OSHA's Bloodborne Pathogens Standard and Your Practice
Employee safety in the practice setting is a shared goal for all health care employers. Exposure to bloodborne pathogens and other infectious substances is a specific risk that merits constant vigilance. An important guide in addressing this risk is the Bloodborne Pathogens Final Standard published by the Occupational Safety and Health Administration (OSHA) in 1992. This standard applies to all employment settings involving individuals whose job responsibilities can be "reasonably anticipated" to result in contact with blood and other potentially infectious material.
OSHA's Bloodborne Pathogens Final Standard requires employers to develop a formal written Exposure Control Plan identifying job classifications where occupational exposure is apt to occur. This plan should be reviewed annually and updated if new or modified tasks have been implemented. Employers are required to make sure their staffs fully understand the plan and are aware of the exposure plan's location. Also, annual employee training should be carried out.

UNIVERSAL PRECAUTIONS
OSHA's standard mandates universal precautions for treating all body fluids/materials as if infectious. Hand washing is emphasized. Restrictions on needle capping are addressed.
Employers are to protect employees through a combination of appropriate work practices, engineering controls, and personal protective equipment (PPE). Personal protective equipment may include masks, one-way CPR masks, protective eyewear, face shields, lab coats, shoe covers, and gloves (including utility gloves). Basically, the employer is obligated to select and make easily accessible the PPE most appropriate for the potential exposures and provide for the cleaning, laundering, disposal, repair, or replacement of this equipment.
As mentioned above, the exposure plan should be reviewed and updated annually. The plan should also be updated when there are changes in the workplace, such as expanded services that require additional employees to have exposure to bloodborne pathogens, new employees who have exposure risk, and a change in an employee's responsibilities resulting in an exposure risk. 


HEPATITIS B 
Hepatitis B vaccination must be made available to all employees who have occupational exposure to blood or other potentially infectious material within 10 working days of assignment unless the employee has previously had the vaccine or wishes to submit to antibody testing which shows the employee to have sufficient immunity. * 
Vaccination must:
· be provided at no cost to each employee who may be exposed to blood;
· be under the supervision of a licensed physician or a licensed healthcare professional; and
· be provided at a reasonable time and place.
Prescreening may not be required as a condition of receiving the vaccine. A declination form must be signed by employees who choose not to be vaccinated, although employees who initially decline the vaccine may later have it provided at no cost.

TRAINING
Training must include an explanation of the OSHA Standard for Bloodborne Pathogens including the epidemiology, symptomatology, and transmission of bloodborne diseases. The Exposure Control Plan should identify the lines of responsibility and how the plan is implemented. Training should also address control methods, procedures, the respective facility's signs and labels, and examples of incidents which can cause exposure. The individual's) to contact for post-exposure evaluation and follow-up should be identified.
Medical records for employees with certain occupational exposures (including exposures to bloodborne pathogens) must be retained for the duration of employment plus thirty (30) years.
To request information on training and educational materials, you may contact OSHA

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