DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Rockville, Maryland 20857
Refer to: OHP/OEHE
INDIAN HEALTH SERVICE CIRCULAR NO. 92-4
Effective Date: 05/15/1992
BLOODBORNE PATHOGEN EXPOSURE POLICY
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Definitions |
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Responsibilities |
6. | Exposure Control Plan |
7. | Supersession |
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PURPOSE. To establish responsibilities and procedures for protecting patients and personnel from bloodborne pathogens, e.g., human . immunodeficiency virus, hepatitis B virus or other pathogens transmitted through
contact with blood and body fluids. |
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SCOPE . This circular applies to all IHS employees, including those assigned to Public Law (P.L) 93-638 facilities. The law and implementing regulations apply to Indian Self-Determination Act, P.L. 93-638 and to
Title V urban program contractors as employers. Tribal contractors are strongly encouraged to adopt this circular. |
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DEFINITIONS. Blood -- means human-blood, human blood components, and blood products made from human blood 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). Body Substance Isolation -- is an infection control system where all body substances are considered to be potentially infectious. It is equivalent to Universal Precautions. Clinical Laboratory -- means a workplace where diagnostic or other screening procedures are performed on blood or other potentially infectious materials. 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 or linen which has been Soiled with blood or other potentially infectious materials or 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 -- is a physical or chemical process to remove,, inactivate, or destroy pathogens on a surface or item so that they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use or disposal. Engineering Controls -- means controls (e.g., sharps disposal containers, self-sheathing needles) that isolate or remove the bloodborne pathogens hazard from the workplace. Exposure Incident -- means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employees duties. Bandwashing Facility -- means a facility providing an adequate supply of tempered running potable water, soap and single use towels or hot air drying machines. HBV -- means hepatitis B virus. Healthcare Professional -- means a physician or other licensed healthcare provider authorized to accomplish the evaluation procedures described in this policy, e.g., a registered nurse could be authorized to perform the required evaluation. HIV --- means human immunodeficiency virus Type-1. Unless it is stated otherwise, all reference to HIV means HIV-l. IHS Facility -- means any IHS healthcare facility. All contract facilities operated by a tribal organization under P.L. 93-638, Indian Self-Determination and Education Assistance: Act or Urban -Indian Health Centers are encouraged to adopt this IHS policy or shall develop equivalent policies which meet the minimum requirements of 29 CFR, 1910.1030. 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 employees duties. Other Potentially Infectious Materials -- means: |
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Parenteral -- means piercing mucous membranes or the skin barrier through such events as needle sticks, human bites, cuts, and abrasions.
Personal Protective Equipment -- is specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g. uniforms, pants, skirts, 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 ā€¯include, but are not limited to hospital and clinic patients trauma victims, clients of drug and alcohol treatment facilities, and human remains. Sterilize -- means the use of a physical or chemical, procedure to destroy all microbial life including highly resistant bacterial endospores. Universal Precautions -- is 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. In the IHS, Body Substance Isolation may be used in place of Universal Precautions. Work Practice Controls -- means controls that reduce the likelihood of exposure blood or body fluids by eliminating a task or altering-the manner in which a task is performed (e.g., prohibiting recapping of needles by two-handed technique).
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EXPOSURE CONTROL PLAN. All IHS facilities and those operated by a tribal organization under P.L. 93-638 and urban Indian health centers shall have an Exposure Control Plan in accordance with 29 CFR, Subsection 1910.1030 (c). See Appendix B for an example of a healthcare facility Exposure Control Plan.
The Exposure Control Plan shall identify job classifications and tasks in which occupational exposure may occur. Each IHS facility shall have departmental policies and procedures that cover tasks in which an occupational exposure may occur. The procedures shall enumerate the correct steps to follow while performing such tasks to minimize any occupational exposure and to prevent contaminating other equipment or surfaces.
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SUPERSESSION.
This is a new circular. It modifies and supplements the Indian Health Manual, Part 1,
Chapter 12, IHS Employee Immunization Program, D. Procedures, 2. Additional Important Protection for Employees. b. Hepatitis B. |