Heard at the February 18, 1999, Public Hearing
Adopted on June 17, 1999
Approved by OAL on July 30, 1999
Effective July 30, 1999
§5193. Bloodborne Pathogens.
(a) Scope and Application. This section applies to all occupational exposure to blood
or other potentially infectious materials as defined by subsection (b) of this section.
EXCEPTION: This regulation does not apply to the construction industry.
(b) Definitions. For purposes of this section, the following shall apply:
"Biological Cabinet" means a device enclosed except for necessary exhaust
purposes on three sides and top and bottom, designed to draw air inward by means of
mechanical ventilation, operated with insertion of only the hands and arms of the user,
and in which virulent pathogens are used. Biological cabinets are classified as:
(1) Class I: A ventilated cabinet for personnel protection with an unrecirculated inward
airflow away from the operator and high-efficiency particulate air (HEPA) filtered exhaust
air for environmental protection.
(2) Class II: A ventilated cabinet for personnel, product, and environmental protection
having an open front with inward airflow for personnel protection, HEPA filtered laminar
airflow for product protection, and HEPA filtered exhaust air for environmental
protection.
(3) Class III: A total enclosed, ventilated cabinet of gas-tight construction. Operations
in the cabinet are conducted through attached protective gloves.
"Blood" means human blood, human blood components, and 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), hepatitis C virus (HCV) and human immunodeficiency virus (HIV).
"Chief" means the Chief of the Division of Occupational Safety and Health of the
California Department of Industrial Relations or designated representative.
"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 a surface or in or on an item.
"Contaminated Laundry" means laundry which has been soiled with blood or other
potentially infectious materials or may contain sharps.
"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. Decontamination includes procedures
regulated by Health and Safety Code Section 118275.
"Engineering Controls" means controls (e.g., sharps disposal containers,
needleless systems and sharps with engineered sharps injury protection) that isolate or
remove the bloodborne pathogens hazard from the workplace.
"Engineered Sharps Injury Protection" means either:
(1) A physical attribute built into a needle device used for withdrawing body fluids,
accessing a vein or artery, or administering medications or other fluids, which
effectively reduces the risk of an exposure incident by a mechanism such as barrier
creation, blunting, encapsulation, withdrawal or other effective mechanisms; or
(2) A physical attribute built into any other type of needle device, or into a non-needle
sharp, which effectively reduces the risk of an exposure incident.
"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 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.
"HCV" means hepatitis C virus.
"HIV" means human immunodeficiency virus.
"Licensed Healthcare Professional" is a person whose licensed scope of practice
includes an activity which this section requires to be performed by a licensed healthcare
professional.
"Needle" or "Needle Device" means a needle of any type, including, but
not limited to, solid and hollow-bore needles.
"Needleless sSystem" means a device that does not
utilize needles for:
(1) The withdrawal of body fluids after initial venous or arterial access is established;
(2) The administration of medication or fluids; and
(3) Any other procedure involving the potential for an exposure incident.
"NIOSH" means the Director of the National Institute for Occupational Safety and
Health, U.S. Department of Health and Human Services, or designated representative.
"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.
"One-Hand Technique" means a procedure wherein the needle of a reusable syringe
is capped in a sterile manner during use. The technique employed shall require the use of
only the hand holding the syringe so that the free hand is not exposed to the uncapped
needle.
"OPIM" means other potentially infectious materials.
"Other Potentially Infectious Materials" means:
(1) 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 other body fluid that is visibly contaminated with blood such as
saliva or vomitus, and all body fluids in situations where it is difficult or impossible
to differentiate between body fluids such as emergency response;
(2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead);
and
(3) Any of the following, if known or reasonably likely to contain or be infected with
HIV, HBV, or HCV:
(A) Cell, tissue, or organ cultures from humans or experimental animals;
(B) Blood, organs, or other tissues from experimental animals; or
(C) Culture medium or other solutions.
"Parenteral Contact" means piercing mucous membranes or the skin barrier
through such events as needlesticks, human bites, cuts, and abrasions.
"Personal Protective Equipment" is specialized clothing or equipment worn or
used 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.
"Production Facility" means a facility engaged in industrial-scale, large-volume
or high concentration production of HIV, HBV or HCV.
"Regulated Waste" means waste that is any of the following:
(1) Liquid or semi-liquid blood or OPIM;
(2) Contaminated items that:
(A) Contain liquid or semi-liquid blood, or are
caked with dried blood or OPIM; and
(B) Are capable of releasing these materials
when handled or compressed.
(3) Contaminated sharps.
(4) Pathological and microbiological wastes containing blood or OPIM.
(5) Regulated Waste includes "medical waste" regulated by Health and Safety Code
Sections 117600 through 118360.
"Research Laboratory" means a laboratory producing or using
research-laboratory-scale amounts of HIV, HBV or HCV. Research laboratories may produce
high concentrations of HIV, HBV or HCV but not in the volume found in production
facilities.
"Sharp" means any object used or encountered in the industries covered by
subsection (a) that can be reasonably anticipated to penetrate the skin or any other part
of the body, and to result in an exposure incident, including, but not limited to, needle
devices, scalpels, lancets, broken glass, broken capillary tubes, exposed ends of dental
wires and dental knives, drills and burs.
"Sharps Injury" means any injury caused by a sharp, including, but not limited
to, cuts, abrasions, or needlesticks.
"Sharps Injury Log" means a written or electronic record satisfying the
requirements of subsection (c)(2).
"Source Individual" means any individual, living or dead, whose blood or OPIM
may be a source of occupational exposure to the employee. Examples include, but are not
limited to, hospital and clinical 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" 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, HCV, and other bloodborne pathogens.
"Work Practice Controls" means controls that reduce the likelihood of exposure
by defining the manner in which a task is performed (e.g., prohibiting recapping of
needles by a two-handed technique and use of patient-handling techniques).
(c) Exposure Response, Prevention and Control.
(1) Exposure Control Plan.
(A) Each employer having an employee(s) with occupational exposure as defined by
subsection (b) of this section shall establish, implement and maintain an effective
Exposure Control Plan, which is designed to eliminate or minimize employee exposure
and which is also consistent with Section 3203.
(B) The Exposure Control Plan shall be in writing and shall contain at least the following
elements:
1. The exposure determination required by subsection (c)(3);
2. The schedule and method of implementation for each of the applicable subsections: (d)
Methods of Compliance, (e) HIV, HBV and HCV Research Laboratories and Production
Facilities, (f) Hepatitis B Vaccination and Post-exposure Evaluation and Follow-up, (g)
Communication of Hazards to Employees, and (h) Recordkeeping, of this standard;
3. The procedure for the evaluation of circumstances surrounding exposure incidents as
required by subsection (f)(3)(A).
By July 1, 1999, the Exposure Control Plan shall additionally contain the
following elements required by subsections (c)(1)(B) 4. through 8.:
4. An effective procedure for gathering the information required by the Sharps Injury Log.
5. An effective procedure for periodic determination of the frequency of use of the types
and brands of sharps involved in the exposure incidents documented on the Sharps Injury
Log;
NOTE: Frequency of use may be approximated by any reasonable and effective method.
6. An effective procedure for identifying currently available engineering controls, and
selecting such controls, where appropriate, for the procedures performed by employees in
their respective work areas or departments;
7. An effective procedure for documenting patient safety determinations made pursuant to
Exception 2. of subsection (d)(3)(A); and
8. An effective procedure for obtaining the active involvement of employees in reviewing
and updating the exposure control plan with respect to the procedures performed by
employees in their respective work areas or departments.
(C) Each employer shall ensure that a copy of the Exposure Control Plan is accessible to
employees in accordance with Section 3204(e).
(D) The Exposure Control Plan shall be reviewed and updated at least annually and whenever
necessary as follows:
1. To reflect new or modified tasks and procedures which affect occupational exposure;
2. By July 1, 1999, iIf sharps are used in the employer's place of
employment, to reflect progress in implementing the use of needleless systems and sharps
with engineered sharps injury protection.;
3. To include new or revised employee positions with occupational exposure;
4. To review and evaluate the exposure incidents which occurred since the previous update;
and
5. To review and respond to information indicating that the Exposure Control Plan is
deficient in any area.
(E) The Exposure Control Plan shall be made available to the Chief or NIOSH or their
respective designee upon request for examination and copying.
(2) Sharps Injury Log
The employer shall establish and maintain a Sharps Injury Log, which is a record of each
exposure incident involving a sharp. The exposure incident shall be recorded on the log
within 14 working days of the date the incident is reported to the employer. The
information recorded shall include the following information, if known or reasonably
available:
(A) Date and time of the exposure incident;
(B) Type and brand of sharp involved in the exposure incident;
(C)
By July 1, 1999, aA description of the exposure incident which shall include:
1. Job classification of the exposed employee;
2. Department or work area where the exposure incident occurred;
3. The procedure that the exposed employee was performing at the time of the incident;
4. How the incident occurred;
5. The body part involved in the exposure incident;
6. If the sharp had engineered sharps injury protection, whether the protective mechanism was activated, and whether the injury occurred before the protective mechanism was activated, during activation of the mechanism or after activation of the mechanism, if applicable;
7. If the sharp had no engineered sharps injury protection, the injured employee's opinion as to whether and how such a mechanism could have prevented the injury; and
8. The employee's opinion about whether any
otherengineering, administrative or work practice control could have prevented the injury.
(3) Exposure Determination.
(A) Each employer who has an employee(s) with occupational exposure as defined by
subsection (b) of this section shall prepare an exposure determination. This exposure
determination shall contain the following:
1. A list of all job classifications in which all employees in those job classifications have occupational exposure;
2. A list of job classifications in which some employees have occupational exposure; and
3. A list of all tasks and procedures or groups of closely related task and procedures in which occupational exposure occurs and that are performed by employees in job classifications listed in accordance with the provisions of subsection (c)(3)(A)2. of this standard.
(B) This exposure determination shall be made without regard to the use of personal
protective equipment.
(d) Methods of Compliance.
(1) General. Universal precautions shall be observed to prevent contact with blood or
OPIM. Under circumstances in which differentiation between body fluid types is difficult
or impossible, all body fluids shall be considered potentially infectious materials.
(2) Engineering and Work Practice Controls - General Requirements.
(A) Engineering and work practice controls shall be used to eliminate or minimize employee
exposure.
(B) Engineering controls shall be examined and maintained or replaced on a regular
schedule to ensure their effectiveness.
(C) Work practice controls shall be evaluated and updated on a regular schedule to ensure
their effectiveness.
(D) All procedures involving blood or OPIM shall be performed in such a manner as to
minimize splashing, spraying, spattering, and generation of droplets of these substances.
(3)Engineering and Work Practice Controls--Specific Requirements.
(A) Needleless Systems, Needle Devices and Non-Needle Sharps. By July 1, 1999, the
employer shall comply with the following requirements:
a. Withdrawal of body fluids after initial venous or arterial access is established;
b. Administration of medications or fluids; and
c. Any other procedure involving the potential for an exposure incident for which a needleless system is available as an alternative to the use of needle devices.
2. Needle Devices. If needleless systems are not used, needles with engineered sharps injury protection shall be used for:
a. Withdrawal of body fluids;
b. Accessing a vein or artery;
c. Administration of medications or fluids; and
d. Any other procedure involving the potential for an exposure incident for which a needle device with engineered sharps injury protection is available.
3. Non-Needle Sharps. If sharps other than needle devices are used, these items shall
include engineered sharps injury protection.
4. EXCEPTIONS: The following exceptions apply to the engineering controls required by
subsections (d)(3)(A)1. – 3.:
a. Market Availability. The engineering control is not required if it is not available in
the marketplace.
b. Patient Safety. The engineering control is not required if a licensed healthcare
professional directly involved in a patient's care determines, in the reasonable exercise
of clinical judgement, that use of the engineering control will jeopardize the patient's
safety or the success of a medical, dental or nursing procedure involving the patient. The
determination shall be documented according to the procedure required by (c)(1)(B)7.
c. Safety Performance. The engineering control is not required if the employer can
demonstrate by means of objective product evaluation criteria that the engineering control
is not more effective in preventing exposure incidents than the alternative used by the
employer.
d. Availability of Safety Performance Information. The engineering control is not required
if the employer can demonstrate that reasonably specific and reliable information is not
available on the safety performance of the engineering control for the employer's
procedures, and that the employer is actively determining by means of objective product
evaluation criteria whether use of the engineering control will reduce the risk of
exposure incidents occurring in the employer's workplace.
(B) Prohibited Practices.
1. Shearing or breaking of contaminated needles and other contaminated sharps is
prohibited.
2. Contaminated sharps shall not be bent, recapped, or removed from devices.
EXCEPTION: Contaminated sharps may be bent, recapped or removed from devices if the
procedure is performed using a mechanical device or a one-handed technique, and the
employer can demonstrate that no alternative is feasible or that such action is required
by a specific medical or dental procedure.
3. Sharps that are contaminated with blood or OPIM 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.
4. Disposable sharps shall not be reused.
5. Broken Glassware. Broken glassware which may be contaminated shall not be picked up
directly with the hands. It shall be cleaned up using mechanical means, such as a brush
and dust pan, tongs, or forceps.
6. The contents of sharps containers shall not be accessed unless properly reprocessed or
decontaminated.
7. Sharps containers shall not be opened, emptied, or cleaned manually or in any other
manner which would expose employees to the risk of sharps injury.
8. Mouth pipetting/suctioning of blood or OPIM is prohibited.
9. 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.
10. Food and drink shall not be kept in refrigerators, freezers, shelves, cabinets or on
countertops or benchtops where blood or OPIM are present.
(C) Requirements for Handling Contaminated Sharps.
1. All procedures involving the use of sharps in connection with patient care, such as
withdrawing body fluids, accessing a vein or artery, or administering vaccines,
medications or fluids, shall be performed using effective patient-handling techniques and
other methods designed to minimize the risk of a sharps injury.
2. Immediately or as soon as possible after use, contaminated sharps shall be placed in
containers meeting the requirements of subsection (d)(3)(D) as applicable.
3. At all time during the use of sharps, containers for contaminated sharps shall be:
a. Easily accessible to personnel and located as close as is feasible to the immediate
area where sharps are used or can be reasonably anticipated to be found (e.g., laundries);
b. Maintained upright throughout use, where feasible; and
c. Replaced as necessary to avoid overfilling.
(D) Sharps Containers for Contaminated Sharps.
1. All sharps containers for contaminated sharps shall be:
a. Rigid;
b. Puncture resistant;
c. Leakproof on the sides and bottom;
d. Portable, if portability is necessary to ensure easy access by the user as required
by subsection (d)(3)(C)3.a.; and
e. Labeled in accordance with subsection (g)(1)(A)(2).
2. If discarded sharps are not to be reused, the sharps container shall also be closeable
and sealable so that when sealed, the container is leak resistant and incapable of being
reopened without great difficulty.
(E) Regulated Waste.
1. General.
Handling, storage, treatment and disposal of all regulated waste shall be in accordance
with Health and Safety Code Chapter 6.1, Sections 117600 through 118360, and other
applicable regulations of the United States, the State, and political subdivisions of the
State.
2. Disposal of Sharps Containers.
When any container of contaminated sharps is moved from the area of use for the purpose of
disposal, the container shall be:
a. Closed immediately prior to removal or replacement to prevent spillage or protrusion of
contents during handling, storage, transport, or shipping; and
b. Placed in a secondary container if leakage is possible. The second container shall be:
i. Closable;
ii. Constructed to contain all contents and prevent leakage during handling, storage,
transport, or shipping; and
iii. Labeled according to subsection (g)(1)(A) of this section.
3. Disposal of Other Regulated Waste. Regulated waste not consisting of sharps shall be
disposed of in containers which are:
a. Closable;
b. Constructed to contain all contents;
c. Labeled and color-coded in accordance with subsection (g)(1)(A) of this section; and
d. Closed prior to removal to prevent spillage or protrusion of contents during handling,
storage, transport, or shipping.
4. Outside Contamination. If outside contamination of a container of regulated
waste 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 and color-coded in accordance with subsection (g)(1)(A) of this section; and
d. Closed prior to removal to prevent spillage or protrusion of contents during handling,
storage, transport, or shipping.
(F) Handling Specimens of Blood or OPIM.
Specimens of blood or OPIM shall be placed in a container which prevents leakage during
collection, handling, processing, storage, transport, or shipping.
1. The container for storage, transport, or shipping shall be labeled or color-coded
according to subsection (g)(1)(A), and closed prior to being stored, transported, or
shipped. When a facility utilizes Universal Precautions in the handling of all specimens,
the labeling/color-coding of specimens is not necessary provided containers are
recognizable as containing specimens. This exemption only applies while such
specimens/containers remain within the facility. Labeling or color-coding in accordance
with subsection (g)(1)(A) is required when such specimens/containers leave the facility.
2. If outside contamination of the primary container occurs, the primary container shall
be placed within a second container which prevents leakage during collection, handling,
processing, storage, transport, or shipping and is labeled or color-coded according to the
requirements of this standard.
3. 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.
(G) Servicing or Shipping Contaminated Equipment.
Equipment which may become contaminated with blood or OPIM shall be examined prior to
servicing or shipping and shall be decontaminated as necessary, unless the employer can
demonstrate that decontamination of such equipment or portions of such equipment is not
feasible or will interfere with a manufacturer’s ability to evaluate failure of
the device.
1. A readily observable label in accordance with subsection (g)(1)(A)8. shall be attached
to the equipment stating which portions remain contaminated.
2. Information concerning all remaining contamination shall be conveyed to all affected
employees, the servicing representative, and/or the manufacturer, as appropriate, prior to
handling, servicing, or shipping so that appropriate precautions will be taken.
(H) Cleaning and Decontamination of the Worksite.
1. General Requirements.
a. Employers shall ensure that the worksite is maintained in a clean and sanitary
condition.
b. Employers shall determine and implement an appropriate written schedule for cleaning
and decontamination of the worksite.
c. The method of cleaning or decontamination used shall be effective and shall be
appropriate for the:
i. Location within the facility;
ii. Type of surface or equipment to be treated;
iii. Type of soil or contamination present; and
iv. Tasks or procedures being performed in the area.
d. All equipment and environmental and work surfaces shall be cleaned and decontaminated
after contact with blood or OPIM no later than at the end of the shift. Cleaning and
decontamination of equipment and work surfaces is required more often as specified below.
2. Specific Requirements.
a. Contaminated Work Surfaces. Contaminated work surfaces shall be cleaned and
decontaminated immediately or as soon as feasible when:
i. Surfaces become overtly contaminated;
ii. There is a spill of blood or OPIM;
iii. Procedures are completed; and
iv. At the end of the work shift if the surface may have become contaminated since the
last cleaning.
b. Receptacles. All bins, pails, cans, and similar receptacles intended for reuse which
have a reasonable likelihood for becoming contaminated with blood or OPIM shall be
inspected and decontaminated on a regularly scheduled basis and cleaned and decontaminated
immediately or as soon as feasible upon visible contamination.
c. Protective Coverings. 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.
(I) Hygiene.
1. Employers shall provide handwashing facilities which are readily accessible to
employees.
2. When provision of handwashing facilities is not feasible, the employer shall provide
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 water as soon as feasible.
3. Employers shall ensure that employees wash their hands immediately or as soon as
feasible after removal of gloves or other personal protective equipment.
4. Employers shall ensure that employees wash hands and any other skin with soap and
water, or flush mucous membranes with water immediately or as soon as feasible following
contact of such body areas with blood or OPIM.
(J) Laundry.
1. Contaminated laundry shall be handled as little as possible with a minimum of
agitation.
a. Contaminated laundry shall be bagged or containerized at the location where it was used
and shall not be sorted or rinsed in the location of use.
b. Contaminated laundry shall be placed and transported in bags or containers labeled or
color-coded in accordance with subsection (g)(1)(A) of this standard. When a facility
utilizes Universal Precautions in the handling of all soiled laundry, alternative labeling
or color-coding is sufficient if it permits all employees to recognize the containers as
requiring compliance with Universal Precautions.
c. Whenever contaminated laundry is wet and presents a reasonable likelihood of soaking
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.
2. The employer shall ensure that employees who have contact with contaminated laundry
wear protective gloves and other appropriate personal protective equipment.
3. When a facility 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 must place such laundry in bags or containers which are labeled or
color-coded in accordance with subsection (g)(1)(A).
(4) Personal Protective Equipment
(A) Provision. Where occupational exposure remains after institution of engineering and
work practice controls, the employer shall provide, 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 will be
considered "appropriate" only if it does not permit blood or OPIM to pass
through to 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 which the protective equipment will be used.
NOTE: For fire fighters, these requirements are in addition to those specified in Sections
3401-3411, and are intended to be consistent with those requirements.
(B) Use. The employer shall ensure that the employee uses appropriate personal protective
equipment unless the employer shows that the employee temporarily and briefly declined to
use personal protective equipment when, under rare and extraordinary circumstances, it was
the employee's professional judgment that in the specific instance its use would have
prevented the 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 the 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
employer shall encourage employees to report all such instances without fear of reprisal
in accordance with Section 3203.
(C) Accessibility. The employer shall ensure that appropriate personal protective
equipment in the appropriate sizes is readily accessible at the worksite or is 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.
(D) Cleaning, Laundering, and Disposal. The employer shall clean, launder, and dispose of
personal protective equipment required by subsections (d) and (e) of this standard, at no
cost to the employee.
(E) Repair and Replacement. The employer shall repair or replace personal protective
equipment as needed to maintain its effectiveness, at no cost to the employee.
(F) Removal
1. If a garment(s) is penetrated by blood or OPIM, the garment(s) shall be removed
immediately or as soon as feasible.
2. All personal protective equipment shall be removed prior to leaving the work area.
3. When personal protective equipment is removed it shall be placed in an appropriately
designated area or container for storage, washing, decontamination or disposal.
(G) Gloves. Gloves shall be worn when it can be reasonably anticipated that the employee
may have hand contact with blood, OPIM, mucous membranes, and non-intact skin; when
performing vascular access procedures except as specified in subsection (d)(4)(G)4.; and
when handling or touching contaminated items or surfaces. These requirements are in
addition to the provisions of Section 3384.
1. 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.
2. Disposable (single use) gloves shall not be washed or decontaminated for re-use.
3. Utility gloves may be decontaminated for re-use if the integrity of the glove is not
compromised. However, they must 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.
4. If an employer in a volunteer blood donation center judges that routine gloving for all
phlebotomies is not necessary then the employer shall:
a. Periodically reevaluate this policy;
b. Make gloves available to all employees who wish to use them for phlebotomy;
c. Not discourage the use of gloves for phlebotomy; and
d. Require that gloves be used for phlebotomy in the following circumstances:
i. When the employee has cuts, scratches, or other breaks in his or her skin;
ii. When the employee judges that hand contamination with blood may occur, for example,
when performing phlebotomy on an uncooperative source individual; and
iii. When the employee is receiving training in phlebotomy.
(H) Masks, Eye Protection, Face Shields, and Respirators.
1. 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,
spatter, or droplets of blood or OPIM may be generated and eye, nose, or mouth
contamination can be reasonably anticipated. These requirements are in addition to the
provisions of Section 3382.
2. Where respiratory protection is used, the provisions of Sections 5144 and 5147 are
required as applicable.
NOTE: Surgical masks are not respirators.
(I) Gowns, Aprons, and Other Protective Body Clothing.
1. 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 will depend upon the task and degree of exposure
anticipated. These requirements are in addition to the provisions of Section 3383.
2. Surgical caps or hoods and/or shoe covers or boots shall be worn in instances when
gross contamination can reasonably be anticipated (e.g., autopsies, orthopaedic surgery).
These requirements are in addition to the provisions of Section 3383.
(e) HIV, HBV and HCV Research Laboratories and Production Facilities.
(1) General.
This subsection applies in addition to the other requirements of this section to research
laboratories and production facilities engaged in the culture, production, concentration,
experimentation, and manipulation of HIV, HBV and HCV.
EXCEPTION: This subsection does not apply to clinical or diagnostic laboratories engaged
solely in the analysis of blood, tissues, or organs.
(2) Research laboratories and production facilities shall meet the following criteria:
(A) Standard Microbiological Practices. All regulated waste shall either be incinerated or
decontaminated by a method such as autoclaving known to effectively destroy bloodborne
pathogens. Such methods are further specified in Health and Safety Code Section 118215.
(B) Special Practices.
1. Laboratory doors shall be kept closed when work involving HIV, HBV or HCV is in
progress.
2. Contaminated materials that are to be decontaminated at a site away from the work area
shall be placed in a durable, leakproof, labeled or color-coded container that is closed
before being removed from the work area.
3. Access to the work area shall be limited to authorized persons. Written policies and
procedures shall be established whereby only persons who have been advised of the
potential biohazard, who meet any specific entry requirements, and who comply with all
entry and exit procedures shall be allowed to enter the work areas and animal rooms.
4. When OPIM or infected animals are present in the work area or containment module, a
hazard warning sign incorporating the universal biohazard symbol shall be posted on all
access doors. The hazard warning sign shall comply with subsection (g)(1)(B) of this
standard.
5. All activities involving OPIM shall be conducted in biological safety cabinets or other
physical-containment devices within the containment module. No work with these OPIM shall
be conducted on the open bench.
6. Laboratory coats, gowns, smocks, uniforms, or other appropriate protective clothing
shall be used in the work area and animal rooms. Protective clothing shall not be worn
outside of the work area and shall be decontaminated before being laundered.
7. Special care shall be taken to avoid skin contact with OPIM. Gloves shall be worn when
handling infected animals and when making hand contact with OPIM is unavoidable.
8. Before disposal, all waste from work areas and from animal rooms shall either be
incinerated or decontaminated by a method such as autoclaving known to effectively destroy
bloodborne pathogens.
9. Vacuum lines shall be protected with liquid disinfectant traps and HEPA filters or
filters of equivalent or superior efficiency and which are checked routinely and
maintained or replaced as necessary.
10. Hypodermic needles and syringes shall be used only for parenteral injection and
aspiration of fluids from laboratory animals and diaphragm bottles. Only needle-locking
syringes or disposable syringe-needle units (i.e., the needle is integral to the syringe)
shall be used for the injection or aspiration of OPIM. Extreme caution shall be used when
handling needles and syringes. A needle shall not be bent, sheared, replaced in the sheath
or guard, or removed from the syringe following use. The needle and syringe shall be
promptly placed in a puncture-resistant container and autoclaved or decontaminated before
reuse or disposal.
11. All spills shall be immediately contained and cleaned up by appropriate professional
staff or others properly trained and equipped to work with potentially concentrated
infectious materials.
12. A spill or accident that results in an exposure incident shall be immediately reported
to the laboratory director or other responsible person.
13. Written biosafety procedures shall be prepared and adopted into the Exposure Control
Plan of subsection (c)(1). Personnel shall be advised of potential hazards, shall be
required to read instructions on practices and procedures, and shall be required to follow
them.
(C) Containment Equipment.
1. Certified biological safety cabinets (Class I, II, or III) or other appropriate
combinations of personal protection or physical containment devices, such as special
protective clothing, respirators, centrifuge safety cups, sealed centrifuge rotors, and
containment caging for animals, shall be used for all activities with OPIM that pose a
threat of exposure to droplets, splashes, spills, or aerosols.
2. Biological safety cabinets shall be certified by the employer that they meet
manufacturers' specifications when installed, whenever they are moved and at least
annually.
(3) HIV, HBV and HCV research laboratories shall meet the following criteria:
(A) Each laboratory shall contain a facility for hand washing and an eye wash facility
which is readily available within the work area.
(B) An autoclave for decontamination of regulated waste shall be available.
NOTE:Treatment of medical waste should meet the requirements of Health and Safety Code
Section 118215.
(4) HIV, HBV and HCV production facilities shall meet the following criteria:
(A) The work areas shall be separated from areas that are open to unrestricted traffic
flow within the building. Passage through two sets of doors shall be the basic requirement
for entry into the work area from access corridors or other contiguous areas. Physical
separation of the high-containment work area from access corridors or other areas or
activities may also be provided by a double-doored clothes-change room (showers may be
included), airlock, or other access facility that requires passing through two sets of
doors before entering the work area.
(B) The surfaces of doors, walls, floors and ceilings in the work area shall be water
resistant so that they can be easily cleaned. Penetrations in these surfaces shall be
sealed or capable of being sealed to facilitate decontamination.
(C) Each work area shall contain a sink for washing hands and a readily available eye wash
facility. The sink shall be foot, elbow, or automatically operated and shall be located
near the exit door of the work area.
(D) Access doors to the work area or containment module shall be self-closing.
(E) An autoclave for decontamination of regulated waste shall be available within or as
near as possible to the work area. NOTE: Treatment of medical waste should meet the
requirements of Health and Safety Code Section 118215.
(F) A ducted exhaust-air ventilation system shall be provided. This system shall create
directional airflow that draws air into the work area through the entry area. The exhaust
air shall not be recirculated to any other area of the building, shall be discharged to
the outside, and shall be dispersed away from occupied areas and air intakes. The proper
direction of the airflow shall be verified (i.e., into the work area). The ventilation
system shall conform to the requirements of Article 107.
(5) Training Requirements.
Training requirements for employees in HIV, HBV and HVC research laboratories and HIV, HBV
and HVC production facilities are specified in subsection (g)(2) and they shall receive in
addition the following initial training:
(A) The employer shall assure that employees demonstrate proficiency in standard
microbiological practices and techniques and in the practices and operations specific to
the facility before being allowed to work with HIV, HBV or HCV.
(B) The employer shall assure that employees have prior experience in the handling of
human pathogens or tissue cultures before working with HIV, HBV or HBV.
(C) The employer shall provide a training program to employees who have no prior
experience in handling human pathogens. Initial work activities shall not include the
handling of infectious agents. A progression of work activities shall be assigned as
techniques are learned and proficiency is developed. The employer shall assure that
employees participate in work activities involving infectious agents only after
proficiency has been demonstrated.
(f) Hepatitis B Vaccination and Bloodborne Pathogen Post-exposure Evaluation and
Follow-up.
(1) General.
(A) The employer shall make available the hepatitis B vaccine and vaccination series to
all employees who have occupational exposure, and post-exposure evaluation and follow-up for
bloodborne pathogens exposure to all employees who have had an exposure incident. When
an employer is also acting as the evaluating health care professional, the employer shall
advise an employee following an exposure incident that the employee may refuse to consent
to post-exposure evaluation and follow-up from the employer-healthcare professional. When
consent is refused, the employer shall make immediately available to exposed employees a
confidential medical evaluation and follow-up from a healthcare professional other than
the exposed employee's employer.
EXCEPTION: Designated first aid providers who have occupational exposure are not required
to be offered pre-exposure hepatitis B vaccine if the following conditions exist:
1. The primary job assignment of such designated first aid providers is not the rendering
of first aid.
a. Any first aid rendered by such persons is rendered only as a collateral duty responding
solely to injuries resulting from workplace incidents, generally at the location where the
incident occurred.
b. This exception does not apply to designated first aid providers who render assistance
on a regular basis, for example, at a first aid station, clinic, dispensary, or other
location where injured employees routinely go for such assistance, and emergency or public
safety personnel who are expected to render first aid in the course of their work.
2. The employer's Exposure Control Plan, subsection (c)(1), shall specifically address the
provision of hepatitis B vaccine to all unvaccinated first aid providers who have rendered
assistance in any situation involving the presence of blood OPIM (regardless of whether an
actual exposure incident, as defined by subsection (b), occurred) and the provision of
appropriate post-exposure evaluation, prophylaxis and follow-ups for those employees who
experience an exposure incident as defined in subsection (b), including:
a. Provisions for a reporting procedure that ensures that all first aid incidents
involving the presence of blood or OPIM shall be reported to the employer before the end
of work shift during which the first aid incident occurred.
i. The report must include the names of all first aid providers who rendered assistance,
regardless of whether personal protective equipment was used and must describe the first
aid incident, including time and date.
A. The description must include a determination of whether or not, in addition to the
presence of blood or OPIM, an exposure incident, as defined in subsection (b), occurred.
B. This determination is necessary in order to ensure that the proper post-exposure
evaluation, prophylaxis and follow-up procedures required by subsection (f)(3) are made
available immediately if there has been an exposure incident, as defined in subsection
(b).
ii. The report shall be recorded on a list of such first aid incidents. It shall be
readily available to all employees and shall be provided to the Chief upon request.
b. Provision for the bloodborne pathogens training program, required by subsection (g)(2),
for designated first aiders to include the specifics of the reporting requirements of
subsection (f)(3) and of this exception.
c. Provision for the full hepatitis B vaccination series to be made available as soon as
possible, but in no event later than 24 hours, to all unvaccinated first aid providers who
have rendered assistance in any situation involving the presence of blood or OPIM
regardless of whether or not a specific exposure incident, as defined by subsection (b),
has occurred.
3. The employer must implement a procedure to ensure that all of the provisions of
subsection 2. of this exception are complied with if pre-exposure hepatitis B vaccine is
not to be offered to employees meeting the conditions of subsection 1. of this exception.
(B) The employer shall ensure that all medical evaluations and procedures, including the
hepatitis B vaccine and vaccination series and post-exposure evaluation and follow-up,
including prophylaxis, are:
1. Made available at no cost to the employee;
2. Made available to the employee at a reasonable time and place;
3. Performed by or under the supervision of a licensed physician or by or under the
supervision of another licensed healthcare professional; and
4. Provided according to recommendations of the U.S. Public Health Service current at the
time these evaluations and procedures take place, except as specified by this subsection
(f).
(C) The employer shall ensure that all laboratory tests are conducted by an accredited
laboratory at no cost to the employee.
(2) Hepatitis B Vaccination.
(A) Hepatitis B vaccination shall be made available after the employee has received the
training required in subsection (g)(2)(G)9. and within 10 working days of initial
assignment to all employees who have occupational exposure unless the employee has
previously received the complete hepatitis B vaccination series, antibody testing has
revealed that the employee is immune, or the vaccine is contraindicated for medical
reasons.
(B) The employer shall not make participation in a prescreening program a prerequisite for
receiving hepatitis B vaccination.
(C) If the employee initially declines hepatitis B vaccination but at a later date while
still covered under the standard decides to accept the vaccination, the employer shall
make available hepatitis B vaccination at that time.
(D) The employer shall assure that employees who decline to accept hepatitis B vaccination
offered by the employer sign the statement in Appendix A.
(E) If a routine booster dose(s) of hepatitis B vaccine is recommended by the U.S. Public
Health Service at a future date, such booster dose(s) shall be made available in
accordance with section (f)(1)(B).
(3) Post-exposure Evaluation and Follow-up.
Following a report of an exposure incident, the employer shall make immediately available
to the exposed employee a confidential medical evaluation and follow-up, including at
least the following elements:
(A) The employer shall document the route(s) of exposure, and the circumstances under
which the exposure incident occurred;
(B) The employer shall identify and document the source individual, unless the employer
can establish that identification is infeasible or prohibited by state or local law;
1. The source individual's blood shall be tested as soon as feasible and after consent is
obtained in order to determine HBV, HCV and HIV infectivity. If consent is not obtained,
the employer shall establish that legally required consent cannot be obtained. When the
source individual's consent is not required by law, the source individual's blood, if
available, shall be tested and the results documented.
2. When the source individual is already known to be infected with HBV, HCV or HIV,
testing for the source individual's known HBV, HCV or HIV status need not be repeated.
3. Results of the source individual's testing shall be made available to the exposed
employee, and the employee shall be informed of applicable laws and regulations concerning
disclosure of the identity and infectious status of the source individual.
(C) The employer shall provide for collection and testing of the employee's blood for HBV,
HCV and HIV serological status;
1. The exposed employee's blood shall be collected as soon as feasible and tested after
consent is obtained.
2. If the employee consents to baseline blood collection, but does not give consent at
that time for HIV serologic testing, the sample shall be preserved for at least 90 days.
If, within 90 days of the exposure incident, the employee elects to have the baseline
sample tested, such testing shall be done as soon as feasible.
3. Additional collection and testing shall be made available as recommended by the U.S.
Public Health Service.
(D) The employer shall provide for post-exposure prophylaxis, when medically indicated, as
recommended by the U.S. Public Health Service;
(E) The employer shall provide for counseling and evaluation of reported illnesses.
(4) Information Provided to the Healthcare Professional.
(A) The employer shall ensure that the healthcare professional responsible for the
employee's hepatitis B vaccination is provided a copy of this regulation.
(B) The employer shall ensure that the healthcare professional evaluating an employee
after an exposure incident is provided the following information:
1. A copy of this regulation;
2. A description of the exposed employee's duties as they relate to the exposure incident;
3. Documentation of the route(s) of exposure and circumstances under which exposure
occurred, as required by subsection (f)(3)(A);
4. Results of the source individual's blood testing, if available; and
5. All medical records relevant to the appropriate treatment of the employee including
vaccination status which are the employer's responsibility to maintain, as required by
subsection (h)(1)(B)2.
(5) Healthcare Professional's Written Opinion.
The employer shall obtain and provide the employee with a copy of the evaluating
healthcare professional's written opinion within 15 days of the completion of the
evaluation.
(A) The healthcare professional's written opinion for hepatitis B vaccination shall be
limited to whether hepatitis B vaccination is indicated for an employee, and if the
employee has received such vaccination.
(B) The healthcare professional's written opinion for post-exposure evaluation and
follow-up shall be limited to the following information:
1. That the employee has been informed of the results of the evaluation; and
2. That the employee has been told about any medical conditions resulting from exposure to
blood or OPIM which require further evaluation or treatment.
(C) All other findings or diagnoses shall remain confidential and shall not be included in
the written report.
(6) Medical Recordkeeping.
Medical records required by this standard shall be maintained in accordance with
subsection (h)(1) of this section.
(g) Communication of Hazards to Employees.
(1) Labels and Signs.
(A) Labels.
1. Warning labels shall be affixed to containers of regulated waste, refrigerators and
freezers containing blood or OPIM; and other containers used to store, transport or ship
blood or OPIM, except as provided in subsection (g)(1)(A)5., 6. and 7.
NOTE: Other labeling provisions, such as Health and Safety Code Sections 118275 though
118320 may be applicable.
2. Labels required by this section shall include any of the following legends as required
by Section 3341:
BIOHAZARD
Or in the case of regulated waste the legend:
BIOHAZARDOUS WASTE or SHARPS WASTE
as described in Health and Safety Code Sections 118275 though 118320.
3. These labels shall be fluorescent orange or orange-red or predominantly
so, with lettering and symbols in a contrasting color.
4. Labels required by subsection (g)(1)(A) 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.
5. Red bags or red containers may be substituted for labels except for sharp
containers or regulated waste red bags. Bags used to contain regulated waste
shall be color-coded red and shall be labeled in accordance with subsection
(g)(1)(A)2. Labels on red bags or red containers do not need to be color-coded
in accordance with subsection (g)(1)(A)3.
6. Containers of blood, blood components, or blood products that are labeled
as to their contents and have been released for transfusion or other clinical
use are exempted from the labeling requirements of subsection (g).
7. Individual containers of blood or OPIM that are placed in a labeled container
during storage, transport, shipment or disposal are exempted from the labeling
requirement.
8. Labels required for contaminated equipment shall be in accordance with this
subsection and shall also state which portions of the equipment remain contaminated.
9. Regulated waste that has been decontaminated need not be labeled or color-coded.
(B) Signs.
1. The employer shall post signs at the entrance to work areas specified in
subsection (e), HIV, HBV and HCV Research Laboratory and Production Facilities,
which shall bear the following legend:
BIOHAZARD
(Name of the Infectious Agent)
(Special requirements for entering the area)
(Name, telephone number of the laboratory director or other responsible person.)
2. These signs shall be fluorescent orange-red or predominantly so, with lettering and
symbols in a contrasting color, and meet the requirements of Section 3340.
(2) Information and Training.
(A) Employers shall ensure that all employees with occupational exposure participate in a
training program which must be provided at no cost to the employee and during working
hours.
(B) Training shall be provided as follows:
1. At the time of initial assignment to tasks where occupational exposure may take place;
2. At least annually thereafter.
(C) For employees who have received training on bloodborne pathogens in the year preceding
the effective date of the standard, only training with respect to the provisions of the
standard which were not included need be provided.
(D) Annual training for all employees shall be provided within one year of their previous
training.
(E) Employers shall provide additional training when changes, such as introduction of new
engineering, administrative or work practice controls, modification of tasks or procedures
or institution of new tasks or procedures, affect the employee's occupational exposure.
The additional training may be limited to addressing the new exposures created.
(F) Material appropriate in content and vocabulary to educational level, literacy, and
language of employees shall be used. (G) The training program shall contain at a minimum
the following elements:
1. Copy and Explanation of Standard. An accessible copy of the regulatory text of this
standard and an explanation of its contents;
2. Epidemiology and Symptoms. A general explanation of the epidemiology and symptoms of
bloodborne diseases;
3. Modes of Transmission. An explanation of the modes of transmission of bloodborne
pathogens;
4. Employer's Exposure Control Plans. An explanation of the employer's exposure control
plan and the means by which the employee can obtain a copy of the written plan;
5. Risk Identification. An explanation of the appropriate methods for recognizing tasks
and other activities that may involve exposure to blood and OPIM;
6. Method of Compliance. An explanation of the use and limitations of methods that will
prevent or reduce exposure including appropriate engineering controls, administrative or
work practice controls and personal protective equipment;
7. Decontamination and Disposal. Information on the types, proper use, location, removal,
handling, decontamination and disposal of personal protective equipment;
8. Personal Protective Equipment. An explanation of the basis for selection of personal
protective equipment;
9. Hepatitis B Vaccination. Information on the hepatitis B vaccine, including information
on its efficacy, safety, method of administration, the benefits of being vaccinated, and
that the vaccine and vaccination will be offered free of charge;
10. Emergency. Information on the appropriate actions to take and persons to contact in an
emergency involving blood or OPIM;
11. Exposure Incident. An explanation of the procedure to follow if an exposure incident
occurs, including the method of reporting the incident, the medical follow-up that will be
made available and the procedure for recording the incident on the Sharps Injury Log;
12. Post-Exposure Evaluation and Follow-up. Information on the post-exposure evaluation
and follow-up that the employer is required to provide for the employee following an
exposure incident;
13. Signs and Labels. An explanation of the signs and labels and/or color coding required
by subsection (g)(1); and
14. Interactive Questions and Answers. An opportunity for interactive questions and
answers with the person conducting the training session.
NOTE: Additional training is required for employees of HIV, HBV and HCV Research
Laboratories and Production Facilities, as described in subsection (e)(5).
(H) 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 will address.
(h) Recordkeeping.
(1) Medical Records.
(A) The employer shall establish and maintain an accurate record for each employee with
occupational exposure, in accordance with Section 3204.
(B) This record shall include:
1. The name and social security number of the employee;
2. A copy of the employee's hepatitis B vaccination status including the dates of all the
hepatitis B vaccinations and any medical records relative to the employee's ability to
receive vaccination as required by subsection (f)(2);
3. A copy of all results of examinations, medical testing, and follow-up procedures as
required by subsection (f)(3);
4. The employer's copy of the healthcare professional's written opinion as required by
subsection (f)(5); and
5. A copy of the information provided to the healthcare professional as required by
subsections (f)(4)(B)2., 3. and 4.
(C) Confidentiality. The employer shall ensure that employee medical records required by
subsection (h)(1) are:
1. Kept confidential; and
2. Not disclosed or reported without the employee's express written consent to any person
within or outside the workplace except as required by this section or as may be required
by law.
(D) The employer shall maintain the records required by subsection (h)(1) for at least the
duration of employment plus 30 years in accordance with Section 3204.
(2) Training Records.
(A) Training records shall include the following information:
1. The dates of the training sessions;
2. The contents or a summary of the training sessions;
3. The names and qualifications of persons conducting the training; and 4. The names and
job titles of all persons attending the training sessions.
(B) Training records shall be maintained for 3 years from the date on which the training
occurred.
(3) Sharps Injury Log.
The Sharps Injury Log shall be maintained 5 years from the date the exposure incident
occurred.
(4) Availability.
(A) The employer shall ensure that all records required to be maintained by this section
shall be made available upon request to the Chief and NIOSH for examination and copying.
(B) Employee training records required by this subsection shall be provided upon request
for examination and copying to employees, to employee representatives, to the Chief, and
to NIOSH.
(C) Employee medical records required by this subsection shall be provided upon request
for examination and copying to the subject employee, to anyone having written consent of
the subject employee, to the Chief, and to NIOSH in accordance with Section 3204.
(D) The Sharps Injury Log required by subsection (c)(2) shall be provided upon request for
examination and copying to employees, to employee representatives, to the Chief, to the
Department of Health Services, and to NIOSH.
(5) Transfer of Records.
(A) The employer shall comply with the requirements involving transfer of records set
forth in Section 3204.
(B) If the employer ceases to do business and there is no successor employer to receive
and retain the records for the prescribed period, the employer shall notify NIOSH, at
least three months prior to their disposal and transmit them to the NIOSH, if required by
the NIOSH to do so, within that three month period.
(i) Appendix.
Appendix A to this section is incorporated as a part of this section and the provision is mandatory.
(MANDATORY)
The employer shall assure that employees who decline to accept hepatitis B vaccination
offered by the employer sign the following statement as required by subsection (f)(2)(D):
I understand that due to my occupational exposure to blood or OPIM 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 decline 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 OPIM and I want to be vaccinated with hepatitis B
vaccine, I can receive the vaccination series at no charge to me.
NOTE: Authority cited: Sections 142.3 and 144.7, Labor Code. Reference: Sections 142.3 and 144.7, Labor Code and Sections 117600 though 118360, Health and Safety Code.