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Management of

Hazardous Material

2

OSHA’s Objective

• To provide a safe work environment for all employees

3

Bloodborne/Hazardous Materials Standard

• Scope and application– All employees at risk of exposure to blood

and other potentially infectious materials (OPIM)

4

Bloodborne/Hazardous Materials Standard

• Methods of compliance– Standard precautions– Engineering and work practice controls– Personal Protective Equipment (PPE)– Housekeeping

5

Bloodborne/Hazardous Materials Standard• Standard Precautions

– All blood and OPIMs are considered infectious

– Same precautions must be taken at all times

6

Bloodborne/Hazardous Materials Standard• Engineering controls

– Primary method of controlling exposure– Must be evaluated and documented

regularly

7

Bloodborne/Hazardous Materials Standard• Sharps containers

– Readily accessible– Puncture resistant– Labeled and color coded– Leak proof– Closable– Replaced frequently

8

Bloodborne/Hazardous Materials Standard• Work practice controls and rules

– Handwashing– Handling needles– Behavior in work – Storage of personal items– Handling of hazardous materials– Transport of specimens– Decontamination

9

Bloodborne/Hazardous Materials Standard• Personal Protective Equipment

– Goggles or face shields– Gloves– Protective overgarments– Resuscitation equipment– Readily accessible and stored at worksite

10

Bloodborne/Hazardous Materials Standard• Eye Protection

– Required if risk of splash, spray, or splatter– Prescription glasses should be fitted with

side shields– There must be a plan for decontamination

11

Bloodborne/Hazardous Materials Standard• Gloves

– Must be worn if handling blood or OPIMs– Variety available to meet needs of

employees

12

Bloodborne/Hazardous Materials Standard• Protective clothing

– Must be worn when risk of splash or splatter

– Variety to choose from depending on exposure risk

13

Bloodborne/Hazardous Materials Standard• Housekeeping

– Written schedule for cleaning and disinfecting

– Clean contaminated work areas or equipment as soon as possible

– Use protective coverings over equipment

14

Bloodborne/Hazardous Materials Standard• Regulated waste containers (nonsharp)

– Closeable– Leak proof– Labeled and color coded

15

Bloodborne/Hazardous Materials Standard• Laundry

– Little handling– Bagged where used– Labeled and color coded– Transported in leak proof bags

16

Bloodborne/Hazardous Materials Standard• Hepatitis B vaccination

– Made available upon employment– Free to employees– Must sign form if declined– Must be available at later date if refused

17

Bloodborne/Hazardous Materials Standard• Post-exposure follow-up

– Wash thoroughly– Have blood drawn as soon as possible or

within two hours– Document incident– Identify source– Attempt to test source– Provide results

18

Bloodborne/Hazardous Materials Standard• Labels

– Should say “Biohazard”– Fluorescent orange and orange-red– Red bags or containers

19

Bloodborne/Hazardous Materials Standard• Information and training

– Required– Initially upon employment

• Annually thereafter

– At adequate levels for employee understanding

– Interactive

20

Bloodborne/Hazardous Materials Standard• Training components

– Explanation of standard– Epidemiology and symptoms– Modes of transmission of HIV/HBV– Exposure control plan– Engineering controls

21

Bloodborne/Hazardous Materials Standard• Training components

– PPE– Decontamination vaccination– Post-exposure procedures– Labels and color coding

22

Bloodborne/Hazardous Materials Standard• Medical records

– Kept for each employee– Vaccination status– Post-exposure follow-up procedures– Health care professional’s written opinion– Maintained for 30 years

23

Bloodborne/Hazardous Materials Standard• Training records

– Kept for three years from date of training – Contents of training– Qualifications of trainer– Names and job titles of persons attending

24

Bloodborne/Hazardous Materials Standard• Exposure control plan components

– Must be written– Must reference existing policies and

procedures

25

Bloodborne/Hazardous Materials Standard• Exposure control plan

– List job classifications at risk– List tasks with risks– State compliance policies and procedures– Sharps disposal procedures

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Bloodborne/Hazardous Materials Standard• Exposure control plan

– Disinfection policies and procedures– PPE procedures– Procedures for disposal of regulated

wastes

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• Employees list tasks and identify category of risk

Laboratory technician

Assistant

Hygienist

Dentist

Exposure to blood,saliva, and body tissue

Category One

Receptionist

Coordinating assistant

Occasional exposure

Category Two

Insurance processor

Accountants

No exposure

Category Three

Exposure Control PlanJob Classifications

Occupational Exposure Determination

28

Bloodborne/Hazardous Materials Standard• Exposure control plan

– Laundry procedures– Hepatitis B vaccination procedures– Post-exposure follow-up procedures– Training– Updated annually

29

Bloodborne/Hazardous Materials Standard• Employee responsibilities

– Attend training– Follow rules– Practice universal precautions, safe work

practices, and engineering controls– Use PPE– Report unsafe conditions– Maintain cleanliness of work areas

30

Revisions to OSHA Standard

• April 2001– Needlestick Safety and Prevention Act – Required OSHA to revise the standard

31

Revisions to OSHA Standard

• Employer must solicit input from employees

• Input must be documented in the plan

• Sharps injury log must be maintained

• Use of safer medical devices

32

Engineering and Work Practice Controls

• Splash guards

• Sharps containers

• Ventilation hoods

• Needleless systems

33

Sharps

• Needle guards

• Never recap using two hands

• Proper disposal

34

Sharps Container

• Red • Biohazard label• Puncture-resistant• Leak-proof• Sealed lid

35

Occupational Exposure to Bloodborne Pathogens• Report exposure immediately

• Provide confidential medical evaluation

• Document exposure on incident report

• Employee testing

• Post-exposure follow-up

36

• Employee “right to know” law– Employees have the right and need to

know the identity and health hazards of the chemicals they use in a dental office.

Hazardous Chemicals

37

Hazardous Chemicals

• Employee training

• Chemical inventory record

• Safety measures for handling of chemicals

• Product MSDS sheets

• Labeling of chemical containers

38

Material Safety Data Sheets

• Identifies chemicals in product

• States health and safety information

• Provided by manufacturer

• One copy for each dental product

• Stored in notebook with easy reference guide

39

Chemical Warning Labels

• Developed by the National Fire Protection Agency

• Warns employees using chemicals about hazards