no cost to the employee. Risk

      Management will provide the evaluating physician instructions on what to do

      for the employee as well as written documentation.

(1)   Blood testing for HIV/HBV/HCV - If the employee tests free of those viruses

      after the initial blood test, he/she will be retested at six weeks, twelve weeks

      and six months after exposure. During that period of time, he/she should

      follow the recommendations given by the evaluating physician.

(2)   Medical evaluations including immune globulin for HBV, following the U.S.

      Public Health Service guidelines will be provided.

(3)   Counseling and illness evaluation.

D.    The health care professional who evaluates the employee will submit a written

      opinion to the Risk Management Department. The opinion will state only the

      employee has been informed of the evaluation results and that he/she was

      counseled about any exposure related conditions that need follow up or

      treatment. All other findings are confidential.

(1)   Risk Management will provide the employee a copy of the written opinion

      within 15 days of the evaluation.

(2)   Risk Management will keep a copy of the written opinion and test results in the

      employee’s confidential medical file.



As a privacy concern, are an employee’s medical evaluation and blood test results

confidential?



Yes. Risk Management will keep all information concerning both the exposed

employee and the person causing the exposure confidential. We will give the exposed

employee the HIV/HBV/HCV test results within five business days after receipt of

same. The test results will not be given to or discussed with anyone in the

school/facility who does not have a need to know.





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If an employee’s job title is on the Occupational Exposure List, what Bloodborne

Pathogens Program training will be offered to that employee?



The Risk Management Department will provide Bloodborne Pathogens Program

training at the school/facility. The employee will be trained when initially assigned to

an occupationally exposed position, and then annually for as long as the employee is

that position. The training will include the following:



�   Basic requirements of the OSHA Bloodborne Pathogens standard.

�   Where a copy of the OSHA Bloodborne Pathogens standard can be obtained.

�   Information on bloodborne diseases and how they are transmitted. The contents of

    the School Board’s Exposure Control Plan.

�   Tasks which might cause the employee to be exposed to blood or OPIM at his/her

    facility/workplace.

�   Control methods which should be utilized to minimize an employee’s exposure to

    blood or OPIM.

�   Information on types, proper use, location, removal, handling, decontamination and

    disposal of personal protective equipment.

�   Hepatitis B Vaccination Program, including information on the vaccine.

�   Post exposure evaluation and follow-up procedures.



Note: If the District trains an employee in First Aid, that employee will be offered the

same annual bloodborne pathogens training given employees whose job titles are

identified on the Occupational Exposure List.



If an employee’s job title is not on the Occupational Exposure List, will he/she receive

any training on the Bloodborne Pathogens Program?



Yes. Annually, all employees review the District’s video on Universal Precautions.

Additionally, the employee will receive general awareness training through booklets,

posters or other forms of information. A basic overview of the program requirements

will also be provided. If an employee has questions about the Bloodborne Pathogens

Program, he/she may also contact Mr. Aston A. Henry, Supervisor, Risk Management

Department, at (754) 321-3200.



What recordkeeping is required by the Bloodborne Pathogens Program?



The Bloodborne Pathogens Standard requires the District to keep both medical and

training records on all employees whose job titles are identified on the District’s

Occupational Exposure List or who have an exposure incident. The District is

required to keep training and medical records for 30 years after the employee leaves

employment.



What is kept in an employee’s Confidential Medical file?









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The following information is maintained in the employee’s confidential file:



�   Name

�   Social security number

�   Hepatitis B vaccination status

�   Hepatitis B vaccination consent/refusal form

�   Post-exposure evaluation (if applicable)

�   Follow-up procedures results (if applicable)

�   Healthcare professional’s written opinion (if applicable)

�   Training dates.

�   Contents or summary of the training sessions.

�   Names and qualifications of the people who trained the employee.



Who has access to an employee’s Confidential Medical file if he/she experiences an

exposure event?



This information is sensitive and protected by The Privacy Act. The information within

the confidential medical file is only available via the employee completing and

submitting a medical releases form. The medical records will only be given to the

following:



�   The employee

�   Any individual the employee gives written consent to receive information

�   Court orders and/or subpoenas

�   Judicial and administrative proceedings

�   When required by law



What are the current Job Classifications requiring the Hepatitis B Vaccine?



       1. Nurses/Paraprofessionals, Behavior Specialists

       2. ESE Aides

       3. Facility Servicepersons

       4. Security Specialists and Campus Monitors

       5. Instructors working in laboratories/clinics

       6. Coaches/Athletics Trainers

       7. Teachers SED Centers/Special needs cluster sites

       8. Staff trained to perform CPR/AED or First Aid

       9. Health Occupational Service Aid Teachers

       10. Other Employees, as evaluated by their Job Classification









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