Sections:
2.120.070 - Methods for implementation and maintenance.
This exposure control plan of the county intends to follow the WISHA Bloodborne Pathogens Standard WISHA WAC 296-62-08001, the Washington Regional Directive WRD 96-2, and any other applicable laws or rules, in order to eliminate or minimize the occupational risk to employees and volunteers from exposure to, and possible subsequent infection with, bloodborne diseases.
(Res. 52-96 (Att. A § I), 1996).
The county applies all safety regulations, as outlined in WAC 296-62-08001 and the Washington Regional Directive WRD 92-6, to the workplace practices of employees considered at occupational risk of exposure. The designation of "occupational risk" applies to all employees who, in the course of their assigned duty, have reasonably anticipated potential for exposure to blood and/or other potentially infectious materials.
(Res. 52-96 (Att. A § II), 1996).
The exposure control plan of the county contains the following elements:
(1)
The exposure determination for occupational risk.
(2)
The methods of implementation for:
(A)
Methods of compliance;
(B)
Hepatitis B vaccination and post-exposure evaluation and follow-up;
(C)
Communication of hazards to employees; and
(D)
Recordkeeping of requirements in the exposure control plan, the standard, and the WRD.
(3)
The procedure for the evaluation of circumstances surrounding exposure incidents.
(Res. 52-96 (Att. A § III), 1996).
(a)
The county makes available to employees a copy of the exposure control plan, the standard, WAC 296-62-8001, and the Washington Regional Directive WRD 92-6. Copies shall be posted in each department. Employees may request personal copies from the department heads and elected officials.
(b)
The county enforces compliance with the components of the exposure control plan. The department heads and elected officials are responsible for implementation, maintenance and supervision of this exposure control plan and of the applicable departmental plans.
(c)
The exposure control plan is reviewed and updated at least annually, and whenever necessary to:
(1)
Reflect new or modified tasks and procedures which affect occupational exposure;
(2)
Address new or revised employee positions with occupational exposure; and
(3)
Address changes in the law.
(d)
The exposure control plan is available to WISHA inspectors upon request for examination and inspection.
(Res. 52-96 (Att. A § IV), 1996).
For the purposes of this chapter:
"Bloodborne pathogens" means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).
"Contaminated" means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.
"Contaminated laundry" means laundry that has been soiled with blood or other potentially infectious materials or which may contain sharps.
"Contaminated sharps" means 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" means 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.
"Department head" means employees, elected officials, or any designated representative, managing departments under the jurisdiction of the county.
"Employee" means any elected official and/or salaried, full-time, part-time, seasonal, intern, or nonsalaried reserve employee, or volunteer, working for the county.
"Engineering controls" means controls (e.g., sharps disposal containers or self-sheathing needles) that isolate or remove the bloodborne pathogens hazard from the workplace.
"Exposure incident" means a specific eye, mouth, other mucous membrane, nonintact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties.
"Handwashing facilities" means a facility providing an adequate supply of running potable water, soap and single use towels or hot-air drying machines.
"HBV" means hepatitis B virus.
"HIV" means human immunodeficiency virus.
"Licensed healthcare professional" means a person whose legally permitted scope of practice allows him or her to independently perform the activities required by the standard, and WRD for hepatitis B vaccination and post-exposure evaluation and follow-up.
"Occupational exposure" means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.
"Other potentially infectious materials" means:
(A)
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;
(B)
Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and
(C)
HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.
"Parenteral" means piercing mucous membranes or the skin barrier through such events as needlesticks, human bites, cuts, and abrasions.
"Personal protective equipment" means specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g., uniforms, pants, shirts or blouses) not intended to function as protection against a hazard are not considered to be personal protective equipment.
"Regulated waste" means liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials.
"Source individual" means any individual, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to the employee. Examples include but are not limited to: hospital and clinic patients; clients in institutions for the developmentally disabled; trauma victims; clients of drug and alcohol treatment facilities; residents of hospices and nursing homes; human remains; and, individuals who donate or sell blood or blood components.
"Universal precautions" means an approach to 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 and other bloodborne pathogens.
"Work practice controls" means controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g., prohibiting recapping of needles by a two-handed technique).
(Res. 52-96 (Att. A § V), 1996).
(a)
Exposure Determination for Occupational Risk.
(1)
Assessment. The county has assessed employees (full-time, part-time, seasonal) and volunteers for reasonably anticipated potential for exposure during the performance of their duties. Exposure determination is based on the risk of exposure potential prior to the use of engineering controls and/or protective equipment. This exposure determination contains the following:
(A)
A list of all job classifications in which all employees have occupational exposure;
(B)
A list of job classifications in which some employees have occupational exposure; and
(C)
A list of all tasks and procedures, or groups of closely related tasks and procedures, in which occupational exposure occurs and that are performed by employees.
This exposure determination applies to all new hires and/or newly created positions.
(2)
Application. Any employee of the county who, in the course of assigned duties, has reasonably anticipated potential for exposure to blood and/or other potentially infectious materials is included in the application of the "Exposure Control Plan for Employees with Occupational Risk" of the county.
The county has determined to offer post-exposure follow-up to employees, who are not included in the occupational risk category, but may have experienced an exposure acting as "good samaritans" in a first aid incident while on duty.
(3)
Criteria for Occupational Exposure. The county uses the definitions of "bloodborne pathogens," "other potentially infectious materials," and "occupational exposure" as criteria in the determination of occupational risk.
(Res. 52-96 (Att. A § VI), 1996).
2.120.070 - Methods for implementation and maintenance.
(a)
Methods of Compliance.
(1)
General. Universal precautions shall be observed to prevent contact with blood or other potentially infectious materials. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered as "other potentially infectious materials" (OPIM).
The department heads and elected officials shall require that employees at occupational risk apply universal precautions at all times of potential risk of exposure to blood or other potentially infectious body fluids.
(2)
Engineering and Workplace Practice Controls.
(A)
Implementation. Engineering and work practice controls shall be used to eliminate or minimize employee exposure. Where occupational exposure remains after institution of these controls, personal protective equipment shall also be used.
The department heads and elected officials shall require that employees use the appropriate engineering control device, together with safe work practices and applicable personal protective equipment.
Employees shall use applicable engineering controls, coupled with safe work practice controls and personal protective equipment, as taught in training. Employees shall have the opportunity to participate in practice sessions, which will give the employee ample opportunity to practice using engineering controls, safe work methods and the correct use/removal of personal protective equipment.
(B)
Examination and Maintenance. Engineering controls shall be examined and maintained or replaced on a regular schedule to ensure their effectiveness.
The department heads and elected officials shall provide appropriate selection, purchase, proper examination, maintenance, and replacement of engineering controls. Employees shall follow established procedures.
(C)
Handwashing Facilities and Interim Methods. The county provides handwashing facilities that are readily accessible to employees.
The department heads and elected officials shall make available designated handwashing facilities. Employees shall use correct handwashing technique, as observed in training.
When provision of handwashing facilities is not feasible in field work, the county provides either an appropriate antiseptic hand cleanser, in conjunction with clean cloth/paper towels, or antiseptic towelettes. When antiseptic hand cleansers or towelettes are used, hands shall be washed with soap and running potable water as soon as feasible.
The department heads and elected officials shall provide interim cleansers at worksites. Employees shall use interim cleansers whenever necessary. Vehicles shall be considered worksites.
(D)
Handwashing Procedures. The county requires that employees wash their hands immediately, or as soon as feasible, after removal of gloves or other personal protective equipment. Employees shall use correct handwashing procedures.
(E)
Post-Exposure Self-Care. The county requires that employees wash hands and any other skin with soap and water, or flush mucous membranes (eyes, nose, mouth) with water immediately, or as soon as feasible, following contact of such body areas with blood or other potentially infectious materials.
The department heads and elected officials or designated employees assisting in post-exposure follow-up shall require that, in the event of an exposure, self-care is appropriately administered. Designated employees assisting in post-exposure follow-up shall use the supervisor checklist form.
(F)
Safe Handling of Needles. Contaminated needles and other contaminated sharps shall not be bent, recapped, or removed except as noted below. Shearing or breaking of contaminated needles is prohibited. The department heads and elected officials shall require that employees handle needles in the prescribed safe manner.
Contaminated needles and other contaminated sharps shall not be recapped, or the needle removed, unless no alternative is feasible or such action is required by a specific medical procedure. The department heads and elected officials shall require that the employee document any variances to the required procedures in writing.
Recapping or needle removal shall be accomplished through the use of a mechanical device or a one-handed technique. Employees shall be trained on the proper technique of using a mechanical device for needle removal or one-handed recapping.
(G)
Use of Sharps Containers. Immediately or as soon as possible after use, contaminated sharps shall be placed in appropriate containers for proper disposal. These containers shall be:
(i)
Puncture resistant;
(ii)
Labeled with a biohazard label or color-coded red, in accordance with the standard;
(iii)
Leakproof on the sides and bottom; and
(iv)
In accordance with the requirements set forth in this exposure control plan, the standard, and the WRD for reusable sharps.
The department heads and elected officials shall make sharps containers available and shall require the use of these containers by employees at all times for disposal and transport of sharps. Proper use and handling of sharps and sharps containers shall be demonstrated in training. Employees shall be given the opportunity to practice these safety procedures.
(H)
Separation of Personal Practices from Work Practices. Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in work areas where there is a reasonable likelihood of occupational exposure.
The department heads and elected officials shall require that employees keep all personal food and cosmetic practices separate from work areas.
County vehicles, such as patrol cars, shall be considered workplaces.
(I)
Separation of Food Storage from Storage of Infectious Material. Food and drink shall not be kept in refrigerators, freezers or cabinets, or on shelves, countertops or benchtops where blood or other potentially infectious materials are present. Special attention shall be placed on areas where evidence is collected, sorted and tagged.
The department heads and elected officials shall require that employees keep all food and drink separate from such work areas.
(J)
Risk Procedures. All procedures involving blood or other potentially infectious materials shall be performed in such a manner as to minimize splashing, spraying, spattering, and generation of droplets of these substances.
The department heads and elected officials shall provide training for employees and require them to consistently use safe techniques when performing procedures with potential exposure to blood and other potentially infectious material.
(K)
Collection, Handling and Transport of Specimens. Specimens of blood or other potentially infectious materials shall be placed in a container which prevents leakage during collection, handling, processing, storage, transport, or shipping.
(L)
Evidence materials are considered specimens and shall be treated accordingly. The department heads and elected officials shall provide special training on evidence handling, transport and storage to employees asked to perform such work practices, and require them to use correct procedures.
Containers for storage, transport or shipping shall be labeled or color-coded in accordance with the exposure control plan of the county, the standard, and the WRD, and closed prior to being stored, transported and/or shipped.
If outside contamination of the primary container occurs, the primary container shall be placed within a second container which prevents leakage during handling, processing, storage, transport, or shipping and is labeled or color-coded according to the requirements of the standard.
If the specimen could puncture the primary container, the primary container shall be placed within a secondary container which is puncture-resistant, in addition to the above characteristics.
The department heads and elected officials shall make such containers available to the employee and shall require the use of proper handling practices.
(M)
Decontamination, Labeling and Shipping of Containers. Equipment which may become contaminated with blood or other potentially infectious materials shall be examined prior to servicing or shipping and shall be decontaminated as necessary, unless decontamination of such equipment or portions of such equipment is not feasible. The department heads and elected officials shall require that employees properly assess and decontaminate such containers.
A readily observable biohazard label, designed in accordance with the exposure control plan, the standard, the WRD, and federal postal regulations, shall be attached to the equipment stating which portions remain contaminated. The department heads and elected officials shall require that employees use proper labeling of such containers.
The county conveys this information to affected employees, the servicing representative, and/or the manufacturer, as appropriate, prior to handling, servicing or shipping, so that correct precautions can be taken. The department heads and elected officials shall require that employees use proper notification, observing all applicable regulations, prior to shipping.
(3)
Personal Protective Equipment.
(A)
Provision of Personal Protective Equipment. When there is the risk of occupational exposure, the county provides, at no cost to the employee, appropriate personal protective equipment such as, but not limited to, gloves, gowns, laboratory coats, face shields or masks and eye protection, and mouthpieces, resuscitation bags, pocket masks, or other ventilation devices.
Personal protective equipment shall be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employee's work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time the protective equipment shall be used.
The department heads and elected officials shall assess exposure-prone tasks and procedures performed by the employees considered at occupational exposure risk, and provide and require the use of appropriate protective equipment. Department heads and elected officials shall provide adequate personal protective equipment for all exposure levels.
Employees at occupational exposure risk shall use protective equipment for the various levels of risk. Department heads and elected officials shall give employees the opportunity to practice the correct use, removal and disposal of personal protective equipment.
Department heads and elected officials shall complete the job hazard analysis form for each task requiring personal protective equipment. Completed forms shall be added to the departmental risk designation and work procedures. Department heads and elected officials shall consult with the employees on the completion of these forms.
(B)
Use of Personal Protective Equipment. The county shall require that employees use appropriate personal protective equipment whenever there is potential for exposure to blood and/or other potentially infectious material.
A variance to this mandate may occur if the department head can show that an employee temporarily and briefly declined to use personal protective equipment when, in the specific rare and extraordinary circumstance, it was the employee's professional judgment that its use would have prevented the timely delivery of health care or public safety services, or would have posed an increased hazard to the safety of the worker or co-worker.
When an individual employee makes this judgment, the circumstances shall be investigated and documented in order to determine whether changes can be instituted to prevent such occurrences in the future.
The department heads and elected officials shall investigate and document each case of nonuse of personal protective equipment, using the documentation form for nonuse of protective equipment.
(C)
Accessibility of Personal Protective Equipment. The county shall make readily accessible appropriate personal protective equipment, in the correct sizes, at the worksite and/or as issued to employees. Hypoallergenic gloves, glove liners, powderless gloves, or other similar alternatives shall be readily accessible to those employees who are allergic to the gloves normally provided.
The department heads and elected officials shall purchase and supply appropriate personal protective equipment. A supply and storage system shall be established at each department. Employee input for alternate and/or additional types of protective equipment shall be solicited through the safety committee. The department heads and elected officials shall require employees to verify access to and availability of their personal protective equipment at the beginning of the workshift.
(D)
Cleaning, Laundering, and Disposal of Personal Protective Equipment. The county shall clean, launder and dispose of personal protective equipment required by the exposure control plan, the standard, and the WRD at no cost to the employee.
The department heads and elected officials shall provide a safe system of cleaning, laundering and/or disposal of personal protective equipment. Employee training shall address the location, safe handling and transport of containers. Should the personal clothing of an employee become contaminated, it shall be handled in the same manner as personal protective equipment.
Under no circumstances shall contaminated personal protective equipment and/or contaminated clothing be taken home.
(E)
Repair and Replacement of Personal Protective Equipment. The county shall repair or replace personal protective equipment, as needed to maintain its effectiveness, at no cost to the employee.
The department heads and elected officials shall provide employees with access to a prompt system of repair and adequate supply of all personal protective equipment for replacement on a temporary or permanent basis.
(F)
Removal of Grossly Contaminated Materials. If a garment(s) is penetrated by blood or other potentially infectious materials, the employee shall remove the garment(s) with gloved hands, immediately or as soon as feasible. If such immediate removal is not possible, the employee shall wear a protective disposable body suit over the contaminated clothing while en route from the exposure site to the decontamination area.
The department head shall set aside a decontamination area (separate from regular bath- and/or locker rooms), where contaminated garments can be removed and stored in red biohazard containers. The department shall inform employees during initial training where such decontamination areas are available.
Employees shall be trained on using gloves for the safe removal of all contaminated garments and placement into the appropriate red biohazard container. A sink with warm water and soap shall be readily accessible for thorough washing of skin areas after removal of soiled garments.
(G)
Removal of Protective Equipment in Work Areas. All personal protective equipment shall be removed prior to leaving the work area. The department heads and elected officials shall require employees to use proper safe removal of all personal protective equipment and safe disposal of any contaminated items.
The use of gloves for removal of all contaminated material is mandatory.
(H)
Placement/Transport of Contaminated Material in Biohazard Containers. When personal protective equipment is removed, it shall be placed in an appropriate designated area or container for storage, washing, decontamination or disposal.
The department heads and elected officials shall provide designated decontamination areas with locations for biohazard red containers. A minimum of one container for disposable regulated biohazardous medical waste and one for contaminated laundry shall be available.
Employees removing contaminated personal protective equipment in the field shall place all material into a biohazard red bag and provide for its safe transport in their vehicles. The department heads and elected officials may offer containers in which to place biohazard bags during transport. Immediately or as soon as possible after return to their duty station, employees shall place biohazard red bags into a proper container.
If outside contamination of bag has occurred, the employee shall wear gloves during handling of the biohazard bag. If leakage can occur during transport (i.e., evidence transport), biohazard red bags shall be placed into a leak- and spill-proof container.
(I)
Gloves. Gloves shall be worn when it can be reasonably anticipated that the employee may have hand contact with blood, other potentially infectious materials, mucous membranes, or nonintact skin, and when handling or touching contaminated items or surfaces.
The department heads and elected officials shall make available and require use of appropriate gloves for all work practices where exposure to blood and body fluids can be reasonably anticipated. Work practices include, but are not limited to: patient care; extrication; first aid assistance; apprehension; search procedures; evidence collection; sewage work; garbage collection; decontamination; and, custodial work.
Disposable (single use) gloves, such as surgical or examination gloves, shall be replaced as soon as practical when contaminated, or as soon as feasible if they are torn, punctured, or when their ability to function as a barrier is compromised.
The department heads and elected officials shall provide appropriate disposable gloves for specific practices. Employees shall be trained to recognize the risk associated with various exposure-prone procedures and wear the appropriate glove (i.e., "green gloves" for first aid procedures, utility gloves for cleaning, cut-resistant gloves for searches).
Employees shall change gloves between each patient in direct care or in first aid incidents.
Disposable (single use) gloves shall not be washed or decontaminated for re-use. Employees shall remove gloves as soon as possible, using safe removal techniques, and place gloves in a biohazard bag.
Utility gloves may be decontaminated for re-use if the integrity of the glove is not compromised. However, they shall be discarded if they are cracked, peeling, torn, punctured, or exhibit other signs of deterioration, or when their ability to function as a barrier is compromised.
Employees shall rinse utility gloves with an appropriate cleaning agent and check for cracking and/or cuts. Leakage through small punctures can be detected by filling gloves with water.
(J)
Masks, Eye Protection, and Face Shields. Masks, in combination with eye protection devices such as goggles or glasses with solid side shields, or chin-length face shields, shall be worn whenever splashes, spray, splatter, droplets of blood or other potentially infectious materials may be generated and eye, nose or mouth contamination can be reasonably anticipated.
The department heads and elected officials shall assess the most practical face shield for the specific work practice. For public safety and emergency medical workers, a one-piece face shield offers immediate covering. Such one-piece face shields shall have foam rubber pads across the top and side shields attached to rubber bands which hook over the ears.
Employees shall have ready access to such face shields and use them whenever there is potential for exposure to facial mucous membranes.
(K)
Gowns, Aprons, and Other Protective Body Clothing. Appropriate protective clothing, such as, but not limited to, gowns, aprons, lab coats, clinic jackets, or similar outer garments shall be worn in occupational exposure situations. The type and characteristics shall depend upon the task and degree of exposure anticipated.
The department heads and elected officials shall assess exposure-prone procedures and issue appropriate protective clothing to be used during work practices and/or during travel from an exposure site. Employees shall be trained to recognize exposure risks and to use correct protective clothing.
(L)
Surgical Caps or Hoods and/or Shoe Covers or Boots. Head and shoe coverings shall be worn in instances when gross contamination can reasonably be anticipated. The department heads and elected officials shall assess exposure-prone procedures and issue appropriate coverings. Employees shall have such coverings readily accessible for use at the worksite and for transport.
During investigations of contaminated crime scenes, the use of appropriate protective clothing is mandatory.
(4)
Housekeeping.
(A)
General. The county requires that worksites are maintained in a clean and sanitary condition.
The department heads and elected officials shall determine and implement an appropriate written schedule for cleaning and methods of decontamination, based on the location within the facility, type of surface to be cleaned, type of soil present, and tasks or procedures being performed in the area. This written schedule shall be posted at the worksite and shall be followed by the employees.
The department heads and elected officials shall direct employees to develop cleaning schedules that address regular maintenance and immediate cleaning following contamination. The cleaning schedules shall be written and posted in the appropriate areas for all worksites, including vehicles.
(B)
Cleaning and Decontamination. All equipment and environmental and working surfaces shall be cleaned and decontaminated after contact with blood or other potentially infectious materials. Such cleaning and decontamination shall be performed with utility gloves and other personal protective equipment, as necessary.
Contaminated work surfaces shall be decontaminated with an appropriate disinfectant: after completion of work procedures; immediately or as soon as feasible when surfaces are overtly contaminated; after any spill of blood or other potentially infectious materials; and, at the end of the work shift if the surface may have become contaminated since the last cleaning.
The department heads and elected officials shall assess all areas for appropriate cleaning procedures and require that employees follow written schedule. Cleaning of any contaminated area and/or equipment shall be with the appropriate germicide or a freshly mixed cleaning solution of one part bleach to ten parts water.
Protective coverings, such as plastic wrap, aluminum foil, or imperviously-backed absorbent paper used to cover equipment and environmental surfaces, shall be removed and replaced as soon as feasible when they become overtly contaminated, or at the end of the workshift if they may have become contaminated during the shift.
The department heads and elected officials shall direct employees in evidence collection areas and patient care areas to use proper coverings and apply all methods of safe removal and cleaning.
All bins, pails, cans, and similar receptacles intended for reuse, which have a reasonable likelihood of becoming contaminated with blood or other potentially infectious materials shall be inspected and decontaminated on a regularly scheduled basis. They shall be cleaned and decontaminated immediately, or as soon as feasible, if there is visible contamination.
The department heads and elected officials shall direct employees to include in the cleaning schedule all sharps containers, biohazard waste containers, containers for contaminated laundry and other receptacles that may have been used for storage and/or transport of contaminated materials.
Broken glassware which may be contaminated shall not be picked up directly with the hands. It shall be removed using mechanical means, such as a brush and dust pan, tongs or forceps.
The department heads and elected officials shall direct employees to decontaminate broken glassware prior to cleaning. Employees shall pour germicide over the area containing the broken glass prior to removing it with mechanical means.
Reusable sharps that are contaminated with blood or other potentially infectious materials shall not be stored or processed in a manner that requires employees to reach by hand into the containers where these sharps have been placed.
The department heads and elected officials shall make available safe storage and disposal systems for sharps containers. Employees shall use appropriate safe techniques for the disposal of sharps into large collection containers.
(C)
Regulated Waste. Regulated waste consists of any material that can release contaminated material in a wet (dripping) or dry (flaking) state. Such contaminated waste shall be handled with the appropriate engineering controls and personal protective equipment, in accordance with the standard, the county exposure control plan, and departmental procedures.
(D)
Contaminated Sharps Discarding and Containment.
(i)
Contaminated sharps shall be discarded immediately, or as soon as feasible, in containers that are:
a.
Closable;
b.
Puncture resistant;
c.
Leakproof on sides and bottom; and
d.
Labeled or color-coded.
(ii)
The department heads and elected officials shall assess the types of sharps containers necessary for collection of sharps at the worksite. Employees who may come in contact with sharps in the field shall be offered small portable "needle keepers" and a pair of tongs.
(iii)
During use, containers for contaminated sharps shall be:
a.
Easily accessible to personnel and located as close as feasible to the immediate area where sharps are used or can be reasonably anticipated to be found (e.g., park grounds, crime scenes);
b.
Maintained upright throughout use; and
c.
Replaced routinely and not be allowed to overfill.
(iv)
The department heads and elected officials shall assist employees in designating placement of sharps containers. Employees may need to carry sharps containers in their vehicles. When depositing the needles into the sharps container, the employee shall place the container directly next to the needle and use tongs for picking up the needle. The employee shall not walk with the needle to the sharps container.
(v)
When moving containers of contaminated sharps from the area of use, the containers shall be:
a.
Closed immediately prior to removal or replacement, to prevent spillage or protrusion of contents during handling, storage, transport, or shipping;
b.
Placed in a secondary container if leakage is possible. The second container shall be:
1.
Closable;
2.
Constructed to contain all contents and prevent leakage during handling, storage, transport, or shipping; and
3.
Labeled or color-coded.
(vi)
The department heads and elected officials shall assess the type of transport necessary and assist employees in using the correct method. Transport from field site to workplace may be in the original sharps container. Disposal transport may need to be in a second larger container, in accordance with all of the requirements of the exposure control plan of the county, the standard, and the WRD.
(vii)
Reusable containers shall not be opened, emptied, or cleaned manually or in any other manner which would expose employees to the risk of percutaneous injury. The department heads and elected officials shall provide training for employees on the safe handling of reusable sharps containers utilized by the individual departments.
(E)
Other Regulated Waste Containment.
(i)
Regulated waste shall be placed in containers which are:
a.
Closable;
b.
Constructed to contain all contents and prevent leakage of fluids during handling, storage, transport or shipping;
c.
Labeled or color-coded; and
d.
Closed prior to removal to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.
(ii)
The department heads and elected officials shall place regulated waste containers in each vehicle for transport and a set of containers at each decontamination area at the worksite. Employees shall use containers for the transport and disposal of disposable regulated waste and for contaminated laundry.
(iii)
If outside contamination of the regulated waste container occurs, it shall be placed in a second container. The second container shall be:
a.
Closable;
b.
Constructed to contain all contents and prevent leakage of fluids during handling, storage, transport or shipping;
c.
Labeled or color-coded; and
d.
Closed prior to removal to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.
(iv)
The department heads and elected officials shall provide and require safe-keeping and transport of regulated waste containers. Employees shall recognize potential contamination and use double containers (i.e., a red bag inside of a rigid plastic container).
(v)
The county implements and abides by the regulated waste disposal regulations of the state and local environmental health regulations.
(F)
Laundry. Contaminated laundry shall be handled as little as possible, with a minimum of agitation. Such items may include bedding, clothing, towels, and/or personal clothing. Contaminated laundry shall be handled with gloves.
Contaminated laundry shall be bagged or placed in a container at the location where it was used and shall not be sorted or rinsed in the location of use.
The department heads and elected officials shall direct employees to "red-bag" all contaminated laundry (with gloved hands) as soon as possible after exposure. Uniforms and/or personal clothing shall be considered contaminated laundry and handled accordingly.
Under no circumstances shall contaminated laundry be taken home for laundering.
Contaminated laundry shall be placed and transported in bags or containers that are labeled or color-coded. The department heads and elected officials shall issue red biohazard bags to be utilized by employees for transporting laundry from field location to a decontamination area.
Whenever contaminated laundry is wet and presents a reasonable likelihood of soak-through or leakage from the bag or container, the laundry shall be placed and transported in bags or containers which prevent soak-through and/or leakage of fluids to the exterior.
The department heads and elected officials shall issue plastic containers to be used by employees in transporting wet contaminated laundry and/or material retained as evidence.
The county requires that employees who have contact with contaminated laundry wear protective gloves and other appropriate personal protective equipment.
The department heads and elected officials shall issue utility gloves and instruct employees to use them for handling contaminated laundry. If gross contamination is present, body coverings may need to be worn. All on-site laundry facilities shall be decontaminated after handling and washing contaminated laundry.
When the county ships contaminated laundry off-site to a second facility which does not utilize universal precautions in the handling of all laundry, the facility generating the contaminated laundry shall place such laundry in bags and/or containers which are labeled or color-coded in accordance with the exposure control plan, the standard, and the WRD.
The department heads and elected officials shall provide appropriate warning labels and require employees to affix them to containers when shipping laundry off-site.
(b)
Hepatitis B Vaccination and Post-Exposure Evaluation and Follow-Up.
(1)
General.
(A)
The county makes available the hepatitis B vaccine and vaccination series to employees who have an occupational exposure, and post-exposure evaluation and follow-up to employees who have had an exposure incident.
(B)
Hepatitis B vaccination shall be offered to employees designated to be at occupational exposure risk within ten days of hire or prior to the risk assignment.
(C)
Employees shall sign the hepatitis B vaccination consent/declination form, which shall be kept in the confidential medical records file for the duration of employment plus thirty years.
(D)
Employees who declined the vaccine at the time of initial employment may elect to be vaccinated at any time while being employed by the county, as long as they continue to be classified in a job with occupational risk determination.
(E)
Employees claiming to have been previously vaccinated shall complete the hepatitis B vaccination verification form, and offer proof of completed vaccine series.
(F)
The department heads and elected officials shall track vaccination dates, and offer reminders and the opportunity to employees to be vaccinated on due dates of the series of three vaccine doses, the titer test and, if necessary, any additional doses.
(G)
The county provides that all medical evaluations and procedures, including the hepatitis B vaccine, complete vaccination series and post-exposure evaluation and follow-up, including prophylaxis and laboratory testing, are:
(i)
Made available at no cost to the employee;
(ii)
Made available to the employee at a reasonable time and place;
(iii)
Performed by or under the supervision of a licensed physician or by or under the supervision of another licensed healthcare professional; and
(iv)
Offered in a manner that complies with current recommendations of the United States Public Health Service.
(H)
The county holds a contract with a local healthcare professional. Employees using services under this contract or going to a personal healthcare professional for hepatitis B vaccine and/or post-exposure follow-up shall be permitted work-time and mileage reimbursement.
(I)
The healthcare professional shall offer the series of three intramuscular doses of synthetic hepatitis B vaccine, to be given within a six-month time interval. (First dose; second dose—one month from first dose; third dose—six months from first dose.)
(J)
Post-vaccine immune level testing shall be performed thirty days (or later) after the third dose of the vaccine. All vaccinated employees shall be offered testing for immune response after each verified occupational exposure. If additional doses of the hepatitis B vaccine are indicated after completion of the titer test, the county shall make these doses available to the employee free of charge.
(K)
The county requires that all laboratory tests are conducted by an accredited laboratory at no cost to the employee. If the healthcare professional subcontracts for tests, they shall be conducted by an accredited laboratory.
(2)
Hepatitis B Vaccination.
(A)
Hepatitis B vaccination shall be made available after the employee has received the training required in the exposure control plan, the standard, and the WRD, and within ten working days of initial assignment.
(B)
The provision of hepatitis B vaccine applies to all employees who have a risk to occupational exposure, unless the employee:
(i)
Has previously received the complete hepatitis B vaccination series and has completed the hepatitis B vaccination verification form;
(ii)
Had antibody testing that revealed that the employee is immune; or
(iii)
Has a medical reason which would prohibit the use of the vaccine.
(C)
The department heads and elected officials shall provide notification to new hires, and provide access to training and vaccine (if the employee consents), within ten days or prior to the risk assignment.
(D)
All records of previous vaccination or adequate immune status shall be offered by the employee to the department heads and elected officials and added to the confidential medical record.
(E)
The county does not make participation in an antibody screening program a prerequisite for receiving hepatitis B vaccination. Employees vaccinated with the Heptavax series may request and receive a screening test for verification of immune status. If the immune status is not adequate, the employee may request and receive vaccination with the synthetic vaccine.
(F)
If the employee initially declines hepatitis B vaccination but at a later date, while still under the occupational risk determination, decides to request the vaccination, the county shall make the hepatitis B vaccination available at that time.
(G)
Declination of hepatitis B vaccine may not impact on the selection or assignment of work-duties.
(H)
The county requires that employees who decline to accept the hepatitis B vaccination offered by the county sign the hepatitis B vaccination consent/declination form, which contains the declination statement mandated by the standard. The department heads and elected officials shall forward the form to the human resources department for entry into the confidential medical record.
(I)
If a routine booster dose(s) of hepatitis B vaccine is recommended by the United States Public Health Service at a future date, such booster dose(s) shall be made available. The department heads and elected officials shall notify employees of the need for boosters, if necessary.
(3)
Post-Exposure Evaluation and Follow-Up.
(A)
Following a report of an exposure incident, the county makes immediately available to the exposed employee a confidential medical evaluation and follow-up, including at least the following elements:
(i)
Documentation of the route(s) of exposure and the circumstances under which the exposure incident occurred;
(ii)
Confidential identification and confidential documentation of the source individual, in accordance with WAC 246-100;
(iii)
A request for the source individual's blood to be tested in accordance with WAC 246-100, to determine HBV and HIV infectivity;
(iv)
Availability of the source individual's test results (if the source individual consents to testing), in accordance with applicable confidentiality laws and regulations (WAC 246-100) regarding disclosure of the identity and infectious status of the source individual.
(B)
A supervisor or designated employee shall assist employees in the event of an exposure. The supervisor shall ensure that self-care has been administered prior to reporting the exposure. The exposed employee shall complete the exposure report form with assistance from the supervisor.
(C)
The employee shall use the employee post-exposure information form for all follow-up steps, in case of an exposure.
(D)
Collection and Testing of Blood of an Exposed Employee for HBV and HIV Serological Status. The exposed employee's blood may be collected as soon as feasible. Testing may only be done after consent is obtained in accordance with WAC 246-100 and processed by an accredited laboratory, which uses medical tests currently approved by the United States Public Health Service and the Federal Food and Drug Administration.
(E)
Antibody status testing for hepatitis B has no special consent and counseling requirements, such as HIV testing. Baseline collection procedures shall clearly separate HIV testing from other blood tests. HIV testing can only be done with specific, separate and informed consent, and with pre- and post-test counseling.
(F)
If the employee consents to baseline blood collection, but does not give consent at that time for HIV serologic testing, the sample may be preserved for at least ninety days. If, within ninety days of the exposure incident, the employee elects to have the baseline sample tested, such testing shall be done as soon as feasible. The medical provider shall offer pre- and post-test counseling as prescribed in WAC 246-100.
(G)
Post-exposure prophylaxis, when medically indicated, shall be offered in accordance with current United States Public Health Service recommendations, such as:
(i)
Hepatitis B immunoglobulin and the possibility of one booster shot (or the first shot of the series) of the vaccine;
(ii)
Counseling; and
(iii)
Evaluation of reported illnesses.
(4)
Information Provided to the Healthcare Professional.
(A)
The county provides to the healthcare professional responsible for the employee's hepatitis B vaccination, a copy of the exposure control plan, the standard, and the WRD. A contractual relationship is established with a local healthcare agency/professional, which includes services for all mandates of the standard, the WRD and the exposure control of the county.
(B)
The county provides to the healthcare professional, who is evaluating an employee after an exposure incident, the following information:
(i)
A copy of the standard, and WRD (in case the employee chooses his/her personal physician for post-exposure evaluation and follow-up);
(ii)
A description of the exposed employee's duties as they relate to the exposure incident;
(iii)
Documentation of the route(s) of exposure and circumstances under which exposure occurred;
(iv)
Results of the source individual's blood testing, if available and disclosed in accordance with the confidentiality requirements of WAC 246-100; and
(v)
All medical records relevant to the appropriate treatment of the employee, including the employee's vaccination status.
(C)
The department head shall require that a supervisor or designated employee is available to assist the employee in filling out the exposure report form. Employees shall take a copy to the healthcare professional when requesting post-exposure evaluation, counseling and treatment.
(D)
A copy of the exposure report form shall be forwarded to the human resources department for filing into the confidential medical file of the employee.
(5)
Healthcare Professional's Written Opinion.
(A)
The county obtains from the healthcare professional, and provides to the employee, a copy of the evaluating healthcare professional's written opinion within fifteen days of the completion of the evaluation.
(B)
The department heads and elected officials shall provide the employee with a copy of the evaluation in the prescribed time frame and forward the original written opinion to the human resources department for filing into the confidential medical file.
(C)
The healthcare professional's written opinion for hepatitis B vaccination shall be limited to whether this vaccine is indicated for an employee, and if the employee has received such vaccination. The department heads and elected officials shall add documentation of the vaccination to the employee's medical file.
(D)
The healthcare professional's written opinion for post-exposure evaluation and follow-up shall be limited to the following information:
(i)
That the employee has been informed of the results of the evaluation; and
(ii)
That the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment.
(E)
The healthcare professional shall offer all results to the employee in the medical setting in a confidential manner. Information offered to the employer shall only cover the fact that all necessary steps in post-exposure counseling, evaluation and treatment (if necessary) have been completed.
(F)
All other findings or diagnoses shall remain confidential and shall not be included in the written report. Insurance claims shall be filed by the healthcare professional observing WRD 89-5 (subject: Access, Review and Handling of Specific Employee Exposure and Medical Records and Related Data).
(6)
Medical Recordkeeping. Medical records required by the exposure control plan, the standard, and the WRD are maintained by the county in a confidential manner (separate from personnel files) for the duration of employment plus thirty years.
Medical records for all departments in the county are kept by the human resources department, with limited and designated access and in accordance with the standard, the WRD, and the county exposure control plan.
The department heads and elected officials shall comply and require compliance with WRD 89-5 (subject: Access, Review and Handling of Specific Employee Exposure and Medical Records and Related Data).
Access and release within or between the departments and/or to other entities shall be documented on the medical information access and release form and can only occur with the employee's signature documenting consent to the release. Each access and/or release must be documented.
(7)
OSHA 200 Recordkeeping. The department heads and elected officials shall complete the required OSHA 200 forms after each reportable exposure. A reportable occupational exposure is defined as:
"Occupational exposure" means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.
OSHA 200 forms shall be kept for five years.
(8)
Exposure Evaluation. Designated employees assisting in post-exposure follow-up, shall complete the exposure incident investigation form and forward it to the department heads and elected officials for evaluation and possible action.
If protective equipment was not used, employees shall complete the documentation form for nonuse of protective equipment. The department heads and elected officials shall investigate the incident for further action.
Prompt evaluation of employee exposure incidents and/or nonuse of protective equipment may determine the need for changes in workplace practices, an upgrade of protective equipment and/or engineering controls.
If the evaluation determines continued noncompliance with the exposure control plan, the standard, and the WRD, the department heads and elected officials may initiate remedial and/or disciplinary action of the employee.
Annual exposure control plan review shall evaluate exposures without the use of identifying information of the exposed employees.
(c)
Communication of Hazards to Employees.
(1)
Labels, Color-Coding and Signs.
(A)
Labels/Signs. The department heads and elected officials shall make available biohazard symbols and/or color-coding of waste containers or other receptacles containing regulated waste or contaminated material. Employees shall recognize these symbols and/or color-coding and use them consistently and appropriately.
Warning labels and/or signs shall be affixed to containers of regulated waste, refrigerators and freezers containing blood or other potentially infectious material, and other containers used to store, transport or ship blood or other potentially infectious materials.
Labels required by this section shall include the biohazard symbol. These labels shall be fluorescent orange or orange-red or predominantly so, with lettering and/or symbols in a contrasting color.
Labels required by the standard, and the WRD shall either be an integral part of the container or shall be affixed as close as feasible to the container by string, wire, adhesive, or other method that prevents their loss or unintentional removal.
(B)
Red bags or red containers may be substituted for biohazard labels. Containers of blood, blood components or blood products that are labeled as to their contents, have been released for transfusion or other clinical use, are exempted from the labeling requirements.
Individual containers of blood or other potentially infectious materials that are placed in a labeled container during storage, transport, shipment or disposal are exempted from the labeling requirement.
Labels required for contaminated equipment shall be in accordance with this section and shall also state which portions of the equipment remain contaminated.
Regulated waste that has been decontaminated need not be labeled or color-coded.
The department heads and elected officials shall require that employees handling, transporting, shipping, and/or disposing of regulated waste or contaminated materials, understand and use all applicable labeling, color-coding and/or signs in order to comply with the standard, the WRD, the exposure control plan of the county, and all other applicable state and federal regulations.
(2)
Information and Training.
(A)
The county requires that employees with occupational exposure participate in training which shall be provided at no cost to the employee and during working hours.
(B)
The department heads and elected officials shall notify new hires with occupational risk determination immediately upon hiring in order to schedule training time.
(C)
Training shall be provided as follows:
(i)
At the time of initial assignment to tasks where occupational exposure may take place. Training on bloodborne pathogens prevention, the standard, and the exposure control plan of the county shall be scheduled within ten days from the date of hiring or prior to the risk assignment; and
(ii)
At least annually thereafter.
(D) Annual training for all employees shall be provided within one year of the date of the previous training.
(E)
The department heads and elected officials shall provide annual training on or before the annual compliance date, and follow the exposure control plan update, in order to present the most recent version of the exposure control plan of the county.
(F)
The county provides additional training when changes such as the modification of tasks or procedures, or institution of new tasks or procedures affect the employee's occupational exposure risk. The additional training may be limited to addressing the new exposure risk. Additional training shall also be provided if any provision of the standard, and/or the exposure control plan changes. The department heads and elected officials shall assess these changes and/or updates and arrange for appropriate training to follow as soon as possible.
(G)
Material appropriate in content and vocabulary to the educational level, literacy, and language of employees shall be used in training.
(H)
The department heads, elected officials and human resources manager shall observe and evaluate training sessions on a regular basis, in order to provide quality control of the training and the trainer. Trainers who do not meet the training requirement as specified by the exposure control plan of the county, the standard, and the WRD, may be removed from this duty by the department heads, elected officials, and/or human resources manager.
(I)
The training program shall contain, at a minimum, the following elements:
(i)
An accessible copy of the regulatory text of this standard, and an explanation of its contents.
Copies of the standards shall be available from the department heads and elected officials upon request and one copy posted in each department at all times. The trainer shall be knowledgeable on all components of the standard, and the WRD.
(ii)
A general explanation of the epidemiology and symptoms of bloodborne diseases.
The trainer shall use the most up-to-date information available from the State Department of Health at 1-800-272-AIDS.
(iii)
An explanation of the modes of transmission of bloodborne pathogens.
The trainer shall explain clearly the risk of transmission in the workplace and the risk to a spouse/partner due to sexual transmission.
(iv)
An explanation of the exposure control plan of the county and the means by which the employee can obtain a copy of the written plan.
Copies of the occupational and collateral exposure control plans of the county and the applicable departmental plan shall be available from the department heads and elected officials upon request and one copy posted in each department at all times. The trainer shall be knowledgeable on all components of the county policies, the exposure control plans and the departmental plans.
(v)
An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials.
The trainer shall present this material in a performance-based and site-specific manner. Knowledge of the work practices of the occupationally and/or collaterally exposed employees of the county is mandatory.
(vi)
An explanation of the use and limitations of methods that shall prevent or reduce exposures, including appropriate engineering controls, work practices and personal protective equipment.
The trainer shall demonstrate all methods used to reduce the likelihood of exposures in a task-specific manner appropriate to the work practices of the employees.
(vii)
Information on the types, proper use, location, removal, handling, decontamination, and disposal of personal protective equipment.
The trainer shall demonstrate all applicable engineering controls, work practices and personal protective equipment, i.e., the safe removal of disposable gloves, handling of contaminated laundry and sharps, collection and storage of evidence, and search procedures. Practice sessions for each employee shall be given, either at the time of training or at the worksite.
(viii)
An explanation of the basis for selection of personal protective equipment.
The trainer shall demonstrate the difference in gloves for safe practices, i.e., utility gloves for cleaning, latex gloves for first aid procedures.
(ix)
Information on the hepatitis B vaccine, including information on its efficacy, safety, method of administration, the benefits of being vaccinated, and that the vaccination shall be offered free of charge.
The trainer shall use the most current medical information on HBV vaccine and offer information on the delivery system of the vaccination for occupationally exposed employees. The trainer shall read the OSHA/WISHA language of the hepatitis B vaccine consent/declination form to all employees during training. Employees shall check consent or declination of the hepatitis B vaccine, sign the form and return to the trainer.
(x)
Information on the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials.
The department heads and elected officials shall designate supervisors who shall be available to assist the employees in case of exposure. The trainer shall make the names of supervisors available during training, or department heads and elected officials shall offer such information prior to the employee's risk assignment.
(xi)
An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that shall be made available.
The trainer shall offer correct self-care information, outline the exposure report form, and explain all components of the medical evaluation and follow-up.
(xii)
Information on the post-exposure evaluation and follow-up that the county is required to provide to the employee following an exposure incident.
The trainer shall explain all components of the medical evaluation and follow-up and the medical report information returned to the county. The confidential recordkeeping system of medical records shall be explained.
(xiii)
An explanation of the signs and labels and/or color-coding required by the exposure control plan, the standard, and the WRD.
The trainer shall offer all information on labels, signs and color-coding as applicable to the departments of the county.
(xiv)
An opportunity for interactive questions and answers with the person conducting the training session.
The trainer shall plan the training with adequate time for questions and answers. If the trainer cannot answer all questions pertaining to the content outlined above, the trainer shall make a referral to a knowledgeable source and/or offer additional time, in order to address all questions.
The person conducting the training shall be knowledgeable in the subject matter covered by the elements contained in the training program, as it relates to the workplace that the training addresses.
The trainer shall be knowledgeable on all required training content in order to train occupationally and/or collaterally exposed employees. The department heads and elected officials shall monitor and evaluate the quality of the training and consistency with the standard, and the mandates of the exposure control plan. Trainers who do not meet the required quality or consistency may be retrained or re-assigned.
The department heads and elected officials may also request the trainer to respond to remedial training requests for employees who have not followed the exposure control plan of the county.
(d)
Recordkeeping.
(1)
Medical Records.
(A)
The county establishes and maintains an accurate record for each employee with an occupational exposure, in accordance with the standard, the WRD and the exposure control plan of the county.
(B)
The human resources department shall be in charge of medical recordkeeping for all departments and employees of the county.
(C)
This record shall be part of a medical records file, which shall be kept in a confidential manner and accessed only by assigned personnel. Access to the record shall be documented on the medical records access and release form, with documentation of the date, time of access, reason, record of transfer, signature of employee accessing the file and the employee giving written permission for access.
(D)
This medical record shall include:
(i)
The name and Social Security number of the employee;
(ii)
A copy of the employee's hepatitis B vaccination status, including the declination form or the dates of all doses of hepatitis B vaccine, and any medical records relative to the employee's ability to receive vaccination, as required by the exposure control plan, the standard, and the WRD, and/or permitted by state laws/rules on confidentiality;
(iii)
A copy of all results of examinations, medical testing (if made available by the employee), and follow-up procedures, as required by the exposure control plan, the standard, and the WRD; and/or permitted by state laws/rules on confidentiality;
(iv)
The county's copy of the healthcare professional's written opinion, as required by the exposure control plan, the standard, and WRD; and
(v)
A copy of the information provided to the health-care professional as required by the exposure control plan, the standard, and the WRD.
(E)
Confidentiality.
(i)
The county provides that employee medical records required by the exposure control plan, the standard, and the WRD, are:
a.
Kept confidential; and
b.
Not disclosed or reported without the employee's expressed written consent to any person within or outside the workplace, except as required by the exposure control plan, the standard, the WRD or as may be required by law.
(ii)
Employees shall sign the medical access and release form for access and transfer of confidential medical records.
(iii)
An employee requesting release of medical records to a new employer shall be counseled that only the information of the hepatitis B vaccination status should be released, but medical information on exposures should stay with the county. A conditional release may be signed by the requesting employee for HBV vaccination information only.
(iv)
The county maintains the records required by the exposure control plan, the standard, and the WRD for at least the duration of employment plus thirty years in accordance with OSHA/WISHA standards.
(2)
Training Records.
(A)
Training records shall include the following information:
(i)
Dates of the training sessions;
(ii)
Contents or a summary of the training sessions;
(iii)
Names and qualifications of persons conducting the training; and,
(iv)
Names and job titles of all persons attending the training sessions.
(B)
The department heads and elected officials shall require trainers to maintain the training roster of attendance with all applicable information and attachments. Trainers shall list all information on acquired training skills and their training qualification.
(C)
Training records shall be maintained for three years from the date on which the training occurred. The human resources department shall establish and maintain a recordkeeping system of completed training.
(3)
Availability of Records. The county makes available all records required to be maintained by the exposure control plan, the standard, and the WRD, upon request, to a WISHA inspector.
Employee training records required by the standard, and the WRD shall be made available, upon request, to a WISHA inspector.
Employee medical records required by this paragraph shall be provided upon request for examination and copying to the subject employee, to anyone having written consent of the subject employee, and/or to a WISHA inspector.
(4)
Transfer of Records. The county complies with the requirements involving transfer of records set forth in the exposure control plan, the standard, and the WRD.
If the county ceases to do business and there is no successor to receive and retain the records for the prescribed period, the county will notify the Washington State Department of Labor and Industries, at least three months prior to their disposal, and transmit them to the department, if required by the department to do so, within that three-month period.
(Res. 52-96 (Att. A § VII), 1996).