Consultation Education & Training (CET) Division MIOSHA Part 554 Bloodborne Infectious Diseases Train the Trainer Program Module 2 Presented By: Consultation Education & Training (CET) Division Michigan Occupational Safety & Health Administration Michigan Department of Energy, Labor & Economic Growth www.michigan.gov/miosha (517) 322-1809

Welcome Welcome to the MIOSHA Bloodborne Infectious Diseases Online Training Module 2. This is a continuation of the MIOSHA program designed to provide an overview of the MIOSHA bloodborne standard. It does NOT fullfill all the training requirements in the Bloodborne Standard nor is it intended to replace facility specific training.

Intended Use: “Train the Trainer” Provide bloodborne infectious diseases information to those who provide training to employees who are at risk of occupational exposure. Provide additional resources to assist trainers in becoming more knowledgeable in topics related to bloodborne infectious diseases.

Module 2 This is a continuation of the MIOSHA Bloodborne Infectious Diseases online training program. This module will provide an overview of Rules 10-16. Note: Rule 12 covers HIV and HBV research laboratories and productions facilities. Due to limited application, this rule will not be included in this overview.

Overview of the Bloodborne Standard Module 1: Module 2: Rule 1 Scope Rule 2 Definitions Rule 3 Exposure determination Rule 4 Exposure control plan Rule 5 Universal precautions Rule 6 Engineering controls Rule 7 Work practices Rule 8 Protective work clothing and equipment Rule 9 Housekeeping Rule 10 Regulated waste Rule 11 Laundry Rule 12 HIV and HBV research laboratories and production facilities Rule 13 Vaccinations and postexposure follow-up Rule 14 Communication of hazards to employees Rule 15 Recordkeeping Rule 16 Information and training Appendices

Rule 10 Regulated Waste Disposal Regulated Waste shall be placed into containers or bags that are: Closable Leakproof Color-coded or labeled For contaminated sharps all the above plus puncture-resistant

Rule 11 Laundry Minimize agitation Bag at the location where it is generated Color-coded bags or containers Cleaned and laundered in such a way to inactivate or destroy bloodborne pathogens

The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard: Rule 10 Regulated Waste Rule 11 Laundry

Rule 10-11 Waste and Laundry Questions and Answers: Questions and answers will appear below. There will be delays to allow time to answer the questions. True or False: This container is acceptable for disposal of contaminated sharps: False. Improper label and/or color. See Rule 10 (2) Employees may launder their contaminated work clothes at home. False. Rule 11 (5) states that the employer is responsible to laundry contaminated clothing. Detergent

Rule 13 Vaccinations and postexposure follow-up Performed by a licensed health care professional Provided at no cost by the employer Provided according to U.S. public health service (Centers for Disease Control and Prevention). Counseling

Rule 13 Vaccinations and postexposure follow-up Continued Hepatitis B Vaccine Offered within 10 days HBV antibody testing offered after new employee vaccination Employees may decline the series Note: Clarification related to offering the HBV vaccination to 1st Aid providers is available through a Federal OSHA letter of interpretation (External link)

HBV Antibody Testing May request an antibody titre test. (i.e. if vaccinated from a previous employer). According to Current CDC recommendations (for new employees): Must offer antibody titre within 60 days of the last vaccine in series. If not responder, offer series of 3 again and titre as described above. If still non-responder, follow CDC guidelines as appropriate. Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis (External link)

The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard: Rule 13 Vaccinations and postexposure follow-up

Rule 13 HBV Vaccination and Titre Questions and Answers: Questions and answers will appear below. There will be delays to allow time to answer the questions. True or False. Antibody testing is to be offered to new employees who accept the HBV vaccine within 30-60 days following administration of the HBV vaccination series. True. Rule 13(2) states that an employer shall provide according to the current recommendations of the U.S. public health service [CDC]. Note: Current CDC recommendations can be found in the Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis (External link)

Rule 13 Vaccinations and postexposure follow-up Continued Medical Evaluation Confidential Route of exposure (i.e. needlestick, splash to eyes, etc.) Source individual identification and testing Exposed individual blood testing Postexposure prophylaxis as recommended by U.S. public health service (CDC) Counseling Evaluation of illnesses

Rule 13 Vaccinations and postexposure follow-up Continued Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV and HIV and Recommendations for Postexposure Prophylaxis Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis (External link)

Rule 13 Vaccinations and postexposure follow-up Continued Employers shall provide to health care professionals a copy of the BID Rules and appendices

Rule 13 Vaccinations and postexposure follow-up Continued Employers shall ensure that health care professionals who evaluate employees after an exposure have been given the following information: Description of employees duties as related to the exposure incident Documentation of the route and circumstances surrounding the exposure Results of the source individual’s blood testing Relevant medical records (including vaccine) Description of PPE used or to be used

Rule 13 Vaccinations and postexposure follow-up Continued Employer shall obtain and provide to exposed employee a copy of the health care professional’s written opinion limited to: Any limitation on employee use of PPE HBV vaccine information Statement that employee has been informed of test results and medical conditions that may have resulted from exposure

The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard: Rule 13 Vaccinations and postexposure follow-up

Rule 13 Post-exposure Follow-up Questions and Answers: Questions and answers will appear below. There will be delays to allow time to answer the questions. True or False: Employee medical evaluations and test results are confidential. True. Rule 13 (5) Employers have the right to know the HIV status of their employees. False. Rule 13 (7) (c) states that the employer has the right to receive a statement that employee has been informed of test results and medical conditions that may have resulted from exposure

Rule 14 Communication of Hazards to Employees Signs posted in work areas Labels affixed to containers of blood or OPIM

Rule 15 Recordkeeping Employer shall establish and maintain medical records for each category A employee for duration of employment plus 30 years. Training records shall be maintained for 3 years

Rule 15 Recordkeeping Continued Sharps Injury Log for contaminated sharps injuries must contain: Type and brand of device Work unit or area where the incident occurred Explanation of how it happened Must protect employee confidentiality Applies to employers required to maintain a log under Part 11 Recording and Reporting of Occupational Injuries and Illnesses Note: Employers are permitted to use the 300 Log to record sharps injuries and are encouraged to use separate page(s) of the log just for recording sharps injuries.

The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard: Rule 14 Communication of hazards to employees Rule 15 Recordkeeping

Rule 15 Recordkeeping Questions and Answers: Questions and answers will appear below. There will be delays to allow time to answer the questions. True or False: Employee medical records shall be kept for 5 years. False. Rule 15 (4) states that an employer shall establish and maintain medical records for each employee for duration of employment plus 30 years. Employers shall establish and maintain a log of contaminated sharps injuries. True. Rule 12 (A) Note: Exception described in Rule 12 (b) and (c) .

Rule 16 Information and Training Required for all category A employees At no cost During work hours At the time of initial assignment Annual refresher Appropriate for the educational level, literacy, and language of employees

Rule 16 Information and Training Continued Contents of the training program: Accessibility and explanation of the BID Rules Epidemiology and symptoms of bloodborne diseases Modes of BID transmission Exposure Control Plan with SOPs Methods for recognizing tasks and procedures that involve exposure to blood or OPIM

Rule 16 Information and Training Continued Contents of the training program (continued): Use and limitations of: Engineering controls Work Practices PPE PPE selection criteria Hepatitis B vaccine including availability, efficacy, benefits and no cost

Rule 16 Information and Training Continued Contents of the training program (continued): What actions to take in case of an emergency involving blood or OPIM Follow-up procedures Signs and labels or color coding

The next slide will provide questions to assist with reviewing the Bloodborne Infectious Diseases Standard: Rule 16 Information and training

Rule 16 Information and Training Questions and Answers: Questions and answers will appear below. There will be delays to allow time to answer the questions. True or False: Training is required for Category A employees initially and at least annually. True. Rule 16 (2). This MIOSHA training program meets all the employee training provisions. False. Refer to Rule 16 (5) (a)-(l) for all the required training elements.

Contact MIOSHA for Additional Information Questions: www.michigan.gov/askmiosha Consultation Education and Training Division: (517) 322-1809 General Industry Safety and Health Division (Compliance): (517) 322-1831 Link to additional online resources. Return to the MIOSHA homepage.

Thank you for participating This completes the overview of the MIOSHA Bloodborne Infectious Diseases Standard. Please take a moment to provide feedback related to your training experience: MIOSHA Website Survey