DEPARTMENT OF ENVIRONMENTAL HEALTH AND SAFETY

1. Develop a written control plan and perform an annual review to determine necessary revisions.
2. Monitor the compliance of the respective departments with the plan and regulations to include compliance with training, hepatitis B vaccination administration, exposure reporting and follow-up and recordkeeping.
3. Obtain from each applicable department at least once per year a statement that the program has been reviewed and that they believe they are in compliance.
4. Provide guidance and technical assistance to departments in the design and selection of appropriate engineering and work practice controls.
5. Provide guidance and technical assistance to departments in the selection of the most appropriate types and quantities of personal protective equipment.
6. Provide guidance and technical assistance to departments in the development and implementation of appropriate housekeeping methods.
7. Provide additional guidance and technical assistance to laboratories engaged in HIV or HBV research.
8. Provide consultation to the departments to assist them in fulfilling their training program.
9. Serve as the campus liaison to the Systems Wide Safety Office. Promote campus compliance with the OSHA Bloodborne Pathogen Standard. Provide a means in which employees can direct suggestions, complaints and concerns regarding the campus bloodborne pathogen compliance program.

INDIVIDUAL DEPARTMENT'S RESPONSIBILITIES

1. Perform surveys as necessary to identify all individuals in departmental activities that have potential exposure to infectious materials.
2. Compile and maintain data on individuals with potential exposure and the associated tasks and responsibilities of those persons.
3. Maintain all departmental records required by the program and the standard. All records shall be maintained in accordance with the requirements Subpart Z of 29 CFR Part 1910 (h)(ii) and (iii) Page 64181 (copy attached).
4. Develop a program that all individuals are provided with the required training within ten (10) days of the commencement of the potential exposure activity. Follow-up training activities are to be provided as necessary to assure that individuals are kept totally current on all necessary protection factors.
5. Design and implement engineering controls and institute activity practice control procedures which will eliminate or minimize exposure to blood and other potentially infectious materials.
6. Provide appropriate personal protective equipment to individuals that have potential exposure.
7. Maintain a clean and sanitary workplace environment. Develop and implement cleaning schedules as deemed appropriate for the types of activities and facilities involved.
8. Comply with additional criteria established for HIV and HBV laboratories.
9. Assure that universal precautions are understood and executed by individuals with potential exposure. Promote practices, procedures and methods that conform to the concept of universal precautions.
10. Affix appropriate labels to containers of regulated waste, refrigerators, and freezers containing blood or other potentially infectious materials; and other containers of blood or potentially infectious materials. HIV and HBV research laboratories will have appropriate signs posted at the entrances to the laboratories.
11. Assure that arrangements are made to offer Hepatitis B Vaccination to all applicable individuals.

    1. For applicable employees, make arrangements for vaccination through the University Student Health Service.
    2. For students and other non-employees, provide information on how they can obtain vaccination at their own expense.
    3. For individuals who refuse to obtain vaccination, ensure that they complete and sign a Hepatitis B Vaccination Declination Form. The original of the form is to be retained in the departmental file.

NOTE: A thorough training program must be presented to the potentially exposed individual before the Hepatitis B Vaccination is offered.

EMPLOYEES, STUDENTS AND OTHER POTENTIALLY EXPOSED INDIVIDUALS

1. Make a conscientious effort to understand the provisions of the plan and the protection afforded by the OSHA standard. Comply with the provisions of the plan and the OSHA requirements.
2. Notify the appropriate University official of activities which present potential exposure concerns that have not been previously identified.
3. Observe universal protection precautions when handling blood or other potentially infectious materials.
4. Be aware of engineering controls and the proper use of those controls. Follow established controls to eliminate or minimize potential exposure.
5. Be aware of the proper use, limitations and location of available personal protective equipment. Use appropriate personal protective equipment to eliminate or minimize potential exposure.
6. Be aware of and observe established housekeeping procedures, e.g. use mechanical devices to clean up broken glass in lieu of using bare hands. Maintain work area in a clean and sanitary manner.
7. Understand the additional requirements and protection afforded to employees working with HIV or HBV and follow established procedures.
8. Accept offered Hepatitis B Vaccination. For those who decline, a mandatory declination statement must be signed.
9. Immediately or as soon as feasible, report all exposure incidents to the immediate supervisor or other appropriate University official.
10. Attend initial and all other training programs and learn as much as possible about the protection.
11. Sign in on appropriate training roster during information and training sessions.
12. Make certain that labels are appropriately affixed; notify the supervisor or other appropriate University official to report labeling problems.
13. Comply with all applicable requirements established in the OSHA Bloodborne Pathogen Standard.