ࡱ> )F&'(s bjbj2)2) )mPCfPCfY_btt""V"V"V"D"""#,F$"fB&X&n&n&n&*6aTr,$6HV"|*"*||""n&n&e4|R"8n&V"n&|ғ>"ܕ&仧*<fϔ4Y}4,u"4V"IzZz@z4{IzIzIz%IzIzIzf||||4IzIzIzIzIzIzIzIzIztX : APPENDIX A WASHINGTON STATE UNIVERSITY VANCOUVER BLOODBORNE PATHOGEN EXPOSURE CONTROL PLAN SectionTitlePage1.0INTRODUCTION12.0JOB CLASSIFICATIONS WITH RISK OF OCCUPATIONAL EXPOSURE13.0UNIVERSAL PRECAUTIONS14.0ENGINEERING CONTROLS15.0SHARPS CONTAINERS26.0SPECIMEN CONTAINERS27.0WORK PRACTICE CONTROLS28.0PERSONAL PROTECTIVE EQUIPMENT48.1Natural Rubber Latex (NRL) Health Alert58.2Gloves59.0BIOHAZARD LABELING610.0CONTAIMATED EQUIPMENT711.0TRAINING712.0 HEPATITIS B VACCINATION INFORMATION813.0POST-EXPOSURE EVALUATION AND FOLLOW-UP1013.1Post-Injury Protocol1013.2Information Provided to Healthcare Provider1013.3Healthcare Professionals Written Opinion1013.4Exposure Incident Reporting1113.5Sharps Injury Log1114.0RECORDKEEPING1115.0ANNUAL BLOODBORNE PATHOGEN REVIEW1116.0BIOHAZARDOUS WASTE1117.0CONTAMINATED SHARPS DISPOSAL1218.0GLASS DISPOSAL PROCEDURES1319.0HANDWASHING1320.0DISINFECTANT FOR BLOOD AND BODY FLUID SPILL CLEAN-UP1321.0EQUIPMENT AND ENVIRONMENTAL SANITATION1422.0SPILL CLEAN-UP PROCEDURE FOR BLOOD AND BODY FLUIDS1523.0FIRST AID INOVLING BLOOD AND BODY FLUIDS1624.0PUBLIC SAFETY PROCEDURES16 WASHINGTON STATE UNIVERSITY VANCOUVER BLOODBORNE EXPOSURE CONTROL PLAN 1.0 INTRODUCTION The purpose of this plan is to provide information regarding handling of human tissue and fluids to reduce the risk of exposure to infectious diseases. It affects all employees of WSU with anticipated occupational exposure to human blood or other potentially infectious materials (OPIM). This plan will outline directions for employees to treat all human blood and bodily fluids as if they contained infectious pathogens, and appropriate personal protective equipment (PPE) and engineering controls to reduce the likelihood of exposure. Employees covered by this section are required to have annual training on bloodborne pathogens, which is offered by EH&S. Employees with reasonably anticipated exposure to human blood or bodily fluids as defined by their job description may also need immunizations for Hepatitis B virus (HBV). Supervisors/departments are required to retain copies of this plan, plan reviews, training records, and employee vaccinations (WAC 296-823). 2.0 JOB CLASSIFICATIONS with RISK of OCCUPATIONAL EXPOSURE Job Classifications with Routine Risk for Occupational Exposure Nursing faculty and students are routinely at risk for Occupational Exposure to Bloodborne Pathogens during patient care. The Nursing Department needs are unique, and the department is required to develop a plan to protect faculty and students from exposure to Bloodborne Pathogens separate from this document. Job Classifications with Tasks with Risk for Occupational Exposure Job ClassificationTasks with Risk of Exposure to Bloodborne Pathogens Custodial StaffEmptying trash containers, discarded needles, blood and OPIM spill clean-up EH&S CoordinatorBlood and OPIM clean-upPublic SafetyFirst aid or altercationsChildcareToileting, child bites, diapering, first aid 3.0 UNIVERSAL PRECAUTIONS All human blood and bodily fluids should be treated as if they contained infectious pathogens. For each task that puts the employee at risk of exposure to human blood or blood products, universal precautions will be used. 4.0 ENGINEERING CONTROLS An engineering control is the use of available technology and device(s) to isolate or remove hazards from the worker. Engineering controls such analytical instruments, processors, local ventilation, permanent barriers, etc need to be evaluated first, before using administrative methods or personal protective equipment to prevent exposure to human blood and body fluids. Available technology will be reviewed at least annually during the Plan review. 5.0 SHARPS CONTAINERS In general, sharps containers used for discarding contaminated needles, etc. must be easily assessable to personnel, closable, puncture resistant, leak-proof on the sides and bottom, and appropriately labeled or color-coded. Additionally, sharps containers must: * Have well designed needle unwinders, which do not create additional hazards, allow employees to use the unwinders with a one-handed technique, and provide secure needle capture that prevents movement of the needle while it is being removed. * Be designed so that it is easily and safely determined when the containers are full, so containers are not overfilled. * Be stable when placed on horizontal surfaces, and when placed in trays, holders, or enclosures as per manufacturers directions. * Be maintained upright and closed when moved or replaced. Contact EHS (6-9706) to obtain and/or replace sharps containers. Single-Use Sharps Disposal Tubes for Custodians and Public Safety The single-use sharp disposal containers available through 91ԹϺ EH&S are used for containment of discarded needles. They are utilized to ensure recapping of needles is unnecessary. When containers are filled, contact the WSUV EH&S Coordinator to have the sharps container removed to Physical Plant Building, Room 20. 6.0 SPECIMEN CONTAINERS See WAC 296-823-14045 for specimen container specifications. Potentially Public Safety could transport Blood or OPIM as evidence. Specimen containers should prevent leakage, be color-coded and labeled and be placed inside secondary containment, when contaminated or specimen could puncture the original container. 7.0 Work Practice Controls The following universal precautions are mandatory: * Persons working with human blood and body fluids will use Universal Precautions, Personal Protective Equipment, barrier protection, work practices and/or engineering controls to help prevent potential exposure to bloodborne pathogens. * Facilities with soap and running water for cleaning hands, other skin, and mucous membranes are readily accessible to employees immediately or as soon as feasible after removal of gloves or other personal protective equipment (PPE). If hand washing is not feasible, then an appropriate hand cleanser or antiseptic towelette may be used followed by soap and running water rinse as soon as possible. * Eating, drinking, smoking, and applying cosmetics or lip balm, or handling contact lenses are prohibited in laboratory work areas. * Avoid wearing rings and long or false fingernails as they may puncture gloves and provide a place for micro-organisms to lodge and grow. * Food and drink, cosmetics or other personal hygiene items will not be stored (in refrigerators, freezers, shelves, etc.) where blood or other potentially infectious materials are present. * Mouth pipetting/suctioning of blood or other potentially infectious materials is prohibited. * All procedures involving blood or other potentially infectious materials will be performed in such a manner as to minimize splashing, spraying, spattering, or droplet formation. * A high degree of caution must be utilized when dealing with any contaminated sharp items such as scalpels, needles, lancets, broken glass, utility blades, or capillary tubes. Sharps of any type need to be disposed of in appropriate sharps containers. * Safe occupational use of hypodermic needles and syringes is addressed in WAC 296-823-14045. They may on occasion handle an improperly discarded needle/syringe or broken glass. * Contaminated broken glass will not be handled directly by hand but must be removed by mechanical means such as tongs, dustpan or forceps and placed in an appropriate sharps container. Broken glass containers should not be stored or processed in a manner that requires employees to reach by hand into the containers where the items are stored. * Employees from other WSU departments or non-WSU contractors that may enter areas containing bloodborne pathogens need to be protected from possible exposure. The departmental supervisor is responsible for ensuring contractors/employees are protected from any hazards, and for ensuring compliance with site-specific requirements and all provisions of the bloodborne pathogens standard. * Contaminated work surfaces, equipment, or receptacles (bins, pails, cans, etc.) will be cleaned immediately and disinfected as needed. One of the following disinfectants Rejuvenal HBV, Blue Skies or a 1:10 dilution of chlorine bleach, should be used for decontaminating surfaces and spill sites. Disinfectant contact time consistent with package labeling (usually not less than 10-15 minutes) should be adhered to when decontaminating items/surfaces. * Any equipment or materials contaminated with blood or human body fluids must be decontaminated before coming into contact with personnel not covered by this or their own bloodborne pathogen plan, or trained in universal precautions, including any outside contractors or university personnel. Any material leaving the facility, which potentially may be contaminated, must be sealed and labeled with required labeling information (see biohazardous labeling section). * Blood Borne Pathogen Training is mandatory for any employee working with human blood or OPIM at 91ԹϺ. * Post exposure medical evaluation, and monitoring is necessary after any exposure to human blood or blood products. * Hand washing: wash hands, skin or flush mucous membranes, if direct contact with blood, OPIM, contaminated equipment and/or surfaces occur. Wash hands after removing gloves or other PPE, upon leaving a potential exposure area, or following spill clean-up. Childcare personnel will be expected to wash hands before and after contact/attending to children. First aid providers are expected to wash hands after patient contact. If hand washing is not feasible, an appropriate hand cleanser or antiseptic towelette may be used followed by hand washing with soap and running water as soon as possible. * Laundry: Contaminated laundry will be handled with a minimum of agitation and contained in a labeled and leak proof container. Appropriate gloves and PPE should be worn when handling contaminated laundry. Contaminated clothing shall be double bagged in biohazard bags and sealed with tape. Label the outer bag to identify the contents and potential hazard(s) of the contents. Laundry will be performed by a commercial laundry service, qualified to properly manage laundry contaminated with human blood and body fluids. Red bags can be obtained from Custodial Services. Contact the EH&S Coordinator for a list of qualified laundry vendors. * Contaminated containers, or specimens, blood or OPIM that could puncture the primary container will be placed in a secondary container that is leak proof and puncture resistant. The container shall be properly labeled in accordance with requirements contained within Section 9.0 of this document (Biohazard Labeling). * Biohazardous waste will be disposed of through a States licensed Biohazardous Waste vendor. 8.0 Personal Protective Equipment * Appropriate personal protective equipment (PPE) will be provided by the employer at no cost to the employee. This would include, but not be limited to: gloves, masks, eye protection, face shields, gowns, aprons, and other protective body clothing. * Before assigning PPE necessary for work tasks, the supervisor will complete a written hazard assessment of the hazards involved and determine the appropriate PPE to be used. When the PPE is assigned to the task, the employee will be trained in its proper use and a written record of this training will be retained (refer to the Personal Protective Equipment section of 91ԹϺs Accident Prevention Program). * PPE will be considered appropriate only if it does not permit blood or OPIM to pass through to or reach the employees work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used. * Persons working with human blood and body fluids will use assigned personal protective equipment, in conjunction with barrier protection, work practices and/or engineering controls to help minimize exposure to bloodborne pathogens. * Keep PPE clean and good repair. Replace defective PPE when necessary. * Inspect PPE for defects before donning (e.g. rips, cracks in gloves, worn areas, etc.). * Remove PPE prior to leaving the work area. * Remove PPE immediately (or as soon as feasible), if blood or OPIM penetrates the PPE. * Non-disposable PPE (Air Purifying Respirators, etc.) should be decontaminated/disinfected immediately after use and inspected prior to reuse. * Disposable PPE should not be re-used, and should be placed in a properly labeled biohazardous waste receptacle upon removal. * Wash hands following removal of PPE. * Launder contaminated PPE through a qualified laundry vendor that can process contaminated items. It is illegal to take contaminated work clothing home to launder. 8.1 Natural Rubber Latex (NRL) Health Alert It is suggested that latex gloves not be utilized due to sensitization issues as well as nitrile powdered gloves due to talc content. Natural Rubber Latex (NRL) products contain proteins that may be absorbed through the skin or inhaled and cause allergic reaction in susceptible workers. Studies have indicated that powder, added to gloves to facilitate donning and removal, can serve as a carrier for the allergenic proteins from the NRL. Chemicals used in NRL glove and other glove processing, sanitizers, disinfectants, biocides, oil-based hand lotions and creams, antioxidants, and glove powders have the potential to cause allergic contact dermatitis or irritant contact dermatitis. Use of NRL products, especially gloves, may result in a variety of symptoms. Reactions can vary from localized redness and rash or hives to nasal, sinus, and eye symptoms to asthmatic manifestations including cough, wheeze, shortness of breath, and chest tightness; and rarely, systemic reactions with swelling of the face, lips, and airways that may progress rapidly to shock and potentially, death. 8.2 Gloves * Utility gloves are sturdy, puncture-resistant, unlined gloves that can be disinfected or sterilized, but need to be replaced when their ability to function as a barrier is compromised (cracked, torn, punctured, etc.). Utility gloves are used for handling of chemicals, contaminated instruments, or housekeeping duties (emptying garbage, handling linen, and spill cleaning up) where risk of accidental puncture wounds is anticipated. * Disposable single-use latex, nitrile and/or vinyl gloves can be used when performing housekeeping duties or first aid where there is no accidental puncture wounds or chemical handling anticipated (this does not include emptying trash containers). Disposable latex, nitrile or vinyl gloves are never to be washed and/or reused. * Some situations may call for double gloving for best protection. * Contaminated Glove Removal Technique: To remove soiled gloves without touching contaminated surface of glove with bare hands: * Pinch with right hand the palm of the glove on the left hand and pull left glove down and off fingers; * Form left glove into a ball and hold in fist of right hand while removing the right glove; * Remove the right glove by inserting 2 fingers of left hand under inside rim of right glove on palm side; * Push glove inside out and down onto fingers and over the left glove; * Grasp gloves that are now together and inside out, with the left hand and remove the glove from the right hand; * Discard gloves in appropriate designated waste receptacle; * Wash hands. 9.0 Biohazard Labeling Biohazard labels are utilized to identify bloodborne pathogens and potentially infectious materials in containers and packages, as well as, in laboratories. * Labels should be affixed on, or as close as feasible, to the biohazard container by adhesive, string, wire, or other method that prevents label loss or unintentional removal or affixed to equipment to denote what part(s) remain contaminated. * Prior to storage, shipment, or transport of individual containers of human blood or other potentially infectious materials, all materials shall be labeled utilizing biohazard labels. Biohazard labels shall: * Identify the identity of the infectious agent(s) or bloodborne pathogen(s); * List the name and telephone of the principle investigator/supervisor generating the infectious waste/substance; * Identify the building and room number(s) where the contaminant originated. * Be fluorescent orange or orange-red or predominantly so, with lettering or symbols in a contrasting color. * May be substituted for by using red bags or red containers instead. BioHazard Label Example:  10.0 Contaminated Equipment Equipment that may be contaminated with bloodborne pathogens must be examined prior to shipping or servicing and shall be decontaminated if necessary and feasible. If not feasible, a readily observable label in accordance with WAC 296-823 must be present and the servicing vender must be alerted to the contamination. 11.0 TRAINING Training is required for all personnel that may be involved in spills or otherwise have the potential for occupational exposure to human blood and OPIM. Safety training can be accessed in the link  HYPERLINK "https://wsu.skillport.com/" https://wsu.skillport.com and found under WSU Safety Courses/ WSU Safety Learning Program. A Training Report is automatically sent to Pullman HR department after completion of the training. Training records are retained for at least three (3) years. Training must be provided on tasks and procedures identified in this document by the department of the employee. Training needs to be provided when an employee is initially assigned to duties, when a change occurs in a task that may alter risks of exposure to bloodborne pathogens, new tasks, and at least annually. Initial and annual training needs to include the items listed in WAC 296-823-12005. HEPATITIS B VACCINATION Departmental personnel in job classifications that have been determined to have a risk for occupational exposure and other departmental personnel shall have the option to have a Hepatitis B vaccination. The employee has the option to have the vaccination or not. An up-to date, confidential, record of departmental personnel who have completed the Hepatitis B vaccine injection series will be maintained by the individual department as well as 91ԹϺ EH&S. The immunization program is considered valid for at least 15-years. Those completing the series shall have their Hepatitis B titer tested one to two-months after completing the series to determine if the vaccine was effective. Injured person with a documented exposure incident will be titer tested for immunity to Hepatitis B within 48-hours of the exposure incident. 12.0 Hepatitis B Vaccination Information Hepatitis B virus is a viral infection with a major effect on the liver. The Antigen Hepatitis B vaccine/recombinant is recommended in persons three months of age or older who have an increased risk of infection. Responsiveness is age dependent, with children showing a more active response to the vaccination than adults. The vaccination appears to provide protection for at least 15-years. The vaccination is given according to United States Public Health Service recommendations, and consists of three doses given intramuscularly in the deltoid area: 1st dose: At elected date; 2nd dose: One-month later; 3rd dose: Six-months after the first dose. Risks and Possible Side Effects Some people will have tenderness at the injection site for a few days. Some will have fevers, chills, headaches, muscular aches or a rash within the first 48-hours. Although no serious adverse reactions attributable to the Hepatitis B vaccination were reported during the course of clinical trials, there is always the possibility that a broader use of the vaccine could reveal adverse reactions not observed in the clinical testing. Special Precautions Children, pregnant women, nursing mothers, and persons with severe heart or lung problems should not receive the vaccination series unless they are following specific physician's advice. People who have received another type of vaccine in the past fourteen (14) days should see a physician prior to taking the Hepatitis B vaccine. WASHINGTON STATE UNIVERSITY VANCOUVER HEPATITIS B VACCINATION CONSENT/DECLINATION FORM NAME _______________________________ Department __________________ WSU ID Number _______________________ Hepatitis B VACCINE CONSENT ( Yes, I want the vaccine ( Yes, I want the vaccine but will consult my doctor first Signature ______________________________________ Date ______________ ( No, I decline the vaccine as; I have already received the Hepatitis B vaccination series. Vaccination series was completed on (date and location): ___________________________________________________________ Signature ______________________________________ Date _____________ Hepatitis B VACCINE DECLINATION ( No, I am not interested in being vaccinated at this time. Please read the statement below, mandatory for declinations. I understand that due to my occupational exposure to blood or other potentially infectious materials I may be at risk of acquiring Hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with Hepatitis B vaccine at no charge to myself. However, I chose to decline the Hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with Hepatitis B vaccine, I can receive the vaccine series at no charge to myself. Signature __________________________________ Date __________ EH&SS WSUV rev1 4/03 A copy of this form may be provided by the 91ԹϺ EH&S Office. 13.0 POST-EXPOSURE EVALUATION AND FOLLOW-UP A confidential post-exposure evaluation and follow-up will be provided at no cost to employees who have had an occupational exposure incident to human blood or OPIM. Employees are mandated to seek medical review within 24-hours of the exposure. An exposure incident is defined as a specific eye, mouth, or other mucous membrane, non-intact skin (e.g., paper cuts, hangnails, dry cracked skin, dermatitis, etc.) or piercing of the skin and/or mucous membranes, contact with blood or other potentially infectious materials. 13.1 Post-Injury Protocol When a potential exposure occurs: 1. Discontinue work procedures immediately. Wash or flush the exposed individual exposure area, and provide first aid as required; 2. For a needlestick or percutaneous Injury wash hands and wound site with anti-microbial soap and water. "Force-bleed" the wound if wound is not bleeding spontaneously, and flush site generously with water. WSU policy is that all needle sticks require medical evaluation. 3. For exposure to the eye proceed immediately to any eyewash station and flush eye aggressively with water for 15-minutes. 4. Initiate body-fluid clean-up procedures. 5. Obtain source of OPIMs name and contact information if possible. Convey need for verification of the sources HBV, HCV, HIV infection status, or need for blood draw from source of OPIM to determine if the source has a bloodborne pathogen infection. When possible, a 91ԹϺ representative should accompany the source to NW Occupational Medical Clinic or other medical facility for blood draw immediately after the incident to ensure testing occurs. 6. Per WSU Policy S2.24, the exposed person must be medically evaluated within 24-hours. 7. An incident Report form must be generated by the exposed persons supervisor within 24-hours of the incident. 13.2 Information Provided to Healthcare Provider Information provided to the Healthcare Professional includes: 1. A description of the exposed employees duties during exposure; 2. Documentation of routes of exposure and the circumstances of the incident; 3. Results of the source individuals blood testing, if available; 4. All medical records relevant to the appropriate treatment of the employee. 13.3 Healthcare Professionals Written Opinion 91ԹϺ shall obtain and provide the employee with a copy of the health care professional's written opinion within 15-days of the completion of the evaluation. The written opinion, for the purposes of this evaluation shall be limited to that the employee has been informed of the results of the evaluation and any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment. All other findings shall remain confidential and shall not be included in the written report. 13.4 Exposure Incident Reporting Bloodborne pathogen exposures shall be reported on the WSU Incident Report form athttps://ihr.hrs.wsu.edu/forms/incident_report.aspx, it should be indicated on the report that an exposure to bloodborne pathogens may have occurred. The following information shall be included when filling out the incident report: 1. The department or work area where the exposure incident occurred; 2. An explanation of how the incident occurred; 3. Engineering controls in use at the time; 4. A description of the devise in use at the time of exposure including its type and brand; 5. Protective equipment/clothing in use at the time; 6. Location of injury; 7. Procedure being performed when the incident occurred; 8. The employees training; 9. Recommendations for avoiding such exposure incidents in the future; 10. A copy of this report needs to be kept on file in the department and routed to the appropriate university departments as directed in the 91ԹϺs Accident Prevention Program. 13.5 Sharps Injury Log 91ԹϺ is required to maintain a sharps injury record (for 5-years). This is accomplished by reporting contaminated sharps injuries to Pullman on a WSU Incident Report format https://ihr.hrs.wsu.edu/forms/incident_report.aspx. WSU Environmental Health and Safety (EH&S) lists the sharps injuries on the annual OSHA 300 log. 14.0 RECORDKEEPING Establish and maintain confidential medical records for employees with risk of occupational exposure according to WAC 296-823-17005. 15.0 ANNUAL BLOODBORNE PATHOGEN REVIEW The Exposure Control Plan will be reviewed annually will be revised with any changes in bloodborne pathogen protocol. Initial and annual retraining of employees will also be provided. 16.0 BIOHAZARDOUS WASTE DEFINITION Regulated biohazardous waste is generally defined as any waste that can cause an infectious disease or that reasonably can be suspected of harboring human pathogenic organisms. It is also know as medical waste, red bag waste, infectious waste, potentially infectious waste and biomedical waste. Waste containing bloodborne pathogens is a biohazardous waste. Regulated bloodborne pathogen waste is defined in WAC 296-823 as: liquid or semi-liquid blood or other potentially infectious material (OPIM); contaminated items that would release blood or OPIM in a liquid or semi-liquid state if compressed; items that are caked with dried blood or OPIM and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or OPIM. BIOHAZARDOUS WASTE IDENTIFICATION for VENDORS Transportation and disposal vendor personnel who handle bio-hazardous waste materials shipped off campus from 91ԹϺ must be informed of the identity of any biological agent present in the waste stream. It is the responsibility of the principal investigator or laboratory manager to provide this information to the transportation/disposal company. Transportation and disposal personnel who handle biohazardous waste materials must be informed when: * The biohazardous material presents a threat to the health of wild or domestic animals in case of an accidental release during shipment or disposal. * The biohazardous material contains recombinant DNA. 17.0 CONTAMINATED SHARPS DISPOSAL Definition The Department of Transportation (DOT) defines sharps as any object that may be contaminated with an infectious substance, and is able to cut or penetrate the skin or packaging material. Sharps include, but are not limited to, contaminated hypodermic syringes and needles, culture slides, scalpels, razor blades, lancets, broken plastic and glass, pipettes, and capillary tubes. APPROVED SHARPS CONTAINER Sharps containers used for discarding contaminated needles, etc. must be easily assessable to personnel, closable, puncture resistant, leak-proof on the sides and bottom, and appropriately labeled and/or color-coded. Additionally, sharps containers must: * Be designed so that it is easily and safely determined when the containers are full so containers are not overfilled. * Be stable when placed on horizontal surfaces, and when placed in trays, holders, or enclosures as per manufacturers directions. * Be maintained upright, and closed when moved or replaced. Custodial and Public Safety personnel may acquire sharps containers by contacting 91ԹϺ EH&S (6-9706) Physical Plant, Rm. 20. SHARPS DISPOSAL Sharps contaminated with biohazards are considered regulated waste and must be disposed of through the WA State licensed biohazardous waste vendor - Stericycle. Improperly discarded sharps pose a particular exposure hazard to refuse and recycle collection personnel, on and off campus. To prevent injuries and comply with State law, those who use sharps are to follow the disposal precautions indicated below: * Place all used sharps in an approved sharps container marked with a biohazard label. * Sharps are to be disposed of through the State licensed infectious waste vendor, Stericycle. * Do not recap needles on syringes after use. * Do not separate needles from syringes prior to disposal. * When full, close the top of the container. Pack container according to Stericycle instructions. Contact WSUV EH&S for removal and replacement of the sharps container. 18.0 GLASS DISPOSAL PROCEDURES Non-contaminated Glass DISPOSAL PROCEDURES Designated waste glass collection containers are required, as containers need to be designed and maintained so laboratory, custodial, and solid waste collection personnel can handle them easily and safely. The total weight of a glass disposal container ready for removal by custodians may not exceed 40-pounds. This limit includes both the weight of the glass and the weight of the container. Also, the container must be designed so there is no failure of the integrity of the container during transport, which could expose laboratory or service personnel to cutting or puncture hazards. Non-contaminated glass waste is to be placed in designated containers and disposed through Facilities Services (6-9000). Contact the 91ԹϺ Facilities Services (6-9000) to obtain replacement glass disposal containers. Custodians will not remove glass containers that are 40-pounds, and appear as if they could rupture during handling. Containers should be labeled as Caution Glass Waste, with the building and room # identified. Line the container with 4.0 mil (thickness) plastic bag liner. When full, close the bag and secure it with a twist tie. Place a lid on the container, and tape around entire lid to ensure it is secure lip to firmly secure lid. Call Facilities Services (6-9000) for disposal. CONTAMINATED GLASS DISPOSAL PROCEDURES Contaminated glass refers to glass, which is contaminated by chemicals or biologically hazardous material. Contaminated glass should never be placed in routine trash receptacles. The generating department is responsible for the proper handling and disposal of contaminated glass. Custodians should not handle contaminated glass. Contact the 91ԹϺ EH&S Coordinator should there be any questions: (6-9706). Biohazard Contamination: Glass that is contaminated with infectious materials needs to be: 1) decontaminated and disposed as non-contaminated glass, or 2) placed in sharps container and disposed of through the State licensed infectious waste contractor, Stericycle. 19.0 HANDWASHING General Hand-washing Procedure To wash hands: * Remove jewelry; * Turn on water; * Moisten hands; * Wash vigorously with soap on all surfaces of the hands for 10-15 seconds (Do not use brush); * Clean between fingers, under and around nails, wrists, and backs of hands; * Rinse well, at least 10-seconds; * Dry hands with paper towel; * Use paper towel on faucets to turn off water. * Discard towel. 20.0 Disinfectant for Blood and Body Fluid Spill Clean-up WISHAs requires disinfectants for bloodborne pathogens to be EPA registered and approved to kill HIV-1 and HBV. Prior to use, read the product label. Some dilute solutions of disinfectant may have a shelf life of 7-days or less. WISHA accepts bleach solution (1:10 solution for spills and 1:100 solution for routine cleaning) as a bloodborne pathogen disinfectant. BLEACH SOLUTION PREPARATION When bleach solution is utilized as a disinfectant, mix as follows for a 1:10 solution: * Clearly label container with bleach. * Mix 1 part bleach and 9 parts water. For a 1:10 solution, mix 3-ounces of bleach with 1-quart water or 1 1/2 cups bleach with 1-gallon water. * Use cool water. * Prepare the bleach/water solution fresh (no more than 24-hours old). * Allow at least 10-minute contact time for the bleach solution. * Prevent bleach solution mixing with soap or detergent, as any organic material could inactivate the hypochlorite ingredient of the bleach. Keep bleach solutions away from ammonia (can form Phosgene gas a nerve agent). 21.0 Equipment and Environmental Sanitation Departments are responsible for clean-up, maintenance, and decontamination of work surfaces, devices, and equipment in the work area on a regularly scheduled basis. Departments are also responsible for clean-up of small spills, but only if employees have been trained in spill clean-up procedures. The custodial staff cleans and decontaminates waste receptacles and floors and are responsible for larger spill clean up of blood and OPIM. Routine environmental and equipment cleaning procedures are: * List surfaces, devices and equipment, which may become contaminated with blood or OPIM including bins, pails, and cans, intended for reuse. * Establish a schedule of cleaning, decontamination, maintenance, and replacement of surfaces, devices and equipment, which may become contaminated with blood or OPIM (frequency of cleaning and maintenance can be when contaminated, after each use, between patients, end of shift, daily, weekly, etc.). * Use appropriate disinfectant. * Decontaminate work surfaces with appropriate disinfectant after completion of procedures, immediately or as soon as feasible when surfaces are overtly contaminated, or after any spill of blood or OPIM, and at the end of the day. * Replace equipment's disposable protective coverings immediately or as soon as feasible after contamination. * Establish a replacement and/or cleaning schedule for equipment's protective coverings. * Clean up spills of blood and OPIM as soon as feasible. * Take precautions that sharps do not enter the regular trash containers. 22.0 Spill Clean-up Procedure for Blood and Body Fluids With the exception of small blood and body fluid spills occurring in clinics, laboratories, or after minor first aid procedures, Custodians are responsible for the clean up of blood and body fluids. Clinic, laboratory, or minor first aid spills are the responsibility of departmental faculty/staff. Small spills are generally considered to be 1-cup or less of blood or body fluid. Contact the 91ԹϺ EH&S Coordinator (6-9706) for technical assistance concerning blood and body fluid spill clean up. MINOR Blood & Body Fluid Spill Clean up For small spills of blood and body fluids: * Alert people in the area of the spill and ask them to avoid the area temporarily. * Don appropriate personal protective equipment (PPE): minimum PPE is utility gloves and safety glasses with side-shields. * Broadcast spray spill with disinfectant and wait the required contact time of 10-minutes. * Remove sharps from spill by use of mechanical devices such as forceps, tongs or dustpan and brush; never use hands to remove sharps. * Dispose of sharps into a sharps container. * Wipe up spill with paper towel/absorbent. Broadcast spray disinfectant on spill area, and wait the required contact time of 10 minutes, allowing disinfectant to air dry. * Disinfect any reusable spill equipment. * Remove gloves. * Dispose of single-use gloves or disinfect reusable utility gloves. * Wash hands. * Ensure proper disposal of spill clean-up materials. CustodiaL Blood & Body Fluid Spill Clean-up Custodians will: * Establish a spill perimeter to prevent through traffic by use of "Caution" or "Wet Floor" signs/tape, barriers, and/or Public Safety personnel. * Don appropriate personal protective equipment (PPE): minimum PPE is utility gloves and goggles/safety glasses with side-shields. * Contain the spill when necessary. * Remove sharps from spill by use of mechanical devices such as tongs or dustpan and brush; never use hands to remove sharps. * Dispose of sharps into a sharps container. * Clean up the blood/body fluid using mop and bucket system with disinfectant water. Change disinfectant water as necessary. * With disinfected or clean mop and fresh disinfectant water mop floor a final time. Allow spill to air dry (at least 10-minutes) for proper disinfectant contact time to occur. * Remove perimeter barriers/signs. * Disinfect any reusable spill equipment. * Remove gloves. * Dispose of or disinfect reusable utility gloves. * Wash hands. * Ensure proper disposal of spill clean-up materials. Note: Blood & Body Fluid Spill Procedure for Carpets Follow procedures in section 22.0 with one exception; use a carpet extractor instead of the mop/bucket system. Note: Dried Blood & Body Fluid Spill Clean-up Procedure Follow procedures in section 23.0. Use enough disinfectant to liquefy the dried blood and body fluid, to allow clean up. 23.0 FIRST AID INVOVLING BLOOD AND BODY FLUIDS Call 7-911 for first aid emergencies. For minor first aid, caregivers should don protective gloves before rendering first aid, and act in a supportive roll as much as possible. Whenever feasible, encourage employee/student to care for their own minor bleeding injury and to apply their own bandages. 24.0 PUBLIC SAFETY PROCEDURES Universal Precautions shall be used at all times when biohazard materials are involved. All evidence that contain blood and body fluids will be handled with Universal Precautions and according to standard police protocol for evidence chain of custody. See the 91ԹϺ Public Safety employee training manual for additional information. Employee Exposure Control Suggestions.     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