Attachment 12 - COBRATF Policies and Procedures.pdf

CDP Medical Support Services

Attachment 12

COBRATF Policies and Procedures

U.S. Department of Homeland Security

Federal Emergency Management Agency

Center for Domestic Preparedness

CDP Safety Plan

(COBRATF)

CDP-OP-5001.6

JULY 2020

REVISION 6

Digitally signed by GARY L

GARY L MILNER MILNER

Date: 2020.07.31 12:07:17 -05'00'

CDP Safety Plan (COBRA TF) Copy __ of __

TABLE OF CONTENTS

Overview

Annex A - Bloodbome Pathogens Plan

Appendix A

Appendix B

Appendix C

Appendix D

Appendix E

Appendix F

Appendix G

Appendix H

Classification I Job Listing

Classification Tl Job Listing

Personnel ot Covered by the Standard Classification lil Job Listing

Required Elements of Occupational Exposure to Bloodbome Pathogens Training

Hepatitis B Vaccination Declination Statement

Health Record- Chronological Record of Medical Care harps Injury Log (SIL)

Employee Input for Safety Needles & yringes

Annex B - Confined pace Program

Annex C - Fall Protection Program

Appendix A Fall Protection Evaluation Form

Annex D - Fire Prevention Plan

Appendix A

Appendix B

Appendix C

Appendix D

Emergency otification Roster tructure Evacuation Routes

Key Personnel & Duties

Assembly Area(s)

Annex E-Forklift Training Program

Annex F - Hazardous Communications Program

Annex G -Hearing Conservation Program

Appendix A Evaluation of the Effectiveness of Hearing Protectors

Annex H - Lockout / Tagout Program

Appendix A

Appendix B

Annex I -Radiation Plan

Lockoutffagout Form

Lockout/Tagout Log Sheet

Annex J - Respiratory Protection Program

Annex K- Spill Prevention & Response Plan

Annex L- CDP COBRA TF Chemical Hygiene Plan

Annex M -CDP COBRA TF Toxic Agent Exposure Control Plan

Annex N -COBRATF Biosafety Manual

CDP Safety Plan (COBRA TF) Overview

1. Introduction

The Chemical, Ordnance, Biological, and Radiological Training Facility (COBRA TF) is operated by the Department of Homeland ecurity (OHS), Federal Emergency Management Agency (FEMA), Center for Domestic Preparedness (CDP). The CDP COBRA TF is a toxic agent training facility that has been in continuous operation since 1987.

2. Objective

This plan was created and implemented to provide a safe and healthy work environment which is an integral part of the CDP COBRA TF. It is part of our daily operations and was established for the protection of our employees, responder students, visitors, property, the en ironment, and the public. By protecting our employees from unsafe working conditions, we are also protecting their families, fellow workers, management, the public, and the environment from the far-reaching effects of potential accidents.

Each Annex of the CDP Safety Plan (COBRA TF) will be reviewed and revised as needed to ensure compliance with all applicable Federal state, and local regulations and guidelines.

3. Responsibilities

Every employee of the CDP COBRA TF is responsible for maintaining a safe and healthy work environment. Managers and supervisors are responsible for identifying safety and health issues, communicating safety and health hazards, investigating hazardous conditions and incidents, providing training, supplying or wearing appropriate personal protective equipment and ensuring all equipment is properly maintained and meets legislated safety and health standards.

Management's role is supported by input from all employees.

All employees, students, and visitors to the CDP are responsible for obeying all safety and health rules, following recommended safe work procedures, wearing and using personal protective equipment when required, participating in safety and health training programs, and informing supervisors of any unsafe work conditions.

Everyone has the right and responsibility to refuse work when unsafe work conditions exist.

4. Violations

Employees (regardless of the source of employment) of the CDP COBRA TF who knowingly violate safety and health rules may face disciplinary action up to termination. Responder students of and visitors to the CDP COBRA TF may be expelled and/or removed from CDP property if they knowingly disobey safety and health rules. Those individuals who do not fulfill their safety and health responsibilities will become accountable for any problems their negligence creates, and may be held liable.

Annex A Bloodborne Pathogens Plan

1. Objective

To establish an Exposure Control Plan (ECP) for Bloodbome Pathogens for the Center for Domestic Preparedness (CDP), Chemical, Ordnance, Biological and Radiological Training Facility (COBRATF), and to reduce the significant risk of infections of employees exposed to body fluids or tissue from infected persons.

2. Procedures

a. Applicability

(I) The provisions of this plan are applicable to all personnel assigned to the CDP COBRATF and the CDP Red Blood Cell Cholinesterase Laboratory (RBC-ChE).

b. Reference

(I) 29 CFR 1910.1030 - Bloodborne Pathogens

(2) 29 CFR 1904 - Recording and reporting, occupational injuries and illnesses

(3) 29 CFR 1910.1020 -Access lo employee exposure and medical records

(4) CDP \\'aste Management Plan

(5) Centers for Disease Control and Prevention (CDC) - Universal and Standard Precautions

c. Responsibilities

(!) Each Project Manager (PM) has overall responsibility for ensuring compliance with the ECP in his/her specific organization at the

CDP COBRA TF.

(2) Contract Physician will provide medical oversight and guidance to ensure proper program management.

(3) Attending Physician will maintain medical records of employees with an occupational exposure to bloodbome pathogens.

(4) Federal Occupational Health Nurse (FOHN). The FOHN will be responsible for overall management and support of the CDP COBRA TF Bloodbome Pathogens Compliance Program. Activities which are delegated to the FOHN include:

(a) Responsibility for implementing the ECP.

(b) Working with administrators and other employees to develop and administer any additional bloodborne pathogens related policies and practices needed to support the effective implementation of this plan.

(c) Looking for ways to improve the ECP, as well as, to revise and update the plan when necessary.

( d) Knowing current legal and medical requirements concerning bloodbome pathogens.

(e) Acting as facility liaison, in regards to medical information, during all external agency inspections.

(5) Project Managers and Supervisors

(a) Project managers or supervisors will assign a risk of exposure Classification I, II, or Ill to each position under their control or purview. (Appendices A, B, C)

(b) This information will be provided to the FOHN on an annual basis.

(c) Changes in personnel assigned to Classifications I and II will be reported as they occur to the FOHN. An annual personnel status report will also be submitted, listing all incumbents in each position.

(d) The PM and/or supervisor is responsible for ensuring that exposure control requirements are met in their respective areas.

(6) Safety Training Manager

The CDP Industrial Hygienist or his/her designated representative, serves as the COBRA TF Safety Training Manager with responsibility for ensuring training to all employees who have potential for exposure to bloodborne pathogens. Safety personnel at the CDP COBRA TF will provide the training and identify responsibilities which include:

(a) Maintaining an up-to-date list of personnel requiring training. Personnel with potential exposure will be trained prior to duty assignment, and will receive annual refresher training thereafter.

(b) Ensuring that the requirements listed in Section 6 of this Annex are met and that the mandatory elements listed in Appendix Dare included in training sessions.

(c) Ensuring that training records are prepared and maintained in accordance with Section 7 (c) of this Annex.

(7) Employees

3. Definitions

(a) Comply with applicable portions of this plan.

(b) Attend initial and annual refresher training.

(c) Become personally aware of work tasks that are a potential infection hazard.

(d) Develop good personal hygiene habits.

(e) Report any instances of improper procedures or behavior that could result in exposure to a bloodbome pathogen to the first line supervisor, FOHN, safety representative, or other responsible individual.

a. Attending Physician - The physician selected by, or assigned to, the patient who has primary responsibility for the treatment and care of the patient.

b. Blood - means human blood, human blood components, and products made from human blood.

c. Bloodborne Pathogens - Pathogenic microorganisms that are present in human blood and that can infect and cause disease in persons who are exposed to blood containing these pathogens.

d. Clinical Laboratory - means a workplace where diagnostic or other screening procedures are performed on blood or other potentially infectious materials.

e. Contaminated - The presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.

f. Contaminated Laundry - Laundry which has been soiled with blood or other potentially infectious materials or may contain contaminated sharps.

g. Decontamination -The use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point at which they are no longer capable of transmitting infectious particles.

h. Engineering Controls - Controls that isolate, minimize, or remove a workplace hazard.

1. Exposure Incident - A specific exposure to the eye, mouth, other mucous membrane, non-intact skin or parenteral exposure to blood, or other potentially infectious materials that result from the performance of an employee's duties.

J. Hand Washing Facilities - A facility providing an adequate supply of running water, soap, and single-use towels.

k. HBV - means hepatitis B virus.

I. HIV - means human immunodeficiency virus.

m. Licensed Health Care Professional - A person whose legally permitted scope of practice allows him or her to independently perform the activities required for Hepatitis B Vaccination and post-exposure follow-up.

n. Occupational Exposure - Mucous membrane or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.

o. Other Potentially Infectious Materials means:

( 1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardia! fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.

(2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead).

(3) Human Immunodeficiency Virus (HIV)-containing cell or tissue cultures, organ cultures, and HIV- or Hepatitis B Virus (HBV) containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or

HBV.

p. Parenteral - The piercing of the skin barrier, including mucous membranes.

q. Personal Protective Equipment (PPE) - Specialized clothing or equipment worn by an individual to protect him or her from a hazard.

r. Program Manager - The designated single point of contact for the Contracting Officer (CO) and the Contracting Officer's Representative (COR) responsible for all respective Contractor work performed under the contract.

s. Regulated Medical Waste - Any one of the following:

(1) Semi-liquid blood or other potentially infectious materials, i.e., saliva, semen, etc.

(2) Contaminated items that would release blood or potentially infectious materials in a liquid or semi-liquid state if compressed.

(3) Items caked with dried blood or other potentially infectious materials which are capable of releasing materials during handling.

(4) Sharps.

(5) Microbiological wastes containing blood or other potentially infectious materials.

t. Sharps - Any used or unused discarded article that may cause punctures or cuts and which has been or is intended for use in animal or human medical care, medical research, or in laboratories utilizing microorganisms. Such waste includes, but is not limited to, hypodermic needles, IV tubing with needles attached, scalpel blades, and syringes (with or without a needle attached). Items listed above that have been removed from their original sterile containers are included in this definition. Glassware, blood vials, pipettes, and similar items are to be handled as sharps if they are contaminated with blood or body fluids.

u. Source Individual - Any individual, living or dead, whose blood or other potentially infectious materials may be a source of occupational exposure to the employee.

v. Sterilize - The use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores.

w. Universal Precaution - A method of infection control in which all human blood and certain body fluids are treated as if known to be infectious for HfV, HBV, and other bloodborne pathogens.

x. Work-Practice Controls - Controls that reduce the likelihood of exposure by altering the manner in which a task is performed.

y. Classification I - Jobs in which required tasks routinely involve a potential for mucous membrane or skin contact with blood, body fluids, tissues, or potential spills or splashes. Use of appropriate measures is required for health care provided in these jobs.

z. Classification II - Jobs in which required tasks normally do not involve exposure to blood, body fluids, or tissues, but may require performing unplanned Classification l tasks. In these jobs the normal work routine involves no exposure to blood, body fluids, or tissues. However, exposure or potential exposure may be required as a condition of employment.

aa. Classification III - Jobs in which required tasks involve no greater exposure to blood, body fluids, or tissues which would be encountered by a visitor, and even rare performance of Category I Tasks is not a condition of employment. The normal work routine involves no exposure to blood or body tissues. The worker is not covered by the rule, and can decline to perform tasks which involve a perceived risk without retribution.

4. Exposure Determination

a. The following job descriptions/classifications are generally considered as Classification I, i.e., individuals most likely to be exposed:

(1) Physician(s), physician's assistants. nurses, and nurse practitioners.

(2) Employees in clinical diagnostic, and pathology laboratories.

(3) Employees in blood banks and plasma centers who collect, transport, and test blood.

(4) Emergency medical technicians, paramedics, and other emergency medical service providers.

b. The fol lowing job descriptions/classifications are generally considered Classification 11, i.e., individuals infrequently exposed:

(1) Housekeeping Staff.

(a) When handling regulated medical waste.

(b) Cleaning areas contaminated with blood or other body fluids or secretions that might contain pathological substances.

(2) Medical equipment repair and service personnel.

(a) When repairing equipment likely to be contaminated with blood or other pathogenic matter.

(b) When working in areas that potentially contain infectious contaminants.

(3) Clerks, receptionists, secretaries, and others that occasionally handle blood or infectious specimens or come in contact with patients.

(4) Protective Clothing and Equipment (PC&E) personnel.

When handling PPE contaminated with blood or other body fluids or secretions.

5. Protective Measures, Methods of Compliance

a. Engineering and Work Practices

Universal precautions to the extent practicable will be followed to include but not limited to:

(I) Hand washing facilities will be available in treatment room or restrooms in the building. Each employee will be required to use the facilities immediately or as soon as feasible after removal of gloves or other PPE.

(2) Contaminated needles and other contaminated sharps will not be bent, recapped, or removed; neither shall there be shearing or breaking of contaminated needles. Needles will be ejected from vacutainer into Sharps Collection System for disposal.

(3) o eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses will be permitted in the medical rooms except in the lounge provided for such practices.

(4) All procedures involving blood and other infectious materials shall be perfonned in such a manner as to minimize splashing, spraying, splattering, and generation of droplets of these substances. Under no conditions will mouth pipetting or mouth suctioning of blood or other potentially infectious materials be allowed.

(5) Specimens of blood or other potentially infectious materials shall be placed in containers which prevent leakage during collection, usual handling, processing, storage, transport or shipping, and shall be color-coded. These containers will be closed before storage.

(6) Secondary containers shall be available in the following cases:

(a) Primary container is contaminated.

(b) Primary container is punctured.

(7) Proper labeling and color coding will be used for all persons who might handle the containers.

(8) In the toxic agent area, any protective mask or chemical protective ensemble which has been soiled with blood or other potentially infectious materials will be placed in biohazard labeled bags by the support team and sent to PC&E. Personnel working in PC&E will transport biohazard labeled bags to CDP COBRA TF incinerator.

c. Personal Protective Equipment (PPE):

( 1) When there is a possibility of occupational exposure, CDP COBRA TF employees will be assigned PPE at no cost to the employee. This equipment includes, but is not limited to:

(a) Gloves

(b) Gowns

(c) Laboratory coats

(d) Face shields/masks

(e) afety glasses

(f) Goggles

(g) Pocket masks

(2) Latex free gloves, glove liners, and similar alternatives will be readily available to employees who are allergic to the gloves normally used.

(3) Managers and supervisors are responsible for ensuring that all departments and work areas have appropriate PPE available to employees.

(4) Employees will be trained regarding the use of the appropriate PPE for their job classifications and tasks/procedures they perform.

Additional training is provided annually, and when necessary, if an employee takes a new position or new job functions are added to their current position.

(5) To determine whether additional training is needed, the employee's previous job classification and tasks are compared to those for any new job or function that they undertake. Any needed training is provided by their department manager or supervisor working with the Safety Training Manager.

(6) To ensure that PPE is not contaminated and is in the appropriate condition to protect employees from potential exposure, the CDP COBRA TF adheres to the following practices:

(a) All PPE is inspected prior to use and repaired or replaced as needed to maintain its effectiveness.

(b) Reusable PPE is cleaned. laundered, and decontaminated as needed.

(c) Gloves are checked for holes and tears prior to use.

(7) To make sure that this equipment is used as effectively as possible, all CDP COBRATF employees will adhere to the following practices when using their PPE:

(a) All garments penetrated by blood or other potentially infectious materials are removed immediately, or as soon as feasible.

(b) All PPE is removed prior to leaving a work area.

(c) Gloves are worn in the following circumstances: whenever employees anticipate hand contact with potentially infectious materials, e.g., blood, when performing vascular access procedures, or when handling or touching contaminated items or surfaces.

(d) Disposable gloves are replaced as soon as practical after contamination or if they are tom, punctured, or otherwise lose their ability to function as an "exposure barrier."

(e) Masks and eye protection, such as goggles, face shields, etc., are used whenever splashes or sprays may generate droplets of infectious materials.

(f) Protective clothing such as gowns and/or aprons are worn whenever the potential for exposure to the body is present.

d. Housekeeping

(1) Maintaining facilities in a clean and sanitary condition is an important part of the ECP. By utilizing a disinfectant that will kill the HJV virus and Hepatitis B virus:

(a) Paramedics and/or Medical Laboratory Technicians (MLT) will clean blood draw chair at the end of each day, if used.

(b) If used, countertops will be cleaned at the end of each day by MLTs.

(c) All equipment and surfaces are cleaned and decontaminated after contact with bl.cod or other potentially infectious materials. After the completion of medical procedures, immediately (or as soon as feasible), clean overtly contaminated surfaces of any spill of blood or infectious materials, and clean at the end of the work shift if the surface may have been contaminated during that shift.

These practices will be followed by paramedics and MLTs.

(d) Protective coverings, such as plastic wrap, aluminum foil or absorbent paper, are removed and replaced, as soon as it is feasible when overtly contaminated. If they may have been contaminated during the shift, all pails, bins, cans, and other receptacles intended for use routinely are inspected, cleaned, and decontaminated as soon as possible. If visibly contaminated, or potentially contaminated, broken glassware is picked up using mechanical means, such as dustpan and brush, tongs, forceps, etc. Contaminated reusable sharps are stored in containers that do not require hand processing. These practices will be followed by paramedics and ML Ts.

(2) Regulated Medical Waste:

Regulated medical waste shall be handled in accordance with the CDP Waste Management Plan.

(3) Hepatitis B Vaccination:

Any CDP COBRA TF employee who may be exposed to potentially infectious materials will be offered at no cost, a vaccination for Hepatitis B, unless the employee has previously completed the Hepatitis B series or antibody testing reveals the employee to be immune. If an employee declines the vaccination, a declination statement must be completed. If employee initially declines Hepatitis B vaccination, but at a later time decides to accept the Hepatitis B vaccination, the employer will make available the Hepatitis B vaccination at that time. {Appendix E)

(4) Post-Exposure Evaluation and Follow-up:

(a) Should an employee be exposed to a potentially infectious material (i.e., needle stick, splash, etc.), the FOHN will be notified and will coordinate follow-up care with employee's physician of choice for evaluation as described herein. (Appendix F)

(b) Following a report of an exposure incident, the employee will be provided a confidential medical evaluation and follow-up, including at least the following elements:

1. Documentation of the route(s) of exposure.

2. HBV and HIV antibody status of the source patient(s), if known.

1. The circumstances under which the exposure occurred.

(c) The attending physician will be provided the following information:

l A copy of the O HA regulation for bloodborne pathogens and its appendices by the FOHN.

2. A description of the affected employee's duties as they relate to the employee's occupational exposure.

(d) The attending physician will provide a written opinion on the employee's medical records as follows:

l The physician's recommended limitations upon the employee's ability to receive Hepatitis B vaccination.

2. A statement that the employee has been informed of the results of the medical evaluation and that the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials which require further evaluation or treatment, specific findings, or diagnoses which are related to the employee's ability to receive HBV vaccination.

(e) The FOHN will maintain a sharps injury log for the recording of percutaneous injuries from contaminated sharps. The information in the sharps injury log shall be recorded and maintained in such a manner as to protect the confidentiality of the injured employee. The sharps injury log shall contain, at a minimum:

l The type and brand of device involved in the incident.

2. The department or work area where the expo ure incident occurred.

� An explanation of how the incident occurred.

6. Communication of Hazards to Employee

a. Training

(I) Will be provided prior to an assignment of an individual to a Classification I or II position.

(2) Refresher training will be provided annually thereafter.

(3) Training will be free of charge and during duty hours.

( 4) The information identified in Appendix D will be included in the training, as well as any new information becoming available since the previous training.

(S) An acknowledgement of training will be completed by each employee completing training.

b. Labels

All untreated medical waste shall be labeled in accordance with Alabama Department of Environmental Management (ADEM) Administrative Code 335:17�3�,01 and the CDP Waste Management Plan.

7. Records

a. Medical Occupational Health Records on each employee with an occupational exposure will be maintained by the attending physician. The records will be maintained for the duration of the employee's employment plus 30 years.

b. The FOHN will maintain:

(I) A copy of the employee's Hepatitis B vaccination status, including the date of all the Hepatitis B vaccinations and a copy of the declination statement as applicable.

(2) The Sharps Injury Log (Appendix G) for the period required by 29 CFR 1904, which is five years.

(3) These records will be confidential and will not be disclosed or reported without the express written consent by the patient, except as required by the Bloodbome Pathogen Standard or by law.

c. Master Training records shall include the following information:

(I) The dates of the training session.

(2) The contents or a summary of the training sessions.

(3) The names and qualifications of the person conducting the training.

( 4) The names and job titles of all those receiving the training.

(5) Training records will be maintained for the duration of the employee's employment plus five years.

d. This plan shall be reviewed and updated annually and will reflect changes in technology that eliminate or reduce exposure to bloodborne pathogens.

(I) Annual consideration and implementation of appropriate commercially available and effective safer medical devices designed to eliminate or minimize occupational exposure will be documented.

(2) Input from non-managerial employees responsible for direct patient care who are potentially exposed to injuries from contaminated sharps will be solicited to identify, evaluate, and select effective engineering and work practice controls.

olicitation shall be documented using Appendix H.

Bloodborne Pathogens Plan (COBRATF) Appendix A Classification I Job Listing

1. Date:

2. Name of Employee

a. ame Here

3. Description

Jobs in which tasks routinely involve a potential for mucous membrane or skin contact with blood, body fluids. tissues, or potential spills or splashes. Use of appropriate measures is required for every health care provider in these jobs.

Job Title

A-I

PPE Required

Rev. 5 (Jan 16)

AppendixB Classification II Job Listing

1. Date:

2. Name of Employee

a. NameHere

3. Description

Jobs in which required tasks normally do not involve exposure to blood, body fluids, or tissues, but may require performing unplanned Classification I tasks. In these jobs the normal work routine involves no exposure to blood or body tissues, but exposure or potential exposure may be required as a condition of employment.

Job Title

B-1

PPE Required

Appendix C Personnel ot Covered by the Standard Classification III Job Li ting

1. Date:

2. ame of Employee

a. ame Here

3. Description

Jobs in which required tasks involve no greater exposure to blood, body fluids. or tissues, than would be encountered by a visitor, and even rare performance of Classification I tasks is not a condition of employment. The normal work routine involves no exposure to blood or body tissues. The worker is not covered by the rule, and can decline to perfom1 tasks which involve a perceived risk without retribution.

Job Title

C-1

PPE Required

Appendix D Required Elements of Occupational Exposure to Blood borne Pathogens Training

1. Topics covered during the Blood borne Pathogen training:

a. Provide employee an accessible copy of the standard and an explanation of its contents.

b. A general explanation of the epidemiology and symptoms of bloodbome diseases.

c. An explanation of the modes of transmission of blood borne pathogens.

d. An explanation of the employer's exposure control program and the means by which the employee can obtain a copy of the written plan.

e. An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials.

f. An explanation of the use and limitations of practices that will prevent or reduce exposure including appropriate engineering controls, work practices, and personal protective equipment.

g. 1nformation on the types, proper use location, removal, handling, decontamination, and/or disposal of personal protective equipment.

h. An explanation of the basis for selection of personal protective equipment.

1. Information on the Hepatitis B vaccine, including information on its efficacy, safety, and the benefits of being vaccinated and that the vaccine will be offered free of charge.

j. Information on the appropriate actions to take and persons to contact in an emergency.

k. An explanation of the procedure to follow if an exposure incident occurs.

including the method of reporting the incident and the medical follow-up that will be made available. Also, information on the medical counseling that the employer is providing for exposed individuals.

I. An explanation of the signs and labels and/or color coding.

D-1 Annex A

m. An opportunity for interactive questions and answers with the person conducting the training session.

n. 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.

D-2 Annex A

Rev.5(Jan 16)

Bloodborne Pathogen Plan (COBRATF) Appendix E Hepatitis B Vaccine Declination Statement

1. Objective

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 (H B V) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine, at no charge to myself. However, l decline hepatitis B vaccination at this time. I understand that by declining this vaccine, J 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 vaccination series at no charge to me.

Employee ignature

E-1

Date

Appendix F Health Record - Chronological Record of Medical Care

Department of Homeland ecurity Federal Emergency Management Agency Center for Domestic Preparedness

COBRATF Date ______ _

Occupational Health Anniston, AL 36205

Report of needle stick or blood/body fluid exposure:

History of the injury:

Physical Exam:

Plan:

1. Wash area with soap and water immediately, or as soon as feasible.

2. Blood drawn for: (Physician's office)

RPR

HIV

LFf

Anti HBC HBs Ag_ Anti-HCV

HBs

3. Tetanus given, Time_ Dosage_

4. Post exposure prophylaxis according to Centers for Disease Control and Prevention (CDC) guidelines.

5. Hepatitis B Vaccine given, Time_ Dosage_ or patient's immunization record shows that he/she has received Hepatitis B Vaccine at 0, 1, and 6 month date(s) ____________ _ Post vaccination antibody titer according to CDC guidelines.

F-1 Annex A

6. ource tested:

RPR

HIV

LIT

Anti-HBC HBsAg_ Anti-HCV

HBs

7. Follow up scheduled with physician.

COBRATF FOHN Print and Sign

Records Maintained At: ___________________ _

Patient's ame:

Sex:

SSN (Last Four): ___________ _

Date of Birth:

F-2 Annex A

Rev. S (Jan 16)

DATE

Bloodboroe Pathogens Plan (COBRATF)

Appendix G harps Injury Log ( IL)

SHARPS INJURY LOG (SIL)

Center for Do,nestic Preparedness

NAME SS# Type of Work (Last Four Device Area

Onlv)

G-1

Narrative

Rev. 5 (Jan I 6)

Blood borne Pathogens Plan (COBRA TF) Appendix R Employee Input for afety eedles and Syringes

1. Employee ame:

2. uggestions for Safer Device or Synopsis of Article Reviewed or Product Report:

H-1 Annex A

CDP Safety Plan (COBRATF) Annex B

Confined Space Program

NOTE: Individual contractors are responsible for developing a Confined pace

Program for their areas of responsiablity.

Annex B

CDP Safety Piao (COBRA TF) Annex C

Fall Protection Program

1. Objective

a. The Center for Domestic Preparedness (CDP), Chemical, Ordnance.

Biological, and Radiological Training Facility (COBRA TF) is dedicated to the protection of its employees from on-the-job injuries and illnesses.

All employees have the responsibility to work safely on the job. The purpose of this plan is:

(l) To supplement the CDP Safety Plan (COBRA TF) by providing safety standards specifically designed to cover fall protection on the job.

(2) To ensure that each employee is trained and made aware of the safety provisions which are to be implemented by this program prior to the start of any work where fall protection is required.

b. This program is designed to enable management and employees to recognize the fall hazards on the job and to establish the procedures that are to be followed in order to prevent falls to lower levels or through holes and openings in walking/working surfaces. Each employee that is required to work at or above regulated heights will be trained in these procedures and shall strictly adhere to them. Exceptions to these procedures must be approved in writing by the Assistant Director COBRA TF, CDP afety and Occupational Health Manager. and all affected Project Managers.

2. cope. This Fall Protection Program applies to all areas of the CDP COBRATF.

This Fall Protection Program identities the conventional fall protective measures that are required for routine tasks at each fixed facility. This program is intended to comply with both Occupational Safety and Health Administration's (0 HA) General Industry tandards and Construction tandards.

3. Responsibilities

a. afety is the responsibility of all employees. The total objective of a safe, accident free workplace can only be accomplished by a dedicated, concerted effort by every individual involved from management to each employee.

b. ft is the responsibility of the CDP afety and Occupational Health Manager and each contractor's safety managers to implement this program. When site specific Fall Protection Plans are required under OSHA's construction standards, a competent person must be designated to implement the plan and continually monitor safety of the work. It is the responsibility of the employee to understand and adhere to the procedures outlined in this program and to follow the safety instructions of their supervisor.

c. pecific Fall Protection Plans are required for non-routine operations, such as new construction, where conventional fall protection cannot be used.

pecific Fall Protection Plans for major construction must be developed and approved by a qualified person as defined in 29 CFR, Subpart M, Fall Protection, 1926 and by the CDP afety and Occupational Health Manager prior to the start of work. Fall Protection Plans for minor construction, or other non-routine operations must be approved by the supervising afety Manager.

4. Procedures

a. Fixed Ladders. The CDP COBRA TF Operations and Maintenance (O&M) Contractor will install and maintain fixed ladders in accordance with the requirements of 29 CFR 1910.23 and 28. Ladders more than 24 feet high will be equipped with cages as required by OSHA standards.

Ladder safety systems with fall arrest may be used in lieu of cages.

Where ladder safety systems are used. all system components must be compatible to ensure proper operation of the system. All employees who are required to climb these fixed ladders will be trained in the proper use of the appropriate equipment. Where ladder safety systems have been installed, use of the fall protection system is mandatory unless it creates additional safety hazards. If the system cannot be used, the employee must notify their supervisor. An evaluation will be made and alternative fall equipment will be implemented as necessary. Alternative fall protection must meet the requirements of all applicable OSHA standards. A detailed inspection of all ladders shall be conducted annually. The O&M contractor will maintain a record of these inspections.

b. Portable Ladders.

(I) Portable ladders will be maintained and used in accordance with applicable O HA standards. They must be inspected prior to each use. Defective ladders will immediately be removed from service.

A detailed inspection of all ladders shall be conducted monthly and the O&M contractor will maintain a record of these inspections.

Inspectors must look for:

(a) Loose. broken. or missing rungs, steps, cleats or side rails.

(b) Missing safety feet, frayed ropes, and other defective parts.

(c) Oil, grease, or other slippery substances on rungs. steps. or side rails.

( d) kid-resistant features on rungs or steps of metal ladders.

(e) Proper operation of movable parts.

(f) Any other safety problems.

(2) Conductive Material Ladders. Ladders made of conductive materials such as aluminum may not be used in any area where contact with live electric current is possible. Employees must use a three point climbing technique where only one limb at a time is in motion and out of contact with the ladder. Employees shall not carry tools or other items with their hands while climbing a ladder. Ladders should not be set up in an aisle way. ]f the ladder must be setup in an aisle. the area around the ladder must be barricaded and warning signs must be erected. Ladders shall not be loaded beyond the live load limit of the ladder.

(3) Step Ladders. Step ladders may be used only in areas where they can safely be placed on firm level ground. Employees shall not stand on the top of the ladder or on the last step before the top.

The ladder must be positioned so that the work is in front of the employee. Employees shall not overreach or lean away from the ladder to perform work.

(4) Extension Ladders. Portable extension ladders will be maintained and used in accordance with applicable OSHA standards. They must be set up with an appropriate 4: I ve1tical to horizontal ratio.

The ladder must be tied off to prevent tipping. The ladder should extend at least 3 feet above the landing. Employees shall not overreach or lean away from the ladder to perform work.

c. Personal Fall Arrest System Equipment

(1) Personal fall arrest systems shall be used whenever work is performed and there is the potential for an employee to fall more than four feet; and, the fall hazard has not been eliminated using other control measures in accordance with OSHA standards.

(2) Only full body harnesses are to be used for fall protection systems. Use of a body belt for fall protection is strictly prohibited.

(3) The strength of any fall protection system is being connected to a secure anchor point. Anchorages shall be capable of supporting at least 5,000 pounds (22.24 K ) per employee attached, or shall be designed, installed and used as follows:

(a) As part of a complete personal fall arrest system which maintains a safety factor of at least two.

(b) Under the direction and supervision of a qualified person.

(4) The O&M Project Manager and O&M Safety Manager are responsible for ensuring the anchor points have been reviewed and approved by qualified personnel. Anchor points must be evaluated by the Safety Manager prior to connection of the fal I protection system if a rating has not previously been determined for strength and structural integrity.

d. Above Ground Storage Tanks. Most tanks at the CDP COBRA TF have stairs that are welded to the tank body and lead to the top of the tank.

Employees and contractor employees are prohibited from walking on the rim or performing work by standing on this rim. Any exceptions must be approved in advance by the O&M Project Manager and/or O&M af ety Manager. Approval will be granted only when it can be demonstrated that access to this area is required in order to perform a specified task and only if adequate fall protection procedures can be developed to protect the employees. ome small diameter tanks are equipped with fixed vertical ladders. These fixed ladders, if higher than 20 feet, must be equipped with a cage or ladder safety system. If ladder safety systems are available, employees must use this system in order to access the top of these tanks.

Ladder Safety ystems wi 11 nonnal ly attach to a D-ring on the front of the full body harness. Consult the manufacturer's literature for proper attachment. When employees are on top of tanks they must use personal fall protection. Anchor points will be identified or installed on top of these tanks. Employees must attach a lanyard to the anchor points at the top of the tank before disconnecting from a ladder protection system. The anchor point should never be at a level lower than the worker. The employee must attach the lanyard in such a way as to prevent tangling of equipment that could entrap or· hang" the employee if he or she falls.

Lanyards must be attached to the D-rings on the back of a full-body harness. Anchor systems must be reviewed and approved by the O&M Project Manager and O&M Safety Manager to ensure that the anchor point will withstand the impact of a fall. Employees shall remain attached to the anchor point at all times. When preparing to descend, the employee must reattach the front D-ring to the ladder rail before disconnecting the lanyard. Fall protection must remain continual whenever there is a fall potential.

e. Leading Edge Work and Roofs

(I) Selection of personal fall protective equipment shall be based on the type of work; the work environment; the weight, size, and shape of user; the type and position of anchorage; and the length of the lanyard.

(2) Personal fall arrest systems, when stopping a fall, shall limit maximum arresting force on an employee to 1,800 lbs. when used with a full-body harness, and cannot allow free fall of more than six feet.

(3) Personal fall arrest systems shall not allow contact with a lower level or other physical hazard and bring an employee to a complete stop and limit maximum deceleration distance traveled to 3.5 feet and system will have sufficient strength to withstand twice the potential impact energy after free falling a distance of six feet or the free fall distance permitted by the system, whichever is less.

f. Guardrail Systems. Fixed guardrails are provided where there are routine access requirements and/or a requirement under OSHA General lndustry Standards. These guardrails will be maintained in accordance with applicable requirements. Guardrails are not normally used for temporary fall protection. Guardrails are not typically provided on rooftops or the tops of all tanks.

g. Walking and Working Surfaces. The O&M Safety Manager is responsible for ensuring that all walking and working surfaces are regularly inspected for slip, trip, or fall hazards. The surfaces are evaluated to ensure they have the strength and structural integrity to support the employees safely.

Employees are not allowed to walk or work on any surface that has questionable structural integrity.

h. Excavations. There is a possibility that trenching or other excavation work may be conducted at the CDP COBRATF. Some excavations may not be readily seen because of location. All trenches and other excavations will be marked and protected in accordance with applicable regulations.

1. Pits, Vaults and Other Below Grade Locations. The CDP COBRATF has several locations that have pits, vaults and other permanent below grade locations. These locations must have a cover in place except when they must be removed to perform work. When covers are removed, the area must be protected by barricades and warning signs to prevent personnel from entering an area where they may fall into the opening.

J. Other Fall Protection Systems. The O&M Safety Manager will evaluate all areas where the need for fall protection is likely to occur. Fall protection systems will be re-evaluated if fall hazards are identified which cannot be controlled with current equipment and procedures.

k. Protection of Workers at Lower Levels. Occasionally, work is performed at elevated heights where there is the possibility that tools or other objects could fall to a lower work level. Toe boards, screens, canopies, or guardrail systems may be erected as appropriate to prevent material from falling to a lower level. Toe boards will be provided whenever required by OSHA Standards. If these measures are not feasible or are inadequate, the area below the work will be protected by barricades and warning signs.

Only authorized personnel will be allowed inside the work area.

5. Training. All employees who may be expected to perform tasks where fall protection is needed will be trained to recognize fall hazards and to take appropriate measures to ensure their safety. They will also be trained in proper use of personal fall protection equipment as required for their job. Initial training will include both classroom and "hands-on" training. Retraining will be provided when:

a. There are changes in the fall protection program.

b. There are changes in worker duties that affect their fall hazards.

c. There are changes in fall protection equipment.

d. A review indicates that the procedures are not being followed.

e. Annually.

6. Enforcement. Constant awareness of and respect for fall hazards, and compliance with all safety rules are considered conditions of employment.

Supervisors and all employees are responsible for enforcing these procedures.

Disciplinary actions may be taken in accordance with CDP policies and may include warnings, suspensions, or termination based on the severity of the offense.

7. Accident Investigations. Accidents and near misses, regardless of their nature, shall be reported and investigated. lf the incident involves this Fall Protection Program, the program shall be reviewed to determine if additional practices, procedures, or training need to be implemented to prevent similar types of falls or incidents from occurring.

8. Changes to Plan. This plan shall be reviewed and updated whenever there are changes in the workplace that require modification of the procedures. The plan will also be revised if workplace reviews or accident investigations indicate that the procedures need to be revised.

Fall Protection Program (COBRA TF)

Fall Protection Evaluation Form

FACILITY LOCATION:. ___________ DATE ______ _

WORK TASK EVALUATED:. _________________ _

WORK LOCATIO : ___________________ _

DESCRIPTION OF WORK ACTIVITIES PERFORMED IN THIS AREA:

IS WORK PERFORMED WHILE STANDING ON A LADDER? YES/NO

IDENTIFY HOW THE ELEVATED SURFACE IS ACCESSED:

Stairs

Fixed Ladder

>24 feet above a lower level

__ Cage in place

__ Ladder Protection System

__ Portable Ladder

__ Type ______ _

__ Height ______ _

__ Other ______ _

EVALUATE WORK SURFACE CONDITIONS:

__ Flat

__ Sloped

__ Structurally Sound

__ Slip Hazard (slick surfaces)

Water Hazard

Other: ____ _

FALL PROTECTION SYSTEMS CURRENTLY IN PLACE:

__ Guard Rails

__ Anchor Points for Fall Arrest

__ Other ______ _

EVA LUA TE THE NEED FOR BARRICADES:

__ Barricades Required to Limit Access to Fall Hazard Area

__ Barricades Required for Overhead Protection

ADDITIONAL OVERHEAD PROTECTION REQUIREMENTS:

DESCRIPTION OF ANCHOR POINTS:

RECOMMENDED PROCEDURES FOR FALL PROTECTION:

ADEQUACY OF ANCHOR POI TS A D STRUCTURAL STABfLITY

DETERMJ ED BY:

__ Existing engineering/design documents

__ Manufacturer's data

__ Certified Engineer

Approved By Date

Annex D Fire Prevention Plan

1. Objective. This plan outlines the procedures designed to provide that degree of safety from fire which will allow occupants of all Center for Domestic Preparedness (CDP), Chemical, Ordnance, Biological and Radiological Training Facility (COBRA TF) structures and buildings to move unimpeded to known safe areas.

2. Scope

a. This plan deals with safety of life and property in case of fire.

b. This plan familiarizes employees with emergency escape procedures and escape route assignments during a fire.

c. This plan outlines the procedures to be followed by employees who will remain to complete critical facility operations before they evacuate the facility.

d. This plan will outline the procedures to account for all employees after an emergency evacuation has been completed.

e. This plan will outline the preferred means for employees to report fires.

f. This plan will provide the names or job titles of persons who can be contacted for further information or explanation of duties under the plan.

g. lncluded in this plan are schematic drawings depicting building configuration, exit locations. direction of travel to the public way, location of assembly areas, and accountability measures.

3. Classification of Occupancies and Hazard of Contents

a. Occupancy. The occupancy of the CDP COBRA TF is classified as:

business, industrial, and storage. For the purposes of this plan, the following occupancies are as follows:

( 1) Business: Administrative Building, Training Building, orthville

(2) Industrial: Operations and Maintenance Building

(3) Storage: Administrative Building, Operations and Maintenance Building

b. Hazard of Contents. The hazard of building contents are classified as low, ordinary, or high.

(1) Low Hazard. Contents are of such low combustibility that no self-propagating fire therein can occur and consequently, the only probable danger requiring the use of emergency exits will be from panic, fumes, smoke, or some external source.

(2) Ordinary Hazard. Contents are liable to burn with moderate rapidity or to give off a considerable volume of smoke, but from which neither poisonous fumes nor explosions are to be feared in case of fire.

(3) High Hazard. Contents are liable to burn with extreme rapidity, or from which poisonous fumes or…